Adam Meier, the state's new health secretary, has moved from creating policy to delivering it

By Melissa Patrick
Kentucky Health News

The state's new health secretary moved from a policy job that he loved to one that puts him squarely into a position of delivering those policies he helped to create, a decision that he didn't take lightly.

Gov. Matt Bevin "didn't have to twist my arm," Adam Meier told Kentucky Health News in an interview. "It was a big decision for me and my family. It was something we thought long and hard about."

Secretary Adam Meier

Bevin put Meier in charge of the Cabinet for Health and Family Services on May 17, the state's largest cabinet with 7,500 employees and an annual budget of nearly $14 billion. He succeeds Vickie Yates Brown Glisson, who left the office at the end of January to run against Democratic Rep. John Yarmuth in Louisville's Third Congressional District.

He had been Bevin's deputy chief of staff for policy, and in that job was responsible for overseeing development of the state's new Medicaid plan, called Kentucky HEALTH, for "Helping to Engage and Achieve Long Term Health," authorized by a federal waiver.

A federal judge in Washington blocked the plan on Friday, June 29, which among other things, included work or community engagement requirements; monthly reporting; lock-out periods for failure to comply; and premiums and co-payments based on income. The plan was set to kick in July 1, with the exception of the work or "community engagement" requirements, which were to be phased in across almost all of the state by Dec. 1.

Meier lives in Fort Thomas with his wife and three young children, but he said he grew up in a working-class neighborhood on the west side of Cincinnati.

"I personally witnessed the value of hard work, often helping my father with various construction jobs on weekends or summers," he said. "Through continuous hard work of both of my parents, I watched as our quality of life and opportunities continued to improve."

Meier said he first came to Kentucky to attend Georgetown College on a combination of athletic and academic scholarships, graduating in 2005 with a degree in political science and communication and media studies. After graduation from the Florida Coastal School of Law, he returned to Kentucky and has lived in the state since.

"I want others to have the same opportunities that my parents gave our family," he said. "The Cabinet for Health and Family Services can provide the support needed to allow those willing to be engaged to improve their quality of life."

Asked why he thought Bevin hired him, Meier said his relationship with the governor had developed in an "organic" kind of way; they connected when he volunteered for Bevin's campaign and discussed policy ideas -- including what it would take to implement a new Medicaid program in Kentucky as a way to "drive innovation in a way that is sustainable" that would "result in better health outcomes, and not just coverage."

"I think he wanted to bring me in because he trusted my opinion and my view points and valued my thoughts on how to approach different issues," Meier said. "We were aligned philosophically and that helps, obviously."

But now he moves from philosophy to practicality.

"Moving from a policy role to this role, I think a big difference is dealing with things like facilities and personnel, there are more operational details. It's not as fun," he said. "I think I went into it knowing I wouldn't enjoy it as much, but I also felt that there is an opportunity for us to lead."

Meier acknowledged that he came into his initial role in the governor's office with little policy or political experience, having been a contracting officer in a field office of the U.S. Environmental Protection Agency and serving one year on the Fort Thomas City Council.

But he said he has never hesitated to share his policy ideas with others -- whether that be at work, with politicians or people in positions to effectuate change -- and that he knew he eventually wanted to work where he would have a direct impact on policy.

"As I came into the policy shop, this was a new role for me. I had never worked in state government," he said. "In my new role I had the opportunity to really drive innovation and change through directing policy for the governor."

As the deputy chief of staff for policy, Meier said he worked on many different issue areas, but most of his focus was been on health care and services, education and workforce and the opioid epidemic.

"It's been a lot to learn," he said.

Scott Brinkman, secretary of the Governor's Executive Cabinet, who served as acting health secretary between Glisson and Meier, said Meier was a "superb" choice to lead the cabinet.

"Although he was involved in a whole host of policy issues, I would say probably 80 percent of his time was spent on policy initiatives that originated within the Cabinet for Health and Family Services, so he has developed over those two and a half years a very good understanding of the workings of the cabinet," Brinkman said.

Meier said his close work with the cabinet allowed him to build "good relationships" with the people who are now his commissioners, whom he trusted and respected.

"I understand that we have good people and I want them to manage their divisions," he said. "My job is to challenge them to be innovative, to think outside of the box, and to be willing to take risk and try different things, calculated risk, but risk that will drive purposeful change towards an outcome that we want."

Meier said his top priorities for the health cabinet will continue to be the Medicaid waiver, and the related education, workforce and human service reforms that go along with it; child welfare and adoption issues; and the opioid epidemic.

He also said he would focus on efficiency and finding ways to improve customer service, "so that we can maximize the ROI [return on investment] for the taxpayer and we can run an efficient and effective agency." He said he sees untapped opportunities for improvement in the areas of child welfare, foster care and adoption.

Meier said the cabinet's greatest strength is a culture of leadership that lends itself toward service and collaboration. He said its greatest challenge is "the need and the funding," which often requires it to find ways to do more with less, while still doing it well.

Deputy Health Commissioner Kristi Putnam said of Meier, "There is no job that he won't do. It's lead by example. Adam's willing to jump in and work on anything next to people and that makes a big difference."

Brinkman said, "He is just extremely bright on policy, very intuitive, insightful. He's got a very good grasp of technology and the appropriate uses of technology. He's a very good manager, he's very organized, he's highly respected, very good with people, knows how to draw the best out of people."