Committee on Health and Human Services - 03/27/24

[Music] good morning I'd like to call the committee um the senate committee on Health and Human Services to order and it is Wednesday March 27th 2024 and we do have a quorum present um today we will begin with Senate file 4584 which is Senator Mansville thank you madam chair members Senate file 4584 makes technical changes to the Minnesota medication repository program um it is an amazing program we've had Minnesota now since 2020 that takes unused unopen medications donated and redistributes th

em to people who otherwise go without their medications due to financial barriers um since its Inception they have donated over 666,000 days of medications to patients all over Minnesota um so in the last four years they've learned how to make this program leaner and meaner and these are the technical changes to do that um I have with me today um Dr Rowan man one of Round Table's Founders and Dr Rachel Rockwell the managing director and pharmacist in charge uh to answer any questions people may

have great well welcome to the committee and uh whoever is planning to testify if you could state your name for the record and begin Madam chair oh cender just just hear for questions for the sake of time we don't have to testify oh all right we will just move do people have questions about Senator mans bill um maybe you could just tell us a little bit more about why or how the changes came about that you've got Incorporated in this bill and you know what drove if you could just tell us a little

bit about how we got to this point yeah I um so my name is Rachel Rockell I'm the managing director of pharmacist in charge at Roundtable orx and I do have a prepared testimony so I may as well just go ahead and um dive into that if that's okay sure yeah that'd be great thank you um so for those unfamiliar or in need of a refresher round t or X operates the Minnesota medication repository program under lure and supervision from the Minnesota Board of Pharmacy patient safety is a top priority fo

r our program and operations donated products received by our program must be sealed in tamper evident p packaging and unexpired of note we do not accept Controlled Substances our inventory is Thoroughly inspected by a pharmacist before being redistributed to motans in need our program continues to grow year after year last year the amount of medications we distributed increased by nearly 100% during this growth we have identified areas of this current Statute in need of change to improve progra

m operations increase impact and enhance access access we are here today to review these proposed changes all proposed changes have been uh made in collaboration with the executive director and legal council to the Minnesota Board of Pharmacy and when applicable with consultation from DHS there are three buckets that our asks fall into the first is to expand the definition of eligible donating facilities the second is to allow medical assistant and Minnesota care recipients to access the program

and the third is to reduce administrative burden on the program in the first bucket we seek to expand the definition of an eligible donor to allow additional Health Care Facility types to contribute such as residential treatment centers or Correctional Facilities none of the safety measures around qualifying donations change rather more types of healthcare facilities would be able to donate their unused quality medications as demand for our inventory increases we need to increase our supply of

donated quality medications to serve the motans in need in our second bucket we seek to expand access to our program for Minnesota's most vulnerable residents we ask uh we are asking for medical assistance and Minnesota care recipients to be eligible for our program during times of need we have received multiple requests from our providers and Clinic partners for this change as they have patients who can benefit from the program but are excluded strictly because they have ma or Minnesota a care

insurance status we worked closely with DHS to make sure the wording and allowances were appropriate per DHS advisement this population would not be allowed to be charged dispensing fee in our third bucket um there are areas in current legislation that are duplicative and place administrative burden on the Minnesota Board of Pharmacy the repository program and our partners without adding value or enhancing safety as a reminder these propos changes were made in collaboration with the executive di

rector and legal counsel to the Minnesota Board of Pharmacy the changes are intended to reduce excess work while still maintaining all documentation and regulations needed for patient safety these include reducing the number of times participants need to sign the exact same form allowing forms to be completed electronically allowing inventory records to be produced by the repository and not duplicated by medication donors requiring the repository to maintain all paperwork and to make it availabl

e for the Board of Pharmacy upon request removing the requirement for um to issue a program ID card to patients changing where in the process safety checks by a pharmacist occur which would be changed from the time of donation to the time of dispensing and finally allowing clinic and Pharmacy Partners to dispense overthe counter medications without a prescription to only qualifying individuals of course we hope you will support these proposed legislative changes ultimately the proposed changes a

