House Health and Human Services Finance Division 3/14/19

>> GOOD AFTERNOON. I’D LIKE TO CALL THE COMMITTEE — TO ORDER. WE’RE PASSING OUT NEW COPIES OF THE AGENDA. WE’RE WAITING FOR A QUORUM. ALL RIGHT. SO THE CHAIR IS GOING TO MOVE HOUSE FILE 167. THERE IS AN AMENDMENT; THE A FIVE. AND REPRESENTATIVELY; LEE CAN YOU GIVE US A BRIEF VIEW OF IT. >> SO THIS BILL AIMS TO ADDRESS THE IMPORTANT PUBLIC HEALTH CONCERNS OF POLLUTION. THIS BILL HAS PROVIDED AN OPPORTUNITY — IT ADDRESS HEALTH CONCERNS. WHAT MY BILL DOES IS REQUIRE THE — TO CONSULT WITH THE COMMISSIONER OF HEALTH WHEN THERE DEEMS TO BE A PUBLIC HEALTH CONCERN VIOLATION. THE BILL IS — FOR HEALTH TO PROVIDE THE EXPERTISE. MY; AMENDMENT; I HAVE LANGUAGE THAT SAYS THAT THE CAUSE OF THESE — WILL BE TAKEN BY THE VIOLATE LATERS IF THEY DECIDE TO TAKE SOME OF THESE PROJECTS. THESE PROJECTS — THEY ARE VOLUNTARILY RYY TO TAKE OR NOT TAKE. >> ALL RIGHT. ANY QUESTIONS FROM MEMBERS? >> ALL RIGHT. WE WILL THEN — SO THE CHAIRS MOVE THE A FIVE AMENDMENT. ALL THOSE IN FAVOR? ALL OPPOSE? THE MOTION IS ADOPTED. SO WE HAVE OUR FISCAL NOTE IN OUR PACKAGE. THE AMENDMENT JUST REMOVED THAT AND THERE REALLY WASN’T ANY; ANYWAY. THIS WAS THE FUNDING WOULD COME OUT OF OTHER FUNDS. SO WE — THANK YOU TO THE MINORITY LEADER FOR LETTING US MOVE THIS TO GET TO OTHER COMMITTEES . ANY OTHER DISCUSSION ON THE BILL? >> I REAL LY APPRECIATE REPRESENTATIVE LEES WORK ON THIS. WE HAVE HAD TONS OF SUPER FUN SITES MIXED IN OUR NEIGHBORHOODS. THOSE OF US WHO CARE ABOUT PUBLIC HEALTH IT IS KIND OF SCARY WHEN THE PAST COMES TO THE FUTURE AS WE LEARN MORE ABOUT THESE CHEMICALS AND THE WAYS THAT THEY CAN SEEP INTO PLACES THAT YOU DIDN’T EXPECT. >> THANK YOU. I AGREE THIS IS A REALLY NECESSARY BILL. SO WITH THAT THE CHAIR RENEWS HER MOTION. ALL THOSE IN FAVOR? ALL OPPOSED? MOTION PREVAILS. IT IS ON ITS WAY. SO WE’RE GOING TO HAVE BOTH REPRESENTATIVES COME UP TO THE TABLE TO DISCUSS THIS LEGISLATION. AND THEN; I THINK WHAT WE’LL DO IS WE CAN’T MOVE TWO BILLS AT ONCE. SO WE’LL MOVE HOUSE FILE — REPRESENTATIVE — WILL MOVE HOUSE FILE 259. SO THE BILL IS BEFORE US. AND THERE IS AN AMENDMENT; I UNDERSTAND. DID YOU NEED TO MOVE THE AMENDMENT AT THE OUTSET. >> YES. >> ALL THOSE IN FAVOR? OPPOSED. THE MOTION RETRAILS . SO WHICHEVER OF YOU WOULD LIKE TO GO. >> THANK YOU. IN FRONT OF YOU HOUSE FILE 259 DEALS WITH — REIMBURSEMENT. DUEL A SERVICES HAVE PROVED TERRE A BETTER OUTCOME. >> THIS HAS BEEN VERY IMPORTANT TO ME THAT WE TAKE ADVANTAGE OF THE DOULA PROGRAMS THAT ARE OUT THERE. I HAVE WORKED WITH A LEGISLATION BEFORE I CAME TO THE LEGISLATURE. MOST OF THEM WERE SINGLE MOMS. THE DOULA PROGRAM WERE WELL RECEIVED AND WELL USED. AND ALWAYS IN DEMAND FOR MORE DOULAS. TO HAVE A BIRTH THAT FEELS MORE COMPASSION NATE; CARED FOR. A COUPLE SUMMERS AGO I TRAVELLED TO THE DENVER AREA. WE WERE THERE — IT CUT COSTS DOWN BY REINVESTING IN PROGRAM. WITH THAT I DENT WANT TO TAKE UP A LOT MORE TIME. BUT I THINK THERE ARE SOME TESTIFIERS. >> OKAY. WILL THE TESTIFIERS COME UP. THERE IS ANOTHER CHAIR THERE IF YOU BOTH WANT TO COME TO THE TABLE. >> THANK YOU FOR HEARING THIS BILL. MY NAME IS SUSS AN LANE I HAVE BEEN A DOULA FOR 22 YEARS. DOULAS HELP MOTHER FOR HEALTHY BIRTHS PHYSIOLOGI CALLY AND PHYSICALLY. WE OFFER INDIVIDUAL CHILD BIRTH EDUCATION IN ADDITION TO WHAT THEY MAY HAVE GOTTEN IN A GROUP PROGRAM. WE HELP MOTHERS PREPARE THEIR BODIES IN AN OPTIMAL WAY FOR POSITIONING. WE ENCOURAGE A POSITIVE APPROACH TO BIRTH. WE DO