Sarah Aker

Sarah Aker

Deputy Director, South Dakota Medicaid
Pierre, SD
Chemistry, Political Science, 2012

"Say yes. Take every opportunity that comes your way. So often, I think we get caught up in thinking about all of the reasons we shouldn’t do something. It’s always easier to take the planned path – it’s much harder to forge your own way. "

Q&A with Sarah:

Describe your current educational or professional pursuits.

I currently serve as the deputy director of the Division of Medical Services in the Department of Social Services (DSS), overseeing policy and programs for South Dakota’s Medicaid program. I oversee our policy and care management teams and provide oversight for South Dakota’s Home and Community Based Services waivers. Since stepping into this role in 2016, I’ve focused on professional development and learning from my colleagues and other leaders in state government about how to manage and lead successful teams.

How did your USD experience influence your career path?

To say that USD only “influenced” my career path feels like an undersell. I came to USD thinking that I had my career already planned. I was a recipient of the Sanford School of Medicine Alumni Scholarship, granting me conditional acceptance into the Sanford School of Medicine upon successful graduation from the USD Honors program. I decided to double major in chemistry and political science. Chemistry to prepare for medical school and political science just for fun. One professor changed that. Mary Pat Bierle took an interest in me, guiding me to opportunities that I hadn’t considered for myself. Under her mentorship, I interned in the United States Senate and at the State Department, took study tours to Morocco and Washington D.C. and was named a finalist for national scholarships.

Most importantly, she helped me recognize my passion for policy and that my interest in political science was never just for fun. She challenged me to seek out new experiences and to never settle for something just because it felt like the safe choice. I ultimately decided not to go to medical school. I realize that it’s not the choice most people would make, but I stand by it as one of my best decisions. Every day I get to combine my interest in health care with my passion for public policy by working in Medicaid. It’s the best of both worlds and I wouldn’t be here if not for USD.

Tell us about your proudest achievement.

I was named deputy director shortly after I turned 26. Stepping into this role and leading a team focused on positive outcomes for South Dakota’s Medicaid program has been my proudest professional achievement. This work is challenging, complex and rewarding. Most rewarding is the work we’ve done with Indian Health Service to save state general funds and use those savings to address gaps in the Medicaid program and increase provider rates. I was recently awarded a Distinguished Service Award for State Official of the Year by the South Dakota Association of Healthcare Organizations for my role in this work.

In my role, I have played a key role in these efforts, drafting reports for the Health Care Solutions Coalition and leading teams to draft policy changes to add substance use disorder services for all Medicaid adults and adding additional mental health provider capacity to the Medicaid program. I led a series of stakeholder workgroups to implement Community Health Workers as a billable Medicaid service. Working closely with tribes has been incredibly humbling and rewarding as I’ve learned about their Community Health Representatives and the vital services they provide in tribal communities. We’re currently working on innovation grants to fund South Dakota innovations in care models for primary and prenatal care. We’ve also continued to work closely with Indian Health Service and other stakeholders to expand our state savings to focus on additional community-based providers like nursing facilities, community support providers and psychiatric residential treatment facilities to generate additional state savings and address provider rates. These projects have made real impacts in the lives of the people we serve in Medicaid and I’m proud to have been so involved in this work.

As an aside, my proudest personal achievement is climbing the Inca Trail to Machu Picchu with my husband on our honeymoon last year.

What was your USD experience like? Were you involved in any campus organizations or activities?

The most defining moments of my years at USD all occurred off campus: Interning in the U.S. Capitol, meeting Hillary Clinton at the State Department and visiting Morocco. Each of those moments pushed me outside my comfort zone and helped shaped the person I am today. However, I wouldn’t have had those moments without my on-campus experiences. In particular, I felt like the Honors program helped define my years at USD, introducing me to complex ideas, inspirational classmates and new opportunities, all the while pushing me to make the most of my time at USD.

My involvement in campus organizations ranged from a brief stint writing for The Volante to serving as treasurer and president of the USD Habitat for Humanity and leading spring break service trips to Miami and Montana. I also served as co-chair of the Student Health Advisory Board and as a member of the University Scholarship Committee. I spent time volunteering at Sanford Children’s Hospital in Sioux Falls and with Meals on Wheels in Vermillion. I worked at the Writing Center, as a technology fellow, and tutored American government students. USD’s campus supports student involvement and encourages students to take on leadership roles. My involvement in campus organizations, and especially serving in leadership roles, better prepared me to be successful in my career.

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