Government reform: Dayton’s turn
by Charley Shaw
Published: October 19,2011
Time posted: 4:11 pm
Tags: AFSCME, DNR, Education, Health Care, Kurt Zellers, Lucinda Jesson, MAPE, Mark Dayton, MPCA, newborn screening, performance contracting, state government reform, tax analytics, Tina Smith, Veterans Homes
Chief of staff Tina Smith previews administration’s plans for overhauling how state conducts its business
With another state budget deficit looming, Gov. Mark Dayton’s administration is planning to go public with ideas to change how government operates. House Republicans have made the most noise this summer and fall about government restructuring with their Reform 2.0 initiative.
Dayton’s chief of staff, Tina Smith, said the administration has also been collecting ideas about possible changes to state programs and new ways for conducting state business. On Tuesday Smith sat down with Capitol Report’s Charley Shaw and offered some hints about what their upcoming proposals will entail. The following is an edited transcript of that conversation.
Capitol Report: How long has the administration been looking at government reform ideas? Is this something that was in process during session? Or was there a point in time after session where you said: “OK, we’re going to dive into this?”
Tina Smith: On the day the governor was inaugurated, he laid out three key priorities for his administration. And the first was to get Minnesota working again, really a focus on jobs. He talked about creating a tax system that was fair. And the third that he talked about on the very first day at his speech at the Landmark Center was building a better government for a better Minnesota. Really making government work again. From the very beginning, actually before we were in office, he asked me to make sure that that happened. We don’t see this as a separate initiative. We see this as baking into the DNA of everything that we do in running the executive branch. But it’s been there since the very beginning.
CR: Can you outline some specific reform ideas that you’ve been looking at and that we might see come to light in the near future?
Smith: We’re calling this Better Government for a Better Minnesota. Our goal is to save money, reduce waste and deliver better services for Minnesotans. If you think about it, you think about it in two different ways. One is what do we need to do to reform the programs and the policies that we have in state government so they work better for people. So for example, how do we need to deliver health care so we’re delivering health and not sickness? How do we need to reform the way we do education policy so that we are focusing on kids and not adults? There’s a whole range of reforms that we’re working on in that arena.
It started with the competitive bidding, changing the way that the state is purchasing health care, that Commissioner [Lucinda] Jesson laid out in March. In fact, later this week or the beginning of next week, we’ll have sort of an updated report on what we’ve gotten out of that competitive bidding process, which is really transforming the way the state is buying and paying for health care so that it is focused on outcomes and not paying for procedures.
CR: I want to ask you a little bit more about that because health care is one of the largest parts of the state’s budget and the bureaucracies in the executive branch are some of the largest in the state. Are you looking a lot at that health care area to make changes to operations or to their processes?
Smith: Beyond the policy and programmatic reforms that we need to take a look at, we also need to take a look at systems in government. What about those systems work and how do they need to be transformed so that we’re getting the very best price for the very best service? Last night Gov. Dayton, when he was talking about this at the Business Partnership (annual dinner in Minneapolis), said: ‘The way I look at this is we need to expect more and pay less,’ although I think that slogan has already been taken — it’s the Target slogan. But that really gets to the gist of it for taxpayers. How much are they paying for the services they are getting?
The same old ways of doing things doesn’t work anymore. So what does that mean exactly? What are some specific examples of things we are doing to make things work better? I’m going to give you some really specific things to show what this means. The Department of Health does newborn screenings. They screened in 2009 73,000 newborns for metabolic and genetic diseases and hearing disorders. Most of those 73,000 infants are just fine. The problem was parents were having to wait months and months to find out the results of their screening. We took a look at that system and the way that system was working. Parents used to have to wait almost two months to get results, and we were able to reduce that amount of time they had to wait by 60 percent. …
There’s a great example of an improvement that was made in veterans homes. As you probably know there’s a big backlog of people waiting to get into veterans homes. It was shockingly taking the veterans services organization months and months to get people into an opening. Meanwhile, there are veterans and their families that are in desperate need of services and unable to get them. We took a look at that system and revamped it and now … people are getting placed in open beds in more like three or four days.
