State DHHR to be reorganized

Nov. 11—The West Virginia Department of Health and Human Resources (DHHR) will undergo a "bold" reorganization plan after the results of a study of the agency were released.

Gov. Jim Justice announced Thursday he received the results of the organizational review conducted by the McChrystal Group LLC, of Alexandria, Va.

Legislators passed a bill earlier this year to divide DHHR into two different agencies, with health the focus of one and human resources the other. That action was taken after problems within the agency surfaced.

But in March 2022 Justice vetoed House Bill 4020 regarding splitting the agency, and hired the McChrystal Group to complete a "top-to-bottom review of DHHR to identify its issues, bottlenecks, and inefficiencies."

Justice said he vetoed the bill because it did "not provide adequate direction on the many questions that must be addressed in this massive endeavor."

He said consultants with the McChrystal Group spent the last few months embedded, physically and virtually, in DHHR and spent hundreds of hours with various department staff.

"When I vetoed House Bill 4020, I committed to making our DHHR the best it can be so that our most vulnerable West Virginians are served with the highest degree of care," Justice said. "I made the right decision to veto this bill in March 2022, and these national experts have confirmed my decision with their report."

The report concluded that "to improve West Virginia's health and human services outcomes, the status quo is not an option; DHHR requires bold organizational change. After completing this organization assessment and strategic plan, the McChrystal Team disagrees that splitting DHHR into two separate departments is the option that will provide the desired results. Instead, the McChrystal Team recommends that DHHR remain a single department and focus all improvement efforts — to both structure and process — around the strategic plan designed to address the highest priorities within West Virginia's environment."

"I have directed (DHHR) Secretary (Bill) Crouch and his leadership team to immediately implement the McChrystal Group's recommendations," Justice said. "They will do so in an effective and efficient way and will ensure there is no lapse in any vital support or services for the West Virginians who rely on the DHHR. I will also work closely with the Legislature on changes to laws or funding that may be necessary to implement these changes."

The actions recommended by the McChrystal Team include:

—Strategic focus: Develop and then communicate detailed action plans to enable execution of each objective in the department-wide strategic plan.

—Structure: Establish an Executive Leadership Team (ELT) and align DHHR's organizational structure to enable the execution of the objectives in the strategic plan. Deepen investment in leadership throughout DHHR, starting at the executive level.

—Operational processes: Design and implement an operating rhythm for each department-wide objective to improve communications and collaboration so DHHR can better understand and respond to the complex needs of West Virginians. Prioritize administrative process improvements after the detailed action plans for the administrative objectives are developed.

The report also took a deep dive into all aspects of the agency, providing specific recommendations for each entity.

The assessment consisted of 65 interviews, the collection of more than 3,400 survey responses, and extensive document review, in addition to comparative analysis of health and human services outcomes and structures in other states. While conducting this organization assessment, the McChrystal Team also facilitated strategy alignment working sessions with DHHR senior leaders to develop a department-wide strategic plan.

According to the report, the complex nature of the health and human services landscape in West Virginia has resulted in the state consistently measuring at or near the bottom nationally in several health and human services outcome rankings.

"West Virginia faces a series of intersecting challenges, ranging from an opioid epidemic and broader substance use disorders to a child welfare crisis, chronic physical and mental health challenges, and multiple barriers to accessing care and support services." the report said, adding that the previously existing challenges were intensified by the COVID-19 pandemic and continue to "severely impact the health and well-being of West Virginians today."

The report said a selection of West Virginia's health and human services outcome rankings among states include:

—Lowest for life expectancy

—Highest rate of drug-related deaths

—Highest for percentage of minors in foster care

—Second highest for food insecurity

—35th for access to care

"Many of these challenges have persisted for decades," the report said. "Notably, poor health and social outcomes are often associated with a high incidence of poverty. Therefore, it is not surprising that West Virginia, as one of the poorest states per capita in the nation, would rate low on these measures."

The larger question is whether the state's limited resources are being used as effectively and efficiently as possible to address these challenges, the report said. "Despite the efforts of committed and well-intentioned leaders and staff, funding increases, and proactive policy changes, the Department of Health and Human Resources has struggled to this point to stabilize the delivery of programs and services while also adapting to a constantly evolving environment."

"I sincerely thank the McChrystal Group for their work on this report, and for their expertise in analyzing this important agency," Justice said. "I have the utmost faith in the great West Virginians who are employed by DHHR to rally together as a team and make the necessary changes to be a better organization for our state."

— Contact Charles Boothe at cboothe@bdtonline.com

Contact Charles Boothe at cboothe@bdtonline.com