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Janek should resign as health commissioner

Kyle Janek should no longer lead the Texas Health and Human Services Commission.

The critical report released Monday by a “strike force” deployed by Gov. Greg Abbott to investigate the health agency’s $110 million no-bid contract with 21CT, an Austin technology company, makes our conclusion unavoidable. While the report did not blame Janek directly for the “policy fiasco” with 21CT that “skirted the limits” of the law, it did find deep organizational issues within the department that Janek either failed to address or that his leadership style made worse.

The organizational issues “can’t be resolved without a significant departure from the status quo,” the report says.

Calling for a departure from the status quo isn’t necessarily the same as calling for Janek’s departure, granted, but an agency’s leader stands as a symbol of its successes or failures. As the American-Statesman has identified in a series of stories over the past several months, the health agency’s managerial problems with contracts go beyond 21CT, and a couple involve Janek more directly.

If responsibility has any meaning — and we all know how politicians and officials like to stand before the public and talk about how they take responsibility when troubles arise — Janek should resign or Abbott should replace him. The Health and Human Services Commission might yet become “a model for good government and ethical leadership,” as Janek wrote in a letter to Lt. Gov. Dan Patrick on Monday, but it must do so with a new leader.

The Texas Senate on Tuesday passed a reform bill by Republican state Sen. Jane Nelson of Flower Mound that sets new reporting requirements for agencies contracting with private businesses, but most state leaders haven’t publicly addressed Janek’s future. As the American-Statesman’s Andrea Ball and J. David McSwane reported, this silence perhaps is because Janek, who served as a Republican state representative and senator from 1995 to 2008, has numerous friends in the Legislature. Friendship should not keep Janek in his job. As state Rep. Garnet Coleman, D-Houston, told Ball and McSwane, “Our duty is not to our friends. It’s to the state of Texas.”

Former Gov. Rick Perry appointed Janek to the health agency’s top post in summer 2012. In an editorial shortly after his appointment, we expressed hope that Janek could use his legislative and medical experience — he’s an anesthesiologist — to put the frequently troubled Health and Human Services Commission on a more stable path. The benefit of the doubt we gave Janek in 2012 has expired.

As has his term, which ended Feb. 1. He remains on the job because Abbott hasn’t reappointed him or named a replacement. Thus replacing Janek does not call for a great deal of political courage. Abbott simply could thank Janek for his service and move forward with someone else. It’s a necessary move.

Leading the Health and Human Services Commission is a complex job — perhaps a hopelessly complex one. It requires extraordinary managerial skills to meet the position’s numerous responsibilities, which include overseeing the state’s Medicaid programs, health department and foster care and child protective services. The department covers five agencies with more than 54,000 employees who serve more than 4 million people — about 1 in 6 Texas residents. Its combined annual budget is about $37 billion, more than one-third of all state appropriations.

In 2003, the Legislature merged 12 health and human services agencies into five to streamline state operations. Experience in the 12 years since, as several contracts to outsource the agency’s work have failed and cost taxpayers hundreds of millions of dollars, says that greater efficiency or savings don’t necessarily follow consolidation and privatization — especially not when the Legislature fails to write tough rules demanding transparency and accountability or fails to set aside enough resources to properly supervise contracts.

“It is clear now that the HHS agencies faced enormous challenges in responding to the 2003 legislation,” Monday’s report says. “While they succeeded in many instances, other aspects of this effort remain incomplete and problematic.”

The Sunset Advisory Commission has recommended that the Legislature further consolidate the Health and Human Services Commission’s five agencies into one by the end of the 2016 fiscal year. Abbott’s strike force wisely warns against further consolidation.

“It can be mandated, but it can’t be achieved successfully,” the report reads. Further consolidation “may not be the right strategy for future success.”

We’re doubtful it is. At any rate, the agency’s contracting rules and leadership changes demand attention first.

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