The legislature’s Executive and Nominations Committee gave Gov. Dannel P. Malloy’s nominee to head the Department of Social Services a thumbs up Tuesday when they sent his nomination to the floor of the Senate.
Roderick Bremby, who started his new job last week, told the committee of his childhood and his eight years as head of the Kansas Department of Health and Environment where he denied a permit for a coal-fired power plant.
In Kansas Bremby was in charge of regulating everything from day cares to oil spills, but his job in Connecticut will be more focused on the administration of the Medicaid, cash assistance for the poor, Supplemental Nutritional Assistance Program (SNAP), child care subsidies, nursing home regulation, and winter heating aid.
But the committee seemed less focused on his past and more focused on where he plans to take the state of Connecticut as head of an agency that oversees an estimated $6 billion annual budget and several human services programs for the poor and disabled.
Sen. Majority Leader Martin Looney, D-New Haven, wanted to know what Bremby thought of the progress of Primary Care Case Management, a type of medical home model which pays primary care doctors a per patient fee to coordinate their care.
The PCCM pilot was stymied by former Gov. M. Jodi Rell’s administration, but Gov. Dannel P. Malloy’s Budget Director Ben Barnes said on Feb. 8 that “we intend to move aggressively to expand the medical home portion … once we convert to the ASO.”
Dr. Mark Schafer, who is still director of Medicaid Services at DSS and is currently working under Bremby, has said PCCM “does not meet my standards,” which leaves Bremby in a difficult position.
“Often times in government service we use acronyms, we use labels and they’re loaded,” Bremby told Looney. “We want to make sure that we share that vision. We will focus on patient centered medical home services.”
“I understand that from internal discussion that the point the DSS person was trying to get to was that we need to ensure high level of quality regardless of what model and how quickly we transition to services and so it may have been a misstatement on his part regrettably, but we are committed to providing quality services in a patient-centered medical home context,” Bremby said.
Bremby admitted he hasn’t spoken to Barnes about this specific issue, but will be working closely with the administration on the roll out of all models.
As part of his budget Malloy proposed transitioning the Medicaid population from a Managed Care Organization model back to an Administrative Services Organization model where the state will be self-insured and taking on the risk as opposed to the insurance companies.
The other concern lawmakers raised was the antiquated information technology and phone system used by the agency. They said they’re constituents call them when they can’t get through to a person or can’t get their calls returned for weeks. Some of the technology in the department dates back to the 1989.
Currently the telephone overflow dumps into an answering machine, which fills up quickly so when they can’t get through to a living human being they start dialing phone numbers within the department and sometimes the governor’s office.
Bremby said they can leapfrog some development of a better more responsive system, but the full modernization of the department will take about three to four years. He said while some of its clients don’t have access to computers they do have access to smartphones and the department can develop smartphone apps that allow them to check on the status of their application for services.
“You can’t complete an application on a smartphone, but you can sure check on the status of your case,” Bremby said. “If we can give people opportunities to access us so there is no wrong door for service I think we’ll all be better served.”
The service levels that are currently being provided are “woefully inadequate” and “something I plan to give my direct attention,” Bremby said.
Bremby said he’ll be looking to create administrative efficiencies in all 90 programs the department oversees by giving the front and back office workers the tools they need to serve the population. He said customer service has to improve too.
“Dare I say I won’t be bored at all,” Bremby said.
He also told the committee there’s no other place he’d rather be than in Connecticut.
His personal 2007 bankruptcy was not raised by any of the committee members.
The committee voted 6 to 0 to approve Bremby’s nomination. Two members were absent. The Senate will now need to confirm the nomination.