Dr. Joshua M. Sharfstein said Wednesday he plans to leave his post as secretary of the state Department of Health and Mental Hygiene, where he drew criticism for the botched rollout of the state's health insurance exchange website.
Sharfstein, a trained pediatrician who has spent his career in public service, will join the Johns Hopkins Bloomberg School of Public Health as an associate dean in January as the O'Malley administration ends.
He took the state post three years ago after developing a national profile for his aggressive pursuit of public health initiatives in children's health, HIV and other areas.
As health secretary in Maryland, he revamped the way hospitals treat and charge patients and the way abortion clinics and tanning salons are regulated. He's worked to reduce a backlog of cases at the board of physicians and pushed for a ban on potentially deadly crib bumpers.
But he also oversaw the state's health insurance exchange, which crashed on the first day and caused problems for thousands trying to buy health insurance. The persistent troubles with the system prompted the state to cut ties with the original contractor and ultimately decide to replace the exchange altogether with new technology.
Sharfstein and the health department also came under scrutiny this month after a medically fragile 10-year-old boy died in a Laurel-area facility overseen by one of its agencies. While the Office of Health Care Quality had been inspecting the LifeLine facility, it acknowledged it didn't know about some financial and care issues there. The office also acknowledged that it had not inspected many of the other 14,000 health facilities under its purview on schedule.
Sharfstein, 44, will not begin his new position as associate dean for public health practice and training until after the relaunch of the health exchange website in the fall.
He told his staff in a letter Wednesday that the technological problems would not make his highlight reel.
"I do remember, however, the moment when Gov. Martin O'Malley pulled me aside and told me that what mattered most was rising to the challenge," wrote Sharfstein, who was paid $169,404 in the fiscal year ended June 30.
One longtime critic of the exchange was quick to lay blame for the exchange troubles on Sharfstein and said it was past time for him to go.
"We were pleased to see that Joshua Sharfstein, secretary of the Department of Health and Mental Hygiene, has finally agreed to resign, especially after the national debacle that he and Anthony Brown were responsible for with the rollout of the Maryland Health Benefit Exchange," said Republican gubernatorial candidate Larry Hogan, referring to the lieutenant governor who also was the state point man for the federal health reform.
"But his resignation should be immediate," he added.
Brown, the Democratic nominee for governor, did not respond to a request for comment.
Others from Annapolis to Baltimore praised the secretary and pointed more to his response than the initial failure — and to the nearly 375,000 people who eventually signed up for health insurance.
Sharfstein was known for his hands-on leadership, long hours and attention to detail — character traits that were necessary to steer the state's largest department, and handle the exchange crisis, said John M. Colmers, his predecessor as health secretary and now a John Hopkins Medicine vice president
Judging Sharfstein solely on the exchange was unfair, Colmers said, considering the vast responsibilities and complexities of the job managing the $10 billion health department budget and overseeing Medicaid and programs in behavioral and public health, as well as those for the disabled.
"It's big and necessarily big," he said of the department. "On a daily basis, things can happen of which you have little control. And being able to achieve the things he was able to achieve is certainly to be commended. It will all have a lasting impact."
Another observer agreed that Sharfstein likely would be recalled for his full body of work, and the announcement of his departure was timely.
"I expect we'll be seeing this from nearly all department heads in next few weeks and few months," said Donald F. Norris, a University of Maryland Baltimore County professor of public policy. "I don't know that any of them will necessarily be retained."
Before Sharfstein starts at Hopkins in January, he plans to work not only on the exchange but on issues such as drug overdoses, patient safety and behavioral health.
His next position, he said, will keep him engaged in policy and government issues, and Dr. Michael J. Klag, dean of the Hopkins Bloomberg School, lauded his experience. Sharfstein will succeed Thomas Burke, who is President Barack Obama's nominee to lead the Environmental Protection Agency's Office of Research and Development.
"Josh will bring a wealth of experience and insights that will strengthen the practice, teaching, and research opportunities available to our faculty and students," Klag said.
Sharfstein has spent his career in government policy. After obtaining undergraduate and medical degrees from Harvard, and training in pediatrics in Boston, he worked on the Democratic staff of the House Government Reform Committee and was a health policy adviser to California Rep. Henry A. Waxman.
He also served as Baltimore's health commissioner, where he began pushing a ban on marketing of children's cold medicine. And he did a nearly two-year stint back in Washington for the Obama administration as principal deputy commissioner of the Food and Drug Administration before Gov. Martin O'Malley brought him back to Maryland for the secretary job in 2011.
"As a pediatrician and as a public servant, Josh Sharfstein has been committed to children, families, and improving people's lives," O'Malley said in a statement. "As the secretary of Health and Mental Hygiene, he's led the way as we have invested in public health and prevention, aligned the health care system to the vision of better health at lower cost and expanded health care coverage to hundreds of thousands of Marylanders."
Sharfstein spent a good portion of his time helping shape legislation or policy in Annapolis, and that won him respect from lawmakers, including Del. Dan K. Morhaim, a Baltimore County Democrat and the legislature's only physician, who has clashed with Sharfstein over issues such as medical marijuana.
It was largely at the insistence of the secretary, backed by O'Malley, that a 2013 bill restricted medical marijuana distribution to academic medical centers. But the legislation was considered a failure because none would participate. A Morhaim-sponsored measure passed this year allows most doctors to apply for certification to recommend marijuana to patients.
"We worked together when we agreed and respected each other when we disagreed," said Morhaim, who serves on the House Health and Government Operations Committee.
Del. Kirill Reznik, a Montgomery County Democrat who also serves on the health committee, praised Sharfstein as "the definitive public health advocate."
Another health committee member, Baltimore County Republican Del. Patrick L. McDonough, said Sharfstein is likable and forthright and that his office has been very helpful with constituent concerns. However, he said Sharfstein damaged his credibility when he appeared before the panel to discuss the exchange.
"We were told repeatedly that everything was OK and there weren't any problems, and that was misinformation," he said.
McDonough said Sharfstein, O'Malley and Brown deserve blame for the website's failure.
Sen. Thomas M. Middleton, chairman of the Senate Finance Committee, which oversees health care, said there were lapses in overseeing the information technology challenges faced in the exchange launch.
"There wasn't the attention to detail that it should have had," said Middleton, who headed the oversight committee on the exchange. He added that he remains confident that the exchange's problems will be fixed in time for open enrollment in November.
"If he can get that system up and going and people are satisfied," he said, "I think he will leave with very high marks."Copyright © 2014, The Baltimore Sun