Legislature(2021 - 2022)ADAMS 519
02/25/2022 01:30 PM House FINANCE
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| Audio | Topic |
|---|---|
| Start | |
| Presentation: Executive Order 121: Department of Health and Social Services Reorganization | |
| Adjourn |
* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
+ teleconferenced
= bill was previously heard/scheduled
| + | TELECONFERENCED | ||
| + | TELECONFERENCED |
HOUSE FINANCE COMMITTEE
February 25, 2022
1:35 p.m.
1:35:23 PM
CALL TO ORDER
Co-Chair Merrick called the House Finance Committee meeting
to order at 1:35 p.m.
MEMBERS PRESENT
Representative Neal Foster, Co-Chair
Representative Kelly Merrick, Co-Chair
Representative Dan Ortiz, Vice-Chair
Representative Bryce Edgmon
Representative DeLena Johnson
Representative Andy Josephson
Representative Bart LeBon
Representative Steve Thompson
MEMBERS ABSENT
Representative Ben Carpenter
Representative Sara Rasmussen
Representative Adam Wool
ALSO PRESENT
Adam Crum, Commissioner, Department of Health and Social
Services; Sylvan Robb, Assistant Commissioner, Department
of Health and Social Services.
PRESENT VIA TELECONFERENCE
Stacie Kraly, Director, Civil Division, Department of Law.
SUMMARY
PRESENTATION: EXECUTIVE ORDER 121: DEPARTMENT OF HEALTH
AND SOCIAL SERVICES REORGANIZATION
Co-Chair Merrick reviewed the agenda for the meeting and
invited testifiers to the table.
^PRESENTATION: EXECUTIVE ORDER 121: DEPARTMENT OF HEALTH
AND SOCIAL SERVICES REORGANIZATION
1:36:14 PM
ADAM CRUM, COMMISSIONER, DEPARTMENT OF HEALTH AND SOCIAL
SERVICES (DHSS), thanked the committee for the hearing. He
indicated that in addition to the presentation, there were
other handouts in members' handouts.
Commissioner Crum introduced the PowerPoint Presentation:
"Executive Order 121: DHSS Reorganization (copy on file).
He discussed slide 3: "DHSS Today:
? FY2022 Management Plan Budget: $3,441,891.3*
Positions (PFT): 3,259
? Programs/Services
.notdef Over 100 programs that serve Alaskans directly
? Major Categories of Services
.notdef Regulatory/Claims Processing/Eligibility for
Services
.notdef Public Health Services
.notdef Protecting Vulnerable Alaskans, Children,
Families (Service/Provider/Provider
Based)
* Does not include COVID funds
Commissioner Crum slide 4: "DHSS is much larger than most
State Departments." He stressed that there were multiple
divisions in DHSS that had more employees that some other
departments.
Commissioner Crum slide 5: "DHSS budget is more than 12
state agencies combined. He stated that the DHSS budget
was nearly 33 percent of the states entire budget.
Commissioner Crum moved to the department's organizational
chart on slide 6. He posed the question of what could be
done deliver better services to the state, and reduce the
span of control.
1:40:01 PM
Commissioner Crum reviewed the EO vision on slide 7:
Executive Order Vision
The Reorganization of DHSS
Goal: Provide proactive, efficient leadership and
management of programs to
achieve better outcomes for Alaskans
Align Current Functions and Programs
1. Direct Care and Services to Alaskans in State
Administered Programs
2. Eligibility for Alaskans and Payment to
Providers
Focus Management to Improve Outcomes
1. Innovation
2. Work Processes
Commissioner Crum discussed the reorganization for DHSS on
slide 8. He shared that the public facing positions would
be placed into new department.
Commissioner Crum continued to slide 9 to review the
Department of Family and Community Services.
Representative Thompson asked if there were organizational
charts to show what the number of personnel would be
impacted by this adjustment.
Commissioner Crum pointed to the number of position control
numbers.
1:44:34 PM
SYLVAN ROBB, ASSISTANT COMMISSIONER, DEPARTMENT OF HEALTH
AND SOCIAL SERVICES, stated that the number should be 1847
positions.
Commissioner Crum could provide further information of the
current sizes of each division.
Co-Chair Merrick asked how the transition were to be
affected if there was a new administration in place in the
following year.
Commissioner Crum replied that the idea to split the
department was suggested by senior employees. He noted that
very early on in his term, a retired commissioner from
another state who advised him to never criticize a
predecessor.
Co-Chair Merrick asked if the commissioner thought the
transition could be completed before the election in
November.