re intended to improve access to our program for motans in need while reducing medication waste and its impact on our environment and I would be happy to take any questions on that information thank you very much um members any other questions now that we've heard an overview um I'm seeing none um Senator AER this is I'm sorry I'm late this is an example of citizens solving something and being phenomenal so way to go thank you yeah it seems like a great program and it it's great to see um over t

ime you know what you've been able to accomplish and um and these changes seem like they would be beneficial so um thank you for bringing them forward um if there aren't any other questions then um Senate file uh 4584 will be laid over for possible inclusion in annous Bill thank you um next we'll move to Senate file 1303 which is Senator P Bill and Senator P are your testifiers here please you can present your bill now Welcome to our committee um thank you for bringing Senate file 1303 forward u

m Senator pod does have a an author's amendment that is included in your packet it's the A3 Amendment um and so um let's see Senator Balden moves um sener the A3 Amendment all those in favor please signify by saying I any opposed the amendment is adopted Senator Pop please proceed with your presentation thank you chair wicklin and members uh thank you for this opportunity to present SF 1303 which will support still birth prevention through fetal tracking through tracking fetal movement chair Wic

kland um every year in the US approximately 2,745 babies are born still according to the US Center for Disease Control Minnesota experiences around 360 plus still birth every year research states that over a third of still births could be preventable with proper education with this bill we could be saving over 120 babies a year in our state a disproportionate number of babies born still are from bipac community where maternal mortality is four times more likely for a birthing person if they expe

rience a still birth research from the American College of Gynecology shows that there are several contributing factors to the racial Health disparities in still birth and these include systemic racism and Health Care leading to discriminatory beliefs values and distribution of care to expected parents of color Access to Health Care early in pregnancy to diagnose conditions and treatments so what can we do about this we need to educate expecting parents to count the kicks or what is technically

called fetal movement tracking during the third trimester of pregnancy every baby is different and we need expecting parents to know what is normal for their baby and when they notice a change in the fetal movement we need to encourage them to seek medical care and evaluation right away I actually had the Good Fortune last year during my pregnancy to use count the kicks that's the fetal movement tracking tool thanks to Senator Papas who shared it with me what a difference this free tool that com

es withed educational materials and resources had on me and my pregnancy and the delivery of my healthy baby girl I wish I would have had this tool in all my other four pregnancies as all of you may know losing a baby so close to their due date is incredibly devastating let's ensure that Minnesota families bring their Healthy Babies home in your hacket members there are letters of support for this bill some of which are from people and families who have experienced a still birth and provided sto

ries explaining why still birth prevention action is so necessary chair Wickland I do have three testifiers today um and then after that I'd be happy to answer questions thank you thank you very much and um we have let's see Amanda Duffy you could state your name for the record and begin your testimony Amanda Duffy still birth prevention Advocate thank you chair Wickland and the Health and Human Services committee my name is Amanda Duffy and I reside in New Brighton Minnesota with my husband and

three living children November 2nd of 2014 was sunny and 70 an anomaly in Minnesota in November I was it was to be our last day before my scheduled delivery with our second child quickly that blissfully bright day turned dark when we learned our perfectly healthy baby's heart had stopped beating eating my daughter ree Christine Duffy was still born she was 8 lb 3 oz with red hair like her daddy a button nose just like her brother and hands that resembled mine there are other lost families in th

is room who are now standing we demand change in the weeks leading up to her birth and death I had noticed Reese's movements changing when I alerted my provider I was told that babies slow down close to birth and that I should try to enjoy the last few weeks of my pregnancy I now know this advice was inaccurate never once throughout my entire pregnancy was I educated on the importance of consistently tracking my baby's movements in the third trimester why I should or what to do if I noticed a ch

ange so when Reese was born with an umbilical cord wrapped tightly around her neck twice I was blindsided with each roll and kick in utero the cord pulled Tighter and she stopped receiving the nutrients her body needed she slow down to preserve energy as the blood flow decreased until it was too late much like you and I we slow down when we don't feel well our normal movements change it wasn't until after she died that I learned that sometimes the first and only indicator a baby is in distress i

