A.1. Agency Mission
The Health Department (HD) is dedicated to “improving the health, safety and wellbeing of Texans with good stewardship of public resources” according to their inaugural
business plan (HD, 2019). The
...
A.1. Agency Mission
The Health Department (HD) is dedicated to “improving the health, safety and wellbeing of Texans with good stewardship of public resources” according to their inaugural
business plan (HD, 2019). The organization is charged with providing healthcare for the
residents of Country using public funds while meeting federal and state requirements and
mandates. The agency oversees all aspects of healthcare including acute and long-term
care, mental and behavioral health, state owned residential treatment facilities, and
community service programs related to the health and well being of all Texans. The agency
strives to make a positive difference in the lives of the people they serve (HD, 2019). The
mission has been in place since the agency’s inception and was developed by the legislative
branch through a bill consolidating twelve agencies into five distinct agencies under the
oversight of HD. The employees and various internal stakeholders are familiar with the
mission of the agency and, as public servants, buy into the mission of the agency. External
stakeholders have high expectations of HD to carryout their mission and provide the most
cost-effective services to Texans. The HD Blueprint for a Healthy Country outlines the vision
and mission of the organization and all stakeholders are encouraged by HD executives to
read and understand the goals of the agency.
A.1.a. Three-Year Goals
The agency outlines numerous goals dedicated to their mission to make a positive
difference in the lives of the people they serve in their inaugural business plan. All levels of
C208: CHANGE MANAGEMENT AND INNOVATION – TASK 1
leadership and subject matter experts provided suggestions and details of the business
plan to ensure agency buy in and collaboration. The plan specifies the agency’s goals for
improving efficiency, effectiveness, and process improvement (HD, 2019). In preceding
years, the executive commissioners have produced various different agency-wide plans and
reports with limited involvement from all levels of staff. The current executive
commissioner ensured all areas were at the table when discussions about the agency’s
future were discussed. The inclusion of all program areas allowed for a greater level of buy
in from the individuals employed by the agency, as well as the stakeholders impacted by the
service provisions of the agency.
The first of the goals identified in the annual business plan covers their purchasing
responsibilities. Over the past five years, the agency received an abundance of negative
press surrounding the procurement and contracting division and numerous agency leaders
lost their positions in the agency. The goal surrounding procurement and contracting
services is to strengthen the organizational structure and develop tools and resources for
employees to properly carry out their functions for the agency (HD, 2019). The agency
plans to perform a transformation of the way procurement and contracting services are
carried out at the agency.
The second agency goal addresses the desire for the agency to improve their culture
through improving their recruitment and retention efforts (HD, 2019). The agency has a
high turnover rate and several positions are not easily filled due to the stressful nature of
the job responsibilities. The agency employs both administrative and clinical staff to
carryout their mission. Due to the competitive nature of clinical positions in highly
C208: CHANGE MANAGEMENT AND INNOVATION – TASK 1
populated areas, the agency struggles with retaining clinical staff. The agency strives to put
forward an agency-wide recruitment and retention plan to address these issues.
The third goal for the agency outlines areas for improvement related to technology and
innovation (HD, 2019). As a public agency reliant on taxpayer funding through legislative
appropriation, technology and innovation often becomes unattainable due to the high cost
for implementation of automation and innovative solutions. The agency aims to leverage
systems already in place along with process improvement methodologies and practices to
improve outcomes without a costly price tag.
A.2. Key Stakeholders
The key stakeholders for this agency include over 40,000 employees, millions of Texans
receiving healthcare services, clinicians, agency contractors, insurance companies,
managed care organizations, taxpayers, and the legislative and executive branches of the
government. As an agency within the executive branch of the state, HD is accountable to the
Governor and must provide numerous reports to outline their progress in meeting their
mission to the legislature and governor’s office, which are available to the general public, as
well. The executive commissioner maintains responsibility and accountability for this
organization although external stakeholders, such as lobbyists and legislators, can influence
the productivity and outcomes of the agency’s mission.
A.3. Leadership
The agency has undergone numerous transformations and consolidations over the last
ten years. In 2002, the organization was consolidated from twelve distinct agencies into five
overseeing the same functions with the Health Department overseeing the enterprise. In
2015, the agency was directed to consolidate even further and two of the agencies were
C208: CHANGE MANAGEMENT AND INNOVATION – TASK 1
abolished and absorbed into HD’s function and another two remained separate, while the
oversight from HD was strengthened. The agency currently stands as the largest state
agency in the nation with over 40,000 employees serving nearly 30 million Texans.
The transformed organization is led by a governor appointed executive commissioner
who also delegates responsibilities down to other leadership in four separate chief areas to
address the unique needs of the enormous agency. The chief areas oversee program and
services, operations, policy and regulation, and legal services. Due to the vastness of the
services provided by HD, additional leadership is required to carryout the functions of the
agency. An additional layer of executive level staff fall beneath the chief areas to oversee the
operation of the day-to-day functions called the deputy executive commissioners. There are
various levels of leadership across the deputy executive commissioner areas based on the
responsibilities for each.
With an agency as large as HD, the adherence to the chain of command and bureaucratic
processes play a major role in communication and policy development. Due to the size of
the organization and the complex nature of the services provided, the agency policies are
developed with the entire agency feedback. This encourages all parties impacted by the
proposed rules and policies to provide feedback and concerns, if necessary. Although this is
beneficial for the agency to maintain awareness of all changes, it does pose a serious issue
in regard to time. The agency must route all proposed changes through nearly twenty levels
of review in order to adopt new policies, procedures, and processes.
The agency is divided into two separate methods of service delivery, program related
services provided to external stakeholders and administrative services provided to internal
stakeholders. Program related services administer services such as Medicaid, Supplemental
[Show More]