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Gov. Moore’s public health pick wants to tackle disparities post covid



Newly appointed Maryland Health Secretary Laura Herrera Scott in her office in Baltimore on Jan. 30. (Marvin Joseph/The Washington Post)

Laura Herrera Scott, Gov. Wes Moore’s newly appointed acting secretary of health, inherits an agency grappling with the effects of some of the biggest challenges facing the state, including a new phase of the coronavirus pandemic, health disparities and access to behavioral-health treatment.

Those who know her say Herrera Scott, who was a major in the Medical Corps of the U.S. Army Reserve and was deployed to Iraq, has a long history of marrying clinical and policy knowledge to build consensus and lead. She has been the chief medical officer of the Baltimore City Health Department, Maryland’s deputy secretary of health in Martin O’Malley’s gubernatorial administration from 2011 to 2015 and has a master’s degree in public health from the Johns Hopkins Bloomberg School of Public Health. She learned firsthand about disparities in health access while training in her native New York state.

Herrera Scott is a longtime Maryland resident who most recently worked at Anthem Blue Cross and Blue Shield and Summit Health. The governor’s office called her “a visionary leader in the health space,” for creating programs that improve care and advance equity. As she awaits a confirmation vote in the state legislature, we talked to Herrera Scott about her priorities.

A: When I was doing my post-baccalaureate program, I volunteered at a hospital in Lower Manhattan, but then my paying job was practicing on the Upper East Side. And my experience working at a hospital in downtown and my experience working on the Upper East Side were very, very, very different. The same service but very, very, very different experience and very different level of care. And after that, I just knew I would be in public service trying to level the playing field.

Q: How did the pandemic affect you personally, and how will that influence your work?


A: We were impacted like other families. We had children at home that weren’t at school. So just the logistics of creating space for people to do remote work, remote learning. Just the exhaustion of doing things remotely, being on camera all the time. I would say, like everybody else, it shrank our worlds.

I’m thinking certainly about, how do we make communities more resilient for the next time, and what does that look like? What are the things we need to put in place to help our communities stay healthy? Understanding who in your community is socially isolated, and building some kind of network to address that [and ensuring] access to food and markets. There’s lots of things to consider that were problematic during covid. And so I’m certainly thinking about, as we think about de-escalating now that the public health emergency is unwinding, and normalizing covid, even though people are still dying from covid, how do we ensure that even if there’s another emerging infectious disease, certain communities are not impacted more than others?

Q: How did your military service inform your public health commitment?

A: I signed on the dotted line right before 9/11, I think it happened in June. Partly for loan repayment. I was the first person in my family to [finish] college, first physician, and I owed a lot of money for student loans. My stepfather was in Vietnam on two tours. I have a lot of family that have served in the Army.

I was in the States for 2004 and 2005 — I was backfill — and then the third time I went overseas, to Iraq. It was just an incredible learning experience [with the] people I got to meet and just how committed to serving people are and also got to do some work for women veterans specifically. I was at the Veterans Health Administration after my third deployment. I went to the VA as the national director of women veteran’s health care.

Q: You helped reduce racial disparities in overdoses in Baltimore. How can you apply those lessons statewide?

A: The numbers were much smaller early on, when the fentanyl numbers started going up. And so we could look at every single case. There’s a lot of work we did at the granular level, at the Zip code, the census block we were geocoding and overlaying other maps. And I think because we were so targeted on what was happening in overdoses at the time that we were putting initiatives in place that really saturated communities where the activity was happening.


And I think, how do you address disparities? You have to be very specific, meet people where they are and try to address the needs of the community in addition to the health thing that you’re trying to manage.

Years ago, I provided HIV care, and when I was trying to get people on antiretrovirals, I had plenty of patients that [said], ‘Doc, I need a place to put my head tonight. You find me a bed and then we can talk about your medicines.’ Even before social drivers of health were so big, I recognized that as a clinician for the patients I was taking care of, that if I didn’t help them get other things in their life straightened out, I couldn’t take care of their HIV needs.

Q: How will you bolster the workforce pipeline and attract staff amid intense competition?

A: Well, first of all, we have Governor Wes Moore, right? I’m being totally serious. It’s why I went back into public service — to work for him, and I think he’s got a bold vision for the state. I think it’s an exciting time to be in health care, working for him and being allowed to think about innovative ways to do different things. And so I think that’s appealing for people who are really committed to serving.

But more practically, you have to be creative. I know, we have lots of jobs that have bachelor’s as part of the requirement; many corporations are now looking at their job descriptions and looking at jobs to see which ones don’t actually need bachelor’s degrees. And could we think about the jobs we have and create a pathway from high school into jobs? Certainly, the governor’s year of service [plan], is that a potential pipeline for creating a workforce of the future?

Wes Moore wants Md. students to do a year of service after graduating

Q: Will you scrap former governor Larry Hogan’s plan to shutter state hospitals?


A: Right now, we’re not talking about closings, but we have to do our due diligence, and I just don’t know what I don’t know at this point. Just looking at national trends, unfortunately, a lot of rural hospitals have closed, and if they haven’t closed fully, they’ve closed really important service lines that impact the community, like OB [obstetric] care as an example.

We want a delivery system that serves everyone. Governor Moore’s campaign to leave no one behind — that’s certainly on my mind as I think about our health-care system and how we are meeting the needs, or not, of Marylanders.

Not necessarily more brick-and-mortar but virtual health with telehealth visit; what does that look like? That’s some of the work that we’ll be looking at over the next few months to really understand the delivery landscape at the urban, suburban and rural [levels]. They’re really not equal communities in their access and the amount of services that they have.

Q: Do you support lawmakers’ plan for a study commission to remake public health?

A: Public health infrastructure has been deteriorating for years, and that’s been a function of the funding that they’ve been getting. We know during covid they were just overwhelmed in the beginning. Thank goodness for public health officials and all the people that got us through the crisis, but I do think it’s time to rethink what the system should look like. I, for one, certainly welcome recommendations about the public health agency of the future.

Q: How will you work to reduce the state’s emergency-department wait times, which are the longest in the nation?

A: I think workforce is certainly part of the problem. There are sicker patients in the hospital. Lengths of stay have gone up, and then discharges on the back end slow things up. There’s also states that don’t have long ER wait times. So, one of the things that I will be looking at is: What are those states doing that makes them so short? So, it’s on my list of things to work with the hospitals and the Maryland Hospital Association to figure out.


Q: Did Gov. Moore have to do much persuading for you to take this role?

A: I was watching the campaign very closely and threw my name in the hat. I feel honored and privileged to be in this role now. It’s a huge opportunity. And I appreciate the magnitude of the opportunity — as well as the magnitude if I don’t get it right.

This interview was edited and condensed for space and clarity.

Source: Washington Post

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