s a change in their movements I know hundreds of Minnesota parents who believe this education could have saved their child's life and I am one of them more than 30 States fund materials to save lives in such a progressive State why are we so far behind in something so simple so non-invasive so low cost with Health Equity at the center and most importantly so life-saving ree should be here today I shouldn't be sitting here speaking on behalf of BPT parents in the state whose baby's death was prev

entable but this is my reality and I do it out of pure Abiding Love I do it because Reese's life matters I do it because our babies matter it doesn't have to be this way for the hundreds of others that will follow if something isn't done on behalf of all Minnesota family impacted by still birth I graciously urge you to pass this life-saving piece of legislation thank you thank you um thank you very much for your work and for sharing your story I'm very sorry for your loss um and now um Sheila Ka

dy or is um Tessa fredman if you could state your name for the record and begin your testimony Tessa fredman um before I begin I'd like to thank chair Wickland and the Health and Human Services committee for this opportunity to share my story like I said my name is Tessa fredman and I am a count the Kick's Advocate and mother to almost 2-year-old William I reside in Dayton Minnesota and I want to take the next few minutes to briefly share some of my story and my experience um using the count the

kicks app which is a fetal movement education I stumbled upon someone on social media who had tragically lost her baby to still birth she explained how she wished she had been more informed about fetal movements and the importance of tracking movement patterns and how it could have potentially saved her baby's life it is through her a complete stranger a grieving mother that the loss of and the loss of her baby that is desperately trying to reach out to others in hopes to prevent what it just h

appened to her that I stumbled upon count the kicks count the kicks is a free resource available in 21 different languages for mothers to be able to routinely monitor her baby's movements from anywhere with my son William I utilized the easy to use app which reminded me daily to monitor fetal movement and patterns the app conveniently tracks your results each time you use it and stores the data for you to be able to look back on and share with your provider if needed it helps you monitor your ba

by baby's movements patterns notifying you if something seems off I started to track my baby's movements and became familiar with his movement patterns around 38 weeks I noticed a significant drop in movement pattern patterns that were not my baby's Norm because I had educated myself and researched the importance of the fetal movement tracking I knew something was not right I called my OB clinic and they sent me directly to Labor and Delivery at my local hospital there they monitored my baby wit

h non-stress testing in ultrasounds and noticed that my baby was under higher than normal stress ultimately they ended up inducing me that day and confirmed at this point in my pregnancy my baby would be safer on the outside than in on the afternoon of May 18th 2022 my healthy baby boy was delivered I can't help but think if I had not been properly informed and educated on the significance of fetal tracking what the result of my pregnancy in my baby's life could have been I knew there was simply

more that needed to be done which is why I 100% support and stand behind SF 1303 and I highly urge lawmakers to pass this bill I am passionate about this movement and I can only hope that someday proper education resources such as count the kicks can be in place to help inform moms in the state of Minnesota and get her baby safe in the arms of her and her family thank you thank you very much and and this is beautiful son William he's very cute thank you thank you for sharing um and Sheila canad

i if you could state your name for the record my name is Sheila Kennedy I'm a certified nurse Midwife and women's health program manager at salside Community Clinic in South Minneapolis good morning chair Wickland committee members thank you for allowing me to speak here today I'm here today on behalf of my patients my profession all those who have been affected by a stillborn baby and most of all my niece player the most difficult thing I ever have to say to a patient is I cannot find your baby

