RCPA - Rehabilitation and Community Providers Association


DPW Secretary Named
January 12, 2011

Governor-elect Tom Corbett has tapped Gary Alexander, JD, of Rhode Island as his nominee for secretary of the Pennsylvania Department of Public Welfare. Alexander served as the Rhode Island cecretary of Health and Human Services since 2009, where he oversaw the Departments of Mental Health, Retardation and Hospitals; Elderly Affairs; and Children, Youth, and Families. Previously, he had served as director of the Rhode Island Department of Human Services for three years and deputy director for eight. Alexander will need to be confirmed by the Republican-controlled Senate before his official appointment.

Alexander received notoriety, both positive and negative, for his approach to Medicaid services in Rhode Island. He was one of a few state officials that agreed to cap Medicaid spending under the Bush administration by crafting the Rhode Island Global Consumer Choice Waiver Compact. The waiver establishes a state-federal compact and contends to provide Rhode Island with greater flexibility while assuring federal funding certainty. Critics contended that the program damaged Rhode Island's Medicaid program for insignificant savings. Alexander describes the program in a recent issue of Health Reform Report.

The centerpiece of Rhode Island's waiver is that it provides budgetary certainty for the state – a cap of $12.075 billion through 2013. The cap forces Rhode Island to create cost containment strategies and medical models in the right place and right setting, whereas, the traditional Medicaid spending plan is open-ended and encourages states to spend as much as they can in order to gain additional federal money.

The Rhode Island Compact is the most comprehensive attempt to fundamentally change the Medicaid system. It ends the existing form of entitlement and crafts a new system designed to engage consumers in their own health care and use taxpayer dollars wisely.

He is also well known for the implementation of RI Works in June 2008, a job training and supplemental aid program for parents of young children on cash assistance. Alexander purports that RI Works has reduced welfare rolls in the state by 30 percent.

PCPA asked Charles Curie, current co-chair of Governor-elect Corbett's Welfare Transition Committee, for his view on this critical appointment. Curie reported that Alexander "had strong credentials in regard to the Medicaid program." He described Alexander's approach as "very innovative." Curie, former deputy secretary of the Office of Mental Health and Substance Abuse Services in Pennsylvania, also commented that he believed Alexander had demonstrated an excellent understanding of behavioral health service systems. Overall, Curie was positive and very supportive of the nominee. PCPA will continue to seek additional information on Mr. Alexander's approach and experience.

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