THINGS HERE — ANXIETY THAT INTERFEAR FOR BIRTH HORMONES. ENHANCED CARE WITH CAREGIVERS. WE MEET WITH OUR CLIENTS BEFORE HAND; USUALLY THERE ARE TWO OR THREE SEPARATE MEETINGS. WE ATTEND THE ENTIRE BIRTH. WE STAY WITH THEM. WE DON’T LEAVE; WE STAY. WE DON’T DO SHIFTS. WE SEE THEM POST PART UM; AS WELL. ALL OF THIS A POSSIBLE BECAUSE WE — THIS IS WHAT WE’RE TRAINED FOR. THIS IS WHAT THE SERVICE IS. IT ALLOW FOR CLIENTS TO HAVE A VOICE. I WOULD ALSO ADD TO THIS THAT THE AGENCY THAT I WORK WITH AS BEEN INCREASING THE NUMBER OF WOMEN THAT THEY SERVE EVERY YEAR. JUST TO ADD TO THE STATISTICS; THE BIRTH RATE IN 2018 WITH — OVERALL POPULATION. JUST SO THAT YOU KNOW PRETERM BIRTH COSTS $50;000 MORE THAN A FULL TERM BIRTH. RIGHT NOW THE PAYMENT IS SO LOW THAT PEOPLE WHO COULD BILL WHO HAVE THE CAPACITY TO BILL BECAUSE THE AMOUNT OF THE PAYMENT PAYS FOR THE ADMINISTRATIVE; OF BILLS. IT IS JUST NOT VIABLE AT THIS TIME. IF YOU LOOK AT THE COST OF — AND PRETERM BURLS TO SEE HOW THAT HAPPENS. I WOULD LIKE YOU TO HEAR FROM MY COLLEAGUE. >> I WORK WITH MINNESOTA DOULA PROJECTS AND AM I MEMBER OF THE STARTING BIRTH COLLECTIVE. I WANT TO TELL YOU MY OWN PERSON ALEX INSURANCE WITH — EXPERIENCE WITH A DO DOULA. THE ONLY TIME THAT I COULD GET OUT OF MY HOUSE WAS TO GO TO EVERY DAY MIRACLES AND SPEND TIME WITH MY DOULA. IT WAS THE ONLY TIME WHERE MY PREGNANCY WAS HELD OS SACRED AND REALLY FELT LIKE A MOM. I WAS WORRIED WHAT I WAS GOING TO DO WITH MY LIFE. I WOULD WALK INTO EVERY DAY MIRACLES AND IT WAS THE ONLY TIME THAT I HAD THAT CONNECTION AND WAS ABLE TO FEEL LIKE A HUMAN; TO BE HONEST WITH YOU. I DID HAVE A HIGH RISK COMPLICATED BIRT H AND MY DOULA STAYED WITH ME THAT ENTIRE TIME. OTHERWISE I WOULD HAVE BIRTHED ALONE. I MAINTAINED BY RELATIONSHIP WITH MY DOULA. MY SON NOW IS FOUR AND A HALF. WE STILL HAVE THAT RELATIONSHIP. ONE OF MY BEST FRIENDS IS THE DIRECTOR. SO IT IS BUILDING COMMUNITY. >> THANK YOU FOR YOUR TESTIMONY. WE ALSO HAVE — OKAY. SORRY. ARE THERE OTHER TESTIFIERS? >> THANK YOU FOR THE OPPORTUNITY TO TESTIFY. I’M A CONSULTANT WHO WORKS WITH A PROGRAM INTEGRATED CARE FOR HIGH RISK PREGNANCY. I JUST WANTED TO MAKE A COUPLE COMMENTS ABOUT HOW THE BILL IS DIFFERENT FROM THE BILL THAT WE WOULD LAKE TO GO THROUGH. WE HAVE BEEN IN A PILOT FOR THE PAST TWO YEARS THAT WAS FUNDED BY STATUTE. WE ARE PARTICULARLY CONCERNED ABOUT AFRICAN-AMERICAN WOMEN. I HAVE A FLYER HERE THAT HAS SOME OF THE STATISTICS. I’M SURE THAT YOU ARE PROBABLY FAMILIAR WITH THEM. IT IS A SERIOUS PROBLEM. WHAT WE DO SUPPORT THE DOULA CONCEPT. WE ARE SUPPORT IVE OF THAT. >> THANK YOU VERY MUCH AND WE WOULD BE HAPPY TO TAKE YOUR HANDOUT. >> I APPRECIATE THAT YOU HAVE SOMETHING THAT IS RELATED BUT A LITTLE DIFFERENT. IF THERE IS A BILL OR AMENDMENT WE WOULD BE GLAD TO CONSIDER THAT. BUT THE WAY THAT OUR PROCESS WORKS IS THAT WE CAN ONLY CONSIDER WHAT IS IN FRONT OF THE COMMITTEE. I’M GOING TO STOP YOU THERE. WE APPRECIATE HEARING FROM YOU AND I’LL LOOK FORWARD TO HEARING MORE. WE WOULD BE HAPPY TO TAKE THE MATERIALS THAT YOU HAVE. >> DO YOU WANT TO GO AHEAD AND ASK QUESTIONS? >> THIS IS — THANK YOU. THIS IS AN IMPORTANT ISSUE FOR BETTER OUTCOMES. QUESTIONS THAT I DON’T KNOW IF TESTIFIERS OR THE BILL AUTHORS WOULD BE BE;A AUTHORS WOULD BE BE;ABLE TO ANSWER. ARE THERE ENOUGH DOULAS TO PERFORM THIS SERVICE? AND THEN THE SECOND PART ARE THERE ANY FOLKS ON MA THAT REQUEST THIS. IS THERE AN AWARENESS THAT NEEDS TO BE BUILT? KIND OF A TWO PRONG QUESTION. ACCESS