Arkansas Human Services nominee called quick learner, “unflappable” leader

In Kentucky cabinet, Kristi Putnam championed Medicaid work requirement and secured federal funds for health services in schools

By: - January 10, 2023 5:00 am
The Arkansas Department of Human Services building on Main Street in downtown Little Rock. (Photo by John Sykes/Arkansas Advocate)

The Arkansas Department of Human Services building on Main Street in downtown Little Rock. (Photo by John Sykes/Arkansas Advocate)

Kristi Putnam entered Kentucky state government in 2016 as an executive assistant in the state’s Cabinet for Health and Family Services, but she was really “an ambassador without a portfolio,” Kentucky Youth Advocates executive director Terry Brooks said.

“It was one of those [roles] where you knew she was brought in to sort of be a problem solver,” he said. “When issues came up, whether they were proactive issues or in response to a crisis, she approached those both with innovation and pragmatism.”

Putnam started in the child welfare and family assistance office and rose to deputy secretary of the department about two years later. Now, Putnam is poised to take over the Arkansas Department of Human Services this month.

“Kristi and I share a vision for bold reforms that support our neighbors in need, care for our most vulnerable, protect children in foster care, and ensure Arkansans are not trapped in a lifetime of poverty,” Republican Gov.-elect Sarah Huckabee Sanders said in her Dec. 27 news release announcing Putnam’s nomination.

Current DHS Secretary Mark White will become the department’s chief of staff, the job he had before replacing Cindy Gillespie upon her resignation in October.

Brooks and others who worked closely with Putnam in Kentucky say she is calm under pressure, well-versed in the Medicaid and Medicare programs, a team player and a firm believer in the policies she champions.

Kristi can be really charismatic. She’s good in meetings, she’s very shiny and she presents well.

– Cara Stewart, Kentucky Voices for Health policy advocacy director

State Rep. Kim Moser, who chairs the Health Services Committee in the Kentucky House of Representatives, said she and other Republican legislators have worked with Putnam on “how to give people a leg up and break the cycle of dependency.”

Moser described Putnam as a “great listener” and “very creative and thoughtful.”

“She has such a strong foundation and background [in Medicaid and Medicare] that I think she can really listen to somebody’s idea and help them articulate it in language that makes sense,” Moser said.

Putnam is best known for her efforts to implement a work requirement for Kentucky Medicaid recipients, something Sanders has stated she wants for Arkansas. Work requirements in both states were struck down in court in 2019.

“We will protect our fellow citizens while prioritizing reforms and identifying efficiencies and taxpayer savings, which is what I have done throughout my career,” Putnam said in the Dec. 27 news release. “I strongly believe that access and opportunity empower people to live their best lives.”

Putnam told the Arkansas Advocate she was willing to be interviewed if Sanders’ team allowed it. Judd Deere, one of Sanders’ deputy chiefs of staff, didn’t respond to a request to interview Putnam.

Professional background

Putnam came to Kentucky from Florida, where she worked for the state Department of Children and Families and the Florida Adoptive/Foster Parent Association. She was originally a teacher, and her experience in both education and child welfare makes her particularly qualified to work in statewide human services, Brooks said.

Kristi Putnam, deputy secretary for Kentucky's Cabinet for Health and Family Services, in 2018. (Screen capture from CHFS Facebook video)
Kristi Putnam, deputy secretary for Kentucky’s Cabinet for Health and Family Services, in 2018. (Screen capture from CHFS Facebook video)

“When we talk about kids and families, policy frequently is made in silos, so it’s just health or just education or just child welfare,” Brooks said. “I always offer the caveat that I’m not smart enough to figure out how kids grow up in silos. I think they live integrated lives… One of my predictions is that [Putnam] is able to craft interdisciplinary solutions.”

Putnam joined the Kentucky Cabinet for Health and Family Services in March 2016 and served as deputy secretary from May 2018 to December 2019. Throughout her tenure at the department, Putnam worked on securing a federal Medicaid waiver that she hoped would lead to a work requirement for Kentucky Medicaid. The policy would not only have required Medicaid recipients to work but also would have enforced penalties on enrollees who did not meet administrative deadlines.

Republican then-Gov. Matt Bevin proposed a Medicaid plan in 2017 that would have removed more than 100,000 Kentuckians from the program, though state officials said this was not part of the plan. Opponents of the plan called it “reprehensible” and “lipstick on a pig” at a legislative hearing.

Arkansas received its own Medicaid waiver and enacted a work requirement that cut 18,000 people from the program.

