In a surprising emergence from his recent retirement, when California faces what is arguably its most grave health care challenge in history, former Department of Social Services Director Will Lightbourne has been named the director of the state health care agency.
The California Department of Health Care Services oversees the state’s vast Medicaid program, known as Medi-Cal, providing medical, dental, mental health and substance use disorder services to about 13 million Californians. In his new post, Lightbourne will also run community mental health services, substance use disorder treatment services and some health programs in rural areas.
Lightbourne, 70, has handled crises affecting the most vulnerable Californians throughout his career, with a characteristically calm outward demeanor.
In 2011, when he left a job in Santa Clara County for his state post, then-county Supervisor Jim Beall (D), now a state senator, said he was well suited to tackle a massive downsizing of social services driven by a dire economic climate. “We need experienced people up there to solve some of these big problems,” Beall said at the time. In a nod to Republicans complaining about his salary, he added: “There’s no doubt he will more than earn his keep up there in terms of saving money.”
Lightbourne will serve under California Health and Human Services Agency Secretary Mark A. Ghaly and will make $195,246 a year, pending confirmation by the state Senate.
He will replace Bradley P. Gilbert, who lasted only four months before resigning earlier this month, in a move he described in a statement as coming after much thought, and in a desire to spend more time with family – a decision “to really retire.” The Department of Health Care Services had been planning a major overhaul of California’s Medicaid waiver this year – before the coronavirus placed those plans on hiatus. The California Advancing and Innovating Medi-Cal proposal was designed to improve health outcomes for people enrolled in the state’s Medi-Cal system, including improved behavioral health services to foster youth.
Lightbourne, who began his career in 1975 as a Catholic Charities director in San Francisco, served as head of the California Department of Social Services from 2011 to 2018. During that time, he helped launch California’s Continuum of Care Reform, a landmark child welfare effort to move more foster children out of institutions and into family-based settings. In recent years, he also led the state child welfare agency’s efforts to increase oversight and accountability of medical care for the many thousands of children in foster care prescribed psychiatric medications in often excessive amounts.
Lightbourne is a well-respected public servant with a long history of safety-net work in Northern California counties, championing once-controversial, now widely supported causes. As head of the Santa Clara County Social Services Agency from 2000 to 2011, he led the charge to shut down the local children’s shelter, before moving to his statewide leadership role where he expanded that work.
Prior to serving as director in Santa Clara County, Lightbourne was executive director of the San Francisco City and County Human Services Agency from 1996 to 2000. For six years prior, he served as the director of the Santa Cruz County Human Services Agency.
When he left his San Jose office for the state in 2011, county supervisors credited Lightbourne with making “extraordinary progress in reducing racial disproportionality in entries to care and in moving from a shelter-based to a home-based system.”
Although he told colleagues he was looking forward to retirement, Lightbourne was appointed to a statewide homelessness advisory group by Newsom in July 2019 tasked with helping find solutions to address “the state’s homelessness epidemic.”
Little did he know managing the nation’s largest public health system during a global pandemic would be his next job.
According to Newsom’s most recent budget proposal, the Department of Health Care Services is slated to receive $115.7 billion for the support of DHCS programs and services – $960 million for state operations and $114.7 billion to support local health programs. That would be an 8.5% increase over the current budget.
Agency budget documents show that the Department of Health Care Services expects the state’s Medi-Cal population to spike to 14.5 million people next month as a result of rising unemployment caused by the economy’s shutdown to prevent the spread of the coronavirus.
Jeremy Loudenback is a senior editor for The Chronicle of Social Change and can be reached at firstname.lastname@example.org.