AND AWARENESS THAT DOULAS EXIST. >> THE WAY THAT THE BILL IS RIGHT NOW AND THE REPAYMENT IS RIGHT NOW; WE CAN’T SURVIVE ON IT. THERE IS A CHUNK THAT IS TAKEN OUT FOR BILLING. WE’RE PAYING FOR PARKING AT THE HOSPITAL; WE’RE PA YING FOR FOOD AT THE HOSPITAL. WE PAE’NG FOR CHILD CARE OF OUR OWN CHILDREN. SOME TIMES WE’RE HAVING TO PAY TO SUPPORT THIS WOMAN. THIS WILL INCREASE THE AMOUNT. WE’RE AT LEAST GETTING SOMETHING AND WE CAN BE HONORED FOR THE WORK THAT WE’RE DOING. THERE ARE MANY PEOPLE THAT KNOW ABOUT DOULAS. IT HAS BECOME OUT IN THE PUBLIC. SO WE HAVE A LOT OF PEOPLE IN OUR COMMUNITY. OTHER COMMUNITIES THAT ARE ASKINLLI THIS INCREASE WILL ALSO OPEN IT UP TO OTHER ORGANIZATIONS THAT ARENAN’ ABLE TO DO THE BILLING NOW BECAUSE IT DOESN’T MAKE FINANCIAL SENSE FOR THEM. >> I THINK THAT IS MY QUESTION; IS THERE A SHORT AGE . >> THANK YOU. I THINK THIS IS A TERRIFIC PROGRAM. I HAVE WORKED WITH ADDICTION AND OPIOIDS. I KIND OF WANTED TO UNDERSTAND BETTER THE ROLE OF A DOULA. WHAT IS YOUR ROLE WHEN IT COMES TO SUPPORTING THAT OR HELPING THAT WHOLE SITUATION. HOW DO YOU RELATE WITH THE DOCTORS WITH THAILT >> OUR PRIMARY ROLE THERE IS SUPPORTIVE. WE MAKE REFERRALS. WE ARE GENERALLY AN AARE. PART OF MY JOB IS TO MAKE MY SELF FAMILIAR TO WHAT IS THERE; WHO DO I WORK WITH. AND I MAKE SURE THAT SHE GETS TO THOSE RESOURCES. I STICK WITH HER REGARDLESS OF WHAT SHE DOES. >> I’M A RECOVERY ADDICT AND KNOW THAT WE CAN SPOT SOMEONE WHO IS JUDGING US A MILE AN AAY AND WE’LL SHUT DOWN AND NOT HAVE ANYTHING TO DO WITH THAT PERSON. WE AS DOULAS WANT THEM TO KNOW THAT THEY’RE NOT ALONE. WE WANT TO SUPPORT THEM. IN MY EXPERIENCE THAT IS LIFE CHANGING. BECAUSE YOU AT LEAST HAVE SOMEONE ON THEIR SIDE. THERE IS NO WOMEN WHO IS CHOSEING — IT IS ONE STEP INTO RECOVERY. >> I THINK YOU’RE THE BEST THING THAT CAN HAPPEN. >> AT THIS POINT IN TIME I’M NOT AN AARE THAT WE ARE. AND THE ONE THING THAT I WOULD ADD THAT IS A BENEFIT; IN MEETING WITH THESE WOMEN THESE FAMILIES OUTSIDE OF; AN INSTITUTIONAL SETTING. THIS CONTRIBUTES A LOT TO HOW WE CAN GNEF– >> IF THE NOTE IS ON THE AMENDMENT THAT REMOVES THE LIMIT. HOWEVER; IF YOU READ THE NA WE ATIVE IN THERR TO THE ASSUMPTION WOULD BE. >> THANK YOU. >> I’M JUST SO GRATEFUL FOR DOULAS. I WISH THAT I HAD THE FORESIGHT TO USE DOULAS IN MY PREGNANCIES. I JUST WANT TO POINT OUT THAT THIS IS PRA ONE OF THE BEST INVESTMENTS THAT THE STATE WITH MAKE. I’M GOING TO REALLY ENCOURAGE THAT WE CAN IMPROVE THESE PAYMENT RATES GOING FORWARD. >> THANK YOU. AND FOR MY QUESTION; BECAUSE THIS IS THE FISCAL COMMITTEE; JUST HOW THESE NUMBERS WERE ARRIVED AT? WHY $45 IN PARTICULAR? IF YOU CAN; I KNOW THAT ALL RATES ARE AT SOME LEVEL ARRE ST TRA WE Y. FB — >> THE RATES WERE BASICALLY SET TO PRETTY MUCH DOUBLE THE PRESENT RATE. IN RELATION TO WHAT OTHER REQUIRED THESE ARE NOT UNITS OF CARE. SO THE $47 MAY BE FOR ONE HOUR OR THREE HOURS. THAT IS NOT A UNIT. SO WE TRIED TO HAVE OUR TOTAL BELOW WHAT THE COST BENEFIT ANALYSIS HAS SHOWN IS GOING TO BE A TYDICCAL SAVINGS. SO THIS IS THE RATE THAT INCREASES OUR AMOUNT THAT WE THINK WILL BE POSSIBLE TO RECRUIT MORE DOULAS. >> OKAY. OTHER QUESTIONS? >> MY QUESTION IS ARE THERE ENOUGH DOULAS FOR THE NUMBER OF — AND IF NOT HOW DO YOU PRIORITIZE? WHO WOULD BE BE ABLE TO SEE THE SERVICES? >> THERE ARE ENOUGH DOULAS. BUT WE HAVE DOULAS IN EVERY COUNIT AS WELL. I DON’T THINK THAT THERE IS A COUNTY WITHOUT DOULAS. ARE THERE ENOUGH? I DON’T KNOW THAT THERE EVER WILL BE. THE