The historic split in Alaska’s massive health department is now law. And after?


The historic split of Alaska’s sprawling Department of Health into two new agencies is now law, despite last-minute legislative opposition and lingering constitutional questions.

The reorganization takes effect July 1.

It splits the Alaska Department of Health and Human Services, the state’s largest agency with a $3 billion budget and 3,200 employees, run by a five-person executive team.

The department includes many sometimes troubled divisions that Alaskans encounter directly, such as the Bureau of Children’s Services, the Alaska Psychiatric Institute, public health nursing, and public assistance.

Rather than enacting immediate changes, however, the split aims to streamline government by creating smaller funding-aligned agencies, each with its own commissioner better able to focus on priorities, state officials say. .

Gov. Mike Dunleavy signed into law the division not by legislation that can be changed by lawmakers, but by executive order — the most sweeping ministerial change enacted by governor’s executive order since Alaska became a state.

It is estimated that the reorganization will cost around $2 million per year initially.

Dunleavy told a press conference on Monday that he believed the split would “reduce costs over, in our view, a short period of time.”

“The idea is that with better oversight and better focus, we’ll get better results,” he said, later saying the success of the split would be measured based on staff and public feedback. , as well as data such as staff turnover and vacancy rates.

The reorganization was designed to minimize disruption to people using department services, officials said.

The new Ministry of Health contains divisions aligned by payment to include those taking Medicaid: Public Health; public assistance; Behavioral health; Health services; and Services for Seniors and Persons with Disabilities.

The new Department of Family and Community Services includes divisions that oversee child protection or provide direct care: Juvenile Justice; the Alaska Psychiatric Institute; Pioneer houses; and the Bureau of Children’s Services.

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Critics, including some lawmakers, say the department needs overhaul, but there is no evidence that the agency’s revamp will improve services to the public.

A spokesperson said the nonprofit Research Alaska public interest group will closely monitor the transition to ensure vulnerable residents are not cut off from essential services.

“We maintain the belief that the Dunleavy administration should have consulted with the legislature and sought more public input before splitting the largest stage agency by executive order,” spokesman Robin O’Donoghue said in an email. . “This process was conducted in great haste and Alaskans will unfortunately have to deal with any errors made by the administration.”

A state reorganization website includes an implementation plan and an email address the public can use to get involved.

The department has spent the last year working on the plan and is now in a transition phase that includes technical fixes and contact with stakeholder groups to ensure “processes are explained or adapted as needs,” Health and Human Services Commissioner Adam Crum said Monday. Report.

Asked how the reorganization will improve services for Alaskans, Crum cited the Bureau of Children’s Services, which has a staff turnover rate approaching 60 percent.

Separating the OCS from divisions receiving Medicaid funding will allow the new commissioner and staff of the new department to “ensure that we are working with the community on preventive elements upstream and not having to worry about budgetary aspects of Medicaid”.

Lawyers for the state Department of Justice say Dunleavy has the authority to order the split. The governor withdrew a similar proposal to split the health department last year.

Previous governors have considered dismantling the health department in an attempt to make it more efficient. And previous orders have created agencies, including one in 1983 that removed the State Department of Corrections from the Health Department.

But the scope of Dunleavy’s more than 100-page order is so sweeping that it may represent an excess of executive power, according to a February analysis by legislative lawyers.

An executive order is either “frowned upon” by a joint session of the Legislative Assembly or allowed to become law. Of 120 proposals since the state’s inception, only seven have been disapproved, according to a 2021 Legal Department memo.

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The health department split automatically went into effect just after midnight Saturday when a joint session deadline passed.

Senate leaders in recent weeks have made it clear they support the reorganization. Senate President Peter Micciche, R-Soldotna, took part in Monday’s briefing and said he suggested a similar idea a few years ago.

Earlier this month and as recently as last week, House leaders unsuccessfully asked their Senate counterparts to hold hearings on a resolution calling for disapproval of the order.

On Monday, House Health and Human Services Committee Co-Chair Rep. Liz Snyder, D-Anchorage, said she was disappointed the order that sets “a significant precedent” became law without the individual legislators can vote in a joint session.

Snyder said that given the lack of immediate relief for agency issues, she hoped the governor would approve health-related budget amendments, including funding for public assistance and nursing positions in public health.

“Our biggest concern is with Alaskans and making sure we provide high quality service,” she said.


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