Bremby leads a department with a budget of more than $5 billion and responsibility for serving more than 750,000 people who rely on its safety net programs, primarily Medicaid. Before joining Gov. Dannel P. Malloy's administration, Bremby served for nearly eight years as secretary of the Kansas Department of Health and Environment, an appointee of then-Gov. Kathleen Sebelius, now secretary of the U.S. Department of Health and Human Services. In Kansas, Bremby oversaw the implementation of several changes aimed at improving efficiency, including an immunization registry, a web-based system to report birth and death records, and the introduction of paperless systems for purchasing, personnel and document routing. Bremby's experience with technology could be particularly useful at DSS, which struggles with an eligibility management system developed in 1989 that is badly in need of replacement. Developing a new system is expected to take several years. Bremby made news in Kansas when he denied a permit for a controversial coal-fired power plant because of concerns about the effects of carbon dioxide emissions. Malloy cited it when he announced Bremby's appointment. "One of the things that initially attracted me to Rod's candidacy is his ability to think independently and make judgments even in very difficult times," Malloy said. Bremby previously worked as an assistant research professor at the University of Kansas, and spent 10 years as assistant city manager and chief operating officer of Lawrence, Kansas and four years as assistant to the city manager in Fort Worth, Texas. After being named commissioner, Bremby spoke of a personal history that he said would help him understand what the department's clients face. "I was born to a single parent home. I lived on the wrong side of the tracks. I helped to integrate a public education system in Alabama during a segregated era," he said. "I think I can empathize with many of our clients," he added.