Commissioner Crum responded in the affirmative. He
indicated a significant amount of work had already been
completed.
Co-Chair Merrick asked if he had anyone in mind for the new
commissioner's position.
Commissioner Crum would put his name forward for the
Department of Health.
Co-Chair Merrick appreciated it was on the commissioner's
radar.
1:49:17 PM
Vice-Chair Ortiz queried the impact on the public.
Commissioner Crum replied that there would be an ongoing
affect, but would be better than the institutional inertia.
Vice-Chair Ortiz understood that it would not happen
instantaneously, but the intention was to better provide
services to the stakeholders.
Commissioner Crum responded, "Yes, Sir."
Representative Thompson asked if additional offices would
be needed.
Commissioner Crum responded in the negative because
existing offices would remain for the individual
departments.
Representative Edgmon thought that in theory it was a good
idea. He noted there was no way he could decide on the
issue because of the size of the policy call being
complicated, and price tag on the change was about $2
million. He thought the price tag was large. Intuitively it
made sense to take a large department and split it in two,
but wondered if the department had thought about having two
commissioners rather than splitting the department.
Commissioner Crum responded that the number was closer to
$2.4 million, and felt that the investment was worth the
cost. He noted that the focus was resolving the high
vacancy and turnover rate in the Office of Childrens
Services (OCS).
1:55:59 PM
Representative Edgmon was a half hour into the meeting and
tribal compacting had not been mentioned in the discussion.
Alaska Native communities had higher rate of cases within
OCS. He thought of the importance of fundamental changes -
paradigm shifts were needed beyond merely restructuring the
department.
Commissioner Crum agreed that compacting was a way to
address child welfare issues in rural Alaska. He remarked
that there was a slide that would address tribal
engagement, and remarked that there would be an
administrative order to certify that there is a tribal
liaison in every division.
Representative Edgmon asked if the administration and the
department were prepared to have government-to-government
relationships with the tribes in the state.
Commissioner Crum relayed that he already had the
relationship.
Representative Edgmon stressed that government-to-
government relationships were essential in resolving the
child welfare issues.
Co-Chair Merrick asked if returning to a defined benefit
program would help with retention in the Office of
Children's Services.
Commissioner Crum indicated that the people who have left
the office were put through an exit interview process, and
stated that returning to a defined benefit program would
help with retention, but it was not one of the primary
identified concerns. He agreed to provide more information
about retention, specifically related to bonuses,
supervisory support, and other aspects.
2:01:41 PM
Representative Johnson asked how the idea of splitting the
department came about.
Commissioner Crum replied that after his first session he
had asked the directors to write down their ideas of how to
improve the department including recommended structural
changes. The largest and most consistent feedback he
received was to split the rest of the department from
Medicare.
2:04:08 PM
Vice-Chair Ortiz returned to the issues of government-to-
government relations. He asked about the tribal liaison
position, and wondered whether the position was in the
current governors budget.
Commissioner Crum replied that the non-inclusion of the
position was to have present the EO in the most fiscally
responsible way possible. He stated that there was a
continued conversation about who would be the tribal
liaison, about whether it would be a new position or a
responsibility for an existing employee.
Vice-Chair Ortiz wondered whether Commissioner Crum had
previously indicated that there was a tribal liaison
position, but there was not in fact a tribal liaison
position.
Commissioner Crum responded that it would be considered a
role rather than a position.
Commissioner Crum advanced to slide 10 to review the new
Department of Health.
2:06:30 PM
Representative LeBon asked if the PCN changed with the
slide.
Commissioner Crum turned to slide 11, Improved Services
for Alaskans:
? Service navigation will be easier for the public
with two
smaller departments
? Innovation will become more seamless as two
departments
will be better able to pursue initiatives and
efficiencies to serve Alaskans
? Smaller bureaucracy for the public to navigate
? Easier for the legislature to oversee
? Successful department reorganizations have happened
in the past
? DHSS is always changing to better serve the public
Co-Chair Merrick complemented the commissioner and the
department for the work that they had done.
Representative Johnson concurred with the co-chair's
comments.
2:10:02 PM
Commissioner Crum advanced to slide 12, Improved
Stakeholder Results:
? More regular checks in with stakeholder groups
? More interaction with federal partners to better
manage programs and seek flexibilities that benefit
Alaska
? Better ability to manage crises and focus effort on
long-range, strategic planning
Co-Chair Merrick asked if he had a list of stakeholders the
department had talked with.
Commissioner Crum indicated there was a list of
stakeholders in members' packets.
