Health board not on board with DSS consolidation

This story was written by Tanner Hall, originally published in The Sylva Herald.

Local health board members say they will go into today’s meeting about possible consolidation with the Department of Social Services’ board with one specific question: Why?

County leaders set these wheels in motion during a Dec. 10 work session, after Commissioner Ron Mau suggested they consider consolidation.

Then, on Feb. 13, Commissioner Mickey Luker told fellow board members that he’s been approached by “multiple people in the community” – more than 50, he said – who wanted the health and DSS boards combined.

The two Republicans are the newest additions to the Jackson County Board of Commissioners. They say consolidation might eliminate duplicate services, increase efficiency and save taxpayers’ money.

Commissioner Boyce Deitz, a Democrat, has publicly challenged trying to fix a system that no one, at least openly, will say is broken. Health board members on Monday echoed his concerns, as did Health Director Shelley Carraway.

“If what they’re asking for is efficiency, saving money and improved services, I don’t think they need to go through consolidation to do it,” she said.

“As far as communication goes, if they want us to meet more, we can meet more, and if they have trouble with us, the Health Department and DSS are available to talk,” she said. “I don’t think that’s the problem, either, so we just to have to get to the bottom of ‘Why?’”

State legislators in 2012 passed a law that allows counties to merge their health and human services departments. Prior to that, only North Carolina’s largest counties could consolidate.

Under the new legislation, Jackson County commissioners have three options:

• Take on the responsibilities of the two boards – health and DSS – with those agencies remaining as they are.

• Create a Consolidated Human Services Agency and appoint a 25-member CHS board.

• Form a CHSA and assume the powers/duties of a CHS board.

Carraway said the second option seems the most popular among counties that have chosen consolidation, including Haywood County.

Haywood leaders decided to meld boards in 2014. Since then, Haywood County Manager Ira Dove said, they have “experienced better communication and coordination of services for our citizens, and some cost savings.”

They studied the process for almost year before going through with it, said Dove, who served as director of Haywood County DSS before being named county manager.

“We worked hard at the transition and made sure that residents didn’t have any issues with consolidation,” he said. “The transition went relatively smoothly, but it does take work to change a business model.”

Local health officials said they weren’t sure the benefits to Jackson County would outweigh a steep learning curve faced by commissioners, or the operational mix-ups that come along with it.

“The bigger the county, the more successful (the consolidation) is, because there are efficiencies when you take those big conglomerates and put them together,” Carraway said. “It all depends on what you’re trying to accomplish – whether you’re trying to save money or gain control.”

Officials on Monday raised additional concerns about politics being at play.

Health board member Jerry DeWeese said he believes the two Democrat commissioners, Chairman Brian McMahan and Deitz, would vote against a consolidation. Among the Republicans, Mau, Luker and Charles Elders, Mau could prove the deciding vote, he said.

Carraway said that health board members approach needs by looking at the community as a whole, while commissioners look at their individual constituents – the people who voted for them and need something.

“My concern is that I don’t know how long the learning curve is to gain that understanding,” she said. “It isn’t a popularity contest here. We have to do the right thing for the community and the environment. I’m not saying all commissioners are politically charged, I’m just saying the potential is there.”

There is one positive, the health director said.

The consolidation options leave room for health and DSS leaders to report to the county manager (either directly or via a CHS director), who could then better inform commissioners at the top of local leadership what their goals and needs are.

“I can see the advantage to everybody answering to the county manager for the vision of Jackson County,” Carraway said. “That makes some sense to me, but I think we already do that, just not with that direct line of supervision.”

Although she’s skeptical about whether consolidation would help the county in the long run, Carraway said she welcomes the discussion.

It’s rare that the health board, DSS board and commissioners all get to sit at the same table, Carraway said.

“Ask some questions, but also be able to answer some questions,” she told her board members.


The meeting

The Jackson County Board of Commissioners will meet today (Thursday) with the boards overseeing the Health Department and the Department of Social Services about possible consolidation.

The meeting takes place at 6 p.m. at the Senior Center. Representatives from the UNC School of Government will lead the discussion.

The first part of the meeting is a question-and-answer session, followed by a presentation intended to air out the pros and cons of consolidation.

The meeting is expected to last until about 9 p.m.

Looking ahead

Health board members, even after consolidation with the Department of Social Services, would remain involved, Health Director Shelley Carraway said Monday.

State law requires that commissioners, when making a consolidation decision involving public health, appoint a health-advisory committee. Current health board members likely would serve in this new capacity, Carraway said during a health board meeting.

Another possibility is that commissioners decide to create a 25-member Consolidated Human Services board.

Then, health board members would likely be included among those 25 appointments, Carraway said.