Kaine seeks advice on reforming health services

BY OLYMPIA MEOLA
Media General News Service
Published: May 16, 2008

The Kaine administration is hiring a private consultant for advice on carrying out pricey reforms of mental health and child-welfare services approved in this year’s legislative session.

The consultant, to be hired by Marilyn B. Tavenner, secretary of Health and Human Resources, would have 90 days to study operations at the Departments of Health, Mental Health and Social Services — the agencies most affected by legislation this past session or identified by Tavenner as having the greatest potential for modernization.

“This is not a staffing reduction,” Tavenner said. “It’s going to be figuring out how to do more with existing staff.”

The extensive organizations deliver public-health and child-welfare services at local levels across the state.

The mental-health department is at the center of changes spurred by the April 2007 slayings at Virginia Tech. The broad reforms effectively revamp how the state identifies, monitors, treats and adjudicates the mentally ill.

Plans are in a hushed preliminary phase and until recently were known only to members of Tavenner’s top staff. She hopes to select a consultant in June to work over the summer. The cost to the state is unknown until the scope is set, she said.

With increased funding to community service boards will come more accountability and monitoring to ensure that people are following new processes, Tavenner said.

“We’re hustling,” Tavenner said in an interview. “If we don’t get it done in 90 days, we’ll get behind on financial changes, support for mental-health patients — I mean, the law basically changes July 1.”

Beyond the legislative and budgetary changes, Tavenner wants the consultant to look at how other states have found successes in areas such as foster care, and to review programs that may no longer be needed or could be delivered differently.

Emergency preparedness programs, for example, didn’t exist as they do post-Sept. 11. Such programs, plus stronger communication efforts, should be integrated to the core of the Department of Health, said Karen Remley, state health commissioner.

Remley, a former vice president of medical affairs at Sentara Leigh Hospital in Norfolk, assumed her health commissioner role in January and has started examining her department for improvements. Tavenner, a former nurse, rose to become a top executive of hospital giant HCA Inc. before joining Kaine’s Cabinet in 2006.

With 18 months left in Kaine’s term, “we want to take a fresh look at how we’re organized,” Tavenner said. “Our roles are changing as time changes. We just think it’s a good time to take a look.”

The examination started last fall with a study by McKinsey & Company, a national consulting firm that looked at potential economies in Medicaid, the Department of Health and state employee health insurance and benefits. From there, Tavenner decided to take a closer look at making operational improvements within the health department.

That $1 million study, funded through the public-private Virginia Health Care Foundation, was considered an “internal working document,” the full text of which was never released to the public.

Olympia Meola is a staff writer for the Richmond Times-Dispatch.