Dunleavy health pick has background in construction training

Adam Crum, 34, has been named by Gov.-elect Mike Dunleavy to lead the Department of Health and Social Services, one of the most difficult management jobs in state government.

The department has more than 3,000 employees and a total budget of more than $3.2 billion, about two-thirds of that from the federal government. A Dunleavy press release said Crum has managed “large teams and multi-million dollar budgets,” but he has not managed anything approaching the largest department in the state.

Crum is a vice president of Northern Industrial Training, which his dad started in 2003 as a truck-driving school in Palmer. His brother Joey Crum is the president. The company, now owned by Crum and his siblings, has grown to also provide training in welding, carpentry, heavy equipment operation and other skills.

His company website has a prominent section promoting the state and federal financial aid programs that people can use to pay for job training at NIT. These include the Alaska Performance Scholarship and loans from the Alaska Commission on Postsecondary Education.

Crum earned a master’s degree in environmental health sciences in 2015 at Johns Hopkins University and did his undergraduate work at Northwestern University, where he was a 285-pound offensive lineman on the football team 11 years ago, He earned bachelor’s degrees in psychology and pre-med.

Crum and his family were early financial backers of Dunleavy’s campaign. I’m sure he’s a fine guy, but he told the Associated Press he is not a “health care policy guy.” He better get to work on that fast.

He had an unsuccessful campaign for the Legislature in 2016 in which he said he wanted to “reduce the budget and stabilize the economy and bring back growth.”

“Our government is too big, does too many things for too many people, and gets in the way of private initiative and investment,” he said, describing himself as a “business owner, truck driver and carpenter.”

In a bit of empty campaign talk, he said gold mining could be a significant new revenue source for the state, to go along with oil. “We have a lot of gold in this state,” he said in a 2016 interview with Alaska Unfiltered. He said the state needs to promote more mining.

“Gold is a commodity that has maintained its price even throughout the dips and bubbles of the housing market,” he said.

Gold prices hit nearly $1,900 an ounce in 2011 and are now about $1,200.

According to VoteSmart, he said during his campaign that the state has to “re-tool the way we collectively care for our most vulnerable Alaskans. Getting people off of state-paid health care and into sustainable jobs will be a priority.”

In the interview with Alaska Unfiltered, he said increased competition would decrease costs.

“On the health care costs, it will take a long time to address the Medicare, Medicaid issues. We can address the formula funding, but things we can do directly right away to help drive down the cost of health care is removing government barriers,” he said.

He wants to end the “certificate of need” process, claiming it is an “anti-competitive measure.” Crum said that opposition by Providence Hospital to a plan by Alaska Regional Hospital for an emergency care facility in Eagle River resulted in “an unserved population with no competition. It allows the prices to drive up, as opposed to private investment, bringing it down.”

The situation is far more complicated than Crum portrayed it, though the certificate of need process has long been attacked by people who want to build expensive health care facilities that specialize in profitable services.

There is no competition to provide unprofitable services, but the needs of patients include areas that have to be subsidized in some manner.

The plan rejected by the state called for spending $25 million on two emergency room facilities, one in Eagle River and one in South Anchorage. The state analysis found the plan to be costly and inefficient.

The report said that treatment in new free-standing emergency departments would be expensive to the government because “under Medicaid and Medicare, both the physicians / professional staff providing the care and the hospital entity receive reimbursement. Only physicians / professional staff are reimbursed for care rendered in an urgent care clinic or physician’s primary care office, meaning there is no additional facility fee that is reimbursed (i.e. fee to the hospital entity).”

Alaska Regional Hospital statistics showed that since 68.7 percent of emergency room visits can be “appropriately cared for in an urgent care clinic or a physician’s primary care office, introducing FSEDs (free standing emergency departments) in Eagle River and South Anchorage will create greater access to a more costly setting, despite there being no need for such care or cost.”

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