Breaking up the Department of Human Services: From skeptic to convert

The author writes, "The creation of the Department of Children, Youth, and Families is a long overdue, and will bring a stronger focus on children’s needs and issues to state government." Photo by Getty Images.

Up until 1959, the Minnesota Department of Public Welfare — renamed the Department of Human Services in 1983 — oversaw Minnesota’s prisons. The Legislature created the Department of Corrections that year.

It might be hard to fathom how DHS and DOC could share a common history. The answer is institutions — the prisons and state hospitals that were spread across the state. The most significant duty of the predecessor agencies — starting with the State Board of Corrections and Charities in 1883 — was to oversee these institutions. 

Running prisons remains a primary responsibility for DOC, but the state hospitals DHS oversaw 65 years ago no longer exist. 

The DHS of 1959 has little in common with the DHS of 2024. 

The human services system has changed dramatically since 1959. The federal government began expanding human services programs in the 1960s and 1970s with the Great Society programs, including Medicare and Medicaid. States began more fully engaging in human services policy about 50 years ago.   

And DHS grew and changed, as well. And, of course, gradual change often goes unnoticed. 

But after controversy focused on DHS overpayments a few years ago, policymakers started raising the question of whether DHS was “too big.”

In 2023, the Legislature decided the time had come to reorganize state human services. Starting in July, with planned completion in 2025, DHS will be split into three agencies: The Department of Children, Youth, and Families; the Department of Direct Care and Treatment; and the Department of Human Services. 

I worked at DHS for 33 years, retiring in 2022. I came back to DHS post-retirement to focus on reorganization, and ended up working on the proposal that passed in 2023. 

I believe the benefits of the plan go well beyond making DHS smaller and more manageable — we’ll have a state government that can better meet Minnesota’s evolving human service needs. 

Let’s start where DHS began: the state hospitals. While the old system of state hospitals is gone, what remains in its place – Direct Care and Treatment – is a critical part of the state’s human services system.  

DCT is a specialized behavioral health system, mostly serving civilly committed people. It operates in over 200 sites across the state, including facilities such as the Anoka Metro Regional Treatment Center, the State Hospital in St. Peter and the Minnesota Sex Offender Program. 

But within the pre-breakup DHS, Direct Care and Service is another service, another division. It sits inside a massive agency largely focused on policy and management of programs administered by counties and tribes. 

Separating DCT also serves to relieve DHS of day-to-day management of a 24/7, highly specialized behavioral health system. The management skill and experience needed to run such a system has little overlap with the rest of DHS, which is focused on policy and oversight of counties, tribal nations, and thousands of private service providers.   

A separate agency also provides more transparency for policymakers as they debate improvements to Minnesota’s mental health system, such as the question of whether Minnesota needs more state-run psychiatric beds.

The creation of the Department of Children, Youth, and Families is a long overdue, and will bring a stronger focus on children’s needs and issues to state government. 

Services for children and families are scattered across multiple agencies, including a core of services in DHS (child protection, public assistance programs like MFIP and SNAP, child support, and child care assistance).

This is not the first time Minnesota has created an agency focused on children. The Department of Children, Families and Learning was created in the administration Gov. Arne Carlson and disbanded by the administration of Gov. Tim Pawlenty. That model moved a somewhat random selection of children’s services from various agencies into the Department of Education. 

Based on conversations over the years, I believe a central problem with the CFL model was that MDE already had a full-time job: Overseeing K-12 education. It was impossible for the children’s services added to MDE to compete for attention, and difficult for MDE to effectively adapt to a broader role.

Over the past 20 to 30 years, the same dynamic has grown within DHS. 

In the case of DHS, the children’s services were competing with the uber-program Medical Assistance, Minnesota’s Medicaid program. 

MA started as a health care coverage program for low-income families. But over the past 40 years, MA has been transformed into a behemoth that spends over $20 billion a year, funding health care for roughly 25% of Minnesotans, long-term care for seniors and people with disabilities and behavioral health services for many Minnesotans.  

This transformation was the result of federal changes in the 1980s that created options for states to leverage federal funding for a variety of new services. 

This expansion has been wonderful for people across Minnesota and has allowed us to create a system of community-based services for seniors and people with disabilities.  

But as we have funded more services through MA, we have also expanded the administrative footprint of the program. When I started at DHS in 1989, one of the four major program areas was devoted to MA. Now, three of the four program areas administer services that are largely funded by MA. 

The fourth program area is Children and Family Services. 

I don’t want to imply that children’s programs at DHS are overlooked, either internally or externally; they remain a vital part of DHS, and the past two administrations have made substantial investments in these programs. 

But the nexus of services funded by MA are expanding and complex to administer. A slimmed-down — but still very large — DHS can better focus on these critical services.  

At the same time, we’ve also learned that consolidating children’s services from across state government can alleviate some of the barriers that make it difficult to deliver coordinated early childhood services and reach the families and children most in need. 

When I came back to DHS to focus on agency reorganization proposals, I had mixed feelings about the narrative that DHS was “too big.” After spending time examining the agency’s history and reflecting on my own time at DHS, I did reach one clear conclusion: It is a lot bigger than it was 40, 30 or even 20 years ago. 

It was time to look at other options. 

I believe the direction we are now going is a win-win-win. 

This won’t be a smooth road; reorganizing services across agencies and creating new agencies is challenging work. But it is the right thing to do. 

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