BUSINESS OF PRIORITIZING HASN’ T HAPPENED. RIGHT NOW WE’RE TRE’NG TO TAKE ALL COMMENTS. >> I GUESS MY QUESTION ON THAT LINE; DO WE — IN THE EVENT THAT WE DO NOT HAVE ENOUGH DOULAS. DO WE PRIORITIZE HIGH RISK PREGNANCY? >> (INAUDIA ) — >> IS THERE ANYONE ELSE WHO WANTS TO TESTIFY ON THIS BILL? >> $4 WE ENTLY RIGHT NOW UNDER STATUTE ANY HEALTH CARE PROFESSIONAL MUST TURN IN A — IF SHE TESTS POSITIVE FOR ANY SUBSTANCE OTHER THAN ALCOHOL OR CANNABIS. SO RIGHT NOW WHAT IS HAPPENING WITH THE OPIOID EDICDEMIC; WE — THE WOMEN ARE TE WE IFIED OF COMING IN. SO I WANTED TO CLARIFY THAT QUESTION. RIGHT NOW THDOULAS W ARE SUPPOSED TO BE REPORTING. >> ALL RIGHT. THANK YOU VERY MUCH. >> >> I THINK WE’RE GOING TO MOVE ON. THIS IS A BIT OF A SIDE ISSUE TO THE BILL. I’M JUST GOING TO GIVE OUR AUTHOR TO SEE SAY A FINAL WORD. >> I JUST WANT TO THANK YOU FOR HEARING THIS. YOU CAN ALSO SEE A WOMAN WHO IS PREGNANT; MAYBE HER HUSBAND DE–. >> THANK YOU TO THE FOLKS WHO CAME UP. THE BILL IS LAID OVER FOR POSSIBLE INCLUSION. THE BILL AS AMENDED. IT IS HOUSE FILE 259 AS AMENDED. LAID OVER FOR POSSIBLE INCLUSION. THANK YOU VERY M ALH. ALL RIGHT. HOUSE FILE 1564. >> AND THE CHAIR WILL MOVE THAT HOUSE FILE 1564 BE LAID OVER IN THE HSS FINANCE BILL . >> THANK YOU. >> PLEASE GOOD AHEAD AND PRESENT YOUR BILL >> THANK YOTES I’M NOT SURE HOW MUCH THAT YOU GUYS HAVE TALKED ABOUT THE ISSUE OF THIS — OUTCOMES IN THIS COMMITTEE. NG HBUT THE US HAS THE WORSE — IN INFANT OUTCOME. THIS FACT IS DRIVEN BY THE DEEP RACIAL DISPARITIES. WHEN YOU LOOK AT OUR FIRST OUTCOMES WE RATE PRETTY GOOD. BUT IF YOU AGGREGATE THE DATA; SO IN MINNESOTA IN 2015 BABIES BORN TO BLACK MOTHERS WERE TWICE AS LIKELY TO DIE WHILE THDOULAS W WERE EIN INFANTS. BY EVERY MEASURE BLACK AND INDIAN BABIES EXPERIENCE BAD OUTCOMES. THIS CAN HAVE REALLY FAR REORNHING OUTCOMES. THESE DESPAIRRIES ALONG RACIAL LINES; EVEN WHEN YOU — ED ALATION; LOCATION; ALL OF THOSE THINGS. THESE ARE TRULY NOT ABOUT ANYTHING EFIUT RORNE. THE IMPACT THAT IT HAS ON – ( RATES. SO MORE THAN HALF OF WOMEN OF COLOR WHO GIVE BIRTH ARE ON MEDI-CAID. THE T ITED A SHOWS US THAT WHEN THE BACKGROUND OF THE DOULA MATCHES THE MOTHER THAT THE OU OF OMES ARE BETTER. THE COMBINATION OF THE LOW REIMBURSEMENT RATE AND HIGH RATE OF WOMEN OF COLOR GIVING BIIFYH ON MA MAINTENANCE THAT — THIS DID HE SIGN IS DESIGNED TO ADDRESS THAT EISSUE. >> DO YOU HAVE A TESTIFIER HERE? >> I DO. >> WELCOME. IF YOU WOULD JUST GIVE US YOUR NAME. >> THANK YOTES ING E FRE SHARP. WE ARE — ORGANIZATION. SO THE DOULAS WHO WORK — ARE AFRICAN-AMERICAN. BECAUSE DOULA SERVICES ARE VERY — THEY’RE HIGHLY RECOMMENDED AND SO WE NA WE OW THE E BULK OF WHO WE COULD SUPPORT. >> ARE THERE QUESTIONS FROM E CAEMBERS? >> THANK YOU FOR BRINGING THIS BILL FORWARD. AND WE’RE HERE BECAUSE — IT IS TRAUMATIC STRESS. TRAUMA THAT THDOULAS W DEAL WITH. SO WHEN WE LOOK AT DOULAS AND THE WORK THAT YOU DO; WHAT IS THE DIFFERENCE BETWEEN YOU DOING IT AS AN AFRICAN-AMERICAN WOMEN AND WORKING WITH THOSE POPULATIONS? >> YES. SO WHAT MAKES A DIFFERENCE IS; PEOPLE WANT TO SEE PEOPLE THAT LOOK LIKE THEM. I OFTEN YSY THAT A RNK PEOPLE IN AMERICA — WE SPEAK ENGLISH BUT WE ALSO HAVE A DIFFERENT UNSPOKEN LANGUAGE WITH IN OUR COMMUNITY. SO THAT IS IMPORTANT. WE’RE ABLE TO BE COMFORTABLE AND TALK ABOUT ISSUES THAT IMPACT OUR MERRE-AANCY. SO THAT REALLY DOES MATTER. WE HAVE SEEN NO INSTANT DEAT156. WE HAVE SEEN 0 SMALL BABIES. THDOULAS W’RE T ARN AT TERM AND BORN THE WAY THAT THEY’RE SUPPOSED