The advisory council working on the merger of the Departments of Human Services and Behavioral and Developmental Services is nearing the end of its work. Accounting consultants are going over the departments’ books now, looking for further signs of trouble. The court has given Maine – meaning DHS-BDS – six months to comply with a consent decree for community-based mental health. The governor’s office has handed more of DHS’ Medicaid responsibilities to its health-care expert. The legislative chairmen of the Health and Human Services Committee are demanding more oversight of the agencies, and Speaker of the House Pat Colwell says he is already hearing about tough turf fights brought on by the merger.
If ever a large, complex and crucial process needed a single person to oversee the many difficulties certain to arise in the next couple of months, it is this merger. The governor should take the advice of lawmakers, including the speaker, who would like him to nominate a provisional commissioner for what will be the merged agency. That person would have leverage because he or she would have the authority to make decisions and would be able to begin immediately to steer the new agency rather than let it form based on the good but uncoordinated work of several groups.
The governor’s office is understandably cautious about assuming the Legislature would approve what his advisory council presents as a merger plan. It is clear, however, that there is not only bipartisan support for a merger of these two agencies, but eagerness to see it done swiftly. Gov. Baldacci earlier this year announced the idea of a merger to reduce administrative costs, improve fiscal accountability, expand the delivery of services and leverage more money from other funding sources. The Legislature already supports this, and will have a chance to affect what the merger looks like when its session starts in January.
The governor’s advisory council, headed by former Labor Commissioner Valerie Landry, is examining a half dozen issues as it completes its report. Among its concerns are how to bring together currently disparate services in finance and administration and licensing and regulation, its acknowledgement that both internal and external communication at the agencies are a mess and the need for strategic planning based on clear data and the advice of those most affected by the system. One crucial way to address these concerns, according to the council, is to find leadership to put strong measures of accountability into effect.
This is more easily described than carried out, but the council is correct, and the sooner that sort of leadership is found the better. The council hasn’t the authority to do it. Trish Riley, director of the governor’s Office of Health Policy and Finance, can oversee Medicaid but can’t make sweeping reforms. Acting commissioners at the departments are called “acting” for good reason. The governor is said to be fairly well along with his interviews of prospective candidates for a new commissioner, but he should make nominating one soon a priority.
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