When the American Health Care Act bill was pulled recently, Dyann Roth, chief executive at RHD, Resources for Human Development, breathed a sigh of relief.

"It was a terrifically bad piece of legislation that would have done real damage to our country," said Roth, 50. "I worry there will be more like it coming, with efforts to cut funding in so many areas in which RHD provides vital safety net services to people,"

Roth leads an organization that relies on Medicaid dollars to provide care to tens of thousands of some of society's most vulnerable members: the elderly, the addicted, the homeless and people with profound intellectual and developmental disabilities or with severe behavioral and medical needs.

"It's all just so shortsighted. It's not just because this kind of legislation robs the most vulnerable people in our society of opportunities they desperately need, but also because the resulting cuts have a disastrous trickle-down effect," she said.

"The people who require these services do not disappear – they show up in emergency rooms, in shelters unable to accommodate them, and in an already overburdened judicial system. Taxpayers will still [have to] pay to provide for people in need, but the people will suffer."

What’s one of the biggest challenges RHD is facing?

Our workforce in human services is at a crisis level. We do not have the people to work our jobs mostly because we don't have wages people can live on. They're professionals. This is not babysitting. Whether you are talking about the aging, the physically disabled, the intellectually disabled, it's very physically and emotionally draining work. That means that when the economy gets better and there's lower unemployment, there's no one to take our jobs.

RHD was founded in 1970 and, in 2013, you became its second CEO. When did you start working at RHD?

My mom worked in the office at RHD and since I was 15, I would go there and work after school. I did night reception at the outpatient clinic. I did filing here. I worked in accounts payable.

Talk about rising through the ranks!

I've had so many different jobs in RHD, and really, each time, that job seemed like the center of the universe. You think, `Wow, accounts payable! No one has it tougher than us. If we don't get our work done, then people don't get paid.' What it helped me do was understand that we're all part of one big system and each is so incredibly important.

You probably knew everybody, growing as the organization grew. Was it weird when you became the boss?

It's been fascinating. For many people, I'm still Dy – no different than I was. For others, the moment my title changed, I became someone different to them. I've become people's manager, director and now CEO. I can't be their buddy in the same way.

Any hints on how to make good decisions?

I've got a great team of people, too, so I don't often make decisions alone anyway. Advice? Listen to people. Don't go with just one perspective. Then just really listen to your gut. Try not to make decisions for the moment, but think about a year down the road. What will the organization need a year from now?