Reforming the Department of Human Services

Reforming the Department of Human Services


PROGRAM. I’M SHANNON LOEHRKE. THE DEPARTMENT OF HUMAN SERVICES HAS EXPERIENCED A TUMULTUOUS FEW MONTHS. THE AGENCY’S NEW COMMISSIONER, JODY HARPSTEAD, APPEARED BEFORE A JOINT MEETING OF THE SENATE HUMAN SERVICES COMMITTEE.>>I HAVE HAD THIS GRANITE PLAQUE WHICH SAYS “TRUSTWORTHY” ON IT ON MY DESK AND THE DESKS OF OUR 90 SENIOR LEADERS AT LUTHERAN SOCIAL SERVICE FOR THE EIGHT YEARS THAT I’VE BEEN CEO. NOT FACING OUT TO TELL THE WORLD THAT WE’RE TRUSTWORTHY BUT FACING IN SO THAT EVERY EMAIL AND EVERY PHONE CALL BUILD THAT TRUST. WE’RE AT AN EXCITING TIME IN OUR NATION’S HISTORY AS WE ALL COME TO GRIPS WITH CARING FOR THE HUGE AGING BABY BOOM, AS WELL AS OTHERS WHO NEED SUPPORT TO LIVE IN COMMUNITY. I’VE BEEN WORKING WITH DHA FOR THE PAST FIVE YEARS TO DEVELOP THE ALL-TIER ACO FOR PEOPLE WITH DEVELOPMENTAL DISABILITIES AND COMMUNITY SERVICES, AND I REMAIN COMMITTED TO EXPLORING NEW DATA-DRIVEN APPROACHES THAT PROMISE TO LEAD TO BETTER HEALTH, FULLER LIVES AND LOWER COST, IN THAT ORDER, FOR ALL MINNESOTANS. THE THEME OF MY 90-DAY PLAN IS TO REBUILD THE DEPARTMENT IN ORDER TO REBUILD TRUST WITH THE PEOPLE OF MINNESOTA. I’M COUNTING ON YOUR SUPPORT TO THE NEXT 90 DAYS.>>THERE IS A LINE, THERE’S PEOPLE WHO YOU GET TO HIRE THAT ARE APPOINTED BASED UPON WHO COMES AND GOES AT THE TOP AND THERE’S RANK AND FILE PEOPLE WHO HAVE MADE THIS THEIR CAREER. AND I AGREE WITH ONE THING YOU SAID ON “ALMANAC” THAT THOSE INDIVIDUALS ARE REALLY HAVING A HARD TIME. SOME OF THEM HAVE REACHED OUT TO US, INDIVIDUALS HAVE CALLED US AND THEY TALK ABOUT THEIR INTEREST IN DOING A GOOD JOB BUT THEIR INABILITY TO ACTUALLY REPORT THINGS THAT IT IS O.I.G. DIDN’T CARE ABOUT TAKING THEIR FRAUD COMPLAINTS, DID NOT CARE. AND LIKE, OH, MY, THAT’S THE ABOVE-THE LINE PEOPLE THAT DIDN’T CARE ABOUT THE BELOW-THE-LINE PEOPLE.>>I HOPE THAT YOU ARE EMPOWERED BY THE STRENGTH OF THE GOVERNOR STANDING BEHIND TO GO IN AND SCULPT — AND EXECUTE PARTICULARLY THE AUDITS AND THE SYSTEMATIC REVIEW OF HOW FUND ARE HANDLED. THAT HAS BEEN I THINK THE MOST PROBLEMATIC AND TROUBLING TO MINNESOTANS OVER THE LAST SEVERAL MONTHS. I APPRECIATE THAT YOU WANT TO REBUILD THE DEPARTMENT, TO REBUILD TRUST. THERE’S SOMETHING WRONG WHEN PEOPLE ARE AFRAID OF TELLING THE TRUTH AND SO I — I AM SO GRATEFUL THAT YOU HAVE THIS LIST OF PRIORITIES BUT AN EMPLOYEE CULTURE WHERE PEOPLE ARE AFRAID IS NOT GOING TO LEAD TO A PRODUCTIVE AGENCY.