Delivering public health, social, and human services to Pennsylvanians in the most efficient and effective way requires innovation, creative thinking, and practical solutions – that’s why Governor Wolf proposed integrating the Departments of Aging, Drug & Alcohol Programs, Health, and Human Services into a new, unified Department of Health & Human Services (HHS).
Over the past several months, Governor Wolf has worked closely with each of these four agencies to identify and break down silos and reimagine how we deliver such critical services. We invite and encourage you to learn more about this initiative by reviewing draft legislation, diving deep into the HHS draft organizational charts, hearing from the prime sponsors in the House and Senate who will propose the legislation that will lead us to the implementation of this new agency, and most importantly weighing in with your own thoughts and ideas. We will continue to update this site as we move through the process.
A broad coalition of advocates for seniors, recovery, people with disabilities, and other health and human services populations is speaking out in support of the unification. Organizations that are endorsing the proposal include:
Creating a new, unified Department of Health & Human Services will dramatically improve our ability to deliver services that will improve lives while reducing costs to taxpayers.
Too often, an individual is served by too many different agencies – and we all know navigating the different layers of government can be complex and cumbersome. The following are just a few examples of the key ways an integrated agency can provide an easier way for citizens to interact with the commonwealth and obtain the services they need.
Enhancing our efforts to fight back against the heroin and opioid epidemic
Governor Wolf has led the battle against the heroin and opioid epidemic, and each of these agencies has been critical to this effort. Among many other initiatives, the Department of Health launched a Prescription Drug Monitoring Program and has been raising awareness of the Physician General’s standing order for Naloxone; the Department of Drug & Alcohol Programs has led the effort to increase the availability of Naloxone and drug take-back boxes; the Department of Human Services has created 45 Centers of Excellence to coordinate treatment for those suffering from substance use disorders; and the Department of Aging has led prescription drug take-back efforts among the senior population by encouraging proper use, storage, and disposal of unused prescription medications.
By creating an organization that is structurally better able to support and coordinate these efforts, individuals in desperate need of substance use disorder treatment will be able to access services through one agency with an integrated data and delivery system. The new HHS will serve as the Single State Authority for Medicaid, substance use, and mental health purposes, which will enable the commonwealth to maximize available federal dollars and offset state costs for staff and services.
Additionally, there will continue to be a cabinet-level position in Governor Wolf’s administration that will be dedicated to battling the epidemic.
Bolstering senior benefits and programs
Seniors will now have a single point of contact within state government to receive health care services, human services, and long-term services and supports. Instead of obtaining PACE prescription assistance through the Department of Aging, applying for the Aging Waiver through the Department of Human Services, finding out where to dispose of unwanted or expired prescription drugs through the Department of Drug & Alcohol Programs, or searching for information on the quality of nursing homes through the Department of Health, seniors would find all the services they need through HHS.
And, although HHS will now ensure that all senior services are streamlined, older Pennsylvanians will still go to their AAAs when they have questions about these services, just like they do today. However, if a senior needs to call HHS about any of these services, they will go to one bureau: the Bureau of Aging Services.
Furthermore, the creation of this department will have no impact on how Lottery Fund dollars are used to support senior programs. The important services funded through the Lottery will continue.
Reducing complexity and confusion for seniors and those with disabilities
Currently, at least 21 separate services across the four agencies provide care for seniors and individuals with physical disabilities. The creation of HHS will eliminate the unnecessary duplication of effort and confusion that currently exists among consumers and their families. The Wolf Administration is dedicated to continuing to provide the same quality services for seniors and individuals with disabilities and will dramatically improve the delivery of services like health screenings, programs allowing individuals to remain in their homes and communities, adult protective services, and home health care and housing supports.
Reducing red tape for providers and non-profits subject to regulation
Providers ranging from hospitals and childcare centers to substance use treatment facilities and nursing homes are currently licensed by multiple agencies, often for the provision of the exact same services. Requiring these businesses to subject themselves to multiple, duplicative inspections and audits costs them money. By centralizing facility licensure in one agency we will improve coordination, increase transparency, and promote uniformity for the health and human services field. The state and providers will be able to better focus our resources on our mission to improve the health and quality of life for citizens rather than back office functions.
