here for PDF format
here for participants' responses to this interview.
Jodi Harpstead, CEO, and
Ember Reichgott Junge, vice president,
Lutheran Social Service of Minnesota
Civic Caucus, 8301 Creekside Circle #920, Bloomington, MN 55437
(chair), David Broden,
Sallie Kemper, Dan
Loritz, Tim McDonald, Jim Olson (phone)
Welcome and introductions
Harpstead is CEO of Lutheran Social Service of Minnesota. She was
named to that position in September 2011, after service as Chief Operating
Officer. With over 2,300 employees,
LSS offers a broad array of
community services for people of all ages throughout Minnesota, including
housing, youth services, mental health counseling, adoption, financial
counseling, senior nutrition, and services for persons with disabilities.
A native of Chicago,
Harpstead received a Master of Business Administration degree in Finance
and a Bachelor's Degree in Business Administration from Michigan State
University in East Lansing before settling in Minnesota.
Prior to joining LSS,
Harpstead spent 23 years with Medtronic, Inc. where she held several key
positions, including President of Global Marketing and U.S. Sales in the
Cardiac Rhythm Management Division. She serves as Vice Chair on the Board
of Regents of Augsburg College in Minneapolis and has volunteered in
leadership capacities for a variety of other organizations.
Ember Reichgott Junge
is Vice President and Chief Advancement Officer at Lutheran Social
Service. A native of Minnesota, Reichgott Junge received her BA from St.
her MBA from the University of St. Thomas and her JD from Duke University.
Reichgott Junge served as a
Minnesota State Senator from 1983 to 2000. She served over 20 years as a
general counsel for businesses and nonprofits in the Twin Cities through
her work with The General Counsel, Ltd. In addition, she formed her own
communications company in 2000, advising and training nonprofit clients in
The guests opened by
describing the scope and reach of Lutheran Social Service, the oldest and
largest non-profit in Minnesota. LSS performs human services that span
pregnancy counseling to companionship for the elderly, and half their work
is for people with disabilities. The organization serves in all 87
counties in the state, with 75 percent of the work occurring outside of
the Twin Cities region. The majority of their revenue comes from contracts
with county, state, and federal government.
Harpstead shared her
conviction along with Reichgott Junge that as
population ages over the coming decades providers will need to redesign
their delivery of services.
"The way we've provided
services in the last 10 to 20 years will need to be different in the
coming 10 to 20 years," Harpstead said. State funds will not keep up with
the growth in demand as the population ages and there are fewer people
working for each of the people needing services. We need to find ways to
reduce cost and improve service.
The current model
prioritizes risk-aversion over quality of life.
The current model of
services for people with disabilities in
is complex and outdated , Harpstead said. Money arrives from Medicaid,
Social Security, and state funds. Every individual has a case or a care
plan. When somebody with disabilities is going to receive services there
is a transaction between the state or county and provider. There are often
many levels of costly oversight.
It is a compliance-based
system, Harpstead said, and is expensive. She contended that today most of
the dollars spent on people with disabilities are spent on protection.
"I'm not sure this was
designed consciously. Over time the rules and regulations to avoid
problems have added up.
"We've also been able to
afford it, but changing demographics will continue to drive increases in
health care costs, and there will be greater demand for new service models
that enhance choice, opportunity, and community integration at lower
Instead allow people to
choose their own levels and kinds of care.
The guests said their vision
is that people live in community with dignity, safety, and hope. People
with disabilities should be allowed to design their own lives, they said,
instead of having their lifestyles determined by standardized practices.
LSS is now proposing that
the state aggregate the varied funds for services, give the funds to the
individual and their trusted partner (for example, a legal guardian), and
then enable them to enter a marketplace to buy the services that the
individual decides he/she needs and wants. Such a marketplace could be on
the Internet -a place with reviews and services for people to assess and
choose themselves or with a professional.
The guests argued that such
a change would shift services for people with disabilities from a
risk-averse to a risk-aware system.
"It's our belief that if
individuals can choose their own level of risk, they will make the best
decisions for them," Reichgott Junge said.
The position of the social
worker would remain central to the process of helping match people to
services. Today there is a transaction between county and provider, and
the county case manager is part of that. Under the new design LSS proposes
there can be a county or private case manager.
Presently there is a
consumer-directed option for care that provides some greater flexibility,
Reichgott Junge added, but not all counties offer this option.
"My Life - My Choices"
seeks to improve value.
To a question about whether
the LSS proposed "My Life - My Choices" design could save money, the
guests said that it has the potential to-but the LSS plan does not cover
how much money should be paid by the state, or what the state should do
with any savings.
"If there are savings to the
state the state may choose to spend less or spend it elsewhere," Harpstead
said. "We don't comment on that with this plan."
Reichgott Junge pointed out
that while spending less is a goal with the new plan, another benefit is
helping people with disabilities live fuller lives so the dollars spent
create far more value.
The guests said LSS is
worried about going to the next biennial budget session and having to
absorb cuts again to the same unsustainable system, without the structure
or incentives for redesigning the services within it.
It is not a good trade to
prioritize risk-aversion over quality of life.
Harpstead said the plan
doesn't seek to eliminate all risk, but allows people with disabilities
more freedom to gauge the risk they wish to accept. As a society we allow
16 years olds to drive with permits and accept the risk as a community.
"But people with disabilities can be overprotected."
"Our community right now is
trying to prevent 100 percent of the risk. Right now we're asking for
people to be allowed to live normal lives. How many of us live 100 percent
Minnesota should seek
federal waivers from regulation while reforming the structure and
incentives in state policy.
"When we spoke here last
time we were in the preliminary stages of developing the "My Life, My
Choices" proposal," Reichgott Junge said. Now the proposal has been
assembled, and worked its way through the legislative process last year
with near universal affirmation in the legislature. It was not enacted
during the special session.
Harpstead said that the
Commissioner of the Department of Human Services is presently petitioning
the federal government for waivers that would achieve flexibility from
federal rules. This is a comprehensive strategy, she said, and is likely
to take 1-3 years.
At the same time she said
there is a lot of room for additional freedom in Minnesota policy, and LSS
is working to offer new service options to individuals within current
A participant asked what two
of the main arguments are against the
proposal. The first, Harpstead said, might have been a preference to wait
for federal approval of waivers before moving forward. "We've talked with
the commissioner about doing both," Reichgott Junge added-applying for the
waiver while moving ahead on reforms in
Minnesota. They think both
the federally-based and state-based strategies are sound.
A second argument against
the proposal involves concern about cost of implementation. DHS has fewer
staff to facilitate redesign, though the Commissioner has re-allocated
staff to the redesign effort.
During public conversations,
Harpstead added, most groups favor the plan. Still there are providers
that prefer the current service model and some counties are hesitant to
adopt new models as they wonder how changes would affect their role and
the people with disabilities who have been under their care.
Harpstead noted this model can apply to services with older adults.
Lutheran Social Service would like to work to apply the model for this
additional segment of the population.
Reichgott Junge said they
are looking forward to working with legislators and the commissioner in
the next legislative session.
"We often find ourselves
among people in our community these days with a feeling of no
possibility," Harpstead said. "We see 'My Life, My Choices' as an
opportunity for people to live in beautiful new ways that cost Minnesota
taxpayers less. I think the people of Minnesota are getting through the
process of figuring out that we have to change."
Thank you to our speakers
for the visit.