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 Response Page - Reichgott Junge  Interview -      


These comments are responses to the questions listed below,
which were generated in regard to the
Ember Reichgott Junge Interview of
10-29-2010.
.

 Overview

Ember Reichgott Junge, of Lutheran Social Service of Minnesota champions the proposition that state government must shift its model from one that provides risk-free social services to a more practical, consumer-directed model that brings in nonprofit social service organizations as partners. Driving this change, she argues, is both consumer choice, and an increasingly obvious reality: that the state cannot sustain its existing model for these services because it has become too expensive.

For the complete interview summary see: http://bit.ly/ha7c30

 The Questions: 

Response Summary:  Readers have been asked to rate, on a scale of (0) most disagreement, to (5) neutral, to (10) most agreement, the following points discussed by Ember Reichgott Junge.  Average response ratings are shown below.  Note:  these average ratings are simply the mean of all readers’ zero-to-ten responses to the ideas proposed and should not be considered an accurate reflection of a scientifically structured poll.

1. New Model (8.7 average response) Minnesota has no choice but to move to a new model of care for persons with developmental disabilities because the state doesn't have the money to sustain its current approach.

2. Functionality (9.3 average response) A new model can be justified on its own merits because persons with disabilities vary considerably in their functionality and all don't need to be cared for at the same level of protection.

3. Shared risk  (9.0 average response) A major shift in how the state views its relationship with persons with disabilities is needed, from 100 percent protection to a continuum of shared risk and choice.

4. Change resisted (8.8 average response) A shift is difficult from long-accepted assumptions and traditional ways of running government programs because too often key policymakers “own” the current system, and resist change.

 

 Response Distribution:

Disagree Strongly

Disagree Moderately

Neutral

Agree Moderately

Agree Strongly

Total Responses

New Model

4%

0%

8%

31%

58%

26

Functionality

0%

4%

0%

27%

69%

26

Shared risk

0%

4%

0%

35%

62%

26

Change resisted

4%

0%

4%

27%

65%

26

Individual Responses:

Anonymous  (5)  (7.5)  (7.5)  (7.5) 
1.  New Model.  Lack of detail for a new system prevents giving a higher rating.  Some parts of the concept (are) valid but I can't fully see that she explained the plan in enough detail to agree or disagree.

Anonymous  (10)  (10)  (10)  (10) 

Bob White  (7.5)  (10)  (10)  (10) 

Orville Lantto  (0)  (2.5)  (2.5)  (0) 

Peter Hennessey  (10)  (7.5)  (7.5)  (10) 
1.  New Model.  The problem with all State programs is that they are run by an expensive and excessively political bureaucracy with a huge paperwork load. But no one ever publishes the numbers to show how much goes to salaries at the different levels, and how much actually goes directly to the immediate purpose of the program, such as the personalized care of a patient. 

2.  Functionality.  Is this another way of saying, you need to diagnose each patient's condition and apply the appropriate therapy? 

3.  Shared risk.  100% protection from what? Life? What is the use of living if you can't do anything because it's too risky"? Whatever happened to individual assessment? 

4.  Change resisted.  Way too many people have made lucrative careers out of what used to be community based charities, staffed mostly by volunteers, not by paid professionals.

