Pore called the department's turnover rate "shocking." The staff is in charge of "enormous" amounts of money and needs strong, professional leaders who know what they're doing, she said.
"These jobs that people have at [the] DHHR are really big jobs that require very sophisticated, educated and thinking people and a long time to understand these systems," she said. Having a 30-percent turnover rate and no plan to replace leaders who retire is a real problem, she said.
In addition to leadership, Pore said, DHHR employees need respect from the Governor's Office on down.
"In my experience, governors have thought that [the] DHHR was a pain to be endured," she said. "We need the governor to respect the work that [the] DHHR does -- and the public, too."
Pore said she also is concerned with the understaffing at the DHHR, particularly at the Bureau for Medical Services.
According to the audit, the BMS, which administers the federal Medicaid program, has 62 filled full-time positions out of an available 100 slots. Those 62 employees oversee the day-to-day operations of a $3 billion program, auditors said.
"We have pointed this out for a long time: The DHHR, and especially Medicaid, is very understaffed," Pore said.
Tomblin has not yet announced if West Virginia will expand its Medicaid program to those who make up to 138 percent of the federal poverty level, as is an option under the Affordable Care Act. The governor has been waiting on the results of an actuarial study about the costs of expansion.
Advocates say that will mean about 120,000 uninsured West Virginians would qualify for coverage under Medicaid.
Pore said the Medicaid program should have three to four deputy commissioners with expertise in each of the programs Medicaid has, for instance long-term care, children and people with disabilities.
Pore said the WVAHC will use the auditors' report to advocate for change at the DHHR beginning next year.
"We can't go on the way we are," she said. "We desperately need change."
Reach Lori Kersey at lori.ker...@wvgazette.com or 304-348-1240.