DHHS Commissioner Shibinette: NH should have one integrated system of care
New Hampshire Health and Human Services Commissioner Lori Shibinette is stepping down at the end of this month. Shibinette has spent much of her three-year tenure responding to the impacts of the COVID-19 pandemic.
She oversaw the state-widerollout of testing and vaccinations, the distribution of millions of dollars in federal pandemic relief, countered the spread of misinformation around vaccines and COVID, and more.
When Shibinette looks back on her pandemic efforts, she attributes the successes in the state’s COVID response to the collaborative efforts of health care entities, community organizations and government departments.
“We were able to organize our response with our community stakeholders to really make a huge difference,” said Shibinette.
Looking ahead to the future of public health in the state, Shibinette says the Department of Health and Human Services needs a system redesign.
“Ideally we should have one integrated system of care so that everybody can access the health and human services they need in our state,” said Shibinette.
NHPR’s All Things Considered host Julia Furukawa spoke with Shibinette about her time in office and what the future holds for public health in the state. Below is a transcript of their conversation.
Julia Furukawa: So you came into your position as commissioner just a few weeks before the pandemic began in earnest. What was the biggest challenge you faced when it came to pandemic response?
Lori Shibinette: The first challenge was realizing that we were going to have to set aside all of the transformation that we wanted to do and the system redesign that we had looked forward to doing in the department, because COVID was going to dominate both our personal and professional lives for the foreseeable future. When it came to vaccine response in general, we had never done this before—a state response on this level. So being able to logistically put all of the different pieces to the puzzle together was probably the most difficult starting off. And once we gelled together, the leadership team, both from the department and the overall state response, we got going, and there was no stopping us once we got going.
Julia Furukawa: So it sounds like strong leadership played a key role in your response to the pandemic. I want to dig into that a little bit and talk about success. What do you think was your biggest success in this role during this challenging time?
Lori Shibinette: Our success in the state of New Hampshire ranged from the fantastic response from the National Guard to our ability to partner with our community organizations. So we were meeting weekly with hospitals and long term care facilities, schools, EMS, towns and cities and fire departments. And they all came to the table and said, ‘how can we help?’ And we were able to organize our response with our community stakeholders to really make a huge difference. So probably what I'm most proud of is how all of our organizations and health care entities and government entities all collaborated together to make this response really an excellent response for the state.
Julia Furukawa: During your time as commissioner, you have publicly called out and tried to counter the spread of misinformation both around COVID and public health in general. What role do you see public health officials playing with the increased politicization of public health and science?
Lori Shibinette: I think that was probably one of my most disappointing areas, how politicized COVID became. It felt like it became a very political statement on whether to wear a mask or not to wear a mask. Public health has a very distinct role. And I've said this a couple of times, we advocate for science and for public health. And although I definitely had some debate with some legislators around science or the role of public health, it led to really important conversations. And I think that's how you have to look at it. We're not always going to agree with all the legislators or both political parties. We're nonpartisan. Our role is to educate the public and to protect the public when necessary. So I think having public health and the leaders within the department be strong advocates for what we do is really important. Because in that process, it leads to really important conversations that need to be had, both with legislators and publicly.
Julia Furukawa: You also played a key role in the state's acquisition of Hampstead Hospital. That was part of an effort to improve psychiatric care for children here in New Hampshire. What do you hope for Hampstead Hospital's future?
Lori Shibinette: You know, when I think about the vision for Hampstead Hospital and that entire campus, and we've said this before, [the hope is for it] to become a center of excellence for children's behavioral health. So right now we're doing the acute side of it, but very soon we'll have psychiatric residential treatment facilities, maybe someday have a partial program there, substance use treatment there. It really secured our ability to take care of young people that have behavioral health issues. Obviously the department's really proud of that acquisition, because the ability to provide that level of care to children was uncertain for a period of time. And New Hampshire Hospital did a great job on it, but it wasn't necessarily the best place to have kids in a state hospital. So having this beautiful campus and a building that feels more residential than institutional is a huge opportunity for our state.
Julia Furukawa: And looking to the future, what still needs to be done to improve public health here in New Hampshire?
Lori Shibinette: Even beyond public health, just in health and human services overall, we really need to kind of do a system redesign on how we access services. All of our systems of care, whether it's mental health or substance use, Medicaid, child protection, public health, are all very separate systems. And oftentimes we may see a family that accesses three or four of our different systems and our department. Maybe they have food stamps and maybe they're involved in child protection or they have substance use disorder. And instead of having them access three different systems of care, ideally we should have one integrated system of care so that everybody can access the health and human services they need in our state.
Julia Furukawa: And Lori Weaver will be taking over as acting commissioner soon. However, a permanent successor has not yet been named. What do you think are the key qualities the next health commissioner needs to possess to succeed?
Lori Shibinette: Leadership, by far. The ability to empower people. You really just need to hire great leaders for your associate commissioners and your division directors and then let them do their jobs and show leadership to their teams. I think that's really important. Thick skin, obviously. It's a very public role. And probably a little bit of grit. That you're able to advocate in the face of adversity and stand your ground when it's necessary to stand your ground. Not necessarily be argumentative, but be an advocate. I think those are really, really important.