>>I BELIEVE THAT I HAVE A GOOD TRACK RECORD BOTH AT MEDTRONIC AND AT LUTHERAN SOCIAL SERVICE OF CREATING A GOOD CULTURE OF TRUST ESPECIALLY BETWEEN ABOVE-THE-LINE, BELOW-THE-LINE, THE HOME OFFICE IN THE FIELD, HOWEVER PEOPLE COME TO WORK CHARACTERIZING THOSE KIND OF SORT OF NATURAL ISSUES. AND SO I VERY MUCH HOPE TO BRING THAT. WE HAD A GOOD CONVERSATION ALREADY YESTERDAY WITH SENIOR LEADERS ABOUT REACHING TO FRONT-LINE EMPLOYEES IN BETTER WAYS TO HAVE COMMUNICATION AND A CONVERSATION.>>WHO IS GOING TO PAY THE FEDS BACK? WE CAN’T RECOVER THE FRAUD THAT HAD BEEN IN OTHER AREAS, PERHAPS, BUT THERE IS THIS LINGERING BILL COMING TO MINNESOTANS FROM OVERPAYMENTS FROM THE FED BECAUSE OF THE BILLING THAT WAS SUGGESTED OR GUIDANCE THAT WAS GIVEN TO THE TRIBAL NATIONS AND OTHER PROVIDERS. AND SO THE QUESTION IS, WHO’S GOING TO PAY FOR THAT? AND HOW MUCH ARE WE TALKING ABOUT, HOW LONG HAS THAT OVER-BILLING BEEN GOING ON, AND WE KNOW THERE’S THE WAY TO STOP IT BUT HOW LONG HAS IT BEEN GOING ON, WHAT’S THE TOTAL AMOUNT AND WHO’S GOING TO PAY? WHERE IS THE MONEY COMING FROM?>>THAT’S VAY GOOD QUESTION, I HAVE THE SAME QUESTION. I HAVE JUST BEGUN TO GET BRIEFED ON THAT ISSUE AND I NEED TO LEARN MORE ABOUT IT. OF COURSE WE’RE WAITING FOR THE REVIEW OF THE WHOLE SITUATION TO REALLY GET THE ENTIRE PICTURE OF SIGHT THAT WE KNOW EXACTLY WHAT YOU’RE ASKING ABOUT, HOW FAR BACK, HOW MUCH, AND THEN THE QUESTION IS, WHAT ARE THE POTENTIAL PATHWAYS GOING FORWARD. I REACHED OUT YESTERDAY TO BOTH THE WHITE EARTH TRIBE AND THE LEECH LAKE TRIBE AND WE HAD CORDIAL CONVERSATIONS ABOUT HOW WE ALL WANT TO SEE THIS REVOLVED IN A WAY THAT’S NOT HARMFUL TO THE TRIBES AND I NEED TO GO AND UNDERSTAND MORE MORE THOROUGHLY WHAT POSSIBLE PATHWAYS THERE ARE FOR US TO REACH THAT OUTCOME AND I DON’T COMPLETELY UNDERSTAND YET WHAT’S POSSIBLE. AND WE’LL WANT TO BE TALKING WITH ALL OF ABOUT YOU THAT AS WE GO FORWARD.>>THANK YOU. AND ONE FINAL COMMENTS.>>SENATOR NELSON.>>THE TAXPAYERS, YES, THE TRIBES BUT THE TAXPAYERS.>>YES, ABSOLUTELY.>>THE TAXPAYERS ARE ON EDGE. THEY WANT TO KNOW –>>I DO HAVE A WISH LIST OF A FEW THINGS I JUST WANTED TO SEND YOU OFF WITH. ON TOPICS LIKE THE 25 MILLION AND THE 48 MILLION, IT SEEMS — I BELIEVE YOU’LL BE CHANGING THIS BUT HISTORICALLY, THE AMOUNT OF INFORMATION THAT HAS FLOWED OUT OF DHS TO US HAS BEEN THE SMALLEST BIT THAT CAN BE GIVEN, IT SEEMS LIKE. I RAISED SIX TEENAGE SONS AND, YOU KNOW, WHAT HAPPENS SOMETIMES IS THEY RUN INTO A CURB OR SOMETHING AND DENT THE FENDER SO THEY PARK THE CAR SO YOU CAN’T SEE IT IT. [Laughter]>>I HAVE TEENAGERS, TOO.>>THAT NEVER HAPPENED TO ANYBODY ELSE’S? [Laughter]>>BUT EVENTUALLY YOU FIND OUT.>>JOINING ME TO OFFER HIS ASSESSMENT OF DHS AS WELL AS POTENTIAL OPPORTUNITIES FOR AGENCY REFORM IS THE CHAIR OF THE SENATE HUMAN SERVICES REFORM COMMITTEE, SENATOR JIM ABELER. THANKS FOR BEING HERE.>>GOOD TO BE HERE. HAPPY A.M.