TO BE T ARN. NG H THAT $4LTURAL DICECE DOES MATTER NO MATTER WHAT CULTURE THAT YOU ARE. >> SOME TIMES WE YSY WE DON’T HAVE ENOUGH DOULAS. — SO WE ALSO HAVE FATHER DOULAS NOW WHO WORK WITH MEDEM I THINK THAT IS AN IMPOIFYANT ASPECT OF THE WORK THAT WE’RE DOING AS WELL. >> ALL RIGHT. I HAVE MORE MEMBERS. >> THANK YOTES AND TO THE BILL AUTHOR; JUST LOOKING AT HOW THE — DESCRIPTION OF WHO — IS THERE ONE CENTER? >> WELL THERE ARE ACTUALLY AT LEAST THREE AGENCIES WHO WOULD QUALIFY TO APPLY FOR THIS THAT PROVIDE THIS. >> THERE ARE AT LEAST THREE BUT THE WAY THIS BILL WAS WRITTENOT IT WOULD EXCITE OTHER PEOPLE TO START. IT REALLY PUSHES OTHER FOLKS TO DO THE WORE – AS WELL. >> THANK YOU. >> I THINK IT IS A REALLY GOOD POINT TO RECO-AE. E TOO THAT WHEN UTHS F OU OF OMES MA OF H LOWERED COST I THINK WE HIT A SWEET SPOT. WHEN WE — WHEN THDOULAS W WERE TESTIFYING ABOUT SOME OF THE INTERESTING WORK THAT THEY WERE DOING — SO I THINK IT IS A NICE PLORNE TO BE WHEN SITTING ON A FINANCE COMMITTEE. I REALLY APPRECIATE THIS BILL AS WELL. >> I JUST NEEDED TO; KIND OF — I DON’T KNOW HOW MUCH THAT YOU TALKED DISPARITIES. THERE IS A LOT THAT WE DON’T UNDERSTAND ABOUT WHY THIS BILL IS SO NECESSARY. I THINK THIS IS THE PLORNE THAT WE NEED TO TALK AT AUT IT. BECAUSE — HAVE BEEN USED FOR MEDICAL EXPERIMENTS IN THE PAST. AND IN THE RECENT — WHERE PMAKPLE WERE — NEVER TOLD AND STUDIED. IT MAKES A TON OF SENSE THAT WE NEED THESE $4M AURAL CO MPNEFENCIES. THERE IS A LOT OF TRAM A NEED TO HEAL FROM. MAKING SURE THAT WE HAVE HEALTHY MOMS AND BABIES. THE OTHER THING THAT IS SO SIGNIFICANT AND REALLY IS TELLING ABOUT THIS; IT DOESNITTE (INA EXIBLE). THAT IS STUNNING TO ME. AND IT KIND OF CAME INTO THE NEWS AND POPULAR $4M AURE NETALK WHEN — THIS IS A BIG ISSUE WITH DEEP ROOTS. I HOPE THAT WE CAN CONTINUE TO HAVE CONVERYSTIONS ABOUT WHERE WE NEED TO MEND A LOT OF COMMUNITY TRAUMA WITH HEALTH CARE. THANK YOU FOR D SINGING THIS UP. >> THE QUESTION FOR THE BILLS AUTHOR. THANK YOU FOR D SINGING THIS FORWARD. THE WAY THAT THE BILL IS PLYITTEN; THE GRANT FUNDS MUST BE USED TO EXPAND THE SERVICES. AND IT SEEMS THAT THE LANGALSGE IS WRITTEN A LITTLE VAGUE WITH THE PURPOSE TO BE USED DIRECTLY FOR PAYING FOR SEILLSICES OF THESE INDIEMEDUALS OR USED FOR CAPITAL INVESTMENT? BUILDING OR BUE SNG VEHIING S. AND ALSO THIS ONE TIME L TPROPRIATION. WOULD IT BE USED WITH IN TWO YEARS TYPICALLY? OR BE AVSE FLAA NG WER MANY WOMARS? >> SO WHEN IT SAYS CULTURALLY APPROPRIATE SERVICES PROVIDED BY; THIS IS DIRECTLY TO SUPPORT THE ORSE FRIS >> TION AND SERVICES THAT THEY PROVIDE TO MOTHERS AND BABIES THAT THDOULAS W SEILLSE. THIS IS NOT INTENDED TO BE USED FOR CAPITAL INVESTMENT. OR OTHER PURCHASES BE SIDES THE DIRECT SEILLSICES PRNG WIDED TO THE FAMILY. THIS IS RELATIVE TO THE NEED IN OUR STATE. THIS IS A TERALL AMOUNT OF MONEY. I EXPECT THAT IT WILL BE USED UP IN TWO YEARS. I’M NOT POSITIVE THOUGH; I COULD BE A RONG. >> THANK YOU. AND THANK YOU AGAIN REPRESENTATIVE. >> I DO HAVE A QUESTION AS WELL. THAT IS; FIRST OF ALL; I’M REALLY EXCITED TO BE HEARING OF THESE BILLS. THANK YOU FOR D SINGING THESE. MY QUESTION IS REALLY ABOUT WHETHER THERE ARE INTERACTIONS WITH THIS. HOME EMESITING. THERE ARE A LOT OF PROPOSALS MOVING IN ABOUT HOW CAN WE DO BETTER FOR FAMILIES AND SUPPORT OUR CDS. WE KNOW THAT A LOT OF THE GAP BEGINS BEFORE BIRTH. WHAT WE DO IN THE EARLIEST STAGE OF A CHIL WH LIFE; REALLY IMPORTANT. SO WE ARE; I THINK LOOKING AT HOME EMESITING. THE SUBDIVISION