Photo of: Photo courtesy of WV Legislative Photography
CHARLESTON — Lawmakers broke Sunday on the heads of West Virginia’s Department of Health and Human Resources and the authors of a $1 million report released last week that recommended organizational changes to a Legislature’s desire to split the department in two share.
The West Virginia Legislature convened for three-day interim sessions Sunday at Cacapon Resort State Park in Berkeley Spring.
The Legislative Oversight Commission on Health and Human Resources Accountability and the Joint Committee on Government and Finance — made up of senior leadership of the Legislature — received briefings Sunday afternoon on a report released Thursday by Gov. Jim Justice and supported by the McChrystal Group on a Organizational review was conducted and strategic plan for DHHR.
Virginia-based McChrystal Group was awarded a $1.08 million contract in June to conduct DHHR’s assessment and develop an action plan for an agency that contributed more than $7.5 billion in state and federal government funds this fiscal year federal funding and employs more than 4,900 government employees.
“The bottom line is that our analysis shows strong consistency with the questions being asked (by the legislature) … but our recommendation is to maintain a single DHHR with a sub-structure, with the aim of — at the lowest cost and the fastest.” Efficiency – getting good results for the citizens of West Virginia,” said Christopher Fussell, President of the McChrystal Group.
The McChrystal Group focused on strategic priorities, structures and operational processes at DHHR. The report recommends that agency managers develop detailed action plans for department-wide goals; build an executive leadership team; invest in leadership development, from the executive level through to the offices; improve communication and collaboration; Prioritizing improvements to administrative processes.
“The state has a truly incredible opportunity to drive change,” said Meghan Bourne, a partner at McChrystal Group. “Everyone agrees that we want better service delivery for West Virginians and better health and social outcomes for West Virginians.”
However, the report recommends not splitting DHHR into two parts. House Bill 4020, passed during the 2022 legislature, would have split the DHHR into the Department of Health and the Department of Human Resources. But Governor Justice vetoed that bill in March, calling for an independent top-down review of the DHHR instead.
According to Bourne, 34 out of 50 states have multiple government agencies that deal separately with health and social issues, while the remaining states have a common government agency for these types of services. However, the report does not provide an analysis of which type of system is better or which systems with better health outcomes are being used to deliver services.
One of the McChrystal report’s recommendations includes the addition of additional assistant secretaries for child protection, access and eligibility, and substance use disorders, with existing DHHR offices responding to these assistant secretaries with integration teams in between to assist in communications within DHHR, with the public and to help to legislators.
But House Majority Leader Amy Summers, R-Taylor, said there have been similar reshuffles of positions within the DHHR in the past. She questioned DHHR Secretary Bill Crouch what he learned from the report.
“We’ve had these teams before, they just had different names,” Summers said. “We’re just disappointed in the gist of the report and I’m trying to figure out how I’ve benefited from it… I’m not gaining anything from it and I’m just trying to figure out how to move forward and I’m asking you what did you learn that cost $1 million.” Has? What have you learned that you didn’t already know?”
“We know that the communication among commissioners wasn’t great and that’s something we need to work on,” Crouch said. “I’m going to go through that and figure out how to implement that.”
“It just seems like (the McChrystal Group) has stated that we need bold change and I’m just trying to figure out what those bold changes are. I would have thought they would come straight to you.”
The McChrystal Group report is the result of a 17-week analysis consisting of 65 interviews with DHHR leaders and stakeholders, more than 3,400 responses to a survey, reviews of department documents and policies, and a review of the state’s health outcomes versus other states. More than 27% of survey respondents said they feel unsupported by DHHR and don’t get the resources they need to get their job done.
The state faces several systemic health and welfare problems, largely due to the number of West Virginians living below the poverty line. Nationwide, West Virginia has the lowest life expectancy, highest rate of drug-related deaths, and highest percentage of minors in foster care. The state also ranks second for food insecurity and 35th for access to health care.
DHHR’s current fiscal year budget of $7.5 billion includes both state and federal funds. DHHR’s spending accounts for more than a quarter of the state’s $4.6 billion general revenue budget and is the second-largest spending after public education.
Bourne said several outside organizations were interviewed, such as the West Virginia Hospital Association and the West Virginia Behavioral Health Association, although a full list of groups was not available. Other constituency groups such as foster families or disability rights groups were not surveyed.
According to a letter written to lawmakers on Friday, DRWV legal director Michael Folio said his group sent emails to Bourne and the team at McChrystal Group in late September through October 17, raising concerns about Issues raised at DHHR. Bourne said it was too late to include her post and Crouch accused Folio of harassment for the number of letters he sends to DHHR requesting information.
Senate President Craig Blair, R-Berkeley, tore at Crouch for his dissatisfaction with the DHHR report, using a word often used by the judiciary and calling the report a “nothingburger.” Blair was also upset that although DHHR was notified of the final report by the McChrystal Group on Oct. 17, the report was not released to the public and lawmakers until Thursday, the day before Veterans Day.
“How do you think this is thorough? That’s a statement from me, no question about it,” Blair said. “How are we supposed to put that in the hands of the legislature until we’re basically getting into this session now so we don’t have time to look into this? How can this happen? What happened from October 17 to November 10 that made it impossible to tell the legislature?”
“I work for the executive branch. This was an executive branch requirement in light of DHHR conducting a top-to-bottom review,” Crouch said. “We didn’t reveal it to anyone until we had time for the governor’s office to review and the governor to review. It would have been inappropriate to give it to the public or anyone else.”
“We’re representing the taxpayer’s dollar in this,” Blair said. “We represent the power of the purse and we have approved funding for it. That in and of itself means you should have shared it. We work together as a “team” to get things done. This information should have been shared.”
“We’re done with this $1 million nothingburger,” Blair said at the end of the meeting.