Three takeaways from Gov.-Elect Dunleavy’s appointment of Adam Crum as Alaska DHSS Commissioner

Today, Governor-Elect Mike Dunleavy announced that his new DHSS Commissioner will be Adam Crum, an Executive Vice President of Northern Industrial Training, based in Palmer.  From the release, Dunleavy said that Crum was known for his organizational planning and leadership strengths.

“In his career, Crum has managed large teams and multi-million dollar budgets for projects all over Alaska. Crum’s strengths are strategic planning and organizational development that helps groups realize efficiencies and refocus on mission-driven services.”

Northern Industrial Training is an organization run by what appears to be Crum’s brother, Joey Crum.

Aaron Crum earned an MPH from The Johns Hopkins University following an undergraduate career at Northwestern University.  While there, Aaron Crum walked on to the Northwestern football team where he later became a starter during the middle part of the last decade.

In 2016, Crum ran for the legislature.  He faced Shelley Hughes in a primary campaign to fill a seat from a retiring member of the Senate.  While he lost that campaign, he was able to put some thoughts about health care on the record.  Here is a comment he posted on his campaign website.  The site has since been taken down, but this was captured by VoteSmart.

“Health Care is the single biggest item in our state budget at over a billion and a half dollars this year alone. That level of funding is simply not sustainable. We must re-tool the way we collectively care for our most vulnerable Alaskans. Getting people off of state-paid health care and into sustainable jobs will be a priority.”

Gov.-Elect Dunleavy appointed two other commissioners today, as well as a budget director.  The common thread throughout each statement in the release is a focus on efficiency and organizational reform.

During our podcast interview with then-candidate Dunleavy, I asked about Medicaid reform, maintaining Medicaid expansion, and his vision for addressing the state’s health care budget.

He said at the time that he was focused on driving efficiencies, not cutting for the sake of cutting.  That focus on efficiency and organizational reform comes through in these appointments.

Taken together, I think Adam Crum’s appointment tells us a few things about Dunleavy’s approach to managing DHSS.

1.  The focus on efficiency is real and continues.  Dunleavy believes there are significant savings to be captured from state government to help address the budget challenges.  This appointment reinforces that approach and focus.

2.  Medicaid reform is likely to be driven by a focus on cost savings rather than improvements to quality or access.  It appears Crum’s hire is because of his approach to organizational leadership, not his understanding of Medicaid.  While he has a good degree from a great school (I’m a Johns Hopkins grad myself, so I’m rooting for him there), his professional experience has been outside of health care.  It’s unlikely he will bring too much subject matter expertise to the topic of health care reform.

3.  There will likely be a continued shakeup at DHSS among senior staff.  Starting with the recent call for all at-will public employees to resign, this hire can likely be seen within the context of Dunleavy wanting to push back on public employee cost increases, reigning in the costs of state government in general.  Alaska has the highest per capita costs of state government in the country at $13,639 — more than twice the nationwide average among states at $6,682.  Those numbers stand out to Dunleavy and likely motivate some of his decision here to hire an efficient administrator rather than a health care expert.