Senate plan revamps health system: Proposal builds on Romney proposal

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Senate plan revamps health system:

Proposal builds on Romney proposal

By Rick Klein

The Boston Globe, May 16, 2003

Massachusetts Senate leaders yesterday unveiled a sweeping proposal to reorganize the state's health and human service delivery system, adopting much of Governor Mitt Romney's plan and expanding an agency designed to cater to senior citizens' needs.

Under the plan, the state's 15 health and human service agencies would be merged into five categories, bringing one-stop shopping to as many residents as possible when they access state services. Senate President Robert E. Travaglini called the proposal a long-overdue overhaul of a bureaucratic structure that many clients call ''the maze.''

''There is a lack of coordination and communication on many levels, as well as administrative duplication,'' Travaglini said, as he outlined the proposal that will be included in the budget document that Senate leaders will release next week. ''Reform is not only necessary, it's crucial.''

The rollout of the plan seems designed to establish the reform credentials of Senate leaders, as Romney tries to build support for the omnibus restructuring proposal he filed yesterday. The message: Legislative leaders can offer real reforms as well, so there's no need for the governor's comprehensive restructuring proposal.

Travaglini, an East Boston Democrat, suggested that the governor and his aides could be moved to abandon their plans to reorganize health and human service agencies when he reviews the Senate's proposal. ''I think this is a little bit better than theirs,'' he said.

Romney filed two bills yesterday under Article 87 of the state Constitution, one with 585 pages that document his proposals to restructure the executive branch, and another 12 pages with the proposal that the office of University of Massachusetts President William M. Bulger be eliminated. Both bills will become law in 60 days unless they are rejected by the House or Senate, and neither can be amended by the Legislature.

A range of advocacy groups has come out against aspects of the reorganization plan, with criticism coming from the Sierra Club, AARP Massachusetts, and the Massachusetts Teachers Association, among others. While each group takes issue with different parts of Romney's proposals, the fact that the proposals are part of an omnibus package means their criticism could build a case for rejecting the full package.

Legislative leaders raised the possibility of rejecting Romney's sprawling plans and building up their own proposals for government reorganization, after the budget for the next fiscal year is finished in June. Legislative proposals could build off the aspects of Romney's plans that lawmakers like, and include other restructuring ideas that have broad support, said Representative Geoffrey D. Hall, House chairman of the Committee on State Administration.

''When you look at his goals, they're admirable. But as often happens, the devil's in the details,'' said Hall, a Westford Democrat. ''We can pull some things out that we all agree are good, and we come back with those.''

Senators said the health and human service proposal proves that the Senate can bring about government reform without the governor's prodding. Putting the 15 agencies into five groups - children, youth, and families; health services; disabilities and community services; elder services; and veterans services - allows the state's neediest people to access the programs they need through single entry points, often by filling out a single form, senators said.

''Our goal is to make the system make sense,'' said Senator Susan C. Tucker, an Andover Democrat who is chairwoman of the Senate's human services committee.

The most significant difference with Romney's proposal is the grouping of Medicaid services for the elderly along with other services for senior citizens. Though Romney's plan would keep some of those services in other parts of the system, a spokesman for the Executive Office of Health and Human Services said the Senate proposal is workable.

''We're pleased that it embraced so much of Governor Romney's plan,'' said Dick Powers, the spokesman.

Senators said the change would save the state between $12 million and $15 million in the next fiscal year, and additional money in future years as more administrative services and state offices are consolidated. Romney pegged the annual savings from his health and human services restructuring at $60 million, but Senate leaders declined to comment on why that plan seems to save more cash than theirs.

Senate leaders also declined to discuss funding levels for health and human service agencies, which have suffered severe cuts over the past two years of tight fiscal times. Stephen E. Collins, executive director of the Massachusetts Human Services Coalition, said streamlined services are a great idea - as long as the programs still exist.

''It would be great if they walked into the integrated offices, but what happens if the services they need aren't there?'' Collins said.