Emily Johnson Piper took one of the toughest jobs in state government this week when she became commissioner of the Department of Human Services. She will oversee more than 6,200 employees, an annual budget of $18 billion and programs that serve more than 1 million Minnesotans, including Medical Assistance, mental health care and child protection. She also faces a string of urgent challenges, including a federal court challenge to the state’s sex offender program and persistent violence at state psychiatric hospitals. This week, Piper, 36, discussed her new assignment with reporter Chris Serres.

Q: Why would you want to run the state’s largest and most complex agency?

A: When I committed myself to public service professionally in 2011, when I went to work for the Commerce Department. … I did so because I wanted to make a difference in people’s lives. I was committed to the administration; I was committed to Gov. Dayton and his values and his work trying to improve how state government provides services to people in Minnesota. … That’s been my guiding principle — how can I do the most I can to impact people’s lives in a positive way. And I can think of no better way to do that than by helping serve those most vulnerable in our population.

Q: What do you see as the most significant challenges facing your agency?

A: I think long-term health care financing is going to be a significant challenge. … We have the provider tax potentially sun-setting, we have rising costs of health care, we have growing needs of populations being served, and we have a really dynamic marketplace as health care reform continues to be implemented in our state and nationally.

Q: Are you concerned that health care spending is rising so fast that it’s absorbing too much of the state budget?

A: That’s always a concern, but it’s one of many concerns. Fundamentally, I think we are on the right track. We have more people with health insurance than we’ve ever had in our state before, and I think that is a really great benchmark of the success of the Affordable Care Act. But we do have challenges with the growing cost of health care and the impact it has on the average person. … We just saw it reported today that 70 percent of the people going through MNsure are eligible for [premium] tax credits, and that just speaks to the need to provide supports for people’s budgets.

Q: What do you see as other major challenges facing your agency?

A: I am focused on [the Minnesota Security Hospital in] St. Peter and the Anoka-Metro Regional Treatment Center. I’ve been involved in the governor’s office in those issues and the systemic problems that are facing direct care and treatment [facilities and programs for people with mental illness and disabilities]. That’s one area that I see as an immediate challenge.

Q: Can you speak to what specifically makes direct care and treatment such a challenge? A shortage of beds? Lack of funding?

A: It’s all of those things. It’s making sure that people, when they go to work, have a safe place to go to work. It’s making sure that people who are committed to our facilities receive treatment in a therapeutic environment. … It’s the impact of the “48-hour rule” [a 2013 state law that requires state mental facilities to accept jail inmates with mental illnesses within 48 hours]. It is the impact that the “48-hour rule” is having on the Anoka-Metro Regional Treatment Center and the issues then upstream from Anoka with patients who should perhaps be placed elsewhere but there’s nowhere else for them to go.

Q: At your news conference this week, you spoke of your passion for helping people with disabilities live better lives. What is the source of this passion?

A: I was thinking about Hubert Humphrey and his famous quote on the moral responsibility of government. He said, “The moral test of government is how it treats those who are in the dawn of life, the children, those who are in the twilight of life, the elderly, and those in the shadows of life, the sick, the needy and [people with disabilities].” As a servant leader, I take the moral responsibility of government to be the moral responsibility of me as a leader.

Q: So you take this moral responsibility personally?

A: It’s very personal to me. I come from a family dedicated to public service. … My dad was a Minneapolis police officer and a United States postal inspector. My brother-in-law is a police officer. My husband [Jeff Piper] is a fireman. My grandpa, who died when he was 39 of lung cancer, leaving my grandma a widow, was a fireman. My grandma’s sister was in the state Legislature.

Q: Is there anything in particular you wish to accomplish that would improve the lives of Minnesotans with disabilities?

A: When I started in the governor’s office, we had had an Olmstead Plan [a blueprint for expanding community services for people with disabilities] that had been submitted to the federal court several times and had been rejected. … I very much felt like we needed to shore up what we were doing on our work specific to Olmstead — in the short term, not only to support the people that needed the services, but also to give the court confidence that we were moving in the right direction as a state.

Q: Over 40 states have adopted Olmstead plans, and the concern has been that a lot of states simply put them on a shelf and forgot about them. But it sounds like you’re not going to let that happen?

A: Well, I’m going to attend my first Olmstead subcabinet meeting next Friday morning as a member. I actually see the [Olmstead] subcabinet as a very effective tool in making sure that people don’t put the plan on a shelf, that we are constantly implementing the work plans and asking for accountability.

Q: Over the years, a number of DHS observers have suggested that the agency is too big and should be broken up into smaller units. Rep. Paul Thissen floated such a proposal this week. Do you have any thoughts about that?

A: I’m open to conversations on how we can reform state government to make it better for the people we serve. So I’m very interested in engaging Rep. Thissen … and others in the legislative leadership that have spoken out on the issue.

Q: I’m guessing your new job won’t leave you with much free time. But what are your interests outside work?

A: I have four little kids — ages 9, 7, 5 and 2. So I’m like every other working mom outside of the home. I spend most of my time running kids to and from and doing laundry and stepping on Legos and all of that good stuff. I coach my second-grader Alice’s basketball team. It’s her first year playing basketball, but the other girls have played for a couple of years. So it’s very entertaining. She is more interested in the social aspects of team sports right now than the competitive side.

Q: Did you also play hoops? Because you seem tall.

A: Oh yeah, I did. I played for DeLaSalle High School [in Minneapolis]. I actually played basketball and volleyball and started the first girls’ golf team with my little sister. When I was a senior in high school and she was a freshman, we thought it was unfair that the boys had a golf team and the girls didn’t, so my sister and I and a few of our friends started a team.

Q: Sorry to put you on the spot here, but do you have a favorite movie or book?

A: Well, I don’t like any movies that are scary and sad but aren’t true. … I only want to read a sad book or watch a sad movie if it’s a true story, because I feel like there’s no reason to be sad unless it’s based on something that actually happened.