What’s in the legislation?
Draft legislation would amend the Administrative Code of 1929 to establish the Department of Health & Human Services, while repealing existing articles that provided the statutory authority for the Departments of Aging, Drug & Alcohol Programs, Health, and Human Services.
In addition to outlining the typical duties of an agency secretary and Physician General, the draft legislation maintains cabinet-level positions focused exclusively on seniors and substance use and addiction: a Commissioner on Aging and a Commissioner on Substance Abuse and Addiction.
HHS will serve as the single state agency to receive and disburse funds under the Older Americans Act of 1965 and will develop and administer the State Plan for Aging required by federal law, in consultation with the Council on Aging. The department will also provide services to older adults through the Area Agencies on Aging (AAAs). The current requirement that each AAA be held harmless to the amount of commonwealth funds received in the prior fiscal year is maintained.
Like the current Department of Drug & Alcohol Programs, HHS will develop and adopt a state plan for the control, prevention, intervention, treatment, rehabilitation, and research related to substance use disorder and education and training matters.
The draft legislation transfers all the powers and duties of the four existing agencies to HHS, including:
- Mental health, intellectual disability, autism, substance use disorder, and gambling addition services;
- Licensing and regulation of facilities and agencies with the primary functions of diagnosis, treatment, care, and rehabilitation of individuals with mental illness, emotional disturbance, intellectual disability, autism, or substance use disorder;
- Licensing, certification, and regulation of health care facilities and medical marijuana organizations;
- Certification and regulation of laboratories, emergency medical services providers, and managed care organizations;
- Public health, disease prevention, newborn screening, and maintenance of vital statistics;
- Child protective services;
- Domestic violence and rape crisis services;
- Controlled substances;
- Residential substance use disorder treatment programs for women and children;
- Programs and services for older adults;
- Home and community-based services
Legislative Prime Sponsors
Republican State Representative Stephen Bloom (Cumberland County) and Democratic Senator Judy Schwank (Berks County) have announced their intent to be the prime sponsors of this bipartisan legislation, and issued a sponsorship memo to their General Assembly colleagues outlining why they agree integrating the agencies would provide such great benefits to the commonwealth:
“In a time of limited resources and ever increasing needs for human services, state government must work continually to streamline delivery and reduce costs. The status quo is no longer acceptable.” – Sen. Judy Schwank (D-Berks)
“I am willing to work with any governor from any party to implement beneficial reforms like this, to make our state government more efficient and effective in delivering vital services, and to save money for our hardworking taxpayers.” – Rep. Stephen Bloom (R-Cumberland)
Draft legislation establishes or maintains in statute four cabinet-level positions: a Secretary of Health & Human Services, Physician General, Commissioner on Aging, and Commissioner on Substance Use & Addiction.
Secretary of Health & Human Services
Governor Wolf intends to nominate current Pennsylvania Insurance Commissioner Teresa Miller to serve as the inaugural Secretary of Health & Human Services. Miller has served as Insurance Commissioner since January 2015 where she has worked on a range of issues including the administration’s top priorities – fighting the opioid epidemic and helping seniors.
Prior to coming to Pennsylvania, Miller served as acting director of the State Exchanges Group, the Oversight Group, and the Insurance Programs Group in the federal government’s Centers for Medicare and Medicaid Services. Before going to Washington, Miller served as the administrator of the Oregon Insurance Division. Miller received her J.D. from Willamette University College of Law, and her B.A., magna cum laude, from Pacific Lutheran University.
Miller is a national leader on insurance issues that impact consumers. At the National Association of Insurance Commissioners (NAIC), she chairs the Senior Issues Task Force and its Long-Term Care Innovation Subgroup, which is examining the future of private solutions to long term care financing, with a focus on removing barriers to pursue concrete solutions that can pave the way for the private market to play a more meaningful role in financing the long term care needs of society. She is also on the Congressional Budget Office’s panel of health advisers, offering input on the potential impact federal policies and proposed legislation may have on health care consumers.
