DELAWARE STATE SENATE

150th GENERAL ASSEMBLY

SENATE CONCURRENT RESOLUTION NO. 65

PROVIDING FOR A STRATEGIC REVIEW OF THE DEPARTMENT OF HEALTH AND SOCIAL SERVICES AND PRESENTATION OF RECOMMENDATIONS REGARDING A COMPREHENSIVE RESTRUCTURING THEREOF TO THE JOINT FINANCE COMMITTEE.

WHEREAS, the Department of Health and Social Services (“Department”) was established by legislative enactment in 1970 and operates under the mandate to supervise “all matters relating to the preservation of the life and health of the people of the State”; and

WHEREAS, in order to achieve its stated purpose, the Department has necessarily evolved to provide a broad array of services to individuals in the State of Delaware, including and especially Delaware’s most vulnerable citizens, by providing services such as the provision of health care coverage for low income families through Medicaid, the administration of the Delaware Healthy Children programs, and support services for the elderly and people living with visual impairment or other disabilities; and

WHEREAS, the Department was designed to advance policy initiatives such as the expansion of public health programs to foster and maintain physical health, as well as to provide resources for those afflicted with opioid and other substance abuse and dependency; and

WHEREAS, the Department has the dual responsibilities to promote its policy objectives for the benefit of public health and well-being, and to provide individualized care to Delawareans for whom the Department’s services are critical for their health and safety; and

WHEREAS, the Department now commands a budget requiring approximately $1.2 billion in appropriations and its personnel and staff constitute one quarter of all state employees, not including those positions dedicated to Education; and

WHEREAS, the population of Delaware has increased by 76% since 1970 from 548,104 to almost 1 million people; and

WHEREAS, the health care sector has begun to put greater emphasis on meeting the social services needs of vulnerable populations as a way to address their physical health goals; and

WHEREAS, the Department has not undergone a significant comprehensive organizational review since its inception, excepting the creation of the Department of Correction in 1975 and in 1983, when portions of the Department were restructured to create the Department of Services for Children, Youth and their Families; and

WHEREAS, the services currently provided by the Department are diverse and critical to maintaining the health and well-being of individual citizens by the provision of direct services, and there is an increasing demand for the Department to undertake initiatives aimed at promoting public health, such as providing health care coverage while also regulating the Delaware health insurance market and providing services to specific at-risk populations while providing broad prevention-based initiatives for the population as a whole; and

WHEREAS, it is in the best interest of the State to undertake a comprehensive review of the Department to determine how best to reorganize the Department to ensure that services are provided effectively, efficiently, and with the greatest value to the citizens of this State; and

WHEREAS, the General Assembly recognizes that strategic planning and potential reorganization will reaffirm and recommit the Department to its original stated purpose, while ensuring that it remains effective without undue waste and the costs associated with a lack of efficiency; and

WHEREAS, any reorganization process should provide ample opportunity for, and encourage, input by service providers, clients, advocates, and the general public.

NOW, THEREFORE:

BE IT RESOLVED by the Senate of the 150 ^th General Assembly, the House of Representatives concurring therein, that there is hereby established a committee for the comprehensive review of the Department of Health and Social Services, which shall be known as the DHSS Reorganization Committee (“the Committee”). In undertaking this strategic planning process, the Committee shall be guided by the following principles:

(1) Services provided to Delawareans must be of the highest quality.

(2) Delawareans must be able to access these services with a minimum of impediments.

(3) Service efficiencies should be maximized through eliminating duplications and promoting coordination with other state agencies, contractual service partners, and other units of government.

(4) Potential operational impacts from adopting any recommendation, including impacts to personnel, information systems, customer service, federal funding, legal considerations, implementation timelines, and budget, should be thoroughly considered.

BE IT FURTHER RESOLVED that the development of implementation of the strategic planning process shall be supported by the Committee. The Committee shall be composed of the following members serving by virtue of position, or a designee appointed by the member:

(1) A Senator from the majority caucus, appointed by the President Pro Tempore, who shall serve as Chair.

