DOVER – Molly Magarik was unanimously confirmed Tuesday by the Delaware State Senate to be the state’s new secretary of the Department of Health and Social Services.
She now takes over for Dr. Kara Odom Walker, who resigned from her leadership role after about three and a half years to take a leadership position at the Nemours Children’s Health System, and will lead the state’s largest agency with 11 divisions and more than 4,000 employees. With a $2 billion annual budget, DHSS is the second largest state agency by allocation, behind only the Department of Education.
Magarik, who was serving as the deputy secretary prior to her confirmation, faced no opposition during her Tuesday afternoon confirmation hearing conducted via videoconference by the Senate Executive Committee, which includes four Democrats and two Republicans.
The hearing saw different legislators reminiscing about ways that Magarik has quickly responded to them and their constituents during the pandemic.
The closest thing to a critical question came from Senate Minority Leader Gerald W. Hocker (R-Ocean View), who asked Magarik about her thoughts about shuttering Delaware businesses should a second COVID-19 wave hit, as other states are beginning to see.
“I think [the state] went overboard,” he said. “I’ve kept five businesses open but many other business owners will close.”
In response, Magarik said, “We’re in a different place than we were in the spring. But many of those issues [such as supply-chain concerns and testing] have largely been resolved. I think [if a second wave arrives], we’d be more surgical around going into particular communities or identifying clusters as opposed to taking a broad-brush stroke that we know has dramatic impacts on the economy.”
Prior to being appointed to the second-in-command position at DHSS, Magarik had no public health experience. She had served as Carney’s state office director when he served in Congress, and prior to that had served as executive director of the Delaware Democratic Party and campaign manager for the late Beau Biden.
When asked about Magarik’s qualifications to be health secretary, Gov. John Carney noted that she was recommended by Walker to be the nominee. He added that he has known Magarik for many years and “implicitly trusts” her judgment and leadership.
“Expertise is really important, but trust is even more important,” he said at his weekly Tuesday press conference in Wilmington. “I just think she’s uniquely suited for this very difficult job.”
Across the country, 26 states have medical doctors in health secretary-level positions, with another seven holding Master of Public Health (MPH) degrees, according to a Delaware Business Times review. Of the 16 states that don’t, 10 have leaders with nursing, social work, or law degrees, typically with a significant amount of institutional experience in health care or insurance systems. When asked whether he had considered replacing Walker, who is a family physician, with another doctor, Carney said that it was not a qualifying factor.
Carney emphasized that Magarik is nearly finished a Master of Health Care Delivery Science degree from Dartmouth College, which markets the unique degree as a merging of a Master of Business Administration and an MPH. The governor added that there are many medical doctors in leadership roles within the department whom she could turn to if needed.
Carney recalled that questioning of Cabinet secretaries’ qualifications is not uncommon, and he came under the same criticism when then-Gov. Tom Carper nominated him to be the state’s Finance Secretary in 1997.
“A lot of people questioned whether I had the ability,” Carney recalled, noting that he didn’t ask Carper for the position because he didn’t have a degree in economics. “But when I found out who else was being considered I said, ‘Hey, I can do as good a job or better than this person.’”
When asked about the timing of Walker’s decision to leave his administration amid a pandemic-spurred state of emergency that has stretched more than three months, Carney praised Walker for her service to the state, calling her a “godsend in terms of her leadership and experience.” He said that her decision to leave the administration amid the pandemic was partly to deal with some family issues and partly professional, calling the national leadership position at Nemours an “incredible opportunity.”
“[Resigning] was a very difficult decision for her,” Carney said, noting that Walker stayed in her state Cabinet position long enough to help Delaware through “the really hard part” of the pandemic.
When asked about the timing of her decision to leave, Carney did say that he was made aware of her thinking “some time ago,” but declined to go into more detail. He said that he had tried to convince Walker to delay her resignation.
“I tried to talk her into staying indefinitely,” Carney said with a laugh.
Walker has said little publicly about her decision to leave now and attempts by DBT to reach her through DHSS and Nemours have not been returned. The governor’s office’s June 16 announcement said that Walker was resigning to “fulfill a desire to pursue health care policy work at the national level.”
The position in Washington is a return for Walker, who came to DHSS after serving as deputy chief science officer at the Patient-Centered Outcomes Research Institute, a nonprofit, non-governmental organization in Washington that is authorized by Congress to improve evidence available to help patients, caregivers, employers, insurers and policymakers make informed health care decisions.
At Nemours, Walker will serve as senior vice president and chief population health officer, overseeing the Nemours National Office of Advocacy and Public Policy. There she will help craft advocacy efforts at national and state levels while also working to advance managed care initiatives, including medically complex case management, school-based wellness programs, and other services for specific populations.
The jump to the private sector will also likely come with a sizable salary increase. According to The News Journal’s database on state employees, Walker earned about $164,000 as the state’s health secretary. A review of Nemours’ 2018 tax returns shows that a similar senior vice president-level national policy position earned more than $400,000 that year.
