In 1989, West Virginia’s Department of Health and Department of Human Services were merged to form what’s known as DHHR. Now, after decades of splitting its bureaus and divisions, there’s a call to go full circle.
Gov. Jim Justice vetoed House Bill 2020, passed in the just completed regular legislative session. The bill would have separated the two departments with a combined staff of nearly 6,000 and a budget of more than $6 billion.
Justice said there was a need for further review.
On Tuesday, DHHR Secretary Bill Crouch told lawmakers with the Joint Legislative Oversight Commission on Health and Human Resources Accountability he will support whatever recommendations are agreed upon.
The whole idea is to improve the services to the state of West Virginia and to the people of West Virginia,” Crouch said. “DHHR is not broken. We can improve, we can get better.”
Crouch said filling the more than 800 vacant positions throughout the department is about more than the much-talked-about Child Protective Service staff shortages.
“Our Bureau of Public Health has six people. We have no one. We have no director, we have no deputy director, we have no finance person, we have no one to help with grants,” Crouch said. “One of our biggest problems in terms of vacancies is accounting. We have eight accounting positions that are vacant, and we’re having trouble recruiting for those. So, we’re having trouble paying our bills.”
Crouch told lawmakers that limiting staff turnover will require better middle management hires and training – to go along with salary increases.
“We’ve got to get better middle managers. We’ve got to get people trained better to manage the folks that they have, because we’re not doing a good job of that,” Crouch said “In these regional and district offices where our turnover is good, we probably have good managers. Where it’s not, we need to do some work there because there’s a reason people leave one office and don’t leave another over and over again.”
Crouch said he has pushed for years without success to privatize DHHR’s larger health facilities, which he said were all substandard.
“I’ve said many times, I don’t think the states are good providers of services. We are too slow, we can’t purchase items quickly,” Crouch said. “If we could convince a private company to take over a facility and build a new building, that’s part of the contract. They hire all of the staff so that all the staff get employed. The city and the county can get the B&O taxes.”
Crouch said political allocation of funds – or allocating no funding at all to certain DHHR entities can have an overall effect on progress.
“West Virginia is number one in smoking in the country. We cut those services and we haven’t put anything back,” Crouch said. “I know we’ve tried a couple of times, but it’s an area that would pay us back in huge ways in terms of reduced medical costs.”
Brian Abraham, the governor’s chief of staff, told lawmakers he’s also seen problems at DHHR’s mid-management level.
“We have counties that I’ve been in, and today, still get complaints in the governor’s office about DHHR offices that may be mismanaged and are having staffing issues because of that mismanagement,” Abraham said. ”So we need to take that moment and have that inflection to look and see what’s going on and have somebody come in from the outside objectively to look at it.”
Gov. Justice has put out a request for proposals. He’s planning to hire what Abraham called a world-class consulting firm to deliver a top-to-bottom organizational assessment and a strategic plan for overhauling DHHR. The review is expected by this fall.