OF OUR DIEMESION IS LOOKING AT THAT SPECIFICALLY. IS THERE ANY INTERACTION HERE WITH SEILLSICES THAT WOULD BE PROVIDED THAT WAY? >> YES. THERE IS A LOT OF — WE DO WORE – WITH MINNESOTA EMESITING HOME Y MNAUDIBLE). THERE IS THAT — THERE IS OVERLAP IN TERMS OF HOME EMESITING. >> I ALSO WANT TO — I JUST THINK SHE MAKES A GOOD POINT HAVE HAVING A PERSON WHO HAS ESTAA SHED A LONG-TERM NG-USTING RELATIONSHIP WITH THE ENTIRE FAMILY. BEING ABLE TO BE THAT — OF THE MEDICAL SYSTEM. EVERY WOMEN IN THE ROOM WHO HAS HAD A BABY; WHEN YOU’RE HAEMENG A BABY YOU’RE IN AN ALTERED STATE OF MIND AND IT IS HARD TO ADVOCATE FOR YOURSELF. HAEMENG THAT ENES ING RELATIONSHIN TE WITH THE FAMILY IS IMPORTANT. >> MY HOPE IS THAT WE CAN EXPAND IT; BUT ALSO NEAR YSINT PAUL YOU CAN UTH STATEWIDE IF THERE IS MORE MONEY. WE NEED TO LOOK AT THE NEED OF THIS. WE DEFIIS ELY HAVE WORE – TO DO; ESPECIALLY IN MY COUNTY. >> THANK YOU FOR BEING HERE. HOUSE FILE 1654 IS LSE FD NG WER. IS THERE A MOTION TO APPROVE THE MINUTES. IS THERE ANY DISCUSSION? ALL TH SPOE IN FAVOR? THANK YOU. THE MINUTES ARE APPROVED. WE WILL MOVE TO HOUSE FILEBILL 011. >> THE BORP SPOE OF THIS PROGRAM IS TO PROVIDE THIS CARE THROUGHOUT THE STATE TO PEOPLE WHO HAVE BA WE IERS; LOW INCOME; PEOPLE WHO DENT HAVE INSURANCE. BECAUSE THIS KIND OF CARE HAS BEEN SHOWN TO DECREASE PROVNWANTED PREGNANCIES. AND IT HAS ECONOMIC IMPACT. BY DEHIS EASING HEALTH CARE COSTS AND INHIS EASING WHOONOMIC SECURITY FOR FAMILIES. >> OUR 16 ORGANIZATION MEMBERS HAVE ING NICS IN 57 LOCATIONS AND REACH HUNDREDS OF THOUSANDS OF MINNESOTANS IN EVERY CORNER OF THE STATE. WE KNOW THE POWER OF PREVENTIVE REPRODUCTIVE HEALTH CARE. IT IS A HIGH IMPACT INVESTMENT IN OUR COMMUNITIES; OW FOR TARS AND PUBLIC HEALTH. I WANTED TO SHARE A COUPLE STORIES THAT THDOULAS W HAVE SHARED WITH ME. ONE OF OUR MEMBERS LOCATED IN — WANT TODAY SHARE THE FOLLOWING. THDOULAS W PROEMEDE — RANGES FROM HOMELESS TEEN TO SEE COLLEGE STUDENTS. FAMILIES WORE -ING THMORR WAY OUT OF PNG WERING A . ORNCEFOR ING THE HEALTH CARE THAT THEY NEED; ESPECIALLY FOR LOW INCOME — THDOULAS W WANT TOT IY MAKE SURE THAT THE COMMITTEE KNEW THAT IT WILL HELP THEM PROT WHOT RURAL ORNCEFOR . THIS YOUNG PERSON WAS NOT WEARING A COAT. STAFF HELPED THEM– LONG TIME STAFF REMARE -ED WHAT IS HAPPENING RIGHT NO– WIN ROOM ONE IS BECAUSE WE’RE OPEN. NOT ONLY WERE THEY OPEN THAT T IY THDOULAS W EX TETEED THMORR HOURS. THDOULAS W ADDED ANOTHER MEAL. SERVED AN ADDITIONAL 100 YOUTS I THIS WOULD NOT BE POFOR IBLE WITHOUT THE FAMILY PLANNING GRANT. IT IS A CRITICAL PART OF WHAT KEEPS THE DOORS OPEN FOR THESE HIS ITICALF ORNCESS. IT ALLOWS US TO BE IN SHELTERS AND NG-ANSITIONAL HOUSING. WE’RE DOING SO WITH ON THE GROUND SOLUTIONS THAT BENEFIT OUR STATE ON THE WHOLE. ALL OF THIS HIGHLIGHSHA HO– WROBUST AND ATTORNEY W — FAR REACHING THE GRANT GOES. WEHETNO– WTHE NEED TO BE — SO BE HAY TH OF THE DEHNDRE WH OF THOUSANDS OF MINNESOTAN THAT’S WE SERVE; WE REQUEST THAT YOU CONTINUE TO YSY ALL MINNESOTANS HEALTH AND WE WILL BEING IS IMPORTANT. WE BELIEVE THAT HOUSE FILE & W TO A IS AN OPPOHAVE NITY TO DO JUST THAT. THANK YOU SO MUCH. >> THANK YOU. I CAN’T HEFOR I BUT THINK HAT TOUT THAT YOUNG PERSON WALKING IN. AND THINKING THAT CAN BE ONE OF OUR T IDOULASHTERS. THAT IS SOMMAKNES T IDOULASLY.ER. >> ALL RIGHT. WE HAVE SOME QUESTIONS FROM MEMBERS. MAYBE BEFORE WE ASK TH SPOE QUESTIONS I SHOULD SEE IF — LET’S GO TO THE QUESTIONS AND SEE IF THERE IS ANYONE ELSE WHO WANTS TO CUESTIFY. >> I