Roles and responsibilities as a Chief of Staff for Maryland Department of Health

This article is from the State Nurses Associations online journal, from the September 20, 2024 issue By: Erin K. McMullen, MPP, MSN, RN, Chief of Staff Maryland Department of Health

I was appointed Chief of Staff at the Maryland Department of Health (MDH) in February 2023. In this role, I bring nearly 15 years of combined state and federal health policy experience to my role. Prior to joining MDH, I held roles including Principal Analyst at the Medicaid and the Children’s Health Insurance Program (CHIP) Payment and Access Commission, various senior and management level roles for the state of Maryland and worked as a policy analyst for the Maryland Department of Legislative Services. I became a registered nurse later in life, obtaining my Masters of Science in Nursing (MSN) at the University of Maryland, Baltimore. I also hold bachelor’s degrees in economics and social sciences, and a master’s in public policy.

As Chief of Staff, I work closely with the Department’s five divisions to develop, review, and implement health policies. I bring a three-fold perspective to this work. From a macro perspective, I ensure the vision and values of the Moore-Miller Administration are reflected in our policy priorities. I also review policies from a micro perspective, ensuring that policies enacted by one administration, complement and support priorities of adjacent programming at MDH. Finally, as a registered nurse, I bring a clinical lens to policy work, making sure the patient perspective is present.

Finally, I lead and direct a variety of cross-agency policy priorities in my role. Per 2023 legislation, operations at the Maryland Board of Nursing were transferred to the Secretary of Health for a two-year period, and I work closely with the Board to fulfill this mandate. I lead and manage staff across MDH to set vision, develop an analytical plan, and ultimately support the Commission on Behavioral Health Treatment and Access. I also influence health policy by representing MDH on the Consortium for Coordinated Community Supports, a new entity responsible for developing a statewide framework to expand access to behavioral health services for Maryland students.

Actionable strategies that nurses in Maryland might adopt to become involved in shaping health policy

The reach of the nursing profession is wide. Roughly 40 percent of nurses work outside of a hospital setting. No matter what setting you are in, there are actionable strategies that nursing students, nurses working at the bedside, and other nursing professionals can adopt if they want to be involved in health policy. A few strategies that have served me well include:

1. Stepping outside your comfort zone.
   Stepping into the world of health policy can feel intimidating. Health policy dictates how care is financed, delivered, accessed, and everything in between. Take baby steps and start by reading up on areas that are outside your comfort zone.
2. Staying engaged. Staying engaged can mean a lot of things.
   Engagement can include joining a professional organization, attending a local school board meeting, or seeking ongoing training and professional development.
3. Holding on to your ideals, but be pragmatic.
   Former Congressman Barney Frank often notes that in the policy making process, pragmatism and idealism are positioned as opposites. Yet to create change both pragmatism and idealism are necessary. There is still much work to be done to achieve equity and true liberation in health care.
4. Making a seat at the table for others.
   Whether you’ve worked in nursing for four months or forty years, you always have something to learn from your colleagues. When getting involved in health policy, making a seat at the table for other nurses is crucial. There is room at the table for all of us. Occupying space together is how we can be most impactful.

Opportunities for nurses in Maryland to engage in health policy initiatives

Nurses are often the first and most frequent contact among people seeking and receiving care, giving them a unique understanding of not only patient needs, but needs of our healthcare system writ large.

Yet, health policy is often developed by individuals that have never worked in a direct care capacity, or by those who don’t understand the patient perspective. This is where nurses come in! The nursing profession has the ability to connect evidence and clinical practice with policy in ways that few others can.

That is why it is important for nurses to speak up, participate, and collaborate. The same therapeutic communication skills that make someone a great nurse, can also make them an amazing policy advocate.

A few ways to engage in policy include testifying at a bill hearing, calling or writing your elected officials, and participating in community forums. Volunteering to serve on a Commission or Workgroup established by the federal, state, or local government is another way to influence policy development and make an impact. Workgroups are often established to examine specific health policy issues. Finally, elected officials are more accessible than you think! Build relationships with policy makers, and share your expertise with them.

Erin K. McMullen, MPP, MSN, RN,
Chief of Staff Maryland Department of Health
Email: erin.mcmullen1@maryland.gov

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