's heartbeat I'm always met with a confused look because this is not something any pregnant person expects to hear nor is it something on the importance of tracking fetal movement this lowcost high impact intervention has the potential to save the lives of so many babies funding this pilot program would mean that every pregnant person in Minnesota would have access to life-saving tools regardless of race ethnicity geographic location or socioeconomic status please pass sf33 which helps prevent s

till Brits and the crushing heartache that accompanies it thank you very much for your testimony um that's all of the testimony we have U members do you have any questions or or comments about the bill Senator AER someone took my little deal out here um I thought Senator Morrison was going to say something so I was going to defer to her but she's not then I'll just have a few thoughts all right well whatever um so I I we've uh we had a Ste birth late in the second time um so I totally appreciate

that was our daughter of all boys um and so uh the different parents have come to me uh uh over the years talking about their still births and and uh so if they're preventable we certainly want to do that so the it's a great Bill and um you know I I would be surprised that the average clinician doesn't already do this but if there's a bell curve and some people aren't and if just people need to be enlightened about that um I hope you can find the money and and do that cuz uh cuz it was 33 years

ago and I didn't forget and so Madam chair just you understand my passion about life that I talk about comes from these experiences would shape me and and we so wish that um I don't know I just realized the value and so I just wanted to encourage the the mothers and I I grieve um personally for the loss of the people that watch this uh and it it never goes away um but I tell people to take all the hugs they can get and willingly and freely cry uh because it's a big deal so anyway thank you mada

m chair thank you uh Senator pal um chair Wickland thank you and uh Senator abler thank you so much for sharing your experience with us I I do want to say um that we have Senator Morrison Senator man Senator Hoffman who are also co-authors on this bill that's in this committee there are many more legislators that support this bill but thank you so much for uh co-authoring and for supporting this Senator Morrison thank you madam chair and thank you Senator P for elevating this issue um and I'm so

sorry for your loss Senator aor that there there truly is in the experience of of caring for people during pregnancy and child birth there is just about nothing worse than a still birth um and so even introducing this bill um is important because it elevates the issue it gets people talking about it um so I'm grateful to you for your advocacy and thank you to the testifiers um as well um just a thank you thank you any other comments no um seeing none um thank you Senator P um I appreciate you'r

e bringing it forward as well and your testifiers every moving um it seems like a a positive um thing that has pretty low low barriers for people to to access it so um with that um Senate file 1303 as amended is laid over for possible inclusion thank you very much um Senator Morrison will'll go to your bill Senate file 3927 thank you madam chair Morrison thank you madam chair I do have um the A1 amendment that I'd like to move Senator Morrison moves the A1 Amendment members all those in favor pl

ease signify by saying I I any opposed the amendment is adopted Senator Morrison uh thank you madam chair the A1 Amendment just adds the specific appropriation um thank you for the opportunity to present Senate file 3927 um which is about the rare disease advisory Council and funding uh for it in 2019 the legislature thanks to Senator Dr man established the Minnesota rare disease advisory Council um it was originally housed at the U ofm the rare disease advisory Council represents the rare disea

se patient communities that while the diseases are individually rare to collectively they impact one in 10 people in the general population rare disease patients have historically been overlooked in our health care System leading to the following poor outcomes 7 to8 years is the average time to diagnosis two to three misdiagnoses on average before a patient is accurate diagnosed and less than 9% of the roughly 10,000 rare disease communities have an FDA approved treatment in 2022 the state trans

itioned the council out of the University of Minnesota and established it as a state Council similar to the Minnesota Council on disabilities in 2023 the in the 2023 legislative session the council's base operational budget was established in coordination with the Minnesota Council on disabilities and the Minnesota management and budget the council identified an operating budget of the requested 654 th000 314,000 was appropriated um so the appropriate amount was significantly lower um than other

agencies of comparable scope and function so the council's requesting that the full initial based budget amount be appropriated this legislative session to allow it to fulfill its compliance requirements as well as execute the directives identified in Statute in addition to funding the proposed structural changes will allow the council to more easily form task forces to address identified areas of concern for the rare disease community and with that Madam chair I will turn it over to my testifi

ers thank you welcome to the committee U Miss Barnes please state your name for the record and begin thank you um Madame chair members of the committee uh my name is Erica Barnes and I'm the executive director of the Minnesota rare disease advisory Council um thank you for the opportunity to testify in support of Senate file 3927 which would make structural changes to the Minnesota rare disease advisory Council and align its base budget operating budget to that of a state agency the Minnesota ra

