Is Massachusetts’ largest state office too big? Some are discussing splitting it up. – The Boston Globe

Some question whether that’s too much for one office to manage.

“It hasn’t gone through a comprehensive reorg or even review from an organizational perspective in a long while,” said state Senator Rebecca Rausch of Needham, a Democrat who worked as an attorney in EOHHS before joining the Senate. “We have a monster executive office. It’s just huge.”

The office’s structure is receiving scrutiny from another legislator, state Representative John Barrett, Democrat of North Adams, in part because some of its departments have been at the center of dramatic, and sometimes tragic, failures.

A COVID outbreak in the Holyoke Soldiers Home, which killed 76 veterans in 2020 and led to charges against the facility’s top administrators, happened under the office’s watch. It also oversees the state’s child welfare agency, which has been castigated for the deaths of children under the agency’s care, including a 14-year-old intellectually disabled boy who died of starvation and neglect in 2021, and a 5-year-old girl whose 2019 murder in New Hampshire wasn’t discovered until last year.

In March, Barrett introduced a bill that would form a commission to evaluate the office’s efficiency. Breaking up the office is one solution to what he sees as an overwhelmed management team.

“The one thing that was clear to me,” said Barrett, who introduced a similar bill in the last legislative session, “is that they didn’t have the management capacity.”

Governor Maura Healey and Kate Walsh, the state’s Secretary of Health and Human Services, did not dismiss the idea.

“Secretary Walsh and her team are constantly evaluating how we can make our state’s health and human services more effective and efficient,” said Karissa Hand, a spokesperson for the governor’s office. “The governor will review any legislation that reaches her desk.”

The governor is free to reorganize executive offices as she sees fit, Barrett noted, without legislative input.

The deaths at Holyoke prompted Governor Healey to make Veterans Services, once overseen by health and human services, an independent cabinet level position this year. Healy also this year sought to address the state’s housing crisis by breaking the Office of Housing and Economic Development in two.

A spokesperson for EOHHS said the office would not comment on pending legislation. The spokesperson did not answer when the office last conducted a comprehensive organizational review, or what routine efficiency evaluations it requires from each of its departments.

There’s no single vision of what a reorganization would look like. A policy document from Barrett’s office suggests creating four new secretariats, including spinning off public health and child welfare as independent entities.

MassHealth, which served about 2.4 million people as of April and has a nearly $20 billion budget, is large enough it could benefit from independence, Rausch said. The program is in the midst of an enormous re-enrollment effort as pandemic-era protections that kept people from losing Medicaid benefits over the past three years end.

Health and human services’ current structure does have advantages, said Doug Howgate, president of the Massachusetts Taxpayers Foundation, a nonprofit budget watchdog. The marginalized communities the office is most likely to serve tend to need assistance from several public programs at once, and they may be easier to coordinate under a single agency.

“The health needs of vulnerable populations also speaks sometimes to coordinating things under the same roof,” Howgate said.

A major health and human services reorganization is worth exploring, but breaking up a large office isn’t in itself a fix, he continued. The governor’s office would need a coherent strategy behind the reorganization, Howgate said. Making MassHealth an independent office, for example, would be worthwhile only if it demonstrably helped free time and resources for other services.

A conservative nonprofit focused on social welfare in the state, though, said creating additional bureaucracy won’t make the state’s social service departments work more effectively. Better instead, said Paul Craney, of the Massachusetts Fiscal Alliance, to combat waste and inefficiency in the existing organization.

“Taxpayers have seen more and more six-figured state salary positions the last few years,” he said.

The idea that more executives, he said, “will somehow magically make state government more accountable is not based in reality.”

Barrett disagrees. The problems in health and human services, he said, demand a significant overhaul.

“I mean, they are supposed to be taking care of or overseeing our most vulnerable citizens,” Barrett said. “People are dying. Kids are dying.”

Jason Laughlin can be reached at jason.laughlin@globe.com. Follow him on Twitter @jasmlaughlin.