Commissioner Crum continued to the topic of an improved
employee experience on slide 13:
The problem: DHSS areas of concern are often large,
complex and difficult to solve
.notdef Inability to see change as a result of your work can
result in staff burnout
.notdef Not being able to interact with department
leadership can lead to programs not getting the
attention they deserve
.notdef Without the ability to focus on long-range planning,
issues with the most immediate deadlines get priority,
but are not necessarily the most important
Commissioner Crum turned to slide 14 to continue the
discussion of the improved employee experience:
The solution: Two smaller departments will allow for
an improved work environment
.notdef A greater ability to focus more comprehensively on
issues to affect change
.notdef Improved communication between staff and department
leadership
.notdef Each division's priorities and concerns can be
addressed more proactively
.notdef Divisions within DOH and DFCS will continue to work
closely together
Commissioner Crum moved to slide 15: "Why an Executive
Order:
Why an Executive Order?
Use of an EO is the proper Governor's authority for
administrative changes under Article III, Section 23
of the Alaska Constitution The governor may make
changes in the organization of the executive branch or
in the assignment of functions among its units which
he considers necessary for efficient administration.
2:15:02 PM
Commissioner Crum advanced to slide 16 to address the
question of why not legislation:
Why Not Legislation?
? This is not substantive law change
? More certainty on programs remaining unchanged
? Definitive timeline
? Executive Order is a more concise document
? Less disruptive
Commissioner Crum turned to slide 17: "Executive Orders:
Used over the years to realign state agencies to
better serve the public.
.notdef EO 108 moved the Alaska Pioneer Homes and regulation
of childcare facilities to DHSS (2003).
.notdef EO 55 created the Department of Corrections, moving
the duties from DHSS (1984).
.notdef EO has been used by many Governors Egan, Sheffield,
Murkowski, Walker, (etc.)
2:16:26 PM
Representative Edgmon brought up scale, scope, and size.
The EO being discussed was 100 pages compared to other
executive orders. He was concerned that the EO was a
separation of powers. He thought a bill should have been
introduced rather than an EO.
Commissioner Crum responded that the current EO had
statutes that pointed in the correct division. He deferred
to Ms. Kraly.
2:18:21 PM
STACIE KRALY, DIRECTOR, CIVIL DIVISION, DEPARTMENT OF LAW
(via teleconference), EO 108 was over 90 sections long and
over 40 pages in length. She indicated that much of the EO
was related to movement of boards and authority.
Representative Edgmon stated that there was one attorney on
the committee and it was not him. He noted listening to the
DHSS hearing on the previous Saturday. He argued that he
would not know the constitutionality but felt that there
needed to be a further examination of the EO.
Representative Johnson commented that the EO was so large,
because the department was large, which was the main reason
for the change.
Commissioner Crum discussed the timeline for the EO on
slide 18:
Timeline for the Executive Order
? Executive Order 121 was introduced the first day of
session January 18, 2022.
? The legislature has 60 days to come together in a
joint session to disapprove the reorganization.
? Upon approval, DHSS will continue to implementation
plans.
? Effective Date: July 1, 2022
Commissioner Crum reviewed the lessons learned from
stakeholder engagement on slide 19:
Stakeholder Engagement: Lessons Learned
? Meaningful engagement takes time: Leadership needs
to spend more time with both internal and external
stakeholders
? Tribal partners recommended Tribal liaison roles in
each Commissioner's office
? Stakeholders recommended transition liaison
positions in each commissioner's offices
? Q and A from stakeholders provided valuable input
which will be utilized in the implementation process
? Repeated engagement ensures better communication and
dispels misinformation
2:25:46 PM
Ms. Robb moved to slide 20 to discuss the small investment
to divide the department. The number of positions for the
Department of Family and Community Services. The budget for
the department was $3.1 million, and the total cost of the
EO was $2 million.
Representative Edgmon asked if there was a tribal liaison
in the Governor's office as well as two other tribal
liaisons - one in each of the health departments.
Commissioner Crum responded in the affirmative.
2:31:57 PM
Representative Edgmon felt that the effort to separate the
department into two separate pieces. However, he was
skeptical about the change. He was not convinced that two
tribal liaisons would be enough for the two new
departments.
Ms. Robb reviewed slide 21: "DFCS, Departmental Support
Services 7.5 New Positions -$1,195.0 total." She stated
that the positions would be in the Department of Health.
Representative Johnson talked to an OCS worker who
indicated the concern was being nimble with some of the
issues with receiving money and delivering money for the
children quickly.
