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:
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.
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.
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.
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.
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
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.
Hively (9) (10) (8) (9)
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)
approach would be helpful in other area of waivered services.
Rick Bishop (10) (10) (10) (10)
analogy can be made for education, also. Especially in item #4.
Chuck Lutz (10) (10) (9) (8)
Carolyn Ring (10) (10) (10) (8)
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)
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)
providers develop relationships with some legislators in order to
protect the government money source.
Dennis McCoy (10) (10) (10) (10)
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)
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)
identified a major problem in government—stubbornness to change. Her
ideas make economic sense and are human centered, that is, better for
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)
how often are the people delivering the service encouraged to suggest
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
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)
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)