The Sunset Advisory Commission requested the Department of State Health Services Council’s input regarding the recommendations included in the Sunset Advisory Commission Staff Report on the Health and Human Services Commission and System Issues. The Council held a telephone meeting on October 15, 2014 for the sole purpose of considering the recommendations. Please see below for a summary of the meeting. 

Recommendations on Issue 1: The Vision for Achieving Better, More Efficiently Run Services Through Consolidation of Health and Human Services Agencies Is Not Yet Complete.

  • Rev. Lovell is very concerned with eliminating advisory councils
  • Calhoun – There was an initial streamlining effort in 2003 to bring efficiency to the Enterprise and there is still a lot of confusion
    • Some are of the opinion that since councils do not have specific authority, therefore are inefficient
  • Chair Juarez – DSHS Council has been very successful – does not believe that the cost savings achieved by eliminating councils is worth it
  • Woolweaver – shocked by this recommendation – seems like it is a movement to block transparency and isolate the public
  • Rev. Lovell – The Ebola crisis emphasizes the need for people in the community from the advisory committees who can be a resource
    • Reduces transparency, diminution of focus on public health
  • Foxhall – Puzzled by this nuclear option
  • Ross – The council is a forum for public opinion to be heard, this depletes local leadership and creates a super bureaucracy and might lead to layoffs
  • Motion was passed opposed to the recommendation, though opened to increased efficiencies

 
Recommendations on Issue 2: Incomplete Centralization of Support Services Deprives the State of Benefits Envisioned in Consolidating the Health and Human Services System.
·        Woolweaver – We have to be careful with complete centralization
·        Calhoun – Believes they should stand mute on this
·        Motion was passed to offer no opinion on this recommendation
 
Recommendation on Issue 3: Fragmented Administration of Medicaid Leads to Uncoordinated Policies and Duplicative Services and Could Place Future Transitions to Managed Care at Risk.
·        Calhoun – Doesn’t believe that this is one of the most important function of DSHS, and supports Medicaid services be consolidated into one entity
·        Rev. Lovell – Supports consolidation of administrative services, but doesn’t want this to negatively impact quality of care
·        Foxhall – The implications of this are uncertain
·        Motion was passed in support of the recommendation with the caveat that DSHS remain the central authority in care delivery for the programs currently under their purview
 
Recommendations on Issue 4: HHSC Has Not Fully Adapted Its Processes to Managed Care, Limiting the Agency’s Ability to Evaluate the Medicaid Program and Provide Sufficient Oversight.
·        Motion passed to take no position
 
Recommendations on Issue 5: Fragmented Provider Enrollment and Credentialing Processes Are Administratively Burdensome and Could Discourage Participation in Medicaid.
·        Motion passed to take no position
 
Recommendations on Issue 6: The State Is Missing Opportunities to More Aggressively Promote Methods to Improve the Quality of Health Care.
·        Motion passed to take no position
 
Recommendation on Issue 7: HHSC Lacks a Comprehensive Approach to Managing Data, Limiting Effective Delivery of Complex and Interconnected Services.
·        Motion passed to take no position
 
Recommendations on Issue 8: Administration of Multiple Women’s Health Programs Wastes Resources and Is Unnecessarily Complicated for Providers and Clients.
·        Motion passes in support of the recommendation
 
Recommendations on Issue 9: NorthSTAR’s Outdated Approach Stifles More Innovative Delivery of Behavioral Health Services in the Dallas Region.
·        Foxhall – Concerned that the new NorthSTAR program is not clearly defined
·        Rev. Lovell – Thinks that NorthSTAR does an incredible job, very uncomfortable to change it to an undefined program
·        Motion passed in opposition to the recommendation because they need more information to consider it
 
Recommendations on Issue 10: Poor Management Threatens the Office of Inspector General’s Effective Execution of Its Fraud, Waste, and Abuse Mission.
·        Motion passed to take no position
 
Recommendations on Issue 11: Credible Allegation of Fraud Payment Hold Hearings Do Not Achieve the Law’s Intent to Act Quickly to Protect the State Against Significant Cases of Fraud.
·        Motion passed to take no position
 
Recommendations on Issue 12: HHSC’s Uncoordinated Approach to Websites, Hotlines, and Complaints Reduces Effectiveness of the System’s Interactions With the Public.
·        Motion passed to take no position
 
Recommendations on Issue 13: HHSC’s Advisory Committees, Including the Interagency Task Force for Children With Special Needs, Could be Combined and Better Managed Free of Statutory Restrictions.
·        Motion passed to take no position
 
Recommendations on Issue 14: HHSC Statutes Do Not Reflect Standard Elements of Sunset Reviews.
·        Motion passed to take no position