By Robert Nott
Newly confirmed New Mexico Health Secretary Patrick Allen doesn’t dodge questions about leaving his post as Oregon’s top health official in early January, just before a new governor took office.
He announced his resignation in November, days after Democratic Gov. Tina Kotek was elected. He didn’t have much of a choice.
It was step down or be tossed out for 60-year-old Allen, who had spent five years as director of the Oregon Health Authority — Kotek had said on the campaign trail she would fire him amid criticism of his handling of problems with the state’s behavioral health system.
“If I were running for governor, I would have probably fired me, too,” Allen said in a recent interview.
During his initial vetting by the Senate Rules Committee after Gov. Michelle Lujan Grisham appointed him to lead New Mexico’s Department of Health, he made similar remarks.
Allen is stepping into an agency struggling with staffing shortages in a post-pandemic period following the retirement of Dr. David Scrase, who became the face of the state’s response to COVID-19 while running both the Health Department and the Human Services Department. He faces tough challenges: filling vacancies; improving access to health care; addressing not just prevalent illnesses among the state’s residents but also community needs, such as water quality, nutritious foods and vaccinations. He also must prepare the state for the next pandemic.
Allen is blunt about the criticism he faced in Oregon.
“The fact is I did not fix the state behavioral health system in the five years I was there,” he said. “Now, you and I might think there are reasons for that, and the pandemic is certainly a piece of that, but voters don’t care. They shouldn’t have to. They know they are unhappy seeing people sleeping on the streets in downtown Portland openly using drugs, and they’re unhappy that their friends and family members can’t get access to services that they need.”
Kotek’s vow to “clean house at the Oregon State Health Authority” after her election was “a pretty natural response,” he said.
Allen, who was confirmed by the Senate in February to serve as Lujan Grisham’s Cabinet health secretary, said the governor charged him with “taking firm hold of the Department of Health. … The agency and the people in it have been through a lot. It’s not an exaggeration to say people are traumatized.
“And like health agencies across the country, we did what we needed to do to get stuff done during the pandemic,” he added. “And that meant leaving some systems by the side of the road while we decided how to get things done quickly.”
His trans-pandemic role, as he likes to describe it, will include dealing with a staff vacancy rate that on paper nears 30% — with more than 1,000 jobs unfilled.
Allen said he believes the vacancy rates are overinflated for a number of reasons, largely because some positions were created with expected funding, including grants, that didn’t come through.
His goal is to first “clean those vacancies out of the system.”
He believes the department’s actual vacancy rate is somewhere in the low- to mid-20% range.
“There’s not a sector out there that is not grievously short of staff,” Allen said, adding his agency has to make a compelling case to target “millennials and post-millennials who are motivated to work in mission-based organizations.”
He said the message should be: “You come to work here not because you are going to make bank as an infectious disease doctor, but because you have an opportunity every single day to help people, to make your corner of New Mexico a better place than it would have been otherwise.”
The Department of Health is in the initial stages of creating a plan to address a number of issues, Allen said.
One main focus is to figure out how to improve health access across the state, which he said goes beyond being able to regularly see a doctor and includes “investments around water quality and access to nutritious food, vaccinations for kids, all those things that help communities be healthy. How do we provide that to all of New Mexico?”
After the pandemic, he said, he hopes “people will pay more attention to the nonsexy stuff that helps us live longer and healthier.”
Allen also will offer advice as the state attempts to create a statewide health care authority — a priority for Lujan Grisham. The Legislature approved Senate Bill 16, which aims to change the Human Services Department to the Health Care Authority Department.
The authority, which would replace the Human Services Division, would combine various divisions and be tasked with reducing health insurance costs for public workers in the state.
The authority would not fall under Allen’s purview, but he said “once the dust settles from the session and we figure out what did or didn’t happen, the governor can figure out what we need to do going forward.”
Looming over Allen’s job is the possibility of another virus, like bird flu, which is working its way through a number of countries, including the United States.
“It’s sort of sobering that this [COVID-19] was a once-in-a-100-year experience,” Allen said. “It’s almost certainly not going to be another 100 years before we see another infectious disease like this.”
Learning about the nature of infectious diseases is just one part of Allen’s new role — and a far cry from his childhood dreams of growing up to be a high school band teacher. The Portland native said he enjoyed playing violin, clarinet and saxophone.
He set aside the instruments for a banker’s ledger after studying economics at Oregon State University and then worked in various banking positions for decades, realizing along the way his “generic skill set is I am able to enter into a situation I don’t know a ton about, be able to learn about it quickly, kind of process through what are the things that need to happen and figure out what to do.”
Allen eventually moved into state government and ended up running Oregon’s Department of Consumer and Business Services, which oversees building safety, workplace safety and finance.
The experience led former Oregon Gov. Kate Brown to appoint him as director of the state’s Health Authority in 2017.
Former Oregon state Rep. Alissa Keny-Guyer, who worked with Allen on a regular basis, said she was “apprehensive” when he took on the job.
“I knew he didn’t have a big background in health and was worried he would not be a visionary,” she said, adding she quickly learned he had the right skills.
“He’s a really good listener, he’s an incredibly hard worker, and as a result, he was a very good director,” she said. “He brought a lot of stability to the division.”
Oregon state Sen. Elizabeth Steiner also lauded his performance. “I’m a firm believer that a good manager doesn’t necessarily have to have expertise in that subject matter. They have to have expertise in recognizing talent, hiring them and keeping people,” she said.
Allen did “an amazing job” during the pandemic, Steiner added. She felt Allen led the health agency with “a surprising amount of grace and good humor and followed the science.”
Steiner said the criticism of Allen’s handling of behavioral health was unfair.
“He did the best he could given the situation,” she said. “Oregon has historically struggled a lot to have a good behavioral health system.”
Some Republican senators in New Mexico voted against Allen, arguing his approach to the pandemic in Oregon was similar to that of New Mexico and resulted in schools and businesses closing down.
Allen stands by his decisions.
The Commonwealth Fund’s 2022 report on how states handled the COVID-19 crisis in terms of health care access, quality, outcomes and spending placed Oregon 14th, tied with Maine and Pennsylvania and far above many states, including New Mexico, which ranked 26th.
Allen said he first met with Lujan Grisham virtually in November as he began weighing other job opportunities. He was looking for a new challenge.
He noted New Mexico and Oregon differ in many ways. “I’m only really beginning to just scratch the surface of understanding those dynamics and think about how I approach things like health equity here,” he said.
“Because if I take the things I learned there and try to do the same thing here, I think I’m going to crash on the rocks and burn — and I should.”