|Easing Administrative Processes
Nearly 90 percent of the Department’s funding comes from sources other than the City’s General Fund, yet the Department is required to adhere to all of the City’s existing administrative rules that govern personnel, procurement, and contracting practices. City policies and procedures governing public sector personnel, procurement, and contracting processes have been established over the years as safeguards to ensure the appropriate expenditure of public funds. These processes represent important internal financial controls to which all City departments must adhere. These requirements sometimes impede the Department’s ability to effectively and efficiently pursue, manage, and expend grant funds.
While every City department may argue that its operations are ‘different’ from other City entities, the Health Department’s arguments are particularly compelling. Factors that set the Health Department apart include: its highly specialized staffing needs (doctors, dentists, nurses), its need to respond quickly to rapidly emerging health trends (strains of highly contagious diseases, virus outbreaks), and the unique types of materials and supplies required to provide health services (medical supplies, vaccines, etc.).
Some have advocated ending the practice of the Department providing direct services to the public, opting instead for a service delivery model where there would be a public health officer with a policy-setting role and all direct clients services would be outsourced to third-party providers. While this was a solution considered by the project team, a ‘demonstration project’ concept was the preferred alternative.
The project team judged the Department as a particularly attractive candidate for a 12 to 24 month controlled experiment to measure the effects of providing increased management and operational autonomy. Conducting such a demonstration project would require a tremendous amount of operational and financial planning and necessitate the establishment of well-defined goals and objectives against which to measure the ultimate success or failure of the experiment. In the event that the Mayor elects to pursue the implementation of this recommendation, members of the Greater Baltimore Committee and Presidents’ Roundtable Health Department project team have volunteered to play an active role in collaborating with the Department’s leadership to develop more concrete plans for the scope of the demonstration, to establish measurable performance goals, to monitor the implementation, and to provide regular reports (monthly or quarterly) to the Mayor, City Council, City Comptroller, and other interested stakeholders.
Introduction: Health Department