Iowa hires consultant to review efficiency of new health, human services department

Iowa's health and human services agency has hired a consulting firm to study ways to boost service delivery following the merger of the state’s former public health and human services departments.

The Iowa Department of Health and Human Services has hired Michigan-based firm Health Management Associates to study the delivery of health and human service programs in Iowa.

The firm, which previously provided technical assistance, support and analysis for Iowa’s Medicaid and the Children’s Health Insurance Program (CHIP), will be paid $430,911 for its work, according to an amendment to its existing contract with HHS.

Of that, $250,000 will come from Centers for Disease Control and Prevention public health infrastructure funding received by the state. The remainder will be paid using state budget surplus funding, according to an HHS spokesman.

HMA kicked off its assessment last week, and will continue through the summer and early fall, according to the state's website on the project. The consulting group is expected to present recommendations to state officials sometime in October.

According to the HHS assessment website, the consulting firm will study current delivery systems and structures under the new state agency’s umbrella, including local public health departments, mental health regions, area agencies on aging, community action agencies, family planning services and more.

Consultants will assess current operational capacities and how services are delivered, including funding and resources and a “scan of providers within the service delivery system.”

In so doing, state officials say they hope to identify gaps as well as duplication of services within those programs, create consistency in the way Iowans access health and human services, make better use of funding, and improve the way the agency works with local community partners.

“The current system does not offer Iowans a clear front door into health and human services,” a department spokesperson said. “Too often, we see people getting shuffled around or stuck in this system. The assessment will address the difficulties participants experience as they navigate the system.

The work will also provide clarity on how to best leverage the investment of dollars for Iowans in need and inform how we measure outcomes for these Iowans.“

Kelly Garcia, director of the Iowa Department of Health and Human Services, said in the release that the ongoing realignment of public health and human services into a single agency presents an opportunity to take lessons learned from the pandemic and address inconsistencies within the agency that create burdens for Iowans and local governments in receiving and administering state services.

“We’ve spent the last two plus years aligning the state agencies that oversee these programs and services,” Garcia said. “Now it’s time to align the system that underpins the delivery of these supports to Iowans.”

Garcia noted Iowans access health and human services in different ways in each of Iowa’s 99 counties, with separate administrative systems and multiple decision-makers at the state, regional, county and city level that create inconsistencies that made it difficult for Iowans to navigate and local officials to administer programs.

“These challenges result in significant inefficiencies that can delay getting necessary funding, resources, and other supports to people on the front-line providing services to Iowans,” Garcia said in her statement. “This assessment aims to understand these systems and provide solutions to improve them.”

HMA will produce a recommendation that will include at least two proposed service delivery options, and at least two proposed funding models, according to HHS officials.

The new Department of Health and Human Services affects hundreds of thousands of Iowans, including those on Medicaid and receiving food assistance.

The merger affected more than 5,000 state workers and more than $2 billion in state funding, or more than a quarter of the state budget. And it helped pave the way for Gov. Kim Reynolds’ larger reorganization of state government passed by Iowa lawmakers this year that consolidates Iowa’s cabinet-level agencies from 37 to 16.

The Gazette’s Erin Murphy contributed to this report

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