Standing up for seniors
Teresa Miller has been a leader in the administration’s efforts to protect seniors. Her work to ensure seniors in Western Pennsylvania were protected and would not lose access to their doctors helped prevent disruption in care for 180,000 by ensuring UPMC providers continued participation in Highmark’s Medicare networks.
In 2017, Teresa was named chair of the National Association of Insurance Commissioners (NAIC) Senior Issues Task Force. Also at the NAIC, Teresa has been a leader in taking on the current challenges of the long term care insurance markets. At her request, the NAIC created the Long Term Care Innovation (LTC) Task Force, which she now chairs and which is working to increase long term care funding options for consumers, including increasing the number of affordable asset protection options available.
Teresa has also looked for ways to innovate in long term care insurance in Pennsylvania, making a change to the requirements for long term care insurance policies that will allow lower- priced products to be considered LTC partnership products; products that allow consumers to retain some assets if they need to transition to Medicaid after exhausting their private coverage.
Teresa has taken on the challenge of the long term care insurance market, holding a public hearing to increase transparency into the market and the process by which rates are determined. Teresa feels strongly about keeping long term care insurance consumers informed, and often personally corresponds with consumers impacted by long term care insurance rate increases.
Fighting the heroin and opioid crisis
Under Teresa’s leadership, the department has begun a comprehensive strategy to ensure insurance companies are complying with all laws related to coverage for mental health and substance use disorder treatment. The strategy includes three prongs: increasing consumer outreach and soliciting consumer complaints, reviewing insurance policy forms to ensure they describe proper coverage, and performing compliance audits on all of Pennsylvania’s major health insurers.
In order to enhance consumer awareness and understanding, the Pennsylvania Insurance Department (PID) published new, comprehensive guidance aimed to help consumers understand what mental health and substance use disorder benefits they are entitled to under law based on the type of health insurance they have and to provide them with information on who to call if they experience issues with this coverage.
Teresa received the Ambassador for Recovery Award at the 2016 Recovery Walk in Philadelphia in recognition of her leadership on parity enforcement. This award is organized and presented by the Pennsylvania Recovery Organization-Achieving Community Together (PRO-ACT) and The Council of Southeast Pennsylvania.
While CHIP was still under PID, Teresa ensured children and teens had access to comprehensive substance use disorder treatment by ensuring all CHIP plans complied with Act 106 requirements.
Working with the federal government, Teresa had direct oversight of implementation of parity for the U.S. Department of Health & Human Services, working to make sure parity was effectively implemented across the country.
In Oregon, Teresa fought for state adoption of parity, and represented drug and alcohol treatment providers, disability providers, and social workers.
“Commissioner Miller has fought to protect health care for seniors and kids, and embodies the best of public service – effectively working across the aisle and state lines – to make the lives of Pennsylvanians better and more secure.” – Governor Tom Wolf
Commissioner on Aging
The Commissioner on Aging will be tasked with advising the Governor and coordinating commonwealth efforts on issues that impact seniors, and will work with the department to develop the State Plan on Aging and State Plan on Alzheimer’s. The Commissioner will work closely with the Deputy Secretary for Aging & Adult Community Living.
Commissioner on Substance Abuse & Addiction
The Commissioner on Substance Abuse & Addiction will be tasked with advising the Governor and coordinating the efforts of commonwealth agencies in the control, prevention, intervention, treatment, rehabilitation, research, education, and training aspects of substance use disorders and gambling addiction. The Commissioner will work closely with the Deputy Secretary for Mental Health and Substance Use Disorder Services.
The Physician General is tasked with advising the Governor and Secretary on health policy, participating in the decision-making process of all state agencies on policies relating to medical and public-health-related issues, and reviewing professional standards and practices in medicine and in public health.
Over the past several months, workgroups comprised of staff from all four agencies, in collaboration with the Governor’s Office, have been hard at work reimagining the ways we deliver critical services. These workgroups examined the current structures in each agency and identified ways to break down silos and enhance their abilities to administer their programs. We think this new employee-driven organizational structure reflects an innovative and pragmatic approach to designing an agency built for the 21st century. Check out the details of each office below for yourself.
We deeply value your feedback on our proposal to create a new Department of Health & Human Services. Fill out the form below and let us know what you think!