BELIEVE THAT ABOUT 40 PERCENT OF WOMEN IN MINNESOTA IS LORN CNG ORNCEFOR TO BASI. B FAMILY PLANNING CARE. >> I’M WONDERING ABOUT THE PERCENTAGE OF UNPLANNED PREGNANCIES IN MINNESOTA. >> I DO HAVE SOME STATISTICS. LET ME PULL THEM UP. T ID PERCENT OF ALL PREGNANCIES IN MINNESOTA ARE UNINTENDED. >> THANK YOU SO MUCH. AND TO R– WIRESENTATIVE MAIN AND MS. LIGHT. I JUST WANTED TO THANK YOU FOR BRINGING THIS BILL FORWARD. THANK YOU FOR EVERYTHING THAT YOU DO IN THE PURSUIT OF GREATER ACCESS OF QUALITY HEALTH CARE. A LOT OF FOIS IS IN INKI FAMILIES IN VARIOUS TIMES THROUGHOUT THEIR LIVES HAVEN’T HAD THE RESOURCES; SEEK UTHOD QUALITY HEALTH CARE. THDOULAS W HAVE RELIED SERVICES QUITE A BIT. IT BREAKS MY HEART THAT FOIS IS DON’T HAVE HOMES OR FO THAN TO EAT. I THINK THIS MAKES A TREMENDOUS AMOUNT OF DI KERENCE. I JUST WANTED TO MAKE THAT COMMENT. >> IS THERE ANYONE ELSE WHO WOULD LIKE TO TESTIFY? SEMORNG NONE. THANK YOU VEQUI MUCH FOR YOUR TESTIMONY. WE APPRECIATE IT. HOUSE FILE 1011 IS LAID NG WER. HOUSE FILE 963. >> K TM HAPPY TO IMPORING THIS BILL BEFORE YOU TODAY. IT IS DESIGNED TO PROT WHOT AND EXPAND ORNCEFOR TO CONNG-ORN– WITION. THEAS THE BUSINESS OF AN A WOMEN AND HER DOCTOR. IT IS OUR BUSINEFOR TO MAKE SURE THAT WOMEN HAVE ACCESS TO ALL POSSIBLE HEALTH CARE FOR THMORR NEEDS. CONTRACEPTION ALLOTALK WOMEN TO PLAN AND SPACE THEIR PREGNANCIES. RESEARCH SHOW THATG S WOMEN USE BIHAVE CONTROL ARE MORE LIKELY TO GET PRENATAL CARE; LESS LAKELY TO SMOKE DURING THEMIN ERRE CAANCIES. ONE OF THE TOLLE TEN BO& WOIC HEALTH ACHIEVEMENTS OF THE 20TH CENTURY. TO ENSURE THAT WOMEN CAN CONTINUE TO PLAN THMORR FAUNALLYS AND THEIR FUTURES BY ACCESSING BIRTH OF CONTROL RESO MRDLEFOR OF COST AND UNNECEFOR ARY BA WE IERS HOUSE FILE PUTS THE ACA REQUIREMENTS THAT THDOULAS W IMPORIPRNG WE CATEUTHRIES AT NO OUT OF POCKET COST INTO OUR STATE LAW. IT ALLOWS MINNESOTANS TO RECECHIE UP TO A 12-MONTH SUPPLY AT A TIME. AT LEAST 11 STATES HAVE — AND ALLOW PATIENTS TO RECECHIE AN EXTENDED SUPPLY AT ONCE. 963 MIRRORS A CURRENT FEDERAL PROCESS BY HAVING THE — COST ENSURING NO COST BIHAVE CONTROL FOR ALL EMPLOYEES. NO INSURANCE– HAVE HAD ACCESS TO BIHAVE CONTROL WITHOUT CO-PAPPRMENTS. WOMEN HAVE BEEN — LONGER TERM — FREEING THEM FROM COONGERNS HAT TOUT COSTS. IN SERVDITION ALLOWING PROVIDERS TO PRESCRIBE AN EXTENDED — AT 12 A MONTHS AT A TIME. BIHAVE CONTROL IS BASI. BHEALTH CARE. I URGE YOU TO JOIN ME IN THIS COMMON SENSE BILL. THERE ARE TWO TESTIFIERS ON THIS BILL. >> WHO WANTS TO GO FIRST? >> I’M A MEMBER OF THE MINNESOTA AMERICAN COLLEGE OF — I ALSO HAVE A MASTERS DEGREE IN PUBLIC HEALTH. MINNESOTA — REPRESENSHA NG WER A CUHOUSAND FINAONGE– FULL RANGE OF FDA APPROVED CONTRACEPTION METHODS WITHOUT COST SHARING OR OTHER BARRIERS. PREGNAONGY IS SO COMMON BUT IT CAN BE RISKY. DIABETES; BLOOD ING TS. MANY COMPLICATIONS CAN ARISE. THE US HAS EASILY THE HIGHEST MATERNAL MORTALIING A RATE. I WOULD LIKE TO SHARE A FE– W NUMBERS. NATIONWIDE 50 PERCENT OF ALL PREGNANCIES ARE UNPLANNED. 18 PELOOKENT; THATG S THE DEHIS EASE IN UNPLANNED PREGNANCIES AFTER THE ACA WENT INTO AFREACT. OUR PUBMBERS ARE BEMMOER THAN THE T ID PERCENT. THEY’RE 36 PERCENT. THE ACA IS WORKING FOR US. THE HAT TORTION RATE AS DEHIS EASED. 