Leadership change for state's health and human services amid major federal challenges

Massachusetts Health and Human Service Secretary Kate Walsh is retiring after two and a half years in the role. In a statement, she said she only planned to be in the job for two years.

Gov. Maura Healey appointed Dr. Kiame Mahaniah, the current undersecretary for health, to replace Walsh. His first day in the new role is Monday.

Walsh led the state’s response to the Steward Health Care bankruptcy, including the closing of two Steward hospitals, and the sales of several others. In an email, Walsh said she’s proud of her team, citing a dramatic reduction in overdose deaths, a massive project to find health coverage for 400,000 MassHealth members, and programs that are reducing health disparities.

“At least once a day we all say 'thank goodness we live in Massachusetts,' ” wrote Walsh, in a statement. “There are tough times ahead but we are working from such a position of strength.”

Mahaniah moves into the top job as Massachusetts faces $3.5 billion in Medicaid cuts yearly and at least $53 million less for the food assistance program SNAP. The state is also experiencing losses of federal research funding for area hospitals; rising health care costs; threats to health equity programs, abortion and transgender care; the elimination of federal funds to assist unauthorized immigrants; and a severe shortage of primary care providers.

In an interview with WBUR, Mahaniah said the Healey administration shares some priorities with the Trump administration like reducing chronic illnesses and focusing on healthy foods. Where the two administrations disagree, Mahaniah said the government, civic leaders and the public will decide what programs to fight for in court, fund with state dollars or stop providing.

“We use this crisis to sharpen our values,” he said. “That will be an ongoing conversation.”

Mahaniah was clear about his own priorities. He co-chairs a current task force on primary care and said the state needs solutions in place within six to 18 months. He has a long-standing commitment to health equity and to streamlining health care services so that patients have a more coordinated, integrated experience. Mahaniah said he’s focused on the most vulnerable clients and patients.

“My work as a physician is very relevant,” said Mahaniah, who continues to see addiction and primary care patients at the Lynn Community Health Center for a half-day every week. He was CEO there before joining the Healey administration.

With any policy decision, “I’m thinking, what does this mean for the people I serve?” he said.

The secretary for health and human services manages a massive budget — $32 billion this fiscal year, just over half the state’s total budget. In addition to Medicaid, known as MassHealth in the state, the secretary oversees 11 agencies including departments in charge of mental health, public health, children and families, and aging and independence.

Walsh will continue to serve as an advisor to Healey on health care issues facing the state. Beyond that, Walsh said she plans to take time off to figure out what’s next.