Article by Erik Smith. Published on Friday, October 09, 2010 EST.
Bringing DSHS Under Control – The Taming of the Washington State Shrew
By William W. Larson
Special to Washington State Wire
OLYMPIA, Oct. 8.–Editor’s note: William Larson is a former social worker at the Department of Social and Health Services. In this op-ed piece, he addresses the agency’s plan to implement across-the-board cuts ordered by the governor.
So the other day I was driving along, listening to the noon news, when suddenly I was captivated by a story about the imminent budget cuts for DSHS.
Like every agency in state government, DSHS has been ordered by the governor to cut its budget about 6 percent – which actually translates into a cut of about 10 percent since the order was made 3 months into the current fiscal year. For DSHS these cuts total $281 million.
To be sure, budget cuts were inevitable and future cuts are very likely, given the projected $4.5 billion dollar shortfall looming on the horizon for the next fiscal year. The problem is that with agencies like DSHS, budget cuts should come only after the agency itself has eliminated the fat and the waste from its operation. Cutting programs to the needy before transforming the administering agency into a flatter, more streamlined entity that is fiscally responsible is unthinkable, and should prompt immediate Legislative intervention.
But the announcement was clear: The planned program cuts were aimed at services to the poor and their children, those in nursing facilities, and the mentally ill. And no legislative intervention was in the offing.
In a recent statement, state Rep. Brendan Williams, D-Olympia, said: “A just society does not make the current-biennium cuts announced by the Department of Social and Health Services. A relevant Legislature would intervene.”
And just what could a “relevant” Legislature have done? It could have insisted that before cutting funding to any program, especially those providing vital services to the poorest and most vulnerable citizens of Washington, DSHS must first cut the waste and fat that is so prevalent within the agency itself. Then, once its own house was in order, and assuming that there remains a further need to cut, the Legislature could direct DSHS to cut some funding to a number of the programs it administers, so that no particular population would have to bear the entire burden.
The Ugly Truth
By refusing to deal with the fat and waste within DSHS, the poorest and most vulnerable citizens of our state will be required to absorb a huge portion of the $281 million in cuts through the loss of vital services.
Reductions in Medicaid will amount to $113 million and will mean the end of subsidized health insurance coverage for more than 27,000 kids, as well as the end of outpatient pharmacy benefits for thousands of Medicaid patients. Services for Medicaid patients in need of dental, hearing, vision, and even hospice care will also come to an end.
DSHS also plans to eliminate 30 beds at Western State Hospital and will significantly reduce services to the mentally ill. Payments in support of nursing home patients will also be cut.
Like it or not, the reality is that Medicaid is a safety net for the poor and vulnerable. The increased number of people begging on our street corners together with considerably more mentally ill folks walking the streets will be a constant reminder that their safety net no longer exists. And this in the 8th highest- taxed state in the union.
DSHS also plans to eliminate 380 jobs. Most – if not all – will be frontline worker positions, instead of the much more costly middle manager and bean counter jobs that are replete within the agency.
In addition, it will require all employees to take one unpaid furlough day per month through June. But watch out. This agency has a long history of passive-aggressive response to government mandates.
Remember how it complied with the last cut ordered by the governor? It furloughed employees to comply with the cut, and then paid employees overtime to make up the difference. I guess you’d call that compliant non-compliance.
Where’s Our Legislature?
One cannot help but wonder why our Legislature continues to postpone dealing with this out-of-control superagency. For years DSHS has blatantly refused to comply with directives from those elected to monitor and supervise its activities.
Time and again it has been exposed as an agency so fraught with internal politics, management silos and fiefdoms that its goals have become skewed in ways that are inconsistent with the public interest.
Over and over again, the department’s lack of transparency, fiscal restraint and accountability has caused outrage among constituents and political overseers alike.
Yet for some mysterious reason our Legislature continues to procrastinate, hesitating to take the steps necessary to do what is necessary to tame the shrew and bring DSHS under control.
State Rep. Williams makes a good point: “A relevant Legislature would intervene.” But where is our Legislature during this time of crisis?
The disturbing fact is that the last several sessions of our Legislature closed with the DSHS problem unresolved. And now with record deficits and ominous forecasts of future shortfalls lawmakers are dumping the problem on the governor, instead of doing their elected duty by attacking it themselves.
The people of Washington deserve a Legislature that will take on the tough issues of the day. With a $4.5 billion dollar shortfall on the horizon, it’s high time that the Legislature plugs some of the leaks in our sinking ship of state. A good place to start is with DSHS.
And, by the way, it’s a slap in the face for every Washingtonian when Legislative leaders refuse to come back together for a special – and emergent – session just because it could cause some political fallout. Legislators are elected to represent the people of Washington, not to place their political ambitions ahead of that public trust.
How to Fix the Problem with DSHS
Forget about attempting to remold the existing structure. Putting lipstick on a pig doesn’t change anything it just makes the pig more laughable.
Forget about outsourcing more of its workload. It already outsources more than 70 percent of its work, yet requires a third of the state’s budget to operate.
Forget about privatizing Children’s Administration. That’s a nightmare that will add even more cost, more bureaucracy and more waste to an agency that is already bleeding money.
Instead, we ought to break DSHS down into logical units (Aging and Disability Services, Alcohol and Substance Abuse, Child Protective and Child Welfare Services, Adult Protective Services, Juvenile Rehabilitation Services, etc.) Then we ought to flatten and streamline the operational structure of each unit, so that there are fewer levels of intervening managers between the employee and the decision-making authority.
Supervision by several layers of management is costly, inefficient, and wasteful. Some parts of DSHS separate line workers from the key decision maker by more than 6 intervening managers. That’s unnecessarily expensive and simply unacceptable.
A flatter and more streamlined organizational structure will also encourage employees to give feedback directly to decision makers. It’s true that if you really want to know what’s wrong with any of our state agencies just ask the folks on the frontlines. They know what’s wrong, and they’ll be happy to tell you how it can be fixed.
Relying on headquarter managers who haven’t been in the field for decades and don’t really understand the issues is how organizations lose their course and eventually become out-of-sync with constituents.
To their credit, senators Joseph Zarelli, R-Ridgefield and Margarita Prentice, D-Seattle recently asked 50,000 state employees for budget-cutting ideas that would help resolve the projected $4.5 billion dollar shortfall. Within 24 hours they had over 3,000 responses. And as of October 1 more than 6,400 suggestions had been received. They asked the right people.
That’s what can happen when the playing field is leveled, and the people on the front lines are invited to give direct input to decision makers. Not only is the input more accurate – since it hasn’t been passed through multiple managers – but just being asked to provide input on important issues makes frontline employees feel valued, something that rarely happens within existing operating structures.
Senators Zarelli and Prentice have given us a glimpse of how much more productive and transparent agencies would be if flatter, more streamlined, operating structures were devised.
It Will Take Work
Understand that I don’t mean to oversimplify the task of bringing DSHS under control. It will take lots of work, and real dedication to purpose.
Fiefdoms, management silos and nepotism will have to go.
Middle managers and bean counters will have to find another easy way to make a buck.
Budgets will have to be followed religiously, and programs will have to become transparent both to the taxpayer and to those elected to represent them.
Front-line employees will become vitally involved in a decentralized decision-making process and will have direct access to senior managers.
Responses to consumer needs will be more prompt and service problems will be easier to resolve.
And when all is said and done, the state of Washington will have eliminated an agency replete with waste and inefficiency, and will have replaced it with smaller, more manageable agencies with operating systems that will better serve the needs of the people of Washington – streamlined systems that are efficient, accountable, economical and manageable.
What a welcome change that would be.
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