(The Center Square) – After naming Paula Nickelson as acting director of the Missouri Department of Health and Senior Services (DHSS) Tuesday, Republican Gov. Mike Parson said she could serve with that title for the rest of his term without Senate confirmation.
Nickelson replaces Donald Kauerauf, who was named director last July but wasn’t confirmed by the Senate in early February. Senate Republicans voiced displeasure with Kauerauf’s approach to COVID-19 vaccinations, his service in the administration of Illinois Democrat Gov. J.B. Pritzker and other views on public health. Nickelson is the fourth director at DHSS since Dr. Randall Williams resigned in April 2021.
“She’ll be doing everything the director would be doing,” Parson told reporters during a media briefing after making the announcement. “I look at her as the director and not so much the acting director. I look at her as being a part of the cabinet from this point moving forward.”
The Missouri Constitution states appointments of all department and division heads are to be made by the governor and shall be “made only by and with the advice and consent of the Senate.” Kauerauf started last July and didn’t face confirmation until February when the Senate was in session. The Constitution states the governor’s appointments must be approved within 30 days after the Senate convenes in regular or special session.
“I’m not sure it’s necessary for the governor to go out and ask the Senate for their permission to appoint a director,” Parson said. “I think it’s their job to confirm the director and they have that choice to make.”
Parson didn’t rule out seeking Senate confirmation for Nickelson, a 22-year employee of DHSS and longtime Missouri resident.
“She could go through the confirmation hearing and everything, but right now we’ll see how that plays out,” Parson said. “We may put her up there and get that confirmation months down the road or next year. But right now, I think we just need stability.”
Parson added Nickelson could serve as acting director of the agency, with its $2.9 billion annual budget, until his term ends in 2024. He admitted challenges with attracting qualified candidates.
“I’m just telling you whether it’s Department of Health or some other (positions), it is difficult to recruit somebody right now,” Parson said. “It’s a pretty temporary position, especially if you talk about somebody moving their family and uprooting to come in here.”
A media release from the governor’s office praised Nickelson for many successful projects during the COVID-19 pandemic, including establishing the state’s first personal protective equipment warehouse, a mitigation strategy for long-term care facilities and overseeing the state’s antigen testing program. When asked about leading DHSS, Nickleson praised Kauerauf and emphasized a focus on the department’s mission.
“Public health is a greater mission than any one human being,” Nickelson said. “And while I had interactions with Director Kauerauf and found him to be qualified, professional and compassionate, certainly in the opportunity that arose afterwards I was interested in assuring that our public health system did not falter and we wanted to move forward quickly.”
Nickelson said public health agencies gained knowledge from their COVID-19 response and the strategies will be studied for decades in the future. She emphasized the necessity of a layered approach to mitigation with masks, vaccinations and therapeutic medications.
“All are useful and should be available to each of us as we make personal choices about how best to safeguard our own health and the health of our family members, and with consultation of our personal physician,” Nickelson said.