Executive Order Broadens and Refines Scope of Previously Created Office of Health and Human Services

Governor Donald L. Carcieri today issued an Executive Order creating the Executive Office of Health and Human Services (EOHHS), effectively broadening and clarifying the role of the former Office of Health and Human Services (OHHS), created by Executive Order in March 2004. Jane A. Hayward, who served as Managing Director of the OHHS, has been named Secretary of the new office.

The new office will enable the state to access and spend federal health and human service dollars, including funding provided through Medicaid, more effectively, while responding quickly to any policy or spending changes enacted by Congress. The office will also help fulfill the mission of the Governor’s Fiscal Fitness program to help reduce or eliminate administrative overlap and duplication among government-funded health and human service programs, while improving how those programs deliver services to Rhode Island consumers.

The OHHS was originally created as on offshoot of the Governor’s Fiscal Fitness Initiative to coordinate the delivery and funding of health and human service programs serving over 248,000 individuals at a cost of over $2.7 billion per year and administered by five existing state departments (the Departments of Health; Human Services; Children, Youth and Families; Elderly Affairs; and, Mental Health, Retardation and Hospitals).

Over the past 18 months, the OHHS has worked to formalize inter-departmental collaboration and has taken steps to improve efficiency as well as the quality of health and human services policy and planning, budgeting and administration with the overall goal of improving service delivery. The OHHS has also played a key role in conducting independent evaluations of critical health and social services issues (such as its review of the Department of Health’s regulation of Hillside Health Center) and is assisting the departments in developing strategies to address consumer and community concerns.

According to the Governor, recent and expected changes in federal policy, particularly with respect to Medicaid, as well as in state programs that affect the financing, organization and delivery of state programs pose new challenges and present opportunities that further increase the need for enhanced interdepartmental coordination.

“While continuing to build on the achievements that have already been made and to perform independent evaluations, the role of the OHHS must be redefined and the scope of its management, supervisory and oversight responsibilities must be clarified,” Governor Carcieri said. “In its relatively short existence, the OHHS has played an instrumental role in state government. By removing the silos separating state agencies and forging new relationships and partnerships between agencies, the OHHS has already made great strides.”

“The OHHS, and now the EOHHS, is in a unique position of viewing health and social services from a more global perspective, more easily identifying areas of duplication, overlap and opportunity,” said the Governor, adding, “I look forward, with its new expanded duties, to even more successful outcomes in the future.”

The new Executive Office of Health and Human Services (EOHHS) will continue working toward the original goals of the OHHS. As the successor of the OHHS, the EOHHS will also coordinate the administration and financing of health care benefits, services and programs including those authorized by the Medicaid State Plan under Title XIX of the United States Social Security Act. This would include:

Serving as the Governor’s chief advisor and liaison to federal policymakers on Medicaid issues and serving as the principal point of contact in the State on all related matters. Reviewing any new Departmental waiver requests and renewals as well as any initiatives and/or proposals requiring Medicaid State Plan amendments that may have an impact on Medicaid state-funded health care programs. The EOHHS will consider all requests from the legal and financial perspective and will also determine if they are consistent with overall state policy and budget priorities and if they are achievable in terms of consumer outcomes and federal approvals. Preparing an annual comprehensive overview of all Medicaid expenditures for the Governor. Currently, a number of departments have portions of Medicaid funding and spending under their agency’s authority and budgets, making it difficult to see the entire Medicaid spending picture in the state.

The EOHHS will also establish an independent advisory committee (EOHHS Advisory Committee), which will assist the Secretary in identifying issues of concern and priorities in the health and social services arena. The Advisory Committee will be composed of representatives of the network of health and human service providers, the communities the departments serve, state and local policymakers and other key stakeholders and consumers.

According to the Governor, the new office will not interfere with, or assume the responsibilities or daily functions of the state’s five existing departments, or affect the authority of their directors. Those agencies will retain their statutory authority and will continue as separate and distinct divisions of state government.

“When I was elected, I promised to make state government operate more efficiently and effectively,” Governor Carcieri said. “That means providing better services to Rhode Island consumers at a better cost to Rhode Island taxpayers. This new Executive Office of Health and Human Services is a major component of that effort. My Fiscal Fitness Program demonstrated that this new office has the potential to save Rhode Island taxpayers tens of millions of dollars while improving the way we deliver services to our citizens.”

“At the end of the day, we cannot forget that our primary goal is to change the way that we do business so that we can focus our efforts more directly on the important business we do,” Carcieri concluded. “Ultimately, these reforms are not just about savings, but about our ability to continue to support the needs of Rhode Island’s most vulnerable citizens.”

“This is a wonderful opportunity to improve the way we deliver services to the most vulnerable citizens of our state,” Jane Hayward said. “This new office will also help the state to more effectively access and spend federal money, while enabling us to continue our efforts to eliminate unnecessary duplication among the five departments responsible for operating the state’s health and human service programs.”

Among the original functions of the OHHS was to make recommendations for the establishment of a permanent, statutory Secretariat of Health and Human Services. Based on those recommendations, the Governor submitted legislation to the General Assembly in February 2005 to establish a permanent Health and Human Services Secretariat in Rhode Island law. The General Assembly declined to approve that legislation. The new EOHHS will consider submitting similar legislation for the 2006 session.

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