By Andrew Jopson, 2016 Academy Summer Intern*
Pamela Doty, Ph.D. is a Senior Policy Analyst and researcher in the Office of the Assistant Secretary for Planning and Evaluation (ASPE) in the U.S. Department of Health and Human Services (DHHS). She has worked in the U.S. Department of Health and Human services for over 30 years, focusing on analyses related to long term services and supports (LTSS) financing and evaluating proposals for LTSS reform. She has served on numerous task forces and commissions related to LTSS issues, including the Pepper Commission as staff to the White House appointee and Hillary Clinton’s health care task force in the early 1990’s.
“Pam Doty is a champion of improving services for all those with a need for long-term care services,” said Anne Montgomery, Deputy Director for the Altarum Institute's Center for Elder Care and Advanced Illness. “She has nurtured and anchored a remarkable body of work at ASPE in this arena, including leading many policy discussions on strategies for adapting Medicaid to incorporate self-directed services, and on why it is important to pay closer attention to improving options for individuals wishing to buy long-term care insurance.”
Doty’s interest in health policy grew as a graduate student at Columbia University under the encouragement and guidance of her faculty adviser, Amitai Etzioni. As a student, she worked for the Center for Policy Research on a variety of projects related to health information systems, telecommunications, and regulating the quality of Medicaid funded nursing homes. After receiving her Ph.D in sociology, Doty moved to Washington, DC to take a post-doc appointment at the Congressional Office of Technology Assessment. She later took a position at the U.S. Department of Health and Human Services and has worked in the federal government ever since.
Doty’s office is an archive of her labor as a career civil servant. Historical reports, inspiring demonstration descriptions, and innovative program brochures are stacked alongside reams of nondescript, bureaucratic papers. Looking around her office, she acknowledges the missed opportunities and failed proposals to reform LTSS financing and delivery over the course of her career, noting the merry-go-round of ideas from one generation of reformers to the next. Yet Doty maintains a resilient perspective amidst the glacial pace of government reform.
She counts the “Cash and Counseling demonstration,” done in conjunction with the Robert Wood Johnson Foundation, among her proudest accomplishments. It gave adults with chronic disabilities and family caregivers of young children with developmental disabilities the flexibility to direct their own home and community-based services. The fifteen-state demonstration, and center for research and technical assistance on self-direction to states, that DHHS sponsored (with the Robert Wood Johnson Foundation, Atlantic Philanthropies and other funders) from 1993 through 2013, led to sweeping changes in Medicaid policy, law, and regulation by elevating the importance of participant-directed services.
With regard to the future of social insurance programs, Doty expresses concern about maintaining the safety-net and underscores the need to make sure that these programs exist for future generations. She advises those who want to follow in her footsteps to figure out how they want to impact policy. “Every place you go will have opportunities and limitations. Academia offers more freedom in research, but you’re far from the center of action and political influence. I wanted to figure out how to have an impact on policy so I came to Washington,” said Doty. She has been a member of the Academy since 2012.
*Andrew Jopson was a 2016 Academy summer intern, placed at Community Catalyst. During his placement, he interviewed Pamela Doty for a glimpse into the professional life of an expert in the field of long-term care.