Texas Rolls Out TIERS Eligibility System After 8-Year Transition

Tom Suehs, executive commissioner of the Texas Health and Human Services Commission, was awarded the Bob Bullock Award for Outstanding Public Stewardship.

December 20, 2011 By Brian Heaton

And Martha Orozco, managing attorney of Lone Star Legal Aid’s Public Benefits Unit, contends that TIERS still struggles to meet requirements for the Food Stamp Act. At first, denial letters issued by the system didn’t include the reasons why an individual failed to qualify for the food stamp program — which Orozco said is mandatory. Those letters now include the required explanation, but the reasons for denial often are “completely wrong and irrelevant,” she said.

Orozco added that application forms generated by the new system can be confusing, especially to non-English speaking applicants. This can result in these applicants failing to provide required information and being denied benefits.

Still, given their progress over the past 16 months, HHSC officials say they’ve achieved an important milestone. The basic rollout of TIERS was completed when the Dallas region came online in September, according to Stewart. As of that date, programs such as Medicaid, food stamps, and the Texas Works employment education and training program were all running through TIERS.

Further deployments to handle Medicaid for the elderly, disability and long-term care, and a three-year certification for the Texas Supplemental Nutrition Assistance Program (SNAP) for people who receive Supplemental Security Income were complete in mid-December.

Still, Suehs wants to keep Stewart around for at least another year — to help with various system changes and improvements, such as Web portal upgrades and early planning for TIERS to acquire a larger client load in January 2014 due to national health-care reform. Suehs also wants Stewart to transfer his skills to the HHSC’s regional directors and supervisors before departing.

Suehs added that while Stewart was brought on as a consultant, he treated him like his deputy chief of staff and gave him that authority. “I think that was critical to the success of the project,” Suehs said. “He wasn’t just an outside adviser; he was responsible, and I was going to hold him accountable.”

To make sure each region in Texas stays on top of things, Stewart gets daily reports from them that list any delinquent cases and follows up on them as necessary.

Stewart was quick to credit Suehs for the TIERS success, however, saying it was his trust in bringing in an outsider and giving Stewart full authority that helped the implementation turn the corner.

As for the future, Stewart said he’ll work with the HHSC to tie up loose ends. But he anticipates the remaining work to be completed quickly because staff members now have bought into TIERS and the new training system.

“I ruffled a few feathers here to get it done,” Stewart said, “but the lesson for other states is that when you bring in a consultant, they must transfer knowledge and involvement to those who are going to be left to run the program.”

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