>>YES, HAPPY AUTUMN. AS A POLICY MAKER, YOU CERTAINLY COMBAT EFFORTS TO COMBAT ADDICTION. IN THOSE EFFORTS, THE DEPARTMENT OF HUMAN SERVICES USED MEDICAID DOLLARS IMPROPERLY AND MUST NOW PAY BACK THE FEDERAL GOVERNMENT $48 MILLION. THIS IS COMPLEX BUT PRESUMABLY DHS MADE THESE OVERPAYMENTS OR MISUSED THESE FUND IN GOOD FAITH SO MY QUESTION IS, IS THE SYSTEM JUST SO COMPLEX? IS IT HUMAN ERROR? IS IT BOTH?>>YOU KNOW, I THINK THEY MEANT WELL BUT I THINK THEY KNEW THEY WERE AT RISK IN 2016 WITH THESE PAYMENTS TO FACILITIES AND THE QUESTION ISN’T DID WE OVERPAY THE PROVIDERS IS IN THE PROVIDERS GOT THE RATE THEY WERE SUPPOSED TO GET AND SO THE QUESTION WAS, DOES MINNESOTA PAY ALL OF IT OR DO THEY PAY HALF AND THE FED PAY HALF? ANYTHING COMING FROM WASHINGTON IS FREE MONEY, BY THE WAY, SO WE ALWAYS TRY TO MAXIMIZE THAT SO OTHER TAXPAYERS CAN PAY FOR MINNESOTA STUFF. SO THEY KIND OF GOT CAUGHT AND IN MAY THE FEDS SAID NOT PAYING ANYTHING, BY THE WAY, WE’RE GOING BACK A COUPLE OF YEARS AND SEND US A CHECK, PLEASE. SO IT’S A BIG PROBLEM. WE ACTUALLY DID FIX IT GOING FORWARD BUT THIS 48 $AND A BUDGETS OF $38 MILLION IS A BIG PROBLEM AND WE’LL BE DISCUSSING A LOT ABOUT THAT IN THE UPCOMING MONTHS.>>IS IT LIKELY THESE KIND OF MISUSE OF FUNDS INADVERTENTLY WILL BE ONGOING JUST BECAUSE THIS MONEY IS EARMARKED FOR THIS AND CAN BE USED THIS WAY AND THIS MONEY IS EARMARKED FOR THIS AND CAN BE USE THAT WAY AND THERE’S JUST SO MUCH COMPLEXITY AROUND IT?>>IT’S REALLY COMING INDICATED. THIS COULD BE USED FOR ACTUARY CLASS IF YOU WANTED TO HAVE PEOPLE TO YOU TOWARD ON COMPLEXITY. SOME THINGS WE SHOULD KNOW ABOUT AND THEY DIDN’T REALLY TELL US IT MIGHT HAPPEN. IT WAS LIKE COULD YOU PLEASE TELL US AND THEN WE WON’T READ ITS IN THE PAPER OR GET A CALL FROM A REPORTER AND THAT’S THE ONGOING ISSUE ABOUT COMMUNICATION.>>>>WHICH WAS MENTIONED IN THE HEARING TODAY. THERE IS ANOTHER HEADLINE IN THE NEWS ABOUT THE $25 MILLION THAT, IN MONEY THAT WAS PAID TO TRIBAL LEADERS FOR THE PURPOSE OF SUBSTANCE ABUSE TREATMENT. THE TRIBAL LEADERS HAVE DOCUMENTED THAT THEY APPLIED FOR THE REIMBURSEMENT AS INSTRUCTED BY DHS, THAT’S WHAT THE “PIONEER PRESS” REPORTED. SHOULD THEY BE REQUIRED TO PAY BACK THE STATE?>>WELL, THEY ASKED AND THEY ASKED. I THINK NO LESS THAN FOUR AGENCIES, IS THIS REALLY OKAY? YEAH, YOU’RE GOOD, GO AHEAD, SO I DON’T THINK THEY SHOULD BE ASKED TO PAY IT BABBLING. THEY’RE NOT GOING TO SCTS $48 MILLION SUBSTANCE ABUSE PEOPLE TO PAY BACK THEIR MONEY THEY RIGHTFULLY THOUGHT THEY HAD COMING FROM THE STATE AND I THINK IN THE SAME WAY THE TRIBES TO BE FAIR. NOT THAT THAT’S NOT A LOT OF MONEY, $73 MILLION IS A LOT OF MONEY BUT THE DEPARTMENT NEEDS TO BE MORE CAREFUL. I’M OPTIMISTIC WITH THE NEW COMMISSIONER COMING IN THAT SHE’S GOING TO TRY TO CREATES A BETTER DISCUSSION. IT’S TIME SO WE’LL TALK ABOUT THAT, MAYBE, BUT I WISH HER A LOT OF SUCCESS.