Ms. Robb replied that OCS would remain unchanged, so there
should be no impact with the EO.
Ms. Robb continued to slide 22: "DFCS, Departmental Support
Services 9 Reclassified Positions --$397.9 total." The
total for the reclassified positions was just under
$400,000.
2:36:52 PM
Ms. Robb advanced to slide 23: "Department of Health,
Departmental Support Services 5.5 New Positions --$692.6
total." There were 5.5 position were being proposed to the
new department.
Ms. Robb turned to slide 24: "Department of Health,
Departmental Support Services 1 Reclassified Position --
$42.3 total." There was only one position that would be
reclassified in the new department.
Commissioner Crum continued to measures and metrics -
benchmarks for the Department of Health on slide 25:
? Make progress in meeting the goals for Healthy
Alaskans 2030
? Hire and retain a Finance Officer and full grants
and contracts team
? Issue RFP(s) and awards for new coordinated care
demonstration projects
? Successfully implement an online application for
Medicaid and other public assistance programs
? Improve processing rate for procurement and
contracts to under 90 days Department of Health
Commissioner Crum discussed the measures and metrics -
benchmarks for the Department of Family and Community
Services on slide 26:
? Consolidate licensing regulations for long-term care
facilities, group homes, and foster homes
? Reduce turnover of front-line OCS by 20 percent
within 12 months
? Achieve full census capability at API within 12
months
? Increase recruitment and retention of Juvenile
Justice Officers by 25 percent
? Improve processing rate for procurement and
contracts to under 90 days Department of Family and
Community Services
2:39:20 PM
Ms. Robb continued to slide 28 and the implementation
segment of the presentation. She reviewed the ongoing
stakeholder and staff engagement timeline. The department
had a very detailed plan including how to split the
department in IRIS.
Representative Edgmon returned to the previous review
hearing over the prior weekend, and the continued work on
the EO was only shared with a few legislators. He wanted to
know more about that issue.
Commissioner Crum recalled the Senate Finance Committee, in
2021, had requested that there be work with the department
in the interim, so therefore that work was done directly
with the Senate.
Representative Edgmon thought he heard that the Senate Co-
Chair was given a copy. However, the House Chair was not
provided a copy. He continued to argue that it was a large
proposition. He felt powerless. He was on a train going
100 miles per hour and he had no way of stopping it. He did
not know if the metrics would improve.
Commissioner Crum indicated the issue was addressed in the
meeting on the prior Saturday. He stated that the
department was committed to addressing implementation and
policy concerns, and statutory issues.
Co-Chair Merrick indicated the commissioner had contacted
her prior to the start of session.
Representative Edgmon noted he had not been contacted about
the EO.
2:47:06 PM
Ms. Robb addressed slide 29, a continuation of the timeline
of implementation.
Commissioner Crum turned to slide 30 which listed the
department's reorganization website. He concluded the
presentation.
Representative Edgmon commented that he sincerely hoped
that the metrics fared well into the future. He wished the
department the best. He wanted the change to work to better
serve families in need. He would be discussing it in the
future.
Co-Chair Merrick thanked the presenters and reviewed the
agenda for the following meeting at which time the
committee would hear HB 64 and HB 30. The amendment
deadline for both bills was Saturday, February 26, 2022 at
6:00 P.M.
ADJOURNMENT
2:52:18 PM
The meeting was adjourned at 2:52 p.m.
| Document Name | Date/Time | Subjects |
|---|---|---|
| E0121- Metrics and Measures .pdf |
HFIN 2/25/2022 1:30:00 PM |
|
| EO 121 DHSS EO Reorg Presentation for HFIN 2.25.22.pdf |
HFIN 2/25/2022 1:30:00 PM |
|
| EO 121 Law response to 2.14.22 Leg Legal Memo.pdf |
HFIN 2/25/2022 1:30:00 PM |
|
| EO 121 Sectional Analysis (2-9-22).pdf |
HFIN 2/25/2022 1:30:00 PM |
|
| EO 121- Summary of New and Reclassified Positions (2-18-22).pdf |
HFIN 2/25/2022 1:30:00 PM |
|
| EO 121 Transition Plan (2-6-22).pdf |
HFIN 2/25/2022 1:30:00 PM |
|
| EO 121 Packet 2.18.2022.pdf |
HFIN 2/25/2022 1:30:00 PM |
|
| EO 121 Public Testimony Rec'd by 22722.pdf |
HFIN 2/25/2022 1:30:00 PM |