[november 2014] Recently, the staff of the legislative Sunset Commission issued a report recommending a sweeping overhaul of the five human services agencies currently under the umbrella of the Health and Human Services Commission (HHSC): the Dept of Assistive and Rehabilitative Services (DARS), Dept of Family and Protective Services (DFPS), Dept of Aging and Disability Services (DADS), Dept of State Health Services (DSHS), and HHSC eligibility services (PDF chart of the proposed new structure).
Key provisions of the 225-page document include recommendations to:
- Consolidate administrative support services and IT
- Consolidate administration of Medicaid functions
- Adapt all HHSC processes for Managed Care expansion
- Streamline Medicaid provider enrollment
- Establish a single women’s health program for HHSC
- Require the now governor-appointed inspector general to be appointed by and report to the HHSC executive commission
- Abolish advisory committees established by the legislature and allow the HHSC executive commissioner to reestablish them as needed
The report claims that consolidating the five HHS agencies and their more than 54,000 employees would result in savings of $32.3 million over the next five years. The recommendations do not include any mention of privatization, outsourcing, or job lay-offs.
The back story
In 2003, HB 2292 was passed and 12 different state agencies were combined into 5 (FPS, DARS, DSHS, DADS, and HHSC). They were all placed administratively under the HHSC Commissioner. HB 2292 also began the process of privatizing eligibility work in HHSC. TSEU members fought from 2003-2008 to stop the outsourcing plan which would have laid off 2,000 staff and shut down 100 local eligibility offices around the state.
Now, the Sunset Report is calling on lawmakers to finish the work of HB 2292. This raises the concern that a renewed consolidation attempt in HHSC will result in more privatization and downsizing of services for vulnerable Texans.
The elephant in the room: low pay+high workloads = increasing turnover rates
High turnover rates due to stagnant pay and increasing workloads is never mentioned in the 225 page report. This is a missed opportunity for legislators and agency officials to address the real crisis occurring in all five of the human services agencies. As state employees are faced by ever increasing workload demands and stagnant pay, they’re leaving state employment in increasing numbers. This high turnover in all five human services agencies threatens the quality of services which vulnerable Texans depend upon.
TSEU’s position: consolidation won’t address the real problems and may just create other problems
While increased communication and coordination of the state’s delivery of vital services such as Medicaid is an important goal worth working towards, a complete rearrangement of the organizations that deliver those services will cause disruptions in the short run, particularly since so many programs are already short staffed. The recommended consolidations will also fail to address the underlying problems in all five Human Services agencies, namely inadequate staffing levels and low pay. Lawmakers and agency leaders should prioritize hiring additional staff and providing across-the-board pay raises, if they want to see a significant improvement in the quality of services.
Another concern is that in such a massive agency (the proposed agency would be the largest in the state) with so many different programs and divisions doing so many different things, the funding needs and priorities of smaller programs would take a back seat to more high profile ones. This raises the possibility of decreased accountability and transparency in the massive new agency.