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DHHR: An 'unfolding train wreck'

Read the full report here.CHARLESTON, W.Va. -- An "unstable work environment" in the West Virginia Department of Health and Human resources has led to a 30 percent turnover rate and a reliance on overtime to get work done, an audit of the DHHR found.The average turnover rate for non-farm industries is 3.3 percent, the audit states. The department has nearly 600 unfilled positions.Reducing the turnover rate and filling critical positions are a couple of the 78 recommendations made in a $320,000 audit of the DHHR by Pennsylvania-based Public Works LLC. Results of the audit were released Friday.In all, the state stands to gain $56.7 million a year in new revenue or savings by following its 78 recommendations, according to auditors.Auditors say the DHHR spends $6.7 million a year in training, recruiting and hiring staff because of the high turnover rate. The department stands to save $2.1 million a year by reducing staff turnover, filling critical vacancies and reducing overtime spending, according to the report.Gordon Simmons, a field organizer for UE Local 170, West Virginia Public Workers Union, said DHHR managers should be held accountable for the unstable workforce."If [the] DHHR was a decent place to work, how is it that there is a constant rate of 600 unfilled positions year after year?" Simmons wrote to the Sunday Gazette-Mail in an emailed response to the audit."A vicious cycle has been created by systematic mismanagement: incompetent management plus low pay equals high turnover," Simmons wrote. "Continuously high turnover coupled with bureaucratic obstacles to hiring equals unrealistic case loads and mandatory overtime. All of which, in turn, creates burnout and increased turnover. It's an ever-intensifying formula for organizational disaster."Government leaders and stakeholders believe the DHHR's size, structure and budget are "unwieldy," and that the department does not have a strategy to replace senior personnel when they retire, the report states. Auditors also took issue with the amount of funds the DHHR spends on travel expenses.The DHHR could save $937,500 a year and $4.7 million over five years by reviewing travel spending and reducing it where needed, according to the audit. The DHHR's travel spending has increased by 35 percent in the past two years. The department spent $6.1 million on travel in 2012, compared to $4.5 million in 2010. Of what was spent on travel in 2012, about 40 percent was spent on travel to training activities.Gov. Earl Ray Tomblin's office on Friday released the 116-page report on the audit, which his office sanctioned. Public Works also did the audit of the state's Department of Education.The report is dated Feb. 27, but was released to the Gazette-Mail on Friday afternoon, one day after the special legislative session ended.Delegate Don Perdue, D-Wayne, said he'd read through the report about a week ago and that the Tomblin administration embargoed its release.
"The report was embargoed by the administration (as I was told) because they wanted to look at a few things more closely before releasing," Perdue said in an email to the Gazette-Mail. "It's my opinion that it was a lot of information to be released the last week of a session wherein several important pieces of legislation were in play and needful of no distractions."Tomblin's spokeswoman, Amy Shuler Goodwin, said the department would take its time reviewing the audit."Because of the immediate demands of the legislative session and the lack of legislative action needed to implement the recommendations in the report, we will dedicate the time necessary to thoroughly review these important recommendations," Shuler said in response to a question regarding the timing of the report's release.Auditors also found that the DHHR could increase revenue by $10 million by improving the way it applies for grants."There is uncertainty, confusion and inconsistency in identifying, applying for and managing grants in DHHR bureaus," the audit states.Public Works recommended that the governor establish an Office of Health Care Improvement, a Clinical Advisory Council and a Payment Advisory Council.
The Office of Health Care Improvement would include the Governor's Office of Health Enhancement and Lifestyle Planning and the West Virginia Health Care Authority.The auditors also recommended there be two deputy secretaries of health. One deputy secretary would oversee the Bureau for Medical Services, the Bureau of Behavioral Health and Health Facilities, the Bureau for Public Health and the Bureau for Senior Services. Another deputy secretary would oversee the Bureau for Child Support and the Bureau for Children and Families.Perdue, who along with Sen. Ron Stollings chairs the Legislative Oversight Commission on Health and Human Resources, said he and Stollings, D-Boone, had resolved to study the workings of the DHHR during legislative interim meetings. They will use the audit as a roadmap, he said.Stollings said there is at least some talk of breaking up the DHHR."I think everything's on the table," Stollings said. "We'll see how it goes over the interim process. Delegate Perdue and I stand ready to help however we can."The audit gives a complete, comprehensive view of the DHHR, Perdue said."If it is to be as effective as it can be in achieving the larger strategic vision it shares, a true commitment to putting it into play must occur," Perdue wrote in an email to the Gazette-Mail. "Otherwise, we will continue to watch an unfolding train wreck that could have been avoided by better track maintenance."Kate Long contributed to this report. Reach Lori Kersey at or 304-348-1240.
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