TMC PULSE

t m c » p u l s e | m a y 2 0 1 8 28 Spotlight For nearly two years, CHARLES SMITH has overseen the Texas Health and Human Services Commission, the newest organization to become a member of the Texas Medical Center (TMC). This budding partnership coincides with a TMC land gift for the first public psychiatric hospital to be built in Harris County in more than 30 years. Smith, a native Texan raised in the Panhandle town of Childress, spoke with Pulse about teamwork, treating people with dignity and presiding over a massive reorganization of the commission, which is respon- sible for the state's Medicaid programs, food subsidy payments and child care licensing. Q | You've earned a reputation as a state agency transformation specialist. How did your rural upbringing influence your leadership style? A | My father was a preacher. My mother was a stay-at-home mom and there were eight children. I am No. 5. Growing up, we went fishing and played with friends. We had the proverbial 'when the street lights came on, we came back home.' I didn't realize we were poor until I went to college. … My grandmother worked as a house cleaner for many of the families in Childress and had a farming background. One of the things she would say was: 'Make a hand'—like a hired hand—'and whatever you do, do your best.' That was really ingrained in me. My dad would help people and he instilled in us the value of helping people who are less fortunate. … My dad always told me that your name and your reputation should be pro- tected. If you do anything, do it to the best of your ability—the first time. Q | You graduated from Texas Tech University in 1988 with a bachelor's degree in psychology, but didn't start your college education there. Why did you transfer? A | When I left high school, I went to East Texas State University [now Texas A&M University- Commerce] and played college football for a couple of years. I met a girl between my freshman and sophomore years living in Childress. We struck up a relationship. I went back to college, played one more year of football, dropped football and transferred to Texas Tech [in Lubbock] because she graduated from high school and went to Lubbock Christian University. It worked out. We've been married for almost 29 years. Q | You previously ran the child support division at the Texas Attorney General's Office. How did you get your first opportunity to work in state government? A | I started at the child support division because I was planning to go to law school. I had an uncle who said if I really wanted to go to law school, I should do a volunteer stint at the Attorney General's office. He knew some people in Lubbock who could make that happen. I started to volun- teer 20 hours a week, which was kind of surprising to them. I was working in the legal area typing pleadings and doing interviews for paternity affi- davits. They asked me if I would like to work there. After about six months of being with the agency, people were coming to me asking questions about the job. The manager asked me what I was doing that made people come to me and I said: 'I took the manuals home and read them.' Q | Did your own socio-economic background inform your work at the Attorney General's office? A | Growing up, I had friends who were in single-parent homes. Once I started dealing with paternity situations, I began to realize how their families struggled. We were all living in the projects—in subsidized housing. My family was eventually able to move out into a home my father bought. He was a disabled veteran. I stayed con- nected to my friends because they were a couple of blocks away. Through the job, I began to realize how difficult things were for them with their mothers trying to make ends meet. This became an opportunity to explain to staff why it was important for us to do a tremendously good job. It's about collecting money and helping families so that children can have a brighter tomorrow. Q | After managing child support offices in Midland, Abilene and the Dallas-Fort Worth region, you went to work in Austin. How did you make the leap from the Attorney General's office to the Health and Human Services Commission? A | After Greg Abbott became Attorney General in 2002, I was asked in October 2003 to come to state headquarters to become the assistant director of field operations. In May 2004, they created the position of deputy director of the child support division and put me there. I stayed in that role until the deputy attorney general retired in September 2013 and that was when Attorney General Abbott appointed me to executive deputy of the child support division. I initially came over to the commission in July 2015 as the chief deputy executive commissioner. Commissioner Chris Traylor retired in May 2016 and I was appointed by now-Governor Abbott. Q | What professional challenges have you faced since you were appointed Executive Commissioner of the Health and Human Services Commission (HHSC) in June 2016, particularly regarding the agency's reorganization? A | The transformation of HHSC really was my sweet spot. At the Attorney General's office, that was my reputation: Turning things around and fixing problems. I'm bringing a sense of clarity to HHSC so that people understand the mission. Health and Human Services has really been focus- ing on outcomes. We have almost 700 programs and more than 35,000 employees. I have changed the human resources policy to make it more aligned with a high-performing agency. We had employees who hadn't had evaluations for years. Credit: HHSC Media and Outreach Services

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