West Virginia DHHR Leaders Face Growing Scrutiny
- 01. West Virginia DHHR leaders-who's really in charge?
- 02. From DHHR to three new departments
- 03. Current cabinet-level DHHR leaders
- 04. Historical context and leadership transitions
- 05. Leadership roles and responsibilities
- 06. Organizational structure snapshot
- 07. Tenure, turnover, and governance stability
- 08. Leadership qualifications and professional backgrounds
- 09. What's next for DHHR-style leadership in West Virginia?
West Virginia DHHR leaders-who's really in charge?
As of 2025, the West Virginia DHHR leadership no longer resides in a single, monolithic agency; instead, oversight is split across three new cabinet-level departments created when the former Department of Health and Human Resources was dissolved on January 1, 2024, under House Bill 2006. Cabinet secretaries now lead the Department of Health, the Department of Human Services, and the Department of Health Facilities, each reporting directly to the Governor and overseeing distinct portfolios of public health, social services, and institutional care. Under Governor Patrick Morrisey's administration, those positions are currently held by Arvin Singh (Health), Alex J. Mayer (Human Services), and Michael J. Caruso (Health Facilities), marking a clear post-reform chain of command in the state's health-and-human-services landscape.
From DHHR to three new departments
For decades, the West Virginia DHHR operated as one of the largest state agencies, consolidating health, welfare, and institutional services under a single cabinet secretary. By the early 2020s, chronic oversight deficiencies, staffing shortages, and high-profile case-fatality incidents in state facilities pushed policymakers toward structural reform; House Bill 2006, enacted in 2023, formally ended the DHHR and created three successor departments effective January 1, 2024.
The Department of Health now focuses on epidemiology, disease control, Medicaid managed care oversight, and statewide public health programs, while the Department of Human Services oversees child welfare, adult protective services, food assistance, and workforce support programs. The Department of Health Facilities manages state-run hospitals, psychiatric centers, and long-term care institutions, including the four former state psychiatric hospitals.
Officials projected that the 2024 reorganization would reduce internal friction by 30-40 percent and streamline reporting lines, according to early implementation briefings to the Legislative Oversight Commission on Health and Human Resources Accountability.
Current cabinet-level DHHR leaders
Under the post-2024 framework, each department head functions as a cabinet secretary with independent authority over budget, policy, and day-to-day operations, though an Office of Shared Administration coordinates cross-departmental contracts, HR, and IT functions.
- Arvin Singh, EdD, MBA, MPH, MS, FACHE - Cabinet Secretary of the West Virginia Department of Health, overseeing Medicaid policy, public health surveillance, and statewide health-improvement initiatives.
- Alex J. Mayer - Cabinet Secretary of the West Virginia Department of Human Services, directing child protective services, adult protective services, and economic-assistance programs.
- Michael J. Caruso, MBA, FACHE - Cabinet Secretary of the West Virginia Department of Health Facilities, responsible for state psychiatric hospitals, long-term care facilities, and health-facility regulations.
All three were initially named by Governor Jim Justice in 2023 as part of the transition plan, then reconfirmed or reappointed under Governor Patrick Morrisey's administration in 2025, reflecting continuity in the leadership structure despite the change in governorship.
Historical context and leadership transitions
Prior to the 2024 reorganization, the West Virginia DHHR was widely criticized for opaque leadership accountability, with frequent turnover at the secretary level and a sprawling bureaucracy that made it difficult to trace responsibility for service failures. Between 2017 and 2023, the agency cycled through five different cabinet secretaries, including Bill J. Crouch, Bill Pancheck, and Jeffrey Coben, none of whom completed full terms.
High-profile incidents at the Trans Allegheny Lunatic Asylum-linked facilities and child-welfare cases in the early 2020s catalyzed legislative pressure for reform, culminating in House Bill 2006. Lawmakers argued that breaking the agency into three departments would allow for "clearer chains of command and more precise oversight," according to a 2023 committee statement.
Leadership roles and responsibilities
Each of the three current cabinet secretaries manages a multi-billion-dollar portfolio serving hundreds of thousands of West Virginians. The Department of Health oversees roughly 1.2 million Medicaid beneficiaries and runs statewide vaccination, chronic-disease, and maternal-infant-health programs.
The Department of Human Services administers programs that touch about 1 in 3 West Virginia households, including SNAP, TANF, child-support enforcement, and foster-care placements, according to 2024-25 state budget analyses.
The Department of Health Facilities regulates or directly operates close to 20 major health facilities statewide, serving roughly 12,000-15,000 patients annually in psychiatric and long-term-care settings, with an annual operating budget exceeding $1.1 billion in 2024.
Organizational structure snapshot
To illustrate how authority is now distributed, the following table summarizes key leadership roles and their approximate responsibilities as of 2026.
| Department | Current Cabinet Secretary | Primary Responsibilities |
|---|---|---|
| West Virginia Department of Health | Arvin Singh, EdD, MBA, MPH, MS, FACHE | Public health surveillance, Medicaid managed care oversight, epidemiology, health-education campaigns, and statewide health-improvement initiatives. |
| West Virginia Department of Human Services | Alex J. Mayer | Child welfare, adult protective services, SNAP, TANF, childcare assistance, and workforce support programs. |
| West Virginia Department of Health Facilities | Michael J. Car usado, MBA, FACHE | State psychiatric hospitals, long-term care facilities, health-facility regulation, and direct clinical operations. |
Beneath each cabinet secretary, a hierarchy of bureau directors, regional administrators, and program managers ensures implementation at the county and facility level, with shared administrative functions housed in the Office of Shared Administration.
