LINCOLN — The new head of Nebraska’s largest state agency named good fiscal management, good procurement and contracting processes and good staff as key concerns Thursday.

Dannette Smith took over as the Department of Health and Human Services chief executive officer last month.

On Thursday, she outlined her vision for the agency at a confirmation hearing before the Legislature’s Health and Human Services Committee.

She said that vision starts with improving the agency’s foundation.

“I think an organization that has a strong infrastructure can do any type of program,” Smith said. “We have got to make sure the infrastructure is in place.”

Starting from that base, she said, she wants to create an integrated service delivery system, which would bring together multiple pieces of the agency to better serve Nebraskans.

Smith also told the committee that HHS officials need to be realistic about the programs they are implementing and transparent about what can and cannot be accomplished.

Regarding specific issues, Smith said the agency is committed to successfully implementing Medicaid expansion.

Voters last fall approved a law expanding the program to an estimated 94,000 more low-income Nebraskans. The law calls for HHS to submit an expansion plan to the federal government by April 1.

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In her last job, Smith said, she was involved when Virginia expanded its Medicaid program.

Smith previously worked as director of the Virginia Beach Department of Human Services.

She called the expansion an “exciting time” for that agency. She said the agency prepared by doing outreach to the community and training for workers.

Smith also drew on her Virginia experience in answering a question from State Sen. Sara Howard of Omaha about creating a plan for getting people with disabilities into the community.

Nebraska is among 16 states without such a plan, called an Olmstead plan after a pivotal U.S. Supreme Court case.

Smith said Virginia was forced by the courts to develop an Olmstead plan and start implementing it.

She said she hopes to avoid a similar lawsuit in Nebraska by getting a plan completed this year and implementation underway by 2020.

Gov. Pete Ricketts chose Smith following a national search to replace former CEO Courtney Phillips. Smith takes over an agency that touches the lives of nearly every Nebraskan in some way — and one that has had numerous struggles.

The agency has an annual budget of $3.6 billion, including both state and federal funds, and employs nearly 5,100 people in five divisions — behavioral health, children and family services, developmental disabilities, Medicaid and long-term care, and public health.

In Virginia Beach, Smith was in charge of about 1,300 employees and a budget of more than $120 million a year in an agency with programs in behavioral health, developmental disability services, child welfare and other social services.

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Martha Stoddard keeps legislators honest from The World-Herald's Lincoln bureau, where she covers news from the State Capitol. Follow her on Twitter @StoddardOWH. Phone: 402-473-9583.

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