August 9, 2006
In this state, the business-friendly leadership has forgotten the first rule of economics when it comes to providing health and human services.
There is, in fact, a free lunch, folks, and y’all are cooking it. You’re cooking it because the State of Texas has placed you in a hot kitchen. And if you don’t pick up the spatula, I worry that no one will.
In so many of the areas in which you all provide critical services, the state has slipped in its own responsibilities to Texans. The same leaders who complain about unfunded mandates from the feds have let this range of obligations fall to you.
Texas ranks in the bottom fifth among the 50 states in workforce education. Who helps Texans become productive members of society? You do.
Texas has the worst high school graduation rate in the nation. Who has to be there for dropouts when they can’t afford a home? Too often, you do.
We are 46th in the country in the number of our children living in poverty. Almost 30% of our children are not immunized, leaving us, again, 46th in the country.
Of course, we could all go on and on and on.
Probably most glaringly, Texas is in the midst of a crisis in how the state gets children and the most needy adults into the programs that exist specifically for them. Who has to help these people when they don’t know how to enroll in these programs, or they can’t navigate the torturous process, or they unwittingly fall off the rolls because of a process created so that they will fall off, or they are wrongly told over the phone by someone making a few-dollars-an-hour that their child doesn’t get health care?
Sadly, but also thankfully, you do.
I know not all of you deal directly with health care. And I’m not one of those people who acts like health and human services have little to do with each other.
But, I do want to talk a little bit about the crisis Texas has run into in its mad rush to privatize the programs that sign people up for Children’s Health Insurance and other services that they need. Remember, in addition to the distinctions I’ve already mentioned, we live in a state that is dead last in the number of kids without insurance.
In rushing to privatize its social services, the state eliminated 1,000 positions while it still needed them to work with needy Texans — and with you.
Now, I believe very strongly in technology. As mayor of Austin, I was privileged to have a front-row seat to watch its wonders.
But I also understand that a computer, no matter how big and fast, is no more a saint than a table saw is. And the truth is, you really, really need to know how to work a table saw before you turn it on.
Well the state and its contractors have flipped on this program and hoped for a miracle. For better or worse, they’ve managed not to cut off a finger. All they’ve cut off are several thousand adults and children whom they’re supposed to be serving.
You know the numbers. For kids enrolled in CHIP, as of July 1, there had been an enrollment drop of 41% from 2003. And our state officials can’t fully explain the decline.
You don’t need me to tell you how much slack that leaves y’all to pick up. At one point, the state assumed that this contract, worth hundreds of millions of dollars to a corporation, would require a million hours of work by non-profits and faith-based groups. Now I admit, the way Mother and Daddy brought me up, I always thought it was bad form to actually take money out of the collection plate during church.
Whatever the motivation, good intentions or bad, when the state’s leaders rip these holes in the safety net, your organizations end up having to fill them. I think that’s a problem, but I’m also realistic enough to know that not everybody feels that way.
But I do say that if it’s going to lean on you this way, the state has an obligation to give you a larger role — and a larger budget — in figuring out how to deliver these services to people.
Instead, I suspect for many of you that the state has indirectly become one of your biggest charity cases. That would be bizarre if it weren’t actually true — and so tragic. Even so, maybe the best characterization really is “bizarre”.
In the midst of its mad embrace with outsourcing, the state must look at its own operation with some common fiscal sense. Contrary to popular belief, that doesn’t mean writing nine-figure checks, crossing your fingers really hard, doing little but hope that everything goes OK, and then remaining in a state of denial for far too long.
Instead, it means spending taxpayer money as wisely and carefully as you all spend your donations. In the realm of health care alone, the state could save untold millions if it invested in disease prevention, or it made a stronger effort to cut down on emergency room visits, or it actually pursued all of the money that the federal government genuinely wants to give us.
If there’s anything good that’s come out of this ongoing privatization crisis, it’s that many more people now understand that state health officials need to be talking with you all, and you all need to be talking with them, as we all try to figure out how to serve the same group of Texans.
And just between you and me: if they’re going to use you, they really need to help you with resources to do the job.
It is time for us to be asking, “Where is the heart of our state?”
When calculating the human cost of the decisions being made on behalf of those who need us, we should ask, “Are we satisfied?”
For our children, their wellness, and their key to a better, more fulfilling life, we must stop asking, “How low are we willing to go?”
Thank you all for being here, and God bless you for all you’re doing in this community. Please stay involved, and keep a close eye on us when the Legislature convenes in January. Believe me, we need you as much as your clients do.