John Selig to Leave Arkansas Department of Human Services

John M. Selig, Arkansas’ Department of Human Services (DHS) director, will leave the position at the end of the year. He held this position for 10 years, making him the longest-serving director in the state’s DHS history. In total, Selig has worked for Arkansas state government for 27 years, all but two of them with DHS. Originally appointed by Republican Governor Mike Huckabee, Selig also served for eight years under Democrat Mike Beebe. At that time, he oversaw the launch of the Medicaid expansion program in Arkansas, known as the private option, which used federal Medicaid funds to subsidize private health insurance for low-income Arkansans. Since enrollment began in 2013, more than 200,000 Arkansans have signed up for the program. For most of his tenure in state government, Selig was also an active member of the Milbank Memorial Fund’s Reforming States Group, serving on the Steering Committee for many years. The Fund recently had a chance to speak to Selig about his career.

Of what work in Arkansas are you most proud?

Selig: I’m most proud of the fact that we always tried to move forward, innovate, and take reasonable risks. Our department certainly wasn’t able to do everything we wanted to do, but you’ve got to pick your battles. I’ve had a chance to work with really good people—in my agency, in state government, and in the private sector—on things like our version of Medicaid expansion and health care payment innovation. It’s nice to look back a few years and see that we’ve made real progress.

Arkansas’s Private Option is certainly an example of innovation. How did that come to be?

Selig: As a southern state, where conservative Republicans had just gained control of the legislature, and where it takes three-fourths votes in both houses to approve expansion, you would think we already had three strikes against us. But we had creative, pragmatic leaders in the legislature and in the governor’s office who said, “We don’t particularly like this [the Affordable Care Act (ACA)], but let’s take advantage of what we do like. Let’s really try to focus on where we want to go and see how the ACA can support that.” The ACA almost requires innovation or you just get dragged along. It’s much better to have a vision of where you want to go and to see how federal funding streams or rules can support what you’re doing.

What will you miss most about state service?

Selig: I’ll miss the people I work with, both in my agency and elsewhere in state government. They are so committed and working so hard. I can’t tell you how many times we’ve hired someone from outside state government and within a few weeks they’re trying to catch their breath and saying, “I had no idea how much you all had going on.” I don’t know that you often find that teamwork and sense of mission.

Why is that?

Selig: I really feel like we’ve been given this huge public trust, that we’re stewards of taxpayer money and responsible for helping our most vulnerable neighbors and community members. We want to serve them well and use the money wisely. Every day, we have some chance to make a difference, even though we don’t necessarily make a difference every day. When we’ve faced big challenges that are going to take a lot of effort, I always remind people that the potential payoffs make the effort worthwhile.

How has the RSG contributed?

Selig: For me, the RSG has continued to be a source of both new ideas and a way of reenergizing. My first meeting was probably 10 or 12 years ago, and I remember thinking, “I’m in over my head. These people really know health and they’re really committed.” But I’ve since learned that everyone feels like that at the start. And now a dozen years in, I still go to these meetings and think these people know so much more than me. But it’s such interesting conversation and ideas. We have implemented several initiatives as a result of RSG.

Can you elaborate?

Selig: Our preferred drug list program came directly out of RSG. We’re also implementing a universal assessment for people with complex needs, and that came directly out of an RSG meeting several years ago. The Fund has often put us in touch with others who are doing cutting-edge work. The other thing that’s interesting to me about the RSG is the international perspective—I think that has been terrific. You hear from health leaders from other countries and you think “it doesn’t have to be this way here.” We don’t have to pay for services this way, we don’t have to have this level of gun violence, there really are more effective ways to address mental health issues. It gives you a renewed sense of hope and almost shames you into thinking, “we’ve got to do something.”