>>AND WHAT YOU WOULD LIKE TO SEE IS MORE TRANSPARENCY IN THE AGENCY AS WAS MENTIONED TODAY, IF THERE IS A PROBLEM, JUST LET THE LEGISLATURE — WILL THE THE SENATE KNOW THERE IS A PROBLEM SO THAT YOU CAN BE FOREWARNED.>>WE’RE SOME KIND OF A PARTNERSHIP, NOT A VERY GOOD ONE SO DHS DOES WHAT THEY WANT AND TRIES TO TELL US WHAT WE NEED TO KNOW TO GET BY BUT A TRUE PARTNERSHIP WILL HELP IT BE STRONGER, BETTER PROGRAMMING, BETTER BUY-IN, STAKEHOLDERS TALK TO US, WE TALK TO THEM AND IT WILL BE GOOD.>>COMMISSIONER HARPSTEAD REFERENCED THIS, THE AGING BABY BOOMER WAIVE AND WHAT IT IS POTENTIAL IMPACTS IS ON HEALTH AND HUMAN SERVICES. WE HAVE THE STATES DEMOGRAPHER ON THE PROGRAM ALSO THIS WEEK AND SHE SAID THAT MINNESOTA JUST PASSED A BENCHMARK IN THAT ITS 65 AND OLDER POPULATION IS NOW MORE THAN OUR SCHOOL CHILDREN POPULATION. EDUCATION, HUMAN SERVICES, BIGGEST PARTS OF OUR STATE BUDGET. AS WE MOVE FORWARD, HOW FEARS IS THE — HOW FIERCE IS THE CONVERSATION GOING TO BE?>>YOU JUST DESCRIBED ME, I JUST TURNED 65 THIS YEAR, WE HAVE NO SCHOOL-AGE KIDS ANYMORE. IT’S GOING TO BE A BIG DEAL. NOT ONLY THAT, THERE’S FEWER PEOPLE PAYING INTO THE PROGRAMS TO SUPPORTS THE ELDERLY, SOCIAL SECURITY, AND EVEN THE MINNESOTA TAX BASE IS AGING SO IT’S GOING TO BE HUGE AND SO YOU’LL HAVE EDUCATION PEOPLE FIGHTING WITH LONG-TERM CARE PEOPLE ABOUT HEALTH CARE AND GOOD LUCK IF YOU CARE ABOUT CLEAN WATER OR ROADS OR OTHER THINGS. SO IT’S GOING TO BE REALLY DIFFICULT, AND SO PART OF THAT IS THE SENIORS NEED TO FIND A WAY TO TAKE BETTER CARE OF THEMSELVES AND BE MORE LIKE THE ANTS INSTEAD OF THE GRASS HOPPER AND RELY ON MAGIC GOVERNMENT TO TAKE CARE OF YOU. SO AT THE END, JESSE VENTURA TALKED ABOUT PERSONAL RESPONSIBILITY. THAT HASN’T CHANGED AND IF YOU’RE JUST TURNED 65, YOU BETTER MAKE SOME PLANS ABOUT LOOKING AFTER YOURSELF.>>AND EATING WELL AND EXERCISING?>>EAT YOUR CARROTS AND CALL YOUR MOM, YEAH. [Laughter]>>ONE ITEM ON THE AGENDA TODAY THAT TOOK QUITE A LOT OF TIME AT THE MEETING WAS THE PROCUREMENT PROCESS REVIEW OF THE PRE-PAID MEDICAL ASSISTANCE PROGRAM, OR PMAP. THERE WAS A RECENT COURT DECISION THAT PROMPTED DHS TO CANCEL ITS REQUEST FOR PROPOSALS FOR NEXT YEAR. WE — DHS IS COMPLEX BUT FOR THE AVERAGE VIEWER, WHAT’S THE GIST OF WHAT’S GOING ON? WHAT DO PEOPLE NEED TO KNOW ABOUT THIS?