DHHR: How Big is Too Big?

West Virginia’s Department of Health and Human Resources (DHHR) is a government behemoth.

The DHHR employs 6,000 individuals and has a budget of $7.5 billion (state and federal dollars).  Its agencies are responsible for medical and behavioral care, family assistance, child protective services, foster care, public health, and responding to the drug epidemic to name just a few.

Every day, tens of thousands of West Virginians have some interaction with DHHR. Everything DHHR does is grouped together in one department, which prompts questions and criticisms of how well one department with one Secretary at the top can handle the load effectively.

This past legislative session, lawmakers passed a bill with bi-partisan support that would have split the agency in two, in hopes of making it more efficient and effective.  Governor Justice vetoed the bill, but he acknowledged there are “very real issues within DHHR.”

“The bill, as presented, does not provide adequate direction on the many questions that must be addressed in this massive endeavor, including important questions regarding how the federal funds flow to ensure we don’t jeopardize significant federal funding,” Justice said.

Meanwhile, DHHR Secretary Bill Crouch fired Deputy Secretary Jeremiah Samples.  Neither Crouch nor Justice would discuss the firing publicly, saying it was a personnel matter.  However, it is apparent that Crouch and Samples had significant differences about the direction of the department.

That was largely confirmed by Samples in a statement he released shortly after his termination.  “Unfortunately, Secretary Crouch and I have not shared the same views on what the problems are, how to handle them, or the urgency of achieving results,” Samples said.   “But I respect this parting of the ways and pray for the state’s success in solving these issues.”

Again, Secretary Crouch will not discuss publicly what he says is a personnel matter, but it seems reasonable that Crouch believed Samples was more interested in pushing his own agenda with legislators than Crouch’s.

Samples enjoyed considerable support in the Legislature, where he was often the point man for the agency.  Delegate Diana Graves (R, Kanawha) objected to Samples’ firing and supports reorganizing DHHR. “What’s happening to Jeremiah is an example of the dysfunction within DHHR,” she said.

Ultimately, lawmakers who wanted to break the agency into two parts got the cart before the horse. They should have made sure early on that the Governor supported the concept.  His veto is confirmation that he did not.

However, his veto message left a door open.  He said, “I am also going to engage with national experts and industry leaders to coordinate and complete a top-to-bottom review of DHHR, so that we may clearly identify its issues, bottlenecks, and inefficiencies.”  The state will soon send out a request for bids for that work.

It makes perfect sense to have outside experts conduct a thorough review of DHHR before making any drastic changes. Maybe it makes sense to split it in two, or three or five agencies, or not at all.  Information is power.

However, the other part of that equation is that once state government has the information, will leaders—the Governor, the agency Secretary and legislators—have the will to follow through?

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