September 11, 2006

Dear Fellow Nebraskans:

Not long ago, I outlined a plan designed to restructure the management of Nebraska’s Health and Human Services System (HHSS) in an effort to bring greater clarity, transparency and comprehension to the state’s largest agency.

The goal of the proposal is to refine, not reinvent, Nebraska’s Health and Human Services System, and a top priority in developing this plan was to create an agency that accurately reflects the core missions of HHSS.

The proposal would reform the system, which currently operates as three distinct agencies, to a structure where HHSS becomes one agency. The single agency structure would consist of six departments, including the Departments of Public Health, Medicaid, Children and Family Services, Behavioral Health, Developmental Disabilities, and Veterans’ Homes. While these departments might not identify every important task within the system, they offer a much clearer indication of the true scope and responsibilities of this agency.

This plan builds on a reorganization that began in 1994 and combined what had once been five separate agencies into three, uniting them under the umbrella of the Health and Human Services System. I believe we have an opportunity to take what we’ve learned since then and find a more effective way to structure HHSS that creates better accountability to those it serves.

The problem we’ve faced is in helping Nebraskans understand what HHSS does and who to contact for an answer to their questions. The agency charged with providing services to our residents should not be a complex maze of names and missions. Rather, it should be organized in a clear, logical and accessible manner.

A key part of the restructuring proposal involves the creation of a separate Department of Children and Family Services. The new department would put an increased focus on efforts to meet the needs of children and vulnerable adults by maintaining strong ties between functions such as protection and safety and economic assistance. Front-line workers throughout the state would continue delivery of services as part of this department.

The current Department of HHS Services is responsible for the delivery of care to citizens ranging from foster children to the consumers of behavioral health care services, management of juvenile and sex offenders, providing support for families receiving economic support, overseeing services for children and adults with developmental disabilities, and managing Nebraska’s veterans’ homes. The new management structure would highlight many of these functions.

This department is critical to fulfilling the core mission of providing support for people in need. If the safety and well-being of Nebraska’s children and their families are going to continue to be a top priority, then we need to ensure that our staff, from front-line workers all the way up the chain of command, has the time to devote to that mission.

By removing some of the current functions of the services agency and elevating them to stand on their own as individual departments, we hope to increase the focus on services provided to children and their families.

This proposal will be discussed at an upcoming hearing of the Legislature’s Health and Human Services Committee, and I look forward to continued discussion as we move forward during the next legislative session.

What Nebraska needs is for this agency to have a leadership structure that enables success and encourages accountability. One of the strongest outcomes of the reorganization that began more than a decade ago has been the increased collaboration and coordination that now takes place between the various programs and departments of the HHS System.

I want to continue building on that relationship. I hope that by taking the next step in improving the services provided to Nebraskans and their families we will be able to meet that goal.