re disease advisory council is a state agency established in 2022 whose mission is to improve care for the one in 10 motans living with a rare disease our aim is to be a comprehensive policy resource for legislators and other state agencies to provide support tools for the medical community and be a convenor and unifier for the rare disease communities when the council transition from the University of Minnesota I worked closely with the small state agency resource team which is a division of th

e Minnesota management and budget office and the Minnesota Council and disability to identify a budget that would allow us to meet all of our compliance requirements associated with being a state agency as well as what we would need to execute on our directives that are established and laid out in statute um as Senator Morrison said last legislative session the council was appropriated roughly 40% of that base uh operating budget there are roughly 7,000 rare diseases and when these are considere

d collectively they affect 25 to 30 million Americans while the underlying causes are varied the Striking commonality among these diseases are the barriers to care that an individual faces when encountering our healthc care system at every point along the healthcare Journey rare disease patients face unique barriers over and above those which individuals with more common diseases face from yearslong delay to diagnosis to only 5% of the thousands of rare disease communities having an FDA approved

treatment it is no wonder that Abby Meyer the founder of the National Organization for rare disorders once said families affected by Rare diseases represent a medically disenfranchised population that falls through the cracks of every Health Care system in the world and these inefficiencies in diagnosis and management represent a significant cost to our Healthcare System as well a recent NIH C burden study found that healthc care costs for people with rare diseases are three to five times highe

r than the cost for people with more common diseases ironically in the last several years the rare disease Community has become Ground Zero for some of the most Innovative medical advances in decades treatments such as gene therapy have opened the possibility of greatly alleviating or even curing diseases which were once Out Of Reach of Medicine with a single Administration but these potentially Curative treatments come at significant cost in order to take these trans formative therapies from th

e lab to the clinic and actually deliver them to the people who need it we will have to identify policies that reshape the healthcare delivery landscape already through its brief existence the council has identified and supported policies that will decrease time to diagnosis facilitate connections to appropriate care and restructure our reimbursement pathway but there is so much more to be done I must tell you that I am tired of meeting Heroes for which the rare disease community in Minnesota ha

s many the majority of the nonprofits that are focused on rare diseases in our states have actually been founded by parents because there was nothing being done for their child's rare disease just like I did I established a non nonprofit because there were so many gaps and nothing being done for our children these families do amazing and heroic work they fund clinical trials they establish standards of care they convene the scientific Community often for the first time so they do amazing and her

oic work but they should not have to be heroes they should be parents and I am asking this room and all of you on this committee to actually turn our Healthcare System into the hero um the worst thing you can call me when you hear my story is a hero I don't want to be a hero I wanted to be a mom um and I know that's true of so many other parents I ask that you provide the funding that we requested last last session and then partner with the council to take the inequitable burden off of rare dise

ase families thank you thank thank you and next Dr David tilstra if you could please state your name for the record and begin hi I'm Dr David tilstra I am a medical geneticist based in St Cloud Minnesota and am on the rare diseases advisory Council as you've heard from the other uh speakers this morning rare diseases um are rare as individual disorders but uh in aggregate they are extremely common and all of us know someone with a rare disease it isn't a day there isn't a day that goes by that I

am talking to someone on the street and they say oh yeah I I had a child with with XYZ diagnosis those diagnoses are hard to do often confusing for um providers who don't deal with them very often difficult for patients who are often um feeling like they're being blown off not listen to by the medical system often because the provider isn't it's not that they don't want to deal with this patient is that it's just a challenging disorder and they don't know what to do with it um payers are also u

m feeling a significant burden because of people with complex disorders and I don't need to tell you that Medical Care is complex um we're dealing with the most complex of the complex and these people are trying to Wade through a system that is almost impossible to navigate it's really a system problem um and we've got lots of advocacy groups out there who put a Band-Aid on things we find a workaround to get around the problems what the arac does is really trying to figure out what are those sys

