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?