Just for kicks, let’s play the “what if” game.

What if you took a 26-question test and only answered one correctly? What sort of grade would that be? Beyond an “F,” I’m pretty sure.

But you and I are individuals, not the government. It plays by a different set of rules and almost always wins. Which is what happened when the state auditor’s office released its follow-up report to last year’s wildly popular audit titled, “Health and Human Services Commission’s Texas Integrated Eligibility Redesign System.”

Whew. That's a mouthful.

TIERS? TIERS, the fancy-pants technology (read: government interface) that was supposed to increase efficiency for Medicaid and food stamp requests, as well as other medical benefits for the state's less fortunate.

The report, full of qualifying remarks, says the computer system, derided as a boondoggle and often on the receiving end of bad press, has "improved,” despite meeting only one benchmark from last year’s audit. (Remember what I said about the government always winning...?)

See, there's a huge difference between conception and execution, and the TIERS computer system has historically failed to deliver either expediency or cost efficiency — something else it was also supposed to do in 2000 when it began replacing the older processing system in three counties, Travis, Hayes and later Williamson. Apparently the auditor’s office knows this as well.

From the report’s opening statement:

"... the Commission needs to determine the actual costs and actual end date for the statewide implementation of TIERS."

Maybe that's because statewide implementation began despite federal attempts to halt expansion of the computer system, according to this Texas Observer piece. Or maybe the state just doesn't have the manpower to actually complete the project.

According to a February article by the Austin American-Statesman, "there aren't enough workers trained in TIERS, and the state is losing them almost as fast as they are hired." The paper goes on to report that the state doled out raises and promotions to 6,000 workers.

But surely the long-suffering state employees who work with the computer system know how to save and process data if something goes wrong? Not a chance. According to the report, auditors "conducted a telephone survey of 101 eligibility workers and determined that 82 percent of those surveyed did not use or were unaware of contingency processing methods for TIERS." And these people were on the TIERS front lines!

Now, back to our little game. The report found that of the 26 recommendations made last year, 22 are currently “in progress,” and three have been “substantially implemented.” That leaves one successfully completed task. For shame.

No system to root out fraud

The Observer points out that the system's greatest flaw is its inability to provide data that would allow the state to pursue cases of Medicaid fraud or to recover overpayments -- something that has been known to happen.

Fraud and overpayment referrals have risen over the last three years, according to the audit; in 2005, 763 referrals made it to the Office of Inspector General. In 2007, that number would increase to 1,050 (2006 saw a slight dip, to 706).

The audit says there's no end in sight for getting all Texas counties to use the computer system:

As of June 2008, the Commission’s conversion plan stated that TIERS would be implemented statewide by December 2010. However, in a Quality Assurance Team monitoring report dated August 2008, the Commission reported that an end date for the TIERS project had not been determined.

Maybe, just maybe, this is a good thing. Maybe the remaining 251 counties can be spared...