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Editorial: Health agency has much to do to overcome efficiency issues

Apr. 24, 2013 @ 07:55 PM

Problems within West Virginia's Department of Health and Human Resources become evident from time to time, such as the still ongoing dispute over the handling of a marketing contract and the long-running court case involving how services are delivered by state-run psychiatric hospitals.

But the magnitude of the problems may be more than many imagined, according to a recently completed audit of the department done at the request of Gov. Earl Ray Tomblin at a cost of $380,000.

The study, completed by Pennsylvania-based consulting company Public Works, came up with 78 recommendations for the department and estimates the state could save or generate $56.7 million over the next year and $283.7 million over the next five years if the suggestions are followed.

While those numbers are big, the underlying problems that contribute to unnecessary spending -- and call into question how effectively the department can deliver its important services -- are more alarming.

The study found that the department had a 30 percent monthly turnover rate, or about nine times more than the national average. The high turnover combined with a months-long process to hire people means that the department typically has about 600 vacant jobs. That, of course, contributes to higher overtime costs (a 35 percent increase from 2010 to 2012 budget years) and higher travel expenses as new hires take trips for training.

Other findings: Some DHHR divisions are burdened with too much work while others are underutilized, and the department misses out on grant opportunities because it has no organized, efficient way to pursue them.

The net result, the report said, is that "West Virginia's health care agencies are largely focused on day-to-day operations and emergencies, with little capacity to collaborate on new efforts or the broader vision of improving health outcomes in West Virginia."

That is a serious shortcoming, considering the state is "in the midst of a health care crisis," as the study described it. Health care spending per person in West Virginia is among the highest in the nation yet health outcomes are among the worst.

There's no question that DHHR has a difficult mission, ranging from administering the Medicaid program, to providing psychiatric services, looking out for the welfare of children and monitoring and responding to public health issues, to name a few of its tasks. Structurally, some changes may be necessary to help the department better manage the multitude of functions, and the study recommends some restructuring.

The governor's office contends that major legislative action isn't likely needed to deal with many of the recommendations included in the audit. Policy changes may address many of the issues raised in the report, a governor's spokesman said.

Even if that's the case, that doesn't relieve the governor's office and DHHR from reporting to the public about the department's progress in tackling the many challenges laid out in the report. DHHR has a huge public health and welfare role in West Virginia, and is receiving a sizable share of the state budget to carry it out.

In that context, it's crucial that the department puts its house in order and more effectively fulfills that role.



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