In January 2001, in the first month of his administration, Gov. Bob Wise summoned his department heads to his conference room.
He told them he wanted to insure everybody in the state. He ordered them to work together to reduce the cost of health care.
"The strong message from Governor Wise to all the players is: You will work together, and you will make these things happen for the people of West Virginia," said Ann Stottlemeyer, commissioner of the Bureau of Senior Services.
They began immediately. Every two weeks, they gather around a big conference table at the Health Care Authority.
One person after another lays out a problem. They all have at it.
"People yell at each other sometimes. And quite frankly, that's why this works," said Susan Small-Plante, Wise's director of constituent services. "These people like each other, but they don't always agree. There's a gut level of honesty that goes on in that room. The meetings often last the entire afternoon. They'll schedule them so they're talking about Subject A from 1 to 2 and Subject B from 2 to 3."
They explore a problem from all angles and decide who's going to work on what. When they need extra money, they decide who's going to write the grant application and what will be in it.
They call their group the HUG, the Health Umbrella Group.
The list of team members reads like a Who's Who in health care in West Virginia government.
Soon after they began, they went on a "big picture" retreat, said Sharon Carte, director of the Children's Health Insurance Program. They listed problems they could attack immediately, problems that would take extra money, and hard-core problems.
"Unfortunately, there weren't many problems on that first list," Carte said.
"All these people are smart and well-versed in their work, but they can't possibly know everything," said Small-Plante. "Twelve or 15 people are sitting around a table, and somebody says, 'Boy it would be good to have some information about this,' and somebody else says, 'Yeah, I could use that too.' And then they say, 'where do we get that from?' And someone else will say, 'Kellogg is likely to fund something like that.' Or 'Benedum will throw in seed money.' Then Sally Richardson will say, 'Well, my office could administer that.'
"It's all these great minds, thinking creatively. All the players who can make the decision are sitting right there at the table."
In the past two years, they have set quite a few balls in motion:
Employees Insurance Agency. At this point, the proposal is limited to businesses that have at least 19 employees.
The HUG will use the maps to target areas that need access to health care. "This will eliminate guesswork," Small-Plante said.