Trump HHS Hires Include Many Dubya Vets

The Trump administration has been slow to nominate people to the top tiers of leadership that require Senate confirmation. But at the Department of Health and Human Services (HHS), it has begun to plug in some new hires among agencies serving youth and families. Some of the hires are familiar faces who worked for the previous two presidents.

Following is a rundown of some key Trump hires at HHS:

Steven Wagner, who ran the human trafficking program at HHS during the George W. Bush administration, is now the acting assistant secretary in charge of the Administration for Children and Families (ACF), the HHS agency responsible for most welfare assistance and child welfare spending.

Wagner was president of QEV Analytics, a public opinion research firm he has owned since 1996. Among QEV’s major clients: the National Center on Addiction and Substance Abuse at Columbia University, headed by Joseph Califano, which used to produce an annual survey of American attitudes on substance abuse. The report was last published in 2012.

In 2013 Wagner founded Solidarity with the Persecuted Church, which raises funds to help Christian churches abroad. In 2007, on the heels of his trafficking post in the Bush administration, he founded The Renewal Forum, which seeks to bring attention to the large amount of trafficking victims in America who are American minors.

Wagner was made a principal deputy assistant secretary, so he is set up for a long-term assignment at ACF. It is possible that Trump will end up nominating him for the top ACF job at some point.

Wagner’s anti-trafficking efforts will be bolstered by the recently created Office on Trafficking in Persons. That office is led by Katherine Chon, the founder and former president of the Polaris Project.

Anna Pilato is Trump’s pick for deputy assistant secretary for external affairs. During the Bush administration, Pilato ran the HHS outpost of Bush’s Office of Faith-Based and Community Initiatives, which used a hub-spoke model to connect domestic agencies to a White House commitment to support religious charities.

Pilato parlayed that experience into a four-year stint as deputy secretary for the Kansas Department for Children and Families, where part of her purview was establishing a faith-based initiative on the state level. She served on Trump’s transition team at HHS after the election.

Clarence Carter, who directed the food stamp program under George W. Bush, has been tapped to head the Office of Family Assistance (OFA), a division of ACF.

OFA has a few small programs: the Obama-era, bipartisan-supported Healthy Marriage & Responsible Fatherhood, and the Health Profession Opportunity Program. But the agency’s central role is to administer the $16.5 billion Temporary Assistance for Needy Families (TANF), the welfare program that replaced the Aid to Families with Dependent Children in 1996.

Carter presided over Virginia’s welfare system during the period following federal welfare reform. During his tenure as commissioner of social services for the commonwealth, the number of families on public assistance dropped from 74,000 to 31,000, according to his bio on the ACF website.

More recently, Carter headed up the Arizona Department of Economic Security for former Gov. Jan Brewer (R). That agency, at the time, had jurisdiction over the state’s child protection system.

Carter was at the helm when it was discovered that a group of employees had established a shadow policy of marking certain referrals “not investigated” before a true assessment of them had been made. More than 6,000 calls to the CPS hotline were essentially ignored.

Brewer spun the state’s child welfare system into an independent agency. Carter resigned at the end of her governorship.

Scott Lloyd is Trump’s pick to lead the Office of Refugee Resettlement (ORR). Lloyd’s most recent post was with the Knights of Columbus, a Catholic fraternal organization. Lloyd, a pro-life activist, was an attorney in the public policy shop and, according to his ACF bio, led the organization’s advocacy for Christians persecuted by the Islamic State. He was a lawyer in the general counsel’s office at HHS during the George W. Bush administration.

Lloyd, with little experience on refugee resettlement, will preside over one of the few domestic federal agencies that saw a dramatic increase in funding during this decade. ORR overseas the Unaccompanied Alien Children program, through which unaccompanied minors who arrive at the U.S.-Mexico border are placed into the custody of HHS while the agency figures out whether to place them with family in America or return them to their home country.

Shannon Christian is in as director of the Office of Child Care. According to her LinkedIn page, she has been an independent public policy consultant for the past two years. Before that, she served former Illinois Gov. Pat Quinn (D) from 2010 to 2012 as director of the Office of Early Childhood Development.

Elsewhere at HHS: Ellie McCance-Katz, who served as Obama’s chief medical officer at the Substance Abuse and Mental Health Services Administration (SAMHSA), has been nominated to head that agency.

McCance-Katz will be the nation’s first assistant secretary for mental health and substance abuse. That is the position created in last year’s 21st Century Cures Act, which elevates the stature of the person in charge of SAMHSA.

At least one Trump backer in Congress was ticked off that Trump brought an Obama-era leader in for the gig. Rep. Tim Murphy (R-Penn.), who was a working psychologist before his election to Congress, blasted the choice to a local paper in late April.

Murphy chafed at the Obama administration’s pushback against his Helping Families in Mental Health Crisis Act. The bill ultimately passed as part of the Cures Act. He told the Pittsburgh Gazette:

I am stunned the president put forth a nominee who served in a key post at SAMHSA under the previous administration when the agency was actively opposing the transformative changes in [the Cures Act]. The old regime at SAMHSA was incapable and unwilling to work with me and my colleagues in Congress to deliver the transformative changes needed.

McCance-Katz is currently chief medical officer for the Rhode Island Department of Behavioral Healthcare, Developmental Disabilities, and Hospitals. The year after she left SAMHSA, she penned an op-ed in Psychiatric Times criticizing the agency’s failure to prioritize treatment of mental illness:

There is a perceptible hostility toward psychiatric medicine: a resistance to addressing the treatment needs of those with serious mental illness and a questioning by some at SAMHSA as to whether mental disorders even exist — for example, is psychosis just a “different way of thinking for some experiencing stress?

SAMHSA has a budget of about $3.7 billion. It is currently headed by acting assistant secretary Kana Enomoto, who has worked at SAMHSA since 2011.

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John Kelly, Editor in Chief, The Chronicle of Social Change
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John Kelly is editor-in-chief of The Chronicle of Social Change. Reach him at