Oregon Health Authority director Dr. Sejal Hathi, shown here in an undated provided photo. Hathi resigned from her position at OHA earlier this month.
Courtesy of Gov. Tina Kotek's office
Last Thursday, Oregon Gov. Tina Kotek announced she had accepted the resignation of the director of the Oregon Health Authority, Dr. Sejal Hathi. As OPB reported, Hathi wrote to OHA employees that she was leaving to focus on her family, health and “personal priorities” without mentioning what she plans to do next. In May, the New York Times published an op-ed Hathi wrote about the lack of postpartum care U.S. mothers such as herself receive, even after complications from childbirth.
Kotek appointed Hathi in November 2023, making her the first person from outside of Oregon to lead the agency. Hathi is also a part-time assistant clinical professor at Stanford University’s medical school, a position she has held while leading OHA.
Hathi is leaving OHA at the end of this month amid a series of challenges facing the agency, including a nearly 5% cut to the Oregon Health Plan, the state Medicaid program that covers 1 in 3 Oregonians. OPB health reporter Amelia Templeton joins us for more details.
Note: The following transcript was transcribed digitally and validated for accuracy, readability and formatting by an OPB volunteer.
Dave Miller: This is Think Out Loud on OPB. I’m Dave Miller. The leader of Oregon’s largest state agency is stepping down. Governor Tina Kotek announced on Thursday that she’d accepted the resignation of the director of the Oregon Health Authority. Doctor Sejal Hathi says she’s leaving to focus on her family, health, and personal priorities. Hathi was appointed by Governor Kotek in November of 2023. She’ll leave at the end of this month amid a series of challenges for the agency, including a nearly 5% cut to the Oregon Health Plan. That’s the state Medicaid program that covers one in three Oregonians. OPB health reporter Amelia Templeton joins us now with more details. Good to have you back on the show.
Amelia Templeton:Thanks so much, Dave.
Miller: Can you remind us what Hathi’s background is, what she was doing before she got to Oregon?
Templeton: She had worked in the White House as a senior policy advisor during the Biden administration. She’d also briefly served as New Jersey’s deputy health commissioner immediately before coming to Oregon, and she’s a physician with a medical degree from Stanford, and a history of, from a very young age, advocacy on gender issues and sort of Democratic Party activism.
Miller: I want to play a short clip from a kind of entrance interview that we did with Hathi back in February of 2024.
Sejal Hathi: I’m here for the long haul and I recognize that to do the type of work that we need to address the challenges that lie before us, I’m going to need to be here not for two years, but for two terms or as long as Oregonians will have me. My husband and I bought a home. We’re here to build a family and to lay down roots.
Miller: All right. Long haul, you know, eight years when she says two terms, the assumption there is gubernatorial terms, but we’re looking at many fewer years than that. How big a surprise was this news?
Templeton: Medium big, I think. I mean, look, the reason that she was answering that question in her entrance interview was because from the jump people wondered, when you have somebody who has such a national resume, you know, is Oregon a stop on a career with greater ambitions or are you in this for the long haul?
Miller: And I think I hadn’t mentioned it in the lead up to that clip we just heard, but I had noted in that question that I asked over here the answer to that, she’d been in the New Jersey post for something like four months.
Templeton: Yes, I think we’ve definitely seen, you know, Oregon has a sort of national profile on healthcare issues, particularly with what we’ve done with our Medicaid program. So we have been able to attract people working on those issues from across the country, sometimes with, you know, pretty high profiles. In terms of how big of a surprise this was, I will say, an email went out to the staff of the health authority at 9 a.m. Tuesday. I don’t think anybody broke the news before then. So it was definitely kept under wraps, and while I’ve talked to some people who say, “Yeah, this sort of makes sense,” or “I’m not shocked,” I don’t think anyone necessarily, you know, immediately saw it coming.
Miller: Do you have a sense for whether this resignation was voluntary? In other words, was she pushed out?
