LITTLE ROCK — The head of the state’s Medicaid program, Roy Jeffus, is stepping down after more than 30 years with state government.
Taking his place is the former director of Iowa’s Medicaid program. Gene Gessow left Iowa after a political rift in that state’s Senate resulted in him not being confirmed as head of the Iowa Department of Human Services.
The Arkansas Department of Human Services announced the leadership change Tuesday as part of its effort to move in a new direction.
Spokesman Julie Munsell said it was a “joint decision” made Monday during a conversation between Medicaiddirector Jeffus and John Selig, director of the Human Services Department.
But Jeffus, who has been director of the department’s Medical Services Division since 2003, said he made the decision to leave. It’s a move he’s been considering for some time, he said.
“I think when you get to a certain point, then maybe it’s important to make some changes and let somebody new come in and make their stamp on things,” Jeffus said.
He said he plans to stay through January to help with the transition.
Gessow said he will take over the division late next month, though a specific date hasn’t been set.
Gessow said he’s been talking with state officials about the position for more than a week.
He has more than 17 years of experience working in state government and has directed Medicaid programs in Iowa and Maine.
In Arkansas, he’ll head the state’s $3.7 billion Medicaid program, the government health program paid for jointly with federal and state funds.
The program covers about 750,000 Arkansans, including children of low-income families, foster children and low-income adults who are disabled, pregnant or have certain cancers.
Gessow’s salary will be $104,080. Jeffus’ salary is $109,480.
Gov. Mike Beebe knew that the change was coming but had no role in selecting Gessow, said Beebe spokesman Matt DeCample.
“Director Selig felt it was the right time to go in a new direction, and we’ll back that play,” DeCample said.
Officials with the Human Services Department did not elaborate on what changes, if any, will occur.
In Iowa, Gessow led the Medicaid program from 2003 until September of 2008, when Gov. Chet Culver appointed him director of that state’s Human Services Department. He served six months. When it came time for the state Senate to confirm his appointment in April, he failed to get the two-thirds vote needed, despite strong support for him from the governor and Senate Democrats.
At the time, Republican senators criticized Gessow for the handling of a February neglect case involving 21 mentally retarded men working for a Texas-based meatprocessing service called Henry’s Turkey Service in Atalissa, Iowa.
Acting on a tip from a law enforcement official, the Human Services Department found the men living in a dilapidated bunkhouse with blocked exits. The structure was later condemned by fire officials.
The men had been paid as little as 44 cents per hour, plus room and board for their labor, according to news reports.
In an April 15 statement, Iowa Senate Republican Leader Paul McKinley said Gessow wasn’t “forthright”when questioned about the case.
“Iowans expect government to be open and transparent, and they expect their elected and appointed officials to be forthcoming and honest, however, Mr. Gessow has failed to be forthright about the Atalissa bunkhouse situation during important legislative oversight committee hearings,” McKinley said in the statement.
McKinley did not return calls or an e-mail Tuesday.
Iowa Democratic state Sen. Jack Hatch defended Gessow on Tuesday. He said he’s a “brilliant” administrator who understands the complexities of Medicaid.
Among other accomplishments, Gessow led Iowa’s Medicaid program through an expansion from 11,000 enrollees to more than 35,000 over four years, Hatch said.
As for the Atalissa case, he said, Gessow “handled it beautifully” and moved quickly to pull in social services and make sure the men got the care they needed. If Gessow hesitated to provide answers during legislative meetings, it was because the case was still under investigation, Hatch said.
“Unfortunately he got caught up in the political maneuvering of the Republicans,” Hatch said.
Gessow said he left Iowa after the confirmation vote failed, and he has been looking for a job ever since. He said he’s not bitter about what happened.
“Was I disappointed? Yes. But I have a great deal of respect for politicians and the political process,” Gessow said. “Sometimes it doesn’t work out quite the way you wanted.”
Munsell, with the Arkansas Department of Human Services, said agency officials were aware of the confirmation hearings and considered them as part of the “vetting process.”
“Extensive research was conducted on Mr. Gessow’s track record, and what emerged was a comprehensive skill set of strong leadership, innovations in health care and effective financial management,” she said.
Selig, director of the Human Services Department, was unavailable for comment Tuesday. In a preparedstatement, he said Jeffus has “been instrumental in helping the program reach many milestones.”
“This is a very challenging time for health care in our country,” Selig said. “We need someone who not only has the leadership experience but also has a great track record in innovations in health.”
The announcement came as a surprise to legislators and to some in the local healthcare industry.
Nick J. Paslidis is president and chief executive officer of the Arkansas Foundation for Medical Care, which works with the state Medicaid program on various initiatives, including an effort under way for a statewide electronic medical record system.
Paslidis said the foundation has had a good relationship with Jeffus and wishes him well.
“We’re looking forward to a new, very successful relationship with director Gessow,” he said.
Arkansas Sen. Percy Malone, chairman of the Senate public health committee, said Medicaid is undergoing a lot of changes.
“The best I can tell [Human Services Department officials] were looking for new ideas and someone who is going to be a little more progressive in some areas,” said Malone, D-Arkadelphia. “I didn’t get any sense that any one event caused it. I got a sense he [Jeffus] was asked to resign.
”State Rep. Gregg Reep, chairman of the House public health committee, said Selig told him that the Human Services Department “had been working on some things with planning and that he just thought changes needed to be made.”
Reep, D-Warren, said Selig described Jeffus’ leaving as a “mutual” move and that the replacement from Iowa could do the things that needed to be done with Medicaid.
Known for wearing cartoon-character ties to committee meetings, Jeffus has a reputation for being easygoing and getting along with legislators.
“He’s always been cooperative,” Reep said. “He seemed to be knowledgeable. I wasn’t expecting [him to leave].”
Jeffus has led the program through the establishment ofseveral initiatives, including ConnectCare, a program that links Medicaid recipients with primary-care doctors. He also has been involved in negotiations with federal officials to expand the state’s Medicaid program for children.
Jeffus said Tuesday that he’s optimistic the expansion will be finalized soon.
Heading the Medicaid program is a stressful position with a lot of responsibility, Jeffus said. Nationwide, Medicaid directors tend to last in the job 12-18 months on average, he said.
“The life expectancy is very short,” Jeffus said. “Every day you come home, you feel like you’ve got a big coat on you. And I feel like I’ve kind of taken a heavy coat off right now.
“When you’re concerned about 700 and something thousand lives every day, you don’t take that off when you come home at night. You don’t sleep a lot of hours, and you hope that you made the right decision for then and in the long run too.”
Gessow said he looks forward to coming to Arkansas. His wife and their two children will remain in Rhode Island for the time being, where the couple owns a house.
“It’s a very exciting time to be involved in Medicaid,” he said. “I like dealing with changing circumstances, and clearly there is a national debate going on in health care that is moving things, and it will be important to make it work for Arkansas.”
Gessow began his career in state government in 1992, when he was legal counsel for the Rhode Island House of Representatives’ Finance Committee. His other experience includes being budget director for the Massachusetts Medical Assistance Division and deputy secretary of finance for the New Mexico Human Services Department.
He has a bachelor’s degree in economics from the University of Wisconsin, a juris doctorate from the University of Denver College of Law, and a master’s in public administration from the Kennedy School of Government at Harvard University.
Information for this article was contributed by Seth Blomeley of the Arkansas Democrat-Gazette.
Front Section, Pages 1 on 12/23/2009