West Virginia’s Department of Health and Human Resources is a giant state agency.
Its annual budget is $4 billion, with the biggest chunk ($2.7 billion) coming from the federal government, mostly to pay for Medicaid.
DHHR has over 6,300 positions, with people in every county who provide a wide range of services, from getting children out of abusive homes to administering care for older West Virginians in nursing homes.
It’s also an agency with a lot of problems.
Public Works, the same firm that performed an independent audit of the West Virginia’s Department of Education, has just issued to Governor Earl Ray Tomblin a comprehensive report on DHHR.
Here are just a few of the findings that stand out:
–DHHR and the public health agencies it works with “are beset by fragmentation, an insufficient workforce, and the lack of an overarching strategic vision and a sustained mechanism for accountability.”
–The agency has a significant turnover problem. DHHR loses about 30 percent of its employees every year, and it takes an average of three months to fill each job. That decreases efficiency and drives up training costs.
–The high turnover rate has left DHHR with 600 unfilled positions, increasing the workload on others and raising overtime costs.
–The state’s Medicaid program loses from between $90 million and $300 million a year through fraud and mistakes.
–Travel expenses have increased 35 percent over the last two years, to $6.1 million.
In fairness to DHHR, the agency’s mission is daunting, especially considering West Virginia’s high rate of chronic illnesses, unhealthy lifestyles and substance abuse issues.
Additionally, the entry level salaries are low for those who have some of the toughest jobs, like child protective service workers. They start at about $31,000.
The Public Works report concludes with a note of optimism. “Our review found that many individuals, both inside and outside state government are eager to make improvements, but they feel they lack the tools and resources to make these improvements.”
The report includes 78 recommendations it says will save $57 million.
Governor Tomblin took the Public Works audit of education and used it as a catalyst for reform. Now, based on the findings of the audit of DHHR, he has a new and potentially more complicated challenge to undertake.