Dannette Smith, the chief executive officer of Nebraska’s Department of Health and Human Services, will step down after nearly four years as the head of the state’s largest agency.
Gov. Jim Pillen announced her resignation Wednesday. She will take a job with a national firm that supports health and human services agencies across the U.S. Her last day will be Aug. 4.
Pillen expressed gratitude for Smith’s leadership, which began under his predecessor, Gov. Pete Ricketts. Smith was appointed in Jan. 2019 to replace Ricketts’ first HHS leader.
Smith said it was an honor to be CEO of HHS and to work with the people of Nebraska. She listed the highlights of her tenure as managing the public health and human services response to the COVID-19 pandemic and turning around the state’s troubled juvenile offender treatment centers.
“I have spent every day challenging myself and my team to work with passion, integrity, and intentionality because the people of Nebraska depend on us,” she said. “Not only do I feel a great sense of accomplishment about what we have achieved, I look forward to taking the energy and the spirit of my fellow Nebraskans with me as I take on the new challenges in my next chapter.”
State Sen. Ben Hansen of Blair, the chairman of the Health and Human Services Committee, praised her work at the helm of HHS.
“I think the time spent leading Nebraska DHHS was constructive and she helped steer the department in the right direction during some difficult times,” he said. “I wished her good luck in her new role.”
Sen. Machaela Cavanaugh of Omaha, a longtime HHS committee member, thanked Smith for her service but was less complimentary about her record.
“Her tenure is marked by chaos, mismanagement and poor decisions, including the refusal to implement voter-approved Medicaid expansion and mishandling the child welfare transition to St. Francis ministries, which have harmed children and wasted taxpayer dollars,” she said.
Cavanaugh said Nebraska also has “significant challenges in maternal health and health disparities, underscoring the need for a renewed commitment to improving the lives of Nebraskans.”
HHS, under Smith, took a leading role in guiding Nebraska’s response to COVID-19, through its public health division. The agency crafted directed health measures that closed schools and businesses, canceled events and set restrictions for a host of activities.
The agency worked with local health departments to provide education, testing, contact tracing and, later, vaccinations aimed at controlling the spread of the potentially fatal virus.
One of Smith’s earlier challenges was the Youth Rehabilitation and Treatment Center for girls in Geneva. By August 2019, changes in management, staff shortages, inadequate programming and rapidly deteriorating buildings combined to create a crisis at the facility.
Smith got personally involved with addressing the problems, first by moving the girls to the formerly boys-only center in Kearney, and later by creating a new girls facility in Hastings, opening a center in Lincoln for youths with especially severe mental and behavioral problems, and revamping the programs provided to juvenile offenders at the centers.
Smith oversaw much of Nebraska’s rollout of the Medicaid expansion program, which had been approved by voters in 2018. The rollout took Nebraska longer than any other state to complete.
The initial expansion program called for two tiers of coverage, with most low-income adults having to meet numerous requirements to get the full array of Medicaid benefits. Federal officials rejected the plan, and the state now offers full benefits to the expansion group.
Her tenure also included the ill-fated decision to contract with St. Francis Ministries of Kansas to manage child welfare cases in the Omaha area.
The private nonprofit got the job by bidding 40% lower than the longtime Omaha contractor. But Nebraska wound up ending the contract early, after St. Francis had to get an emergency increase in payments that wiped out any savings, yet never complied with key requirements of the contract.
As HHS CEO, Smith oversaw a staff of 5,000 and managed an annual budget of $6.3 billion, including state and federal funds. The agency’s five divisions — behavioral health, children and family services, developmental disabilities, Medicaid and long-term care, and public health — touch the lives of nearly every Nebraskan.
Pillen said he would appoint an interim director soon. That person will lead the agency while a national search is undertaken to find a permanent CEO.
He has yet to fill two other key positions in HHS. He did not keep Ricketts’ director of the children and family services division or the director of behavioral health. Smith has been interim director of children and family services since January.
Before coming to Nebraska, Smith held top positions at human services departments in North Carolina, Virginia, Washington state and Georgia.
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