In recent months the Oregon Health Authority has been the subject of negative headlines highlighting missteps that hurt Oregonians and cost the state untold millions of dollars.
And Republicans such as Knute Buehler, who recently declared he is running for governor, have made no secret of their intent to lay the agency's troubles at Gov. Kate Brown's door.
Now, having removed the health authority's director Lynne Saxton, Brown must decide if Pat Allen, who she named as Saxton's acting replacement last week, can get the agency out of the news.
And her choice has the potential to be more than a placeholder.
Allen confirmed Aug. 19 to the Portland Tribune that, as rumored, he's thrown his hat in the ring to permanently replace Saxton to head the 4,000-person agency.
So who is Allen, and does he have what it takes to get an agency that oversees care for more than 1 million Oregonians back on track?
Since 2011, Allen has headed the Department of Consumer and Business Services, or DCBS, with a staff of about 900. Before that, he was an administrator in the department's building codes division. On the side, he serves on the Sherwood School Board.
Aggressive history earned fans
The Grant High School graduate and former congressional aide has piloted DCBS into a more prominent and activist role as changes under Obamacare have thrown the health insurance market into upheaval.
In 2015, after the $300 million Cover Oregon information technology project imploded and became a national punch line, the Legislature handed the project to Allen and DCBS to get it out of the headlines — a task at which he largely succeeded.
Then, in 2016, he worked with Insurance Commissioner Laura Cali Robison to persuade some health insurers to stay in rural counties they'd planned to stop serving.
This year, he helped drive a bill through the Legislature to let DCBS take action to stabilize the health insurance market if the Trump administration or Congress took action to repeal or gut Obamacare.
With such efforts, Allen has developed a fan base.
Ken Provencher, president and chief executive officer of the health insurer PacificSource, called Allen a great choice by Brown, describing him as "a very capable leader with a high level of integrity."
Rep. Mitch Greenlick, D-Portland, said, "I think he's a fabulous guy. He's straightforward, he's smart, he takes responsibility. I think he'll do great at OHA. I have great confidence in Pat Allen."
Agency in turmoil
Allen takes over an agency that has been blasted for dragging its heels on checking the eligibility of people enrolled in the Oregon Health Plan, while not doing enough to help those people who can qualify get onto the plan.
Meanwhile, Allen needs to start the process of rebuilding the health authority's relations with entities that do business with the health authority. The revelation that Saxton had ordered the preparation of a plan to undermine FamilyCare — one of the agency's contractors that provides care for the Oregon Health Plan — is viewed by many as trashing the agency's credibility as an honest player.
Meanwhile, much of the agency's talent has left during the past two years — in part due to layoffs by Saxton, and in part due to poor morale.
With Saxton's forced resignation, which is effective Aug. 31, the agency's three top positions are either vacant or lack a permanent appointee, including vacancies as Medicaid director and chief medical officer. Meanwhile, other key positions still are filled by members of Saxton's leadership team
In her Aug. 16 letter to Allen setting out her charge to him, Brown empowered him to clean house, urging him to "make personnel changes as you see fit" in the agency's leadership team.
Not many alternatives
It's unclear how much competition Allen faces for the permanent job. Greenlick, chairman of the House Health Care Committee, had earlier considered Allen's subordinate, Insurance Commissioner Laura Cali Robison, and even toyed with the idea of Bruce Goldberg, the politically savvy doctor who held the job before Saxton. The name of Bob Dannenhoffer, a longtime health care administrator, has come up, while some have floated the idea of a lawmaker, such as former state Rep. Peter Buckley.
What's clear is that Brown is not interested in bringing in someone from out of state. Top Brown aides last week circulated a draft job description that calls for the permanent director to be a skilled, self-aware communicator with a "working knowledge of the Oregon and federal health care landscape" as well as a strong collaborator with positive relationships with Oregon legislators, stakeholders and Tribes.
The director also should have a "good media history" and a "deep knowledge of Oregon politics."
If Allen gets the job, he'll receive a raise from $168,276 to $185,508. But he says that's not why he's interested in taking it over permanently.
"I believe in the mission of the agency," Allen said. "And I think I've got skills that can help get them out of crisis and help focus on that mission."