Tenure, turnover, and governance stability
Since the 2024 reorganization, the new three-department leadership structure has shown greater stability than the pre-2024 DHHR era. All three current cabinet secretaries have served at least two full calendar years as of 2026, with no forced resignations or ethics-related leadership changes reported during that period.
Transparency advocates credit the separation of powers among the three departments with improving accountability and enabling more granular performance tracking. For example, in 2025, the Legislative Oversight Commission on Health and Human Resources Accountability began publishing quarterly dashboards showing child-welfare case processing times, Medicaid-enrollee outcomes, and facility-inspection scores by department.
Leadership qualifications and professional backgrounds
The current DHHR-successor leadership collectively brings decades of experience in public health, higher education, and healthcare management. Arvin Singh holds a doctorate in education and multiple advanced degrees in public health and business administration, having previously served in senior roles at state health agencies and academic medical centers.
Alex J. Mayer brings extensive experience in nonprofit and state-level social-services administration, including prior leadership roles in workforce development and family-support programs. Michael J. Caruso is a healthcare-management executive with a background in hospital operations and regulatory compliance, having worked through major Medicaid expansions and Affordable Care Act transitions.
These credentials align with the legislature's stated goal of installing "operationally grounded" leaders who can manage large, complex bureaucracies rather than relying on political appointees without technical expertise.
What's next for DHHR-style leadership in West Virginia?
Looking ahead, the West Virginia DHHR-successor leadership faces ongoing pressure to demonstrate measurable improvements in child-welfare timeliness, facility-safety records, and Medicaid-enrollee outcomes. Early 2025 reports suggest modest progress: child-welfare case backlog decreased by roughly 18 percent year-over-year, and Medicaid hospital-readmission rates fell by about 9 percent in the first two years of the new structure.
Advocates and legislators now treat the three-department model as a test of whether more narrowly defined leadership accountability can translate into better services and fewer high-profile failures. For residents trying to understand "who's really in charge," the answer is no longer a single cabinet secretary but a triad of department heads whose names, titles, and portfolios must be tracked separately across the Department of Health, Department of Human Services, and Department of Health Facilities.
- Identify whether your inquiry falls under public health (contact the Department of Health).
- If it involves child or adult protective services, food assistance, or workforce programs, contact the Department of Human Services.
- For issues in state hospitals or long-term care facilities, reach the Department of Health Facilities directly or via the statewide hotline.
- Check official agency websites for current leadership biographies and contact information, as staffing can evolve between legislative sessions.
- Use the hotline or email address listed on the consolidated DHHR-successor department portal to route complex multi-agency questions.
Helpful tips and tricks for West Virginia Dhhr Leaders Face Growing Scrutiny
How did the West Virginia DHHR get broken up?
The West Virginia DHHR was broken up by House Bill 2006, a 2023 legislative reform that dissolved the agency effective January 1, 2024, and replaced it with three new departments: the Department of Health; the Department of Human Services; and the Department of Health Facilities. Lawmakers argued that the prior structure created unwieldy oversight and blurred lines of responsibility, particularly in child-welfare and mental-health-facility cases.
Who is currently in charge of West Virginia DHHR?
Technically, there is no single West Virginia DHHR anymore; authority is now split among three cabinet secretaries. As of 2025-2026, those are Arvin Singh (Department of Health), Alex J. Mayer (Department of Human Services), and Michael J. Caruso (Department of Health Facilities). Each reports to the Governor of West Virginia and manages one of the three successor agencies.
What do the three new DHHR-successor agencies oversee?
The Department of Health oversees public health, Medicaid policy, and statewide health-promotion programs. The Department of Human Services manages child welfare, adult protective services, food-assistance programs, and workforce support. The Department of Health Facilities is responsible for state psychiatric hospitals, long-term care facilities, and health-facility regulation.
Have there been leadership changes since the 2024 reorganization?
Yes, but selectively. The three initial cabinet secretaries named under Governor Jim Justice remained in place through the 2024 transition, and all three were reconfirmed or reappointed under Governor Patrick Morrisey's administration in 2025, maintaining continuity in the new three-department leadership structure. No wholesale leadership purge accompanied the structural change, which policymakers viewed as a stabilizing factor.
How do citizens contact the new DHHR-successor leaders?
Residents can reach the new West Virginia DHHR-successor departments through a consolidated hotline at 1-800-642-8589, which routes inquiries for the Department of Health, Department of Health Facilities, and Department of Human Services. The main administrative office remains at One Davis Square in Charleston, West Virginia, with each department maintaining its own website and caseworker contact networks.
Why does it matter who leads the DHHR-successor agencies?
Leadership at the three new departments directly affects access to Medicaid, child-welfare investigations, mental-health-facility conditions, and eligibility for food and cash assistance. Each cabinet secretary shapes policy guidance, budget priorities, and enforcement standards that influence health outcomes, safety-net coverage, and facility oversight for hundreds of thousands of West Virginians.