CR: In your exploration of this, are there next steps to take and processes to be improved that you’re going to be making an effort to work on?
Smith: Yes. Every single one of our agencies is looking at ways to improve the way they do business so that they are delivering better services at a better price. Every single one. For example, in Pollution Control and DNR, the governor charged those agencies with improving the permitting time so they can be much faster. They are already hitting their 150-day goal that the governor set 90 percent of the time. The next step is how can they take processes that are relatively low impact and should be easy to perform and make that always happen in a 30-day window. That’s a next step that we’re following up in the permitting process. You’ll recall that during the legislative session, the governor signed an executive order asking all of our agencies to better understand and to use data analytics wherever possible to improve the way we’re delivering a better service at a better cost. The data analytics RFP was concluded around the end of May, early June. We’re expecting by the end of the year in the area of Medicaid and tax analytics, we’ll be implementing that and we’ll be able to see some real results.
CR: There are some ways you can go about reform like permitting that, as I see it, don’t involve labor a whole lot. There are other ways of going about it in which labor unions are centrally involved. What is the labor component of what you’re working on right now?
Smith: The people who work in state government — the snow plowers, the people who work the printers, the people who are providing health care, the troopers — they are at the center of this. Nobody knows better than those people what needs to be fixed and what isn’t working. Nobody knows better than they do. …
They’ve been right-sized and downsized and budget cut and reformed and blamed for everything that goes wrong. A key part of our work is to change that so that the people who are doing the work are the first to give us advice.
CR: Last Friday, Speaker [Kurt] Zellers was at the TwinWest Chamber of Commerce talking about what they refer to as Reform 2.0, and he mentioned something similar about needing to hear from employees in state agencies and interacting with MAPE and AFSCME. I’m wondering about the Reform 2.0 process; are you chatting with House Republican leadership as they’re putting this together? As far as I know the only substantive proposal so far is a two-thirds requirement for tax increases to get passed in the Legislature. I’m not sure if the administration is going to share that. I’m wondering if you have thoughts on what you’ve seen of Reform 2.0.
Smith: I’d say a couple things. Making government work better for people is not a Democratic issue or Republican issue. It’s not a public sector or private sector issue. We are open to all ideas from all places. And there are, and in fact there were in the last legislative session, places where you could see good collaboration across party lines. The areas of alternative licensure for teachers and permitting reform are two great examples. Having said that, just cutting isn’t reforming. Just cutting isn’t reforming. The question is: How do you deliver better service at less cost?
CR: I wanted to ask you about local governments. Is this a state government focus, or can we also expect an emphasis from you on consolidation at the local level where you deem possible?
Smith: I think there’s a huge opportunity that again has been identified by both Democrats and Republicans to reform the way the state and counties continue to work together to deliver basic human services to people. Why should it be that if I’m a mom living in Goodhue County and I have to apply 10 times for 10 services rather than applying once and I actually have a coordinated system I can apply to? That requires really detailed thinking by the state and the counties to be able to integrate those services. In that process you’re bound to find places where there’s duplication and redundancy, and that means that you’re going to probably be in a position to deliver a better service at lower cost. That is something that Commissioner Jesson is already looking at, and there are some great examples of that collaboration already happening.
CR: It sounds like health care is going to be a big part of this and also the environment, among the usual suspects. By way of preview, is there anything you can steer me to that could be a sleeper issue?
Smith: I guess I would say the whole issue of performance contracting where basically the state is contracting with maybe a nonprofit or maybe a for-profit company and slightly changing the way we do contracting. Instead of saying: ‘We’re going to pay you for processing these 10 widgets,’ we’re saying to them: ‘We’re going to pay you for getting these results.’ There was some stuff that came out of the legislative session around that: the performance bond strategy that was in the state government bill. Some of the performance contracting that is going to be coming again out of Human Services and other places — I think that is a sleeper issue and a big opportunity for the taxpayers.