Dennis L. Johnson  (10)  (10)  (7.5)  (10) 
General Comment on all questions:  In 1970, Pennsylvania began a plan to move from State Institutions for the "Retarded" (now called Developmentally Disabled") to a state wide system of group homes in the communities, the first state to do so. I prepared the first plan for this "deinstitutionalization" in Philadelphia. The plan was to take ten years; it took nearly 30 but is now fully implemented. Most homes are operated under contract by social service agencies with the State. I founded the first program in Philadelphia operated by a community group itself, which continues today, known as East Mt. Airy Group Homes, Inc, with four homes and four apartments. One of the largest providers in SE PA is Ken-Crest Homes, Inc., a Lutheran agency serving hundreds of persons in some 60 or more dispersed facilities.  The thrust behind the plan was not primarily to save money, although I believe it has. The effort was mainly to create humane, neighborhood homes in as normal a setting as possible as opposed to dehumanizing, large institutions where residents are locked away from the public at large.  This program has become a model for many states and has been successfully received in most areas. Even those requiring almost constant care have thrived in these community-based settings, and the residents have been almost universally accepted by their neighbors.    The only negative side would be to guard against bureaucratic rigidities which seem to almost inevitably creep into any state-funded system, pressures for unionization of staff, and the temptations of favoritism in awarding service contracts, etc. These negatives are far outweighed by the much more humane, dignified care received by those with developmental (existing from birth) disabilities whether they have families or not.    A statewide system of group homes needs a backup network of available support facilities such as medical care, work training centers, placement services, etc. in order to be fully effective. The Civic Caucus should seek to hear from someone knowledgeable about the cost impact on those states that have moved into services provided under contract from private providers to answer this question more completely and accurately.

Don Anderson  (10)  (10)  (10)  (10) 
1.  New Model.  This may be one area the State could cut costs without jeopardizing other programs.

W. D. (Bill) Hamm  (10)  (10)  (10)  (5) 
1.  New Model.  "New model", what you’re actually talking about is returning to a modern version of the pre-welfare state model, (w)hen virtually all such services were provided by religious organizations. This has got to challenge the atheistic socialist model Reichgott Junge served as a DFL'er. 

2.  Functionality.  During my primary battle against Jim Oberstar this year, I had the opportunity to visit with some of these folks at a rather small LSS gathering in the Brainerd area. I was not surprised by the very human connections I saw, rather than the heartless on(e) size fits all logic I have seen from our "Social Circus" crowd. This makes sense and will therefore be adamantly opposed by our entrenched socialist, DFL, public employee union neighbors. 

3.  Shared risk.  I loved the example given; sadly it is only one of a minor nature. The state’s reach into these peoples’ lives is domineering and disgraceful. 

4.  Change resisted.  This statement undermines "the truth and nothing but the truth" by being primarily dishonest in a misguided attempt to be diplomatic. This reform effort, no matter how needed, will be adamantly opposed by MAPP and AFSME as well as the DFL because it means diminishing numbers of public employees.

Jan Hively  (9)  (10)  (8)  (9)  Excellent and important presentation!  We need to include disability services for all ages under the umbrella that Reichgott Junge describes.    People say, "We can't raise the retirement age because there are a lot of people in their late 60s who have disabilities that would keep them from employment."  Not a problem if we offer disability services to people of all ages.  It's not the age... it's the physical and mental condition, that should be the criterion.  

I hope that the Civic Caucus will add its endorsement for changing the regulations so that ALL seniors can join the Senior Corps (foster grandparent, senior companion) and receive (or waive, if they wish) the stipend.  Lutheran Social Services has been a national leader in lobbying for change.

Dan McElroy  (10)  (10)  (10)  (10) 
This same approach would be helpful in other area of waivered services.

Rick Bishop  (10)  (10)  (10)  (10) 
An analogy can be made for education, also.  Especially in item #4.

Chuck Lutz  (10)  (10)  (9)  (8)

Carolyn Ring  (10)  (10)  (10)  (8) 
When government is spending $1.5 billion dollars to serve 21, 000 people, which calculates to $71,429 a apiece, obviously something is wrong.  When we were an agrarian society, people took care of their own family members and neighbors.  When we moved into an industrial society, people did not see their neighbors’ needs. In the past, Churches and volunteers have done a much greater part of care for those disabled or have other needs, but more and more the government has taken over the role, and as is true, whenever that happens the cost goes way up and the regulations become overly burdensome. Individuals, families and communities who can better access the individual needs, should be a large part of the equation with government being the last resort.

Robert J. Brown  (10)  (10)  (10)  (10)

Paul and Ruth Hauge  (9)  (9)  (9)  (8) 
The shift from institutional to residential care some years ago may need to be relooked at if the care is uniform for consumers who have varying levels or needs of care. Cost is driving this area as well as many others that traditionally use government funding. It's unlikely that the private sector can pick up the tremendous cost required in this area as well as the many other areas that government serves.