Templeton: It’s a big question. I have asked several people who know the agency well that question, and so far, none of my sources think she was forced out. The official statement that came from the governor and Hathi’s official statement that came with it, is that she chose to step down in order to focus on family, personal priorities, and her health.
And the people I’ve spoken with, do you think that is like on its face a credible statement, that running the Oregon Health Authority is, you know, it’s the largest state agency, massive budget, it’s a more than 80 hour a week job. She is a new parent and she’s spoken publicly in multiple ways about wanting to start a family, about the importance of mental health and balance. So I think while “I’m focusing on my family” is definitely the kind of thing people sometimes say in a scenario when they’re pushed out, it also is something that is credible based on her own statements so far.
Miller: How much can you say about what Sejal Hathi accomplished as the leader of this massive organization?
Templeton: Well, as she said in her own words, two years is hard to make a mark and make headway on major issues of health and public health in two years. And she’s been leading the agency in this period of incredible transition politically, so, you know, the Oregon Health Authority’s sort of north star as she came in was we want to be an agency that prioritizes, you know, DEI issues.
That, of course, has become far more politically fraught and challenging. I’ve spoken with some people. I’ve sort of heard two different takes, and the negative take would be that people have felt the agency has been somewhat rudderless in recent years, that just the nuts and bolts of the work the agency does, you know, overseeing Medicaid and contracting with CCOs, that the people have needed more active leadership in this time of change. And some of that has been, you know, somewhat troubled. On the positive side, with her rolodex, her close ties to D.C., sort of network across the country, her ambition, she has helped the agency deal with a lot of rapid-fire changes and helped people understand even just sort of what the policy is as it’s coming down.
Miller: What’s happening right now with the Oregon State Hospital?
Templeton: Oh boy. The Oregon State Hospital, which also has been part of her portfolio, has been undergoing this really, I think, big shift from being a facility that served in more equal measure people who were patients through the civil commitment process and people who are, you know, awaiting trial or people who needed long-term psychiatric care because they had been found guilty, but for insanity, to really primarily being a facility that’s taking in people from county jails and providing mental health treatment for the specific narrow legal purpose of helping people be well enough to participate in a trial. That’s a really profound change.
There’s just a tremendous amount of sort of challenge and disruption happening at the state hospital. It’s a less consistent and stable patient population. And at the same time, there have been just longstanding concerns about patient rights around the practices that are used to balance the safety of all of the people working and who are patients there against the individual rights of any one patient. You know, the biggest issue, of course, recently being, the extended seclusion of a patient who subsequently died while in seclusion.
So in terms of Hathi and her, you know, oversight, again, you can sort of point to the positive, you can point to the negative. On the positive side, the state hospital has made a lot of progress towards coming into sort of compliance with orders that they treat patients more efficiently, basically, and that they move people in and out of jail so that you don’t have patients languishing in jail waiting for admission, and that’s been a years-long process. And on the negative side, she’s faced real questions, particularly from The Oregonian, over whether she’s taken accountability for what she knew, and when, about seclusion practices there.
Miller: Is there any clarity about what she might do next?
Templeton: No, there, there isn’t yet. She did write an
op-ed in The New York Times pretty recently about her experience becoming a mother for the first time and how unsupported that was. I think, you know, you can take from that what you will, but she’s clearly still very interested in issues around gender and healthcare and women’s experiences of the healthcare system, as well as like, I think clearly wants more time to be a parent. And then, unrelated to her role at OHA, her husband is also a venture capitalist who recently became one of the co-owners of the Blazers. Unclear how that will play into her future as well.
Miller: Right, do we know if her resignation is gonna have any effect on the ownership structure of the team? He has been, even though he’s a relatively new Oregonian, he was the local member of the new ownership stake.
Templeton: Yes, and I think that now gives Blazers fans a reason to be invested in what the departing director of the Oregon Health Authority does next and whether she remains an Oregonian.
Miller: Amelia, thanks very much.
Templeton: You’re welcome.
Miller: Amelia Templeton is OPB’s Health Reporter.
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