tem problems and how do we start to address those and because it's such a complex system um we really need to spend a lot of time and effort on trying to sort this out and that's really what the ardac is in intending to do but it needs funding to really get to address those sorts of things put the the effort into building the programs and policies that would help to simplify this extremely complex system thank you um members do you have any questions or comments about the bill Senator Hoffman th

ank you madam chair is this um is this money in the taals or is this just the onetime appropriation I'm having a hard time when I was looking at this um do you know off hand I think that the intent is that become something that is ongoing I mean it should be yeah am makes it ongo oh the amendment made it ongoing okay sorry I should read the amendment thank you madam chair that was I mean this is such an important I mean it's all subject to what we can do this year but but that's I think the inte

nt and the of Senator Morrison yeah great than I think maybe we should talk because this this is this the rare disease Council and what they're doing at the University of Minnesota is really important stuff um there's some folks there that just they keep doing what they're doing and and to see uh the council here it's like you know it's important would be I think it's important so thank you I just wanted to throw that across to you at that one so thank you madam chair any other questions or comm

ents um one question I guess so I think this bill because you want to make changes to the structure of the council it should go to state government cuz that's where they um that's in their jurisdiction so what I'd like to do is um pass this today over to them and then you can talk with them about you know whether you can get a hearing um scheduled so um if there aren't any other questions or Senator Morrison any final thoughts thank you madam chair and then Madam chair would it come back to us a

t HHS after state government I believe it would I mean I believe the obviously the funding mechanism is within our jurisdiction thank you so Madam chair I just I want to thank the director and the doctor with me this morning who are both incredible um and I think that um you know if you think about s to eight years to diagnosis I mean just think about that in a an individual and a family's life alone forget the rest of the challenges that go with having a rare disease we're going to be confronte

d with really challenging questions going forward with all of the advances potentially miraculous advances that are already happening and the council has such an important role in tackling some of those questions so a final plea to be included in our in our final budget but thank you for your consideration thank you Senator Morrison so um Senator Morrison moves that um Senate file 3927 as amended be recommended to pass and be referred to the committee on state government um members all those in

favor please signify by saying I I any opposed the motion does prevail and Senate file uh 3 3927 as amended is passed and referred to the committee on state government thank you madam chair thank you very much Senator Hoffman you're up and first we'll take up Senate file 2960 and I believe you have a an A1 Amendment Madam chair and members in front of you is the A1 amendments I move the A1 Amendment members all those in favor of the A1 Amendment please signify by saying I I I any opposed the A1

amendment is adopted Senator Hoffman thank you madam chair and members I also want to thank uh my co-authors uh Senator dram uh papis Senator Jang and Senator abler what you did with the A1 amendment is just updated the fiscal year appropriation which was flagged by staff just wanted to make that note and so in 2022 we passed the mental health Omnibus Bill and it helped provide mental health support for teens all over the state um we we still need to help those teens many emergency rooms are exp

eriencing a huge amount of pressure to try to provide quality care for youth mental health and you hear about the hospitals and the folks um saying when the teens are dropped off at the emergency rooms and what this does is we could help take the pressure off those emergency rooms and would also provide the necessary services to support teens through this Mental Health crisis and with us uh Madam chair is is the uh former State represent from the other body and current Ramsey County Commissioner

um Reena Moran I'm so glad she's here with us today to give some additional information thank you welcome to the committee commissioner Moran please state your name for the record and begin so good morning um Madam chair and members um and just want to say thank you madam chair for having this bill before your committee this morning so I am rampton County Commissioner Reena Moran and I'm excited to be here today to talk about the youth Medical Health Urgency Care bill so the Mental Health Urgen

t Care was born out of a need for non-emergency level care and resp options for youth in a behavior or Mental Health crisis in 2022 the legislature passed a 1 million $1 million in startup funding for a youth mental health urgency room thank you for that the legislation gave r County the right of first refusal to take on this pallet project but Ramsey County accepted the challenge and we have been working with the Department of Human Service to bring this Vision to life from the start this team