>>WELL, WE HAVE MONEY MANY GROUPS THAT HELP PROVIDE HEALTH CARE. AMONG THOSE ARE COUNTIES THAT BAND TOGETHER TO MAKE A COUNTIES-BASED PURCHASING GROUP. THEY’RE EXTREMELY EFFECTIVE AND THEY HAVE EVERY REASON TO CONSERVE THE MONEY BECAUSE THEIR TAXPAYERS ARE BACKING IT BUT THEY ALSO CARE ABOUT THE PEOPLE AND THEY WANT TO WRAP OTHER COUNTY PROGRAMS IN TOGETHER TO SERVE THE PEOPLE. AND THE DEPARTMENT JUST DID NOT LISTEN TO THE CONCERNS AND THE COURT CASE ACTUALLY SAVED THE DAY FOR NOT SHUTTING DOWN ITASCA AND SOUTH COUNTRY THAT HAVE BEEN AROUND FOR OVER 20 YEARS, TRYING — AND THEY ARE DOING GREAT WORK AND SO WE’RE GOING TO SLOW DOWN AND IF MY OPTIMISM ABOUT COMMISSIONER HARPSTEAD IS PROPERLY FOUNDED, THERE WILL BE BETTER LISTENING GOING ON AND A BETTER DISCUSSION WITH THE COUNTIES, HOW SHALL WE SERVE OUR INDIVIDUALS AND YOU HAVE TO BE AN OPTIMIST AROUND HERE BECAUSE IT’S ALMOST ALWAYS RAINING, BUT THE SUN WILL COME OUT AND IT WILL BE COMING SOON AND I CAN SEE IT.>>AND THE IDEA BEHIND THIS, THOUGH, IS THAT IT IS LOCAL AREAS HAVE A BETTER TAKE ON WHAT THEIR PEOPLE NEED VERSUS A STATE AGENCY SORT OF ONE-SIZE-FITS-ALL, IS THAT KIND OF THE GIST BEHIND THIS?>>OKAY ABSOLUTELY, OR EVEN THE HEALTH PLAN CENTERED IN EAGAN OR MINNEAPOLIS SOMEPLACE DECIDED WHAT SHOULD HAPPEN IN BA WHICH BACK OR KOOCHICHING COUNTIES SOMEWHERE.>>ONE LAST THING. FORMER ACTING COMMISSIONER OF DHS, PAM WHEELOCK, ACKNOWLEDGED THE DEPARTMENT OF HUMAN SERVICES SHOULD BE BROKEN UP. OTHER LAWMAKERS ARE WEIGHING IN ON BREAKING UP THIS HUGE AGENCY. I WOULD LIKE YOUR TAKE.>>WELL, DHS — IT’S NOT THE SIZE THAT MATTERS, IT’S THE FUNCTION AND FORMER REPRESENTATIVE PAUL THISSEN AND I EIGHT YEARS AGO TALKED ABOUT HOW WE COULD DO DIFFERENT MODELS BUT SO DHS HAS 7,000 EMPLOYEES, WHICH DOESN’T MATTER HOW MANY THERE ARE BUT THEY’RE REGULATORS, THEY PROVIDE SERVICE AND THEY INVESTIGATE THEMSELVES. IN MY OPINION, THE PEOPLE DOING THE SERVICE SHOULD BE DOING THE SERVICE AS — WITH THE SEX OFFENDERS AND ALL THE CARE FOR PEOPLE WITH DISABILITIES, AND THE REGULATORS SHOULD OVERSEE THEM. AND IT’S NOT EVEN FAIR TO THE STATE EMPLOYEES, THE AFSCME AND MAPE INDIVIDUALS AND OTHERS WHO ARE WORKING THERE THAT — TO BE OVERSEEN BY THEIR CONTEMPORARIES, AND IF THERE’S SOMETHING WRONG, THE INSPECTOR GENERAL SHOULDN’T BE IN THE SAME GROUP BECAUSE THEN THE COMMISSIONER COULD SAY, DON’T INVESTIGATE THAT. WHICH, BY THE WAY, HAPPENED. AND SO A LOT OF FRAUD, A LOT OF ISSUES AND LEGISLATIVE AUDITOR WENT INTO SOME DETAIL ABOUT HOW INVESTIGATIONS AREN’T HAPPENING. AND EVEN WHISTLE-BLOWING INDIVIDUALS HAVE CALLED ME SINCE THE HEARINGS WHEN THEY REPORT THINGS TO THE INSPECTOR GENERAL, NOTHING HAPPENS. SO IT’S TIME. THERE IS A DISCUSSION, THE GOVERNOR’S OPEN TO IT, PAUL GAZELKA IS, I’M SURE REPRESENTATIVE HORTMAN IS. WE’RE GOING TO FIND A GOOD WAY TO GET THIS TO BE SERVING MINNESOTA WELL.>>SENATOR JIM

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