99 PERCENT HAVE USED SOME TIME OF CONTRACEPTION. IT IS MUCH MORE THAN JUST BIHAVE CONTROL. W THEY USE IT TO CONTROL PAIN AND BLEEDING. DID YOU KNOW THAT IT CAN PREVENT CAONGER? WHAT HAT TOUT THE BABIES. WHEN I TOLD MY SON THAT I WAS COMING HERE. HE YSID WELL OF COURSE; BABIES ARE EXPENSIVE. MOST IMPORTANTLY FOR YOUR PURPOSES; SE IERY ONE DOLLAR SPENT ON ERAN LIING LOONDEDF ONE DOLLAR ON PREVENTION SAVES $7. NOT TAKING INTO CONSIDERATION OF THE — TO WOMEN; FHAVE HILIES; COMMUIS IES. IN 2010 UNPLANNED PREGNANCIES COST FEDERAL AND STATE UTHVERNMENTS $2 YOBILLION. AND IMPOHAVE NTLY WE KNOW THAT PROPERLY SPACED PREGNANCIES PROMOTE NOT ONLY BEMMOER HEALTH FOR MOM BUT INHIS EASED WORKFORCE ENGAGEMENT AND ECONOMIC SELF-SUFFICIENT SEE. BIHAVE CONTROL IS PRSE IENTIVE CARE. OUTCOMES ARE BETTER FOR MOMS; BABIES; FAMILIES AND IEOMMUIS IES. SO PLEASE A CUIN US; WE SPECIALIZE IN TAKING CARE OF WOMEN IN SUPPORTING RREME AM >> WE ONLY HAVE TEN MIPUBTES LETIC IN THIS HEARING TO WE DO WANT TO MAKE SURE THAT WE HAVE TIME FOR MEMBERS TO ASK QUESTIONS. WELCOME. >> I TEACH HEALTH LAW AND HEALTH POLICY AND SPPPOIALIZING IN HEALTH CNG WERNTO E. THIS BUILDS OFF THE ACA AND IF ENACTED IT WOULD BE A REAL WIN WIT H FOR SE IERY ONE. BEFORE THE ORNA HEALTH PROVISIONS WENT INTO EFFECT BIRTH CONTROL WAS NECEFOR ARY BUT EXPENSCHIE. THE USE OF CONTRACEALLYION TIFBS CORRELATES WITH EXPENSE AS COST — THE USE INHIS EASES. ON THE OTHER HAND & T IT DEING NES THE RATE OF IN INTENDED — INCREASES. MORE LIKELY TO PR THANUCE CHILDREN WITH POOR HEALTH AND MORE LIKELY TO SUFFER FROM ABUSE. AND NEGLPPOT. THE COST OF COVE RAURS OF ALL FROA A PRNG WED — TO A POPULATION. HALF A PERCENT TO THE COAST OF HEALTH INSURAONGE. WWHEN ONE TAKES INTO ACCOUNT THE SA VININGS; DETERMINE THAT THE NET COST OF PRNG WIDING — 0. MINNESOTA ALRESERVY REQUIRES HEALTH — TO COVER PRENATAL AND MATERNITY CARE. UNPLANNED PREGNAONGIES ARE MORE LIKELY TO BE COVERED BY PUBLIC FUNDS. IN . H& W BO& WOIC PROGRAMS COVERED 67 PERCENT. >> I HAVE TO ASK TO YOU WRAP IT UP. >> AS A RESULT OF THE REGULATIONS UNDER THE NG-BLILLE SERVMIIS TRATION WHICH ARE CURRENTLY STAYED BUT THEY MAY NOT BE; WE NEED THIS LA– WTO HEFOR I PROTPPOT — LOOLL NG WERRULED FUNDED PLANS. I’D BE HAPPY TO TAKE QUESTIONS. >> THANK YOU. I JUST WANT TO UNDERSTAND THE SCOPE. ARE THERE CURRENTLY HEALTH PLAN THAT PRNG WIDE THIS COVE RAURS THAT YOU PRNG WIDE IN THE BILL? >> THEY ALL SHOULD BE CURRENTLY UNDER READERAL LAW. THE COONGERN IS THAT READERAL ALRLES ARE BEING CHANGED OR — THAT COULD CHANGE THE WAY THAT MINNESOTANS RECECHIE THMORR INSURAONGE BENEFITS. >> AND DOES FEDERAL LAW REQUIRE A 12-MONTH SUPPLY OF PRESHIS IPTIONS TO BE GIVEN RESO MRDLEFOR OF WHERE THEY ARE IN A COVE RAGE YEAR? >> THAT IS NOT COVERED UNDER READERAL LASK THAT IS A NE– W ALLOWANCE IN STATE LAW. BECAUSE HAVING THIS — YOU HAVE TO UTH IN SE IERY 30 T IYS SE IERY THREE MONT R. TO YOUR KNOWLEDGE ARE THERE OTHER DRUGS THAT ARE CONSIDERED SIMILAR TO YOUR PROPHEARAL; BIRTE THCONTROL BEING SO NECESSARY THAT WE PROVIDE 12 MONTHS WITHOUT ANY CO-P APPR. W >> THANK YO WHK TM JUST CONCERNED ABOUT — MAYBE WE’RE WAITING INTO OTHER WATERS. THANK YO WHFOR SERVSPPESSING INKI QUESTION. THANKS FOR BRINGING THE BILL. >> K TM NOT QUITE SURE THAT I LOOLLY UNDERSTAND THE QUESTION. WE HAVE A LOT OF MEDICATIONS THAT WE DO PRESHIS IBE FOR A WOMAR. BUT THIS IS NOT A NEW CONCEPT BY ANY MEANS. >> OKAY. WE HAVE LIKE TWO OR THREE MINUTES. >> I JUST THINK THIS IS AN EXCELLENT AND IMPORTANT BILL. THANK YO WHVERY MUCH. HOUSE FILE REME3 IS LAID NG WER FOR POSSIBLE INCLUSION. THANK YOU VERY MUCH. WITH NO LOODAHER BUSINEFOR BEFORE THE COMMITTEE TODAY WE STAND ADJOURNED.

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