(2) A designee of the Governor who shall serve as Co-Chair.

(3) The Secretary of the Department of Health and Social Services.

(4) The Secretary of the Department of Human Resources.

(5) A Senator from the minority caucus, appointed by the President Pro Tempore of the Senate.

(6) A Representative from the majority caucus, appointed by the Speaker of the House of Representatives.

(7) A Representative from the minority caucus, appointed by the Speaker of the House of Representatives.

(8) The Director of the Office of Management and Budget.

(9) The Controller General.

(10) A designee of the State Council for Persons with Disabilities (SCPD).

(11) A designee of the Delaware Healthcare Association.

(12) A designee of Delaware Alliance for Non-profit Advancement.

(13) A designee of the Behavioral Health Consortium, who shall be appointed by the Chair.

(14) One member of the public who has expertise in the delivery of health and social services to vulnerable populations, appointed by the President Pro Tempore of the Senate.

(15) One member of the public who has expertise in the delivery of health and social services to vulnerable populations, appointed by the Speaker of the House of Representatives.

(16) Two members of the public who have expertise in the delivery of health and social services to vulnerable populations, appointed by the Governor.

BE IT FURTHER RESOLVED that, i n fulfilling the responsibilities under this legislation, the Committee shall:

(1) Meet no less than quarterly;

(2) Review the Department’s progress in developing the strategic plan;

(3) Advise and make recommendations to the Secretary of the Department on the development and implementation of the Department’s strategic plan.

(4) Ensure that public input received is considered as part of the strategic planning process.

BE IT FURTHER RESOLVED that, in fulfilling the responsibilities under this legislation, the Committee shall provide for an open and transparent process whereby members of the public and stakeholder groups are encouraged to provide comment. The Committee is encouraged to utilize various methods to garner public input including survey instruments and focus groups. The Committee shall also provide for input to be submitted electronically, either through website or email.

BE IT FURTHER RESOLVED that the Committee shall report to the Joint Finance Committee as follows:

By March 31, 2020, the Committee will report on progress in developing the strategic plan, including efforts to engage the public, key findings, vision, and initial strategic objectives and recommendations in support of the vision. Said plan shall consider at a minimum: impacts to personnel, information systems, service to consumers, federal funding, as well as a potential timeline, necessary changes to the Delaware Code, change management requirements, and projected costs to implement. The strategic plan shall also include metrics to measure progress in achieving the strategic objectives identified throughout the planning process.

BE IT FURTHER RESOLVED that it is the intent of the General Assembly that the information resulting from the strategic planning process, including any organizational restructuring, be given due consideration by the Joint Finance Committee for inclusion in future fiscal years.

BE IT FURTHER RESOLVED that the 150 ^th General Assembly supports this initiative in order to ensure that high quality, efficient, and effective services continue to be available to the citizens of Delaware.

SYNOPSIS

The Department of Health and Human Services (“DHSS”) was established in 1970 by legislative enactment with a broad and crucial mandate: to supervise the health, well being, and life of Delaware citizens. In the decades since, the population of Delaware has increased, and the needs of Delaware citizens have required increasingly complex and costly medical interventions; particularly for those most vulnerable among us, such as the elderly and those suffering from addiction. To serve this broad array of individual needs, DHSS has adapted to provide personalized and individualized services to citizens at a level of direct care. Additionally, the broad language of DHSS’ authorizing statute has required it to maintain focus on other policy initiatives, such as promoting public health and administering healthcare through Medicaid while maintaining compliance with state and Federal laws and regulations, which themselves have grown in complexity. Given the advancements in both individualized care and the policy landscape, this Resolution creates a committee designed to investigate whether to reorganize or restructure the Department as a means to reaffirm its original purpose. Its goal is to ensure that Delawareans receive high-quality care on an individualized basis, and will recommit the Department to its important policy objectives, such as maximizing efficiency and reducing cost.

Author: Senator Poore