Gov.-elect Tina Kotek will appoint a 20-year health care veteran to lead the Oregon Health Authority in early January, at least temporarily.
In a statement on Tuesday, she said that James Schroeder, currently the CEO of the state’s largest Medicaid insurer, Health Share of Oregon, will serve as interim director.
“James brings over 20 years of management, leadership and health care delivery experience and a deep respect for the work of the OHA,” Kotek said. “Addressing the cracks in our mental health and addiction services systems will be a top priority for my administration, and I am confident that James has the experience and determination to get results for Oregonians.”
Schroeder will start Jan. 10, the day after Kotek takes office. He will replace Patrick Allen, who announced last month that he will step down Jan. 9. Steve Allen, the health authority’s behavioral health director, will leave the same day. Kotek said during her campaign she would replace both Allens, who are not related.
Patrick Allen brought to the agency years of government leadership experience, including as director of the Department of Consumer and Business Services, which oversees most insurance companies. Schroeder has clinical and administrative health care experience. He was trained as a physician’s assistant, a role that includes prescribing medications, and has worked in clinical and managerial roles.
For the past two years, he’s led Health Share, which insures 426,000 Medicaid patients in the Portland area. Before that he held several top positions at Kaiser Permanente, including as vice president of safety net transformation and medical director of Medicaid. And since 2013, he’s served as medical officer in the Oregon Air National Guard, according to his LinkedIn page.
Schroeder also has worked as a clinician and executive in medical clinics that serve many Medicaid patients, founding and serving as CEO of the Neighborhood Health Center in the Portland area.
A leading Portland advocate, Kevin Fitts, executive director at Oregon Mental Health Consumers Association, welcomed Schroeder’s medical background. Fitts said his experience working with patients and ethical training to “do no harm” will be crucial for the state’s work in Medicaid and behavioral health.
Andrea Cooper, Kotek’s chief of staff, told health authority employees in an email on Tuesday that they will likely see Schroeder in the office before he assumes the interim role, working with Allen on the transition. She urged them to support him in the new role.
Multi-billion dollar budget
The health authority is one of the biggest agencies in Oregon in terms of budget – more than $17 billion a year in the current budget cycle – and it has 4,770 employees. The agency is responsible for most of the state’s health care programs, including behavioral health, public health and Medicaid, which covers one in three Oregonians.
When the federal health care emergency ends, which could happen in mid-January, the agency will need to audit the 1.4 million Oregonians covered by Medicaid to weed out those who no longer qualify because they make too much money. The agency also needs to bolster the state’s mental health services. For years, Oregon has ranked in national surveys as having the highest or among the highest share of people suffering with mental health and addiction problems and a lack of treatment options.
The Legislature has allocated $1 billion to create behavioral health and addiction treatment and social service networks, but Fitts said the behavioral health system continues to languish. He said the next director will need to ask tough questions and look for solutions that go beyond the system as it is now, he said.
Schroeder acknowledged that challenge in a statement.
“Our state is at a critical turning point, especially when it comes to the delivery of mental health and addiction services. I am honored by this appointment, and I want Oregonians across the state to know that I take this responsibility very seriously,” Schroeder said in a statement. “I will work tirelessly to ensure that the OHA team produces results for our communities.”
Focus on equity
Allen said he’s worked closely with Schroeder for years, saying he’s well qualified. The two have been in contact more frequently in recent weeks as it became clear that Schroeder would succeed him, at least on an interim basis.
Besides working on behavioral health issues and homelessness, two of Kotek’s priorities, Schroeder will face a big challenge trying to make health care more equitable, Allen said. He set an agency goal of achieving equity by 2030. Allen said the agency’s culture has changed since he took the helm to emphasize equity. He said that needs to be a part of all of the agency’s programs for the state to advance.
“If you’ve got big chunks of the population that are disconnected from all of that and you don’t pay attention to health equity, you’re really not serving the need that you need to serve,” Allen said. “That’s a big cultural change that took a long time to begin to get to.”
Allen said keeping a focus on equity has been one of the most difficult parts of the job because the agency is frequently grappling with a crisis, such as a disease outbreak. For much of the past three years, it’s been focused on the pandemic. Allen said it’s human nature to focus on the immediate crisis but that can mean that health inequities continue to dog the state.
“For any director of OHA, that part is harder. And it’s often the part that gets left behind because because the rest of the problem is so urgent.”
It’s not clear whether Kotek plans to appoint Schroeder to serve as the permanent director or will consider him. A spokeswoman, Katie Wertheimer, did not immediately respond to a request for comment about that.
Allen said that when he was appointed to lead the agency by Gov. Kate Brown in 2017 it was initially on an interim basis.
Fitts said he’s optimistic that Schroeder will be able to bring needed change to the health authority.
“The status quo is unacceptable,” Fitts said. “I think we need a visionary and we need somebody to have the courage to be above board and talk about these issues.”
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