Overhaul of health, human service begins

Ten years after its last overhaul, the state health system senators have called an embarrassment to Nebraska is poised for another reorganization.

But this time around, CEO Chris Peterson said, the changes are being met with optimism.

"It's an exciting time to be in health and human services in Nebraska," she said, her face breaking out in a smile.

When the health system was reorganized in 1996, workers protested, picket lines formed and unrest spread within the department.

That's not the case today. Peterson said.

"It really hard not to be excited," she said. "We know that the expectation is high, and I don't doubt people can rise to that expectation and meet it."

In August, Gov. Dave Heineman unveiled a plan to overhaul the Health and Human Services System, which is composed of nearly 6,300 employees in three separate departments run by a committee called a policy cabinet.

As senators debated the reorganization bill this past legislative session, they described the current structure as broken and unwieldy. They said it fails children, endangers others by not adequately regulating potentially dangerous people, has a poor record of taking people off welfare rolls and is a main source of complaints from residents of their districts.

The resulting reorganization law created six divisions and division directors within a revamped Department of Health and Human Services, with a chief executive officer at the top who reports to the governor.

Those divisions are public health, Medicaid, children and family services, behavioral health, developmental disabilities and veterans homes.

Heineman has since filled six of the seven leadership posts:

-- Peterson, chief executive officer;

-- Scot Adams, behavioral health;

-- Dr. Joann Schaefer, Nebraska chief medical officer and director of the public health division;

-- John Hilgert, veterans homes;

-- Vivianne Chaumont, Medicaid and long-term care;

-- Todd Landry, children and family services.

Heineman spokeswoman Ashley Cradduck said this week that the governor is still searching for the right candidate to lead the Division of Development Disabilities, so a temporary appointee may be put in place Monday, when the reorganization takes practical hold.

Offices and cubicles in the Health and Human Services headquarters were being moved last week as part of the transition. Peterson said it will take about a month to get everything changed over.

The department has an annual budget of about $1.4 billion. Peterson said that once the department settles into its new form, the increased efficiency will likely save money.

The present structure went into effect in 1997, developed after a year's worth of meetings with the leaders of what was then five different agencies. Those five agencies were combined into the three current departments of HHS: Health and Human Services, Finance and Support, and Regulation and Licensure.

The policy cabinet, which consists of the heads of each of those departments, a policy secretary and the chief medical officer, was created so all three parts could work together.

Peterson said that's where the problem was: "You just can't have divided leadership like that."

The reorganization fixes that by putting one person in charge -- Peterson -- and holding her accountable, she said. It also breaks down the barriers that separated the HHS departments.

"Our system is integrated at just about any angle," Peterson said.

Heineman has said the latest reorganization will create a clearer chain of command that will increase accountability and transparency, as well as make it more responsive to Nebraskans.

But he's not expecting immediate changes.

"It won't be overnight" the governor said last week. "It takes time ... when you look at an agency this large."
source:www.siouxcityjournal.com