Gov. Martin O'Malley and the state's health advocates are right to be ecstatic that Dr. Joshua Sharfstein is leaving his post as deputy administrator of the federal Food and Drug Administration to become Maryland's secretary of the Department of Health and Mental Hygiene. Dr. Sharfstein is a public health superstar, and his experience on the local and federal levels will be invaluable as the state works to implement Maryland's piece of the national health care reform law. But we should not overlook the singular quality of the man he will replace at the health department: John Colmers.
Mr. Colmers ("Dr. Colmers," he would say, "is my father's name") has managed the state's largest agency in budgetary terms, and fourth-largest by the number of employees, during an extremely difficult time. Governor O'Malley went to the Board of Public Works to make midyear budget cuts seven times during his first term, and each time, Mr. Colmers' agency was hit hardest — by far. In all, the health department had to absorb $447,627,869 in cuts, an astonishing 42 percent of all the spending reductions the governor made. His agency was forced to make and defend painful decisions, such as the closure of the Upper Shore Community Mental Health Center.
In spite of that, the last four years were also a time of tremendous progress in providing health care services to Marylanders, and Mr. Colmers deserves much of the credit.
The signature public health achievement of Mr. O'Malley's first term was the expansion of the state's Medicaid program, which was among the stingiest in the nation when it came to providing health care to adults. Before the expansion of the program approved by the legislature in 2007, a working parent in a family of three would have had to earn less than $6,288 a year — about half of a full-time, minimum wage job. Childless adults were all but excluded altogether.
Before the 2007 legislative session, Del. Pete Hammen, the chairman of the Health and Government Operations Committee, put together a working group of health policy experts to come up with a way to begin addressing that problem, and one of his top recruits was Mr. Colmers, who was then chairman of CareFirst BlueCross BlueShield of Maryland. Delegate Hammen said Mr. Colmers was instrumental in devising a mechanism to pay for expanding Medicaid without bankrupting the state, and then later, as health secretary, in selling it to the General Assembly and implementing the law. Mr. Colmers extensively advertised the availability of health coverage under the law and simplified the process for people to enroll. As a result, the state has been able to extend care to more than 200,000 people. "If it weren't for him, it wouldn't have happened," Delegate Hammen says.
In 2007, a 12-year-old Maryland boy named Deamonte Driver died from complications of an oral infection that could have been prevented if he had access to even basic dental care. In response, Mr. Colmers convened a coalition of dental providers, advocates and others to find a way to expand the availability of dental care to poor and minority children. By 2010, the Pew Center on the States recognized Maryland as one of the top states in the nation for its oral health programs. "A tragedy like Deamonte Driver won't happen in Maryland again," says Vincent DeMarco, president of the Maryland Citizens Health Initiative. "Dental care improved tremendously under his leadership."
For years, advocates had been pushing for the closure of the Rosewood Center, the state residential facility for the developmentally disabled. It had grown increasingly dilapidated, and its residents suffered from substandard care, dangerous conditions and patient-on-patient violence. In 2008, Mr. Colmers finally announced that the center would be shut for good. Susan O'Brien, who was a lobbyist at the time and working for a coalition of family members of Rosewood residents who wanted the facility shut down, says that what made it finally happen was Mr. Colmers' ability to make a strong financial case for closure and to combine it with compassion for both those who wanted to move out and those who feared doing so. "He was the magic that made it happen," she says.
There was more. Mr. Colmers was a major force in the passage of the state's ban on smoking in bars and restaurants, the creation of a plan to help subsidize prescription drugs for seniors who fall into the Medicare "doughnut hole" and the expansion of access to substance abuse treatment to some 33,000 low-income Marylanders. The fact that he was able to accomplish all that at a time of shrinking budgets and constant cuts is a testament to his managerial ability and unparalleled understanding of Maryland's unique system for financing health care. "He was the right person for a difficult time," says Dr. Peter Beilenson, the Howard County health officer.
We have every confidence that Dr. Sharfstein — a Baltimore native and former city health commissioner with strong ties on Capitol Hill — will make an excellent health secretary. Nonetheless, we hope Mr. Colmers, who says he is leaving the administration to work more directly on health care reform, won't be far away.