DHHR Secretary Rocco Fucillo looks ahead, forward - Beckley, Bluefield & Lewisburg News, Weather, Sports

DHHR Secretary Rocco Fucillo looks ahead, forward

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CHARLESTON, WV -

West Virginia's Department of Health and Human Resources Cabinet Secretary Rocco Fucillo might not be the busiest public official in the state, but he's one of them.

Fucillo spoke with The State Journal this week to look back at the legislative session and also to look ahead at what's next for the department with roughly 6,000 employees and a $4.3 billion budget.

Legislative Process

Fucillo, who just finished his first legislative session as DHHR secretary, said as soon as he came in the door, he worked to be as cordial and collaborative as possible with legislative leaders.

Fucillo said one of Gov. Earl Ray Tomblin's initiatives from last year's session was heavier regulation of so-called pill mills. Rules to carry out those regulations were implemented during this year's session.

"That's going to be significant, and beneficial in so many regards," Fucillo said of those new rules. "It will get them off those addictions to those pain pills, and it's really an economic development issue.

"It creeps throughout society, and it will help in terms of the work force we have, to create a more able and ready work force."

Fucillo said he was pleased to see the Feed to Achieve Act stem from the Senate Select Committee on Children and Poverty.

"I think that's an excellent starting point to build a lot of the programs we want to work around," Fucillo said. "It also highlights the opportunity for a private-public partnership that sets up funding availability from private sources to be able to fund the program.

"We really understand that there are limited resources, and it has to be that we're all working collaboratively together – the private sector, foundations, government – we all have a role to play."

Fucillo said he's equally pleased with an issue that didn't become law.

"The courts have done a very fine job, Justice Robin Davis and Judge (Allen) Moats from Taylor County, of promoting initiatives to reduce truancy," Fucillo said. "There was proposed legislation during the session to expand the definition of child abuse and neglect to include children who have heavy absenteeism from school.

"We saw that and thought we didn't need legislation to do it."

Fucillo said that measure could have done more than what was intended and created fiscal concerns because it was broad.

So all the stakeholders came up with an agreement.

Fucillo said now DHHR will accept referrals for children ages five through 11 with 10 or more days of unexcused school absences in a semester. DHHR will then look at each case on an individual basis and make the appropriate referral.

"This is when you can reach those children, before they get too old, and make a difference in their lives," Fucillo said.

And Fucillo was pleased to present his white paper to lawmakers in March.

"These are issues I've been discussing with the respective chairs of both committees since July," he said. "It looks at ways we can assure positive outcomes, quality services, access, but also fiscally responsible. … It all works together."

Department Audit

Public Works LLC, the same firm that audited the state's education system, completed an audit of DHHR in late February.

The results quietly came out at the end of the legislative session, but Fucillo said several recommendations were familiar.

"We've recognized and tried to implement, in the short time I've been the secretary, some of the measures that are reflected in the report," he said. "We recognize that the department needs help, and over several years it's gotten to the point it is.

"We have a great work force that does wonderful things, but we understand that times change and we need to be more efficient and effective in what we deliver."

Fucillo said he looks forward to working with the Legislature and other partners in the next year to implement "as much as is practical" of the report.

"I also understand we're a large agency, and it's very important to answer questions and work with our partners," he said.

Fucillo said internally, his plan is to go through the 111-page report one page at a time with each of the department's commissioners, department heads and deputy secretaries to review the findings.

"If you look at the report, they match pretty consistently with what's in our white paper about trying to improve health care," he said.

The audit's conclusion states that DHHR and other health agencies, "rather than working together to mitigate these problems, are beset by fragmentation, an insufficient work force, and the lack of an overarching strategic vision and a sustained mechanism for accountability." The report also outlines what it calls a strategic vision for the state's health care system, centered on three goals for better health, better care and lower costs along with 78 recommendations it states have the potential to save the general fund $56.7 million.

Fucillo said he is committed to the labor-intensive process of addressing the audit and working collaboratively to address each recommendation in a "comprehensive fashion."

Medicaid Expansion and Beyond

Fucillo said the department's work force problems pointed out in the audit – an increase in travel, overtime and high turnover – are cyclical.

"If you didn't have a high turnover rate, you wouldn't have to travel so much for training and you wouldn't use as much overtime," he explained.

But there is already a plan in place to work on recruitment and retention. Fucillo said the department also has a recognition program to show appreciation for staff who go above and beyond the call of duty and a newsletter updated weekly on the department's internal website. He said video conferencing is being developed to help cut down on travel for training.

But for the rest of the year, the state's expansion of Medicaid is one of the biggest items on Fucillo's radar.

"We'll ensure we follow the governor's directives effectively and efficiently to implement the Medicaid and make sure we're fiscally responsible while encouraging personal responsibility," he said. "And we'll also need to keep an ear to Washington to keep aware of what's going on."

Fucillo said DHHR is still waiting on final rules governing what the expansion population is going to look at from the federal perspective, so plans are fluid.

"We'll get it done, but it's going to take a lot of heavy lifting and waiting to see what our federal partners do," Fucillo said. "That's why the governor, I think, did such a good job of being diligent."

And he has one more plan to make his employees a little happier while also being fiscally responsible. He said he's currently studying a way for employees to show a way they are saving the department money so they, in turn, could be rewarded with a one-time pay increase.

"We have hard-working employees that are doing the best they can, and we'll never use the excuse that we don't have enough employees, but obviously there is only so much you can do," he said. "These are interesting times, and they are challenging times – the Medicaid expansion, these other initiatives we are undertaking, budget cuts in programs and more demands for services, but our most important resource is our employees."