A federal judge ruled against both states’ Medicaid waiver projects in March 2019 after the Southern Poverty Law Center filed lawsuits against them. Arkansas received a new Medicaid waiver in December 2021 to revamp the program, now called ARHOME. It does not include a work requirement.

Sanders said while campaigning for governor that she will work with the state Legislature to submit a new Medicaid work requirement to the federal government.

Cara Stewart, director of policy advocacy at Kentucky Voices for Health, said she has seen firsthand Putnam’s commitment to Medicaid work requirements.

“Kristi can be really charismatic,” Stewart said. “She’s good in meetings, she’s very shiny and she presents well. She’s had tons of experience in Kentucky being in hostile legislative committees, and she never loses her cool, ever.”

Putnam’s other work at the Cabinet for Health and Family Services included securing Medicaid funding for health services in schools after a school shooting in January 2018 left two Kentucky teenagers dead and 18 more people injured.

“​​There was a lot of talk about behavioral and mental health support [for kids],” Brooks said. “Kentucky, like Arkansas, is not the richest state, so the issue was always ‘What about the fiscal component?’”

Putnam secured federal funding that matched $3 for every dollar a school district spent on mental and behavioral health care in schools, turning what could have been a “pie-in-the-sky idea” into a reality, Brooks said.

She keeps a level head, she stays calm, she takes a logical and analytical approach to problem solving, and that results in measured outcomes.

– Adam Meier, former Kentucky Secretary of Health and Family Services

Putnam’s connections in her home state aided Bevin’s administration in 2018 when Bevin named a Florida pastor and his wife “special advisers” to his adoption and foster care reform efforts in Kentucky, according to the Louisville Courier-Journal. Chris and Alicia Johnson were friends of Putnam’s, and Chris Johnson worked with Putnam at the Florida Adoptive/Foster Parent Association. Putnam personally introduced Bevin and the Johnsons at her home, according to a 2016 Facebook post.

Some Kentucky child welfare advocates told the Courier-Journal they were concerned about the introduction of religious beliefs into a state program.

Here in Arkansas, Putnam will take the reins of DHS at the start of a Medicaid eligibility review. DHS will look at the enrollment of 418,855 Medicaid clients who might no longer be eligible but had their coverage extended through an agreement written into Congress’ first COVID-19 relief law in 2020, department spokesman Gavin Lesnick said in a Monday email.

“Benevolent disrupter”

After Bevin lost his reelection bid to Democratic Gov. Andy Beshear in 2019, Putnam left the Cabinet for Health and Family Services and became Kentucky House Republicans’ policy adviser for public benefits issues.

Stewart was chief of staff for the Kentucky House Democrats at the time, and she said she and Putnam share a strong conviction in their work despite their different views and approaches.

“She’s unflappable, no matter what happens,” Stewart said.

Putnam co-founded a consulting firm, Connecting the Dots Policy Solutions, with former Health and Family Services Secretary and former colleague Adam Meier, along with former state legislator and CHFS supervisor Scott Brinkman.

Brinkman is now secretary of the University of Louisville board of trustees. Meier served as Montana’s Secretary of Public Health and Human Services from early 2021 to late 2022 and recently moved back to Kentucky.

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He praised Putnam’s “exceptional” leadership ability in an interview.

“She keeps a level head, she stays calm, she takes a logical and analytical approach to problem solving, and that results in measured outcomes,” Meier said. “The results are making sure that we’re thinking strategically about not just the step immediately in front of us but [also] the downstream impact, steps two, three, four and five.”

Connecting the Dots Policy Solutions’ website describes Putnam as “a benevolent disrupter capable of driving collaboration between disparate agencies or programs to maximize program outcomes.”

Most recently, Putnam was chief personnel officer for AppHarvest, a Kentucky agricultural technology startup that opened in 2020 and started three high-tech indoor produce farms in 2022. The project moved forward after AppHarvest recorded falling stocks and a $166 million loss in 2021.

Putnam’s associates said that overall she will be an asset to Arkansas’ executive branch and public benefits programs.

“She holds tightly to a vision and loosely to implementation, and that’s a really important formula,” Brooks said.

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Tess Vrbin
Tess Vrbin

Tess Vrbin came to the Advocate from the Arkansas Democrat-Gazette, where she reported on low-income housing and tenants' rights, and won awards for her coverage of 2021 flooding and tornado damage in rural Arkansas. She previously covered local government for The Commercial Dispatch in Mississippi and state government for the Columbia Daily Tribune in Missouri.