The dysfunction of the Minnesota Department of Human Services continues.

The latest dysfunction episode is a temporary restraining order Aug. 30 putting on hold the state's efforts to finalize new

provider contracts for public health program in 80 counties outside of the Twin Cities metro area. This resulted from the DHS's recent contract decision ignoring many county recommendations. The metro counties of Hennepin and Ramsey are scheduled for new provider decisions in 2020.

The Department of Human Services, the state's largest agency, has been hit recently by resignations of top staff, allegations of fraud and retaliation against whistleblowers.

Kandiyohi County was one of the many counties surprised when the state did not approve the county's recommended decision to utilize PrimeWest Health as the sole health plan provider. The decision would impact nearly 10,000 Kandiyohi County residents on Medical Assistance, MinnesotaCare, Minnesota Senior Health Options and other publicly funded health programs that cover low-income populations.

The Kandiyohi County Board had approved resolutions designating the county on Jan. 1 to join PrimeWest Health, a county-based purchasing organization that in essence allows the 24 participating counties to collectively function as a health plan, contract with providers and assume the financial risk.

In July, the state's DHS instead decided Kandiyohi County must offer plans with two provider options for Medical Assistance enrollees and four choices for the publicly funded senior care plans.

The Kandiyohi County Board is not the only county or organization frustrated by the state's procurement process for publicly funded health programs.

The issue for Kandiyohi County is headed for mediation, according to county officials. That session is scheduled for Sept. 23. If the results are unfavorable, county officials may consider a lawsuit.

The DHS decision has also introduced significant uncertainty for Kandiyohi County's entry into the PrimeWest Health organization, scheduled to start on Jan. 1. Neither the health organization, Kandiyohi County nor the other 24 participating counties know what the future holds now. This makes health care management decisions difficult for all involved.

The South Country Health Alliance has filed a lawsuit against the state after the organization was not selected as a provider for the next contract round starting in 2020.

Numerous officials from outstate Minnesota counties have criticized the DHS selection process for diminishing the influence of local leaders in picking providers.

In Kandiyohi County, the state blatantly disregarded the County Board and staff's "reasoned choice of making PrimeWest Health our since choice" for the needed services, according to Roland A. Nissen, Kandiyohi County Board chair. We agree.

PrimeWest Health's designation as the single plan has for years in other participating counties ensured access to high-quality care and helped reduce health care costs.

Without the single plan designation, Kandiyohi County may not be able to participate in the county-based purchasing of PrimeWest Health. This could result in less local control and high costs for providing the county's public health services.

Kandiyohi County would be a joint owner of PrimeWest Health. The county-based purchasing program ensures that state budget dollars for the county are solely used for those purposes. Any cost savings under the current health maintenance organization programs adds to those organization's profit and does not benefit our county.

A major advantage of the PrimeWest Health option is keeping local control in the counties over how health care is provided to a vulnerable population that often has multiple needs. Metro-based HMOs' plans often fall short in serving local needs, such as transportation, language interpreters and provider shortages. These HMOs also often have poor communications and limited local input in rural counties.

Gov. Tim Walz has often spoken of his support for state-county partnerships. The current DHS procurement decision is not a partnership decision, but another top-down mandate from the state.

The Department of Human Services needs to get its act together and become a true partner with Minnesota counties in the procurement process of publicly funded health programs. If not, the Minnesota Legislature needs to take a serious look at DHS operations in 2020.

This editorial is the opinion of the West Central Tribune's editorial board of publisher Steve Ammermann and editor Kelly Boldan.