Al Quie  (10)  (10)  (10)  (10) 
The providers develop relationships with some legislators in order to protect the government money source.

Dennis McCoy  (10)  (10)  (10)  (10) 
The state's approach is antiquated at best and not affordable. However, the state DHS has consistently refused to consider other models because it had the state senate to back it up. The system really needs to evolve in a thoughtful yet affordable way.

Chuck Slocum  (8)  (10)  (10)  (10) 
1. “Doing nothing” is always a choice but not a wise one in this instance.

I am largely unaware of the policy implications involved regarding persons with disabilities but did appreciate the topic and the information shared by the interviewee.   This is the kind of new area of fiscal and social engagement that the CC can help bring to fruition.

Wayne Jennings  (10)  (10)  (10)  (10) 
Junge has identified a major problem in government—stubbornness to change. Her ideas make economic sense and are human centered, that is, better for people. 

She reminded me of the work by Mary T Inc. headed by Mary Tjosvold who has built a substantial business of caring for handicapped and elderly people. You might have her on the program one of these days. She has been much honored for her work. 

Lyall Schwarzkopf  (9)  (9)  (10)  (7) 

Vici and Seiki Oshiro  (7)  (9)  (6)  (7) 
4. And how often are the people delivering the service encouraged to suggest system improvements? 

Each of the above questions carries with it one or more assumptions which may or may not be true now and need not be true in the future even if care continues to be provided by the state.  State programs may be inefficient and ineffective or they can be the opposite.  And are usually somewhere between.  Same is true with private programs.  Key to redesign may not always be resorting to private entities.

Marianne Curry  (10)  (10)  (10)  (10) 
It is not the policymakers who stand in the way of rethinking how we deliver necessary services to those in need, but the bureaucrats and current providers whose positions/incomes depend upon the status quo.  There is certainly a sense of entitlement attendant to the old way of thinking and doing.  Sometimes government just needs to get out of the way with burdensome rules and regulations.  However, voluntary not-for-profit organizations also need monetary support and training.  Every existing program in the public and not-for-profit sectors have their lobbying constituencies to protect their interests at public expense. 

Term limits and public campaign finance may be the only way back to providing efficient services in the “public interest” as well as limiting double and triple dipping from public pension funds.  These non-systems of delivery are unsustainable and will bankrupt this state and this country.  Whatever happened to families being responsible for their own problems and offering them improved financial incentives to provide direct care?  In my opinion, the disconnect between demand for care and paying for it has created the conundrum.  People on the demand side have very little “skin in the game.”  Some of us remember a time when quality was not an issue, precisely because consumers were fully engaged in both demand and paying.

Jim Keller  (8)  (10)  (10)  (10) 
I believe the above statements are statements of fact.

Tom Spitznagle  (5)  (8)  (9)  (10) 
We have a family member with a disability currently living in a group home and have been alarmed over the years over how inflexible the various social service programs are.  It is apparent that significant inefficiencies exist and are perpetuated in the current scheme for helping people with disabilities.  The net effect is still positive under the current scheme but there are always ways to improve that the current scheme seems to be able to fend off.  This is fairly typical of any program that is heavily government-controlled or financed.

Bert Press  (10)  (10)  (10)  (10) 

William Kuisle  (9)  (8)  (9)  (10) 

 

    

The Civic Caucus   is a non-partisan, tax-exempt educational organization.   The Core participants include persons of varying political persuasions, reflecting years of leadership in politics and business. Click here  to see a short personal background of each.

   Verne C. Johnson, chair;  David Broden, Charles Clay, Marianne Curry, Bill Frenzel, Paul Gilje,  Jim Hetland,  Marina Lyon, Joe Mansky, John Mooty,  Jim Olson,  and Wayne Popham 


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The Civic Caucus, 01-01-2008
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