The WV Department of Health & Human Resources (DHHR) was established in 1989 by merging the state’s Department of Health and the Department of Human Services. It is the State’s largest Department, employing some 5,000 employees across all 55 counties and has a budget in excess of $7 billion (state and federal money combined).
DHHR oversees West Virginia health, social and welfare programs. Over the years, DHHR has received many complaints ranging from failing to care for children who require foster care, to providing bad checks to caregivers, to poor health results compared to other states. The McChrystal Group, an independent consultant, has noted that West Virginia, as compared to other states, is rated “lowest for life expectancy, as having the highest rate of drug-related deaths, the highest percentage of minors in foster care, is second highest for food insecurity, and 35th for access to care.”
Legislative actions to address performance
House Bill 2006, passed by the legislature in February of this year, is intended to improve DHHR services. The bill follows a similar bill that was passed in the prior legislative session that called for breaking DHHR into two parts, but was vetoed by the Governor. Following the veto, the McChrystal Group was hired to study DHHR. The study concluded that simply splitting DHHR into two departments would not just by itself resolve the problems. Rather, it suggested more systemic changes, including improving the organizational structure, creating an organization-wide strategic focus, and developing operational efficiencies so that workers receive necessary resources.
The 2023 bill ultimately reorganized DHHR into three parts — the Department of Health, the Department of Human Resources, and the Department of Health Facilities. It provides for the governor to add three new cabinet secretaries who will focus on their respective departments. In May these positions were filled by professionals with strong backgrounds related to the focus of each department. The transition to the three departments was also guided by suggestions and concerns expressed by staff “on the ground”, those who provide services directly to the public.
The bill strengthens the Office of the Inspector General and establishes the Office of Shared Administration which all three departments will use for such things as information technology, human resources and communications. The transition to three departments is to occur effective January 1, 2024.
An Example – Child Protective Services
The new Department of Human Services includes the Bureau of Social Services which includes Child Protective Services (CPS). CPS is charged with investigating reports of child abuse and neglect as well as providing services to protect children including placing them in foster care. Over the past several years, many complaints have been raised about CPS failures to administer foster care properly, often as a result of understaffing, with case workers being given an impossible number of cases to administer and having a lack of resources to care for children and their families.
Others have noted that not only are CPS staffing levels inadequate but also that staff need to be highly trained and have timely access to resources to perform their duties. Training takes time and must be supported from the top down. Professional managers and staff are a must.
The legislature, meanwhile, is aware that reorganizing in and of itself may not be enough to address needs of the public. Mike Pushkin, D-Kanawha, House Health and Human Resources Committee Minority Chairman, voted for the bill. He said that the hope is that the three different departments, which will have additional oversight, will do better. He also noted, however, that recruiting additional employees, such as for Child Protective Services, is difficult because of low staff pay levels compared to other states.
Transition and Next Steps
According to the Governor’s office, the transition is going well and there have been no significant roadblocks to reaching the goal of completing the transition by January 1, 2024. At the same time, the Legislature is continuing working on restructuring DHHR’s $7.7 billion dollar budget and the Legislative Oversight Commission on Health and Human Resources Accountability is working on performance and outcome reporting for the new departments.
Summary
Will the reorganization of DHHR into smaller, more focused, departments improve services to West Virginians? The Governor, the interim leader of DHHR, the new cabinet secretaries and others in the legislature are hopeful that this reorganization and focus on health and social services will result in better services to the public. Others are concerned that without intense focus by professional staff leading the new departments as well as full professional staffing for serving the public directly, the reorganization will be nothing more than moving pieces on a chess board. Time will tell if the reorganization leads to improvement in the health and welfare of West Virginians.
More information about DHHR can be found online at dhhr.wv.gov.
Complete McChrystal Group report and chart summarizing the reorganization (PDF Link).
Susan Benzinger is a retired tax attorney and active volunteer in Jefferson County. During her 2022 campaign for WV State Delegate campaign she became very familiar with the issues facing West Virginia and offered to share updates on the state legislature during the 2023 session for The Observer.
By Susan Benzinger