ST. PAUL — The longtime medical director of Minnesota’s Medicaid program is out at the Department of Human Services, and his colleagues say his departure could impair the state’s opioid response efforts.

Dr. Jeff Schiff said he was told earlier this month that the position he held for 13 years had been eliminated. Schiff, described by his colleagues as the brains behind the state Opioid Prescribing Work Group, said the move was sudden and done without clear explanation.

“I was told very specifically that this was not a performance issue, that they just wanted to go in a different direction,” Schiff said.

The decision to let go of Schiff stunned members of the opioid work group, a panel of experts created in 2015 to address inappropriate prescribing practices among Minnesota’s health care providers. Schiff helped write the legislation that created the body and set the group’s agendas and direction as an ex-officio member.

In response to Schiff’s departure, work group members penned an open letter to Gov. Tim Walz and Lt. Gov. Peggy Flanagan asking for reconsideration. The 11 voting members of the Opioid Prescribing Work Group expressed their “collective astonishment and dismay” at a decision they believe “undermines the effectiveness of our group and puts patients’ lives at risk.”

“While Dr. Schiff’s work at DHS entailed far more than spearheading the state’s response to the opioid crisis, the loss of his leadership from the OPWG has the greatest potential to cause harm to both physicians and patients alike,” the members wrote.

In a statement Wednesday, DHS Commissioner Tony Lourey said the department chose to break Schiff’s position into two jobs: a behavioral health clinical director and a medical director. The restructuring, he said, is meant to help address issues with health disparities and access across the state.

“Our restructure demonstrates our commitment to treating behavioral health needs on par with physical needs,” Lourey said. “The important work of the Opioid Prescribing Work Group will continue as part of these efforts.”

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A critical time for group

The loss of Schiff comes at a critical time for the work group, said Dr. Chris Johnson, an emergency medicine physician at Allina Health who chairs the panel.

The group is about to send individual reports to 16,500 clinicians showing their opioid prescribing behaviors and how they compare with their peers who practice the same specialty. As medical director of the state Medicaid program, Johnson said, Schiff lent credibility to the reports and knew how to help providers get their prescribing practices back in line.

“I don’t think (DHS) thought this through. And if they did think it through, they didn’t think very well,” Johnson said. “And they have put the effectiveness of this group on the line by doing this.”

State Sen. Chris Eaton, a Democrat from Brooklyn Center and work group member, said Schiff was well-connected in the clinical community. She added that she is worried about the group’s future without him.

“I’m hoping that there’s enough foundation that everything will continue,” Eaton said. “If you’ve been watching the news, we’re nowhere close to solving this issue.”

The news comes as the Twin Cities has experienced a recent spike in drug overdoses, with officials pointing the finger at opioids in several high-profile cases. In 2017, the latest year figures are available, there were 422 overdose deaths in Minnesota involving opioids.