| Recommendation Number | Recommendation |
|---|---|
| 2.3.1 | Increase the level of detail in the Budget Alignment and Core Services Alignment documents. |
| 2.3.2 | Use the Budget Overview Presentations to make a case. |
| 2.3.3 | Refine individual elements of the Budget Overview Presentations. |
| 2.3.4 | Improve readability and usefulness. |
| 2.3.5 | Illustrate interconnectivity at fiscal analysis stage. |
| 2.3.6 | Consider phasing in a zero-based budget process. |
| 3.1.B.1 | Evaluate positions that have been vacant for more than six months to determine need. |
| 3.1.B.2 | Repurpose vacant positions that have never been filled. |
| 3.2.B.1 | Establish an internal audit section for the entire department. |
| 3.2.C.2 | Foster care home licensing should remain a separate function because it is so closely integrated with the fieldwork performed by child welfare workers. |
| 3.2.D.1 | Expand cross-training opportunities so staff can conduct multi-purpose site visits. |
| 3.2.D.2 | Consider creating a formal process for coordinating site visits. |
| 3.2.D.3 | While maintaining needed subject matter expertise, explore opportunities for interdivisional DHSS site visit compliance teams that can evaluate multiple department grantees during limited visits to remote areas of the state. |
| 3.2.D.4 | Expand collaboration with other local and state agencies that perform site visits (such as the Fire Marshal) to alert the department to any potential issues. |
| 3.2.I.2 | Separate foster care licensing statutes and regulations from other residential care facilities. |
| 3.2.I.3 | Clarify the waiver and variance process for kinship placements in department regulations. |
| 3.2.I.4 | Develop a template or checklist for OCS workers and/or eligibility technicians to assist in correctly documenting the components of Title IV-E eligibility within the appropriate timeframes. |
| 3.2.I.5 | Prioritize technology purchases and implementation to assist OCS workers. |
| 3.2.J.1 | Prioritize and accelerate plans to shift OCS intake from a regional intake system to a centralized intake system comprised of a distinct unit of trained CPS workers who receive reports of child abuse and neglect 24 hours a day, 7 days a week. |
| 3.3.A.1 | Further integrate Medicaid functions across the department to achieve cost savings and create a more streamlined authority for Medicaid policy, programming, budget, and oversight. |
| 3.3.A.2 | Increase the pace at which coordinated care for Medicaid enrollees and cost saving opportunities are identified within the Medicaid program through a focused and concerted efforts across all divisions. |
| 3.3.C.2 | Create a Quality Committee whose membership includes the DHSS Chief Medical Officer and external stakeholders, such as providers. |
| 4.1 | The efforts of the Alaska Council on Emergency Medical Services should be refocused from professional advocacy to providing more formalized policy and budget advice to the DHSS commissioner and governor. |
| 4.4 | To maintain and augment the effectiveness and efficiency of all DHSS advisory bodies, policymakers should: 1. Review periodically, beyond traditional sunset audits, whether each membership body is better equipped to determine policies/oversee programs than other available alternatives such as internal agency workgroups or subject matter experts from academia or the public/private sectors. 2. Establish and enforce expectations regarding the use of performance management tools by agency councils, boards and commissions. 3. Use the criteria developed in this analysis when considering the creation of any new advisory bodies. |
| 6.1.1 | Alaska should maintain a single state agency for health and social services. |
| 6.3.2 | Move forward with the transfer of the ILP program to DEED. |
| 7.1.1 | Revise the prioritization scoring system to address the concerns, weaknesses and unintended consequences identified in this review. |
| 7.1.2 | Revise the ITG process to limit the number of projects that must be vetted by the ITG Committee. |
| 7.1.3 | Require the completion of all information on the Application Development Project Status Report. |
| 7.1.4 | Identify and correct inconsistencies in IT policy, procedures, terminology, and titles throughout the department noted in the discussion. |
| 7.3.1 | Implement mandatory project management training and mentoring for IT and division staff, including Division Business Alignment Liaisons and project managers, who are tasked with responsibilities concerning development, integration and implementation of technology systems. |
| 7.4.A.1 | Allocate resources to IT security systems and other tools to ensure critical concerns cited in the OCR Audit and the Risk Mitigation Plan are addressed. |
| 7.4.A.2 | Educate division leaders and system users on the risks of mobile computing and social media, and obtain agreement on policies concerning need for restrictions and why waivers from security requirements should be more closely monitored and restricted. |
| 7.4.A.3 | Develop and offer on-line security awareness training programs. |
| 7.4.A.4 | Restrict and closely scrutinize requests for IT security waivers that may facilitate security breaches. |
| 7.4.A.5 | Implement strict enforcement policies and procedures regarding the use of USB drives, external hard drives, social media, and other possible points of entry for cyberattacks. |
| 7.4.B.1 | Develop a plan to address the significant shortcomings and productivity issues identified by operational staff using DSM. |
| 7.4.B.2 | Expedite the execution of this plan. |
| 7.4.B.3 | Communicate progress on the plan and how problems are being addressed to all DHSS staff at regular intervals. |
| 7.5.1 | Continue to expand the use and availability of technology in SOPHN to improve patient communications, improve services and maximize efficiency. |
| 7.5.2 | Prioritize migration to electronic health records (EHRs) for all divisions – particularly SOPHN – to reduce medical errors, maximize operational efficiency, and minimize redundant training. |
| 8.1.B.2 | Update current charges to reflect the true cost of testing for ASPHL’s contractual work with other health entities. |
| 8.1.B.4 | Maintain services for state agencies currently receiving laboratory work from ASPHL when instituting a fee-for-service system. |