Rethinking Health and Human Resources
By Samantha Cart
As a West Virginia citizen, if you need to report an instance of child abuse or suspected human trafficking, find information on child support or family assistance or file a civil rights complaint or FOIA request, you will be utilizing resources provided by the West Virginia Department of Health and Human Resources (DHHR). Created in 1989 by the West Virginia Legislature, the DHHR is responsible for the state’s health and welfare programs and several social services and has served the needs of thousands over the past three decades. From 2020-2023, alongside the West Virginia National Guard, it led the state government’s efforts in addressing the COVID-19 pandemic. As the largest executive branch agency in the Mountain State, the DHHR provides services in all 55 counties and employs close to 6,000 people.
Restructuring
On March 6, 2023, Governor Jim Justice signed House Bill (HB) 2006, splitting the current DHHR into three separate departments: the West Virginia Department of Health, West Virginia Department of Human Services and West Virginia Department of Health Facilities. Effective January 1, 2024, the goal of the reorganization is to ensure West Virginians are served with the highest degree of care.
“The goal of the separation is to distribute the authority and responsibility for these programs among three co-equal, cabinet-level secretaries to maximize efficiencies resulting in optimal service delivery for state residents,” says Sherri Young, D.O., MBA, FAAFP.
On May 24, 2023, Justice appointed the three cabinet secretaries: Young, interim DHHR secretary and incoming secretary of the West Virginia Department of Health; Cynthia Persily, Ph.D., secretary of the West Virginia Department of Human Services; and Michael Caruso, secretary of the West Virginia Department of Health Facilities. Each began working with their respective departments on July 5, 2023, in preparation for the official transition.
Each new department will be structured as follows:
- The West Virginia Department of Health will include the Bureau for Public Health, Office of Emergency Medical Services, Office of the Chief Medical Examiner, Center for Threat Preparedness, Health Care Authority, Office of the Inspector General, Human Rights Commission, Developmental Disabilities Council, Advisory Council on Rare Diseases, Commission for the Deaf and Hard of Hearing and Early Intervention Interagency Coordinating Council.
- The West Virginia Department of Human Services will include the Bureau for Behavioral Health, Bureau for Child Support Enforcement, Bureau for Family Assistance, Bureau for Medical Services, Bureau for Social Services, Office of Drug Control Policy, Commission to Study Residential Placement of Children, Family Protection Services Board, James “Tiger” Morton Catastrophic Illness Commission and Women’s Commission.
- The West Virginia Department of Health Facilities will include Hopemont Hospital, Jackie Withrow Hospital, John Manchin Sr. Health Care Center, Lakin Hospital, Mildred Mitchell-Bateman Hospital, Welch Community Hospital and William R. Sharpe Jr. Hospital.
- The Office of Shared Administration, developed by the three cabinet secretaries in a memorandum of understanding, will provide shared services from centralized units such as finance, human resources management, management information services and constituent services.
Rethinking
HB 2006 was written and passed largely due to concerns over inefficiencies in the sizable department, and this reorganization provides a rare opportunity in government to create something new.
“The restructuring of the DHHR provides us with an opportunity to work collaboratively to create a more focused, strategic and coordinated approach to health and human services,” Persily says. “This can lead to more comprehensive solutions for the people of West Virginia and improve their quality of life.”
In June, Young, Persily and Caruso provided members of the Legislative Oversight Commission on Health and Human Resources Accountability with updates on the restructuring process, including the identification of critical vacancies, concerns over the number of open positions, plans for financial review and potential improvements to the department’s health management information systems, among other things. However, the leaders asked for grace and flexibility during the massive undertaking.
The concern of any budget-conscious citizen or elected official is, of course, the cost of reorganizing and possibly expanding an already large agency and inadvertently adding additional levels of bureaucracy to health and social services access. HB 2006 was designed to be budget neutral by streamlining and eliminating several existing positions while establishing the new secretarial positions. The bill does not call for a mandatory reduction in jobs or services, and Young does not anticipate any job loss.
“There are many job vacancies within the West Virginia Department of Health and Human Resources, and it remains important to continue to fill vacant positions to ensure access to vital services for West Virginians. If warranted, additional positions may be added after an analysis of functions and outcomes by the secretaries and their teams,” she says.
According to Young, the restructuring will also enable more efficient resource allocation, which should have positive fiscal effects.
“With guidance from the Justice administration, resources can be directed toward the most critical priorities and programs, ensuring that taxpayer dollars are used more effectively to address key health and human services needs,” she says.
Revitalizing
With the freedom to try new things, Young, Persily and Caruso are also focusing on improving existing critical services.
“As we restructure the DHHR, we have the opportunity to make a tremendous impact on West Virginians by focusing on programs that will continue to seamlessly deliver essential resources to the public throughout the transition,” Young says. “Addressing complex health issues like substance use, obesity, diabetes and mental health typically requires a multifaceted approach that includes prevention, early intervention, treatment and ongoing support. The restructuring should enable each new department to take a more focused and strategic approach to these challenges, leading to more effective outcomes in the long term.”
Persily is eager to help West Virginia’s children and strengthen families across the state.
“My focus is on providing the support necessary to build healthy and strong individuals, families and communities,” she says. “With a focus on resources, systems and processes needed to provide for physical, mental, emotional and social supports, we will transform our focus on prevention at all levels and in all bureaus in the department.”
Persily is poised to tackle prevalent issues related to foster care, food insecurity and the well-being of vulnerable populations.
“To address these challenges, I aim to strengthen safety net programs, expand access to social services and promote workforce development initiatives to help individuals and families become self-sufficient,” she says.
Caruso is focused on improving outcomes, enhancing services and evaluating opportunities for the patients and residents at state-owned and operated facilities by ensuring West Virginia’s facilities are well-maintained and equipped. His priorities include working with a financial advisory firm for an evaluation of the expensive deferred maintenance costs of the aging facilities and addressing the rapidly advancing technology required to maintain compliance with state and federal regulations, the need to continue to bolster care delivery and the structure and visibility essential to manage operational and financial challenges.
“I see the restructuring of DHHR as a step toward a more efficient and effective health care delivery system in the state,” he says. “Under the leadership of Governor Justice and in coordination with the Department of Health and the Department of Human Services, we can create a health care ecosystem that addresses the needs of West Virginians comprehensively, with a focus on patient care and potential opportunities for state-owned facilities to be utilized in a manner that provides the maximum benefit to the state.”
Young says she is incredibly humbled by her appointment, and she has set goals to improve health in West Virginia by ensuring access to quality health care services, promoting public health initiatives and addressing the unique health challenges faced by West Virginians.
“Leading the West Virginia Department of Health means taking on a range of health-related challenges within the state, and I am committed to addressing them effectively,” she says. “I plan to strengthen public health initiatives and the state’s preparedness for emergencies, in addition to promoting health equity and eliminating disparities in health care delivery. I believe the restructuring of the DHHR is a positive step toward a more integrated and coordinated approach to health and human services in the state. This will enable us to leverage our resources and expertise more effectively to improve the health and well-being of West Virginians.”
Newly Appointed Cabinet Secretaries
Michael Caruso
Secretary of the West Virginia Department of Health Facilities
Cynthia Persily, Ph.D.
Secretary of the West Virginia Department of Human Services
Sherri Young, D.O., MBA, FAAFP
Interim DHHR Secretary and Incoming Secretary of the West Virginia Department of Health
