ADMINISTRATION DISCUSSES HEALTH AND HUMAN SERVICES PROPOSAL
By Matt Hess, Pennsylvania Legislative Services
The Wolf Administration held a press conference this afternoon to discuss the governor’s proposal to create a new Department of Health and Human Services (HHS) and the proposed budget for the department.
Randy Albright, Secretary of the Budget, explained the new HHS would be comprised of four existing departments: Aging (PDA), Drug and Alcohol Programs (DDAP), Health (DOH), and Human Services (DHS). He argued they all have the same core mission and serve similar and in some cases the same populations. “A new, unified department will be established to coordinate services and enhance program effectiveness while also saving taxpayers over $90 million,” he stated. “Duplication and administrative overhead associated with the current fragmented service delivery model will be eliminated. This will result in more streamlined services, less bureaucracy, and additional funds that can be redirected to service delivery.”
Sec. Albright highlighted the main benefits of the consolidation, including the following:
· Establishes one point of contact for Pennsylvanians to more easily access health and human services;
· Combines intake and eligibility processes to reduce confusion for individuals and families seeking benefits, services, and supports;
· Creates a single state authority for Medicaid, mental health, and substance abuse services, resulting in an improved service delivery model that maximizes available federal dollars to offset state costs.
In terms of services for older Pennsylvanians, Sec. Albright said the consolidation will enhance and allow for the expansion of home and community-based services in ways not realized today, with the goal of improving continuity of care regardless of which service is needed and emphasized that no additional Lottery Fund dollars will be transferred to offset General Fund expenditures.
Sec. Albright also discussed prescription drug services and said the consolidation will provide better coordination among multiple programs throughout the commonwealth that purchase, dispense, and monitor prescriptions drugs. He emphasized that consolidation into a single bureau with uniformity of program services, rules, and fees would reduce costs by more than $45 million annually.
Turning to State Health Centers, Sec. Albright said DOH operates 55 State Health Centers that provide clinical services for uninsured and underinsured Pennsylvanians and the “proposed modernization reduces brick-and-mortar health centers and relocates them into community-based settings to increase regular participation and provide enhanced service and education for the consumers,” which will provide $15 million in savings.
Sec. Albright also discussed County Assistance Offices (CAOs). “The back-office functions of CAOs will be consolidated by shifting these functions to processing centers to reduce the physical footprint of CAOs, starting with those with the highest staff turnover,” he stated. “This reorganization and streamlining will result in improved staff retention and productivity, while saving $7 million.”
Concluding with licensing and quality assurance, Sec. Albright affirmed that a “consolidated HHS structure will reduce bureaucratic hurdles, provide clearer and more cohesive guidance to providers, save money, and give providers the opportunity to spend more time delivering services to Pennsylvanians in need.”
Moving onto the governor’s budget proposal, Sarah Galbally, Secretary of Policy and Planning, said it will provide $26.5 million to serve more people in the community and strengthen support for adults with Intellectual Disabilities and Autism and also provide $10 million to serve an additional 1,800 children on the child care subsidy waiting list. In addition, Sec. Galbally said the proposed budget expands evidence-based home visiting services by $9 million to serve an estimated 1,700 families and partners with the Department of Education to invest $65 million for Pre-K Counts and $10 million for the Head Start Supplemental Assistance Program serving 8,400 children in high-quality pre-K programs.
Turning to the heroin and opioid epidemic, Sec. Galbally said Pennsylvania will maintain a cabinet-level position to address the issue and highlighted ways the budget addresses the health crisis:
· Continues the $20.4 million investment in 2016-17, creating 45 Centers of Excellence to improve treatment outcomes;
· Partners with the Commission on Crime and Delinquency to increase access to naloxone for first responders by providing $10 million and expands specialty drug courts with an additional $3.4 million;
· Maximizes $26.5 million in federal Cures Act funding annually for next two years
Teresa Osborne, Secretary of the Department of Aging, spoke in support of consolidating the departments. “For many of our seniors navigating our long term services and supports system is confusing, often fragmented, and regularly entrenched in individual silos, incredibly frustrating, and not always depictive of government that works,” she stated. “A new unified agency will ensure that our seniors have a single agency as their point of contact within Pennsylvania government to receive the health and human services they need and deserve.”
Jennifer Smith, Acting Secretary of the Department of Drug and Alcohol Programs, said consolidation will enhance collaboration with counties and provide streamlined licensing and inspection requirements for treatment providers. “I see improvements for the morale of the employees in my department…this consolidation will improve their ability to perform their job. They will feel finally that they have the access to the resources they need to truly help individuals suffering from substance abuse disorder,” she stated. “Most importantly the citizens of the commonwealth are going to benefit from this consolidation; increased accessibility to services, increased transparency, and overall sustainability of government.”
Dr. Karen Murphy, Secretary of the Department of Health, affirmed that consolidation will improve services for Pennsylvanians. “We’ve all worked hard over the last two years at the governor’s request for leadership and we look forward to working together with him as well as our cabinet secretaries and our employees at figuring out what is the best way to do this for Pennsylvanians,” she stated.
Ted Dallas, Secretary of the Department of Human Services, emphasized that consolidation puts the focus on the consumer. “Everything we do every day is to make sure we keep the focus on the person that needs those services every day,” he stated. “We can start to break down walls and put the focus on serving people in a comprehensive way.”
The secretaries then responded to questions from the media.
When will the consolidation be implemented?
Sec. Albright stated, “From the budget assumptions we’ve been making we assume the unified agency is statutorily put in place July 1 of the current calendar year. From this point forward this is a constant work in progress. The ultimate implementation, refinements, and changes is a constant improvement process so there is no end.”
Will 500 positions be cut?
Sec. Albright said “what we have not put in place is a hiring freeze, we put a complement controls in place and we will continue to work with all departments to continue to try to manage their complement. We hope to reach certain benchmarks and those are the assumptions that we based the cost of all our agency functions in the 17-18 Fiscal Year. We have an early retirement proposed plan in place and will work with every cabinet agency to try to manage complement to manage those goals without any furloughs. We think any furloughs will be modest in the end in terms of the delivery model and the end result in providing those services…we are not willing to concede any loss in serving the clients through the unified agency we are creating here.”
If all of the personnel are going to be preserved at State Health Centers, where does the savings come from?
Sec. Albright explained “it comes from reducing our physical footprint and also comes from finding other ways some of the employees now will find another place from within a unified agency.”
Take you talk more about the proposal for CAOs?
Sec. Dallas replied “what we’re looking at is leaving the front end part of the service intake but consolidating that back end service. We are looking at moving to five regional backend processing centers and using those economies of scale getting that training better, getting better consistency of services, getting them at those locations. The consumer may not see that change because it’s really about that backend processing and getting more efficient there.”
How does this save $90 million?
Sec. Albright said “the largest component of this is the pharmaceutical savings at $45 million; State Health Centers is another $15. There are complement savings; we’ve put that at $15 million right now. The County Assistance Offices is another significant piece of this. Finally, there are smaller programs through all the agencies that through a unified delivery system can generate another $15 million in additional services. That’s the math and that’s close to $100 million already.
Who will lead the department?
Sec. Albright stated “that’s a decision for the governor to make at the appropriate time.”
When the departments are consolidated will there be a new procurement process?
Sec. Dallas stated “ultimately we are trying to use the state’s purchasing power through fewer contracts and using the consolidated buying power.”