has been committed to engaging with parents and the community with the help of the parent support outreach program and St Paul Public Schools 261 parents were engaged at school-based events using a survey tool that was distributed in English Spanish Somali oomo mug and Karin the survey results reveal parents knowledge and needs in supporting their children mental health Wellness so I am pleased to say that Ramsey County Youth Mental Health Urgent Care will open just down the street at 402 Univer

sity Avenue later this year the Mental Health Urgent Care was serve adolescence between 13 and 18 it will provide family centered Crisis Support that is shortterm and bridges to longer term services and other supports as needed we will provide culturally appropriate Comprehensive Mental Health crisis services for teens and their families residents can expect a thoughtful comprehensive compassionate and Family Center approach to their care from the Urgent Care team the initial Services included a

comprehensive crisis assessment families will also be engaged in developing we will do this with family in developing a crisis and safety plan rapid psych psychatric services will be accessible on site so after the initial visit the family may choose to engage in an intensive therapeu intervention plan for 4 to 6 weeks this service meets them where they are and helps increase their Mental Health crisis through interventions such as coping skills development family communication planning safety

planning and more and it's really important that we don't just look at the child but we look at including the family in this Dynamic and if requested the mental health Urgent Care will coordinate with other service providers to support the family and will partner with the family to identify which services are a good fit and receive a warm handoff to other services and support So Madam chair Senate filed 2960 request of $1.5 million per year in ongoing funding to support this important innovation

project while we anticipate that there would that we will be able to build Ma and the insurance company some of the services for this program that we seek to provide are not eligible for reimbursement for example if a young person is in need of a short-term resic stay we are not able to draw down Federal fore funding this is because resic stays may take place in a family or k home or in a licensed home when resp takes place in a licensed home the county would need to pay for this and as you kno

w our county is trapped because the work that we do is done through a levy families in our community urgently need mental health services and supports to help them through a crisis this Mental Health Urgent Care provides an option for families that is not Bor in for weeks in a hospital emergency room simply waiting for a mental health bed to open up and receiving no services or mental health treatment in the meantime should not be an option so we are proud of this program that we have built and

we hope that you will support it we just want to say thank you thank you for your work and thank you for your leadership and again thank you for giving us the opportunity to do this work in Ramsey County thank you very much um members do you have questions about the bill or comments Senator abler no it's a good project I hope you can find the money thanks thank you thank you um Senator Hoffman any any final thoughts Madam chair and members I just want to thank uh commissioner Moran for her leade

rship uh in this field and even when she was in the other body I'll never forget she and I were the only elected officials taken testifying on on the children's protective the childhood protected task force that she actually was one of the the founding member of that and really cares deeply about this and and it's deeply needed and I just am honored to be here with her and thank you for considering this Bill thank you and and thank you for coming today to tell us more about it um it's it sounds

like a lot of good work has been done and I know there's um definitely need for for youth um and access to services in in your your county as as well as across the state so thank you very much for coming today thank you and uh with that um Senate file 2960 as amended is laid over for possible inclusion thank you and then uh next we have Senator Hoffman you have Senate file 4986 Madam chair uh members there's a an A1 Amendment um that should be in front of you Senator Hoffman moves the A1 Amendme

nt all those in favor please signify by saying I I I any opposed the A1 amendment is adopted and that was uh the the amendment was needed because the original language was redundant and we had some work from Christy Grom and the folks at the Department of Human Services to help clean that up and um Jenny Palin and Christy are here to explain this technicality if you have questions but since you don't um I would just like to get Ben fagel and Rosa talk up here to uh to testify so uh with that mem

bers this will allow the kidas Latinos unidas and CIO Clues otherwise known as and I remember 30 years ago when uh Jesus vior used to talk to me about Clues Madam chair um this is really through their certified community behavioral health clinic and with support from samsa Clues has developed an outstanding model of services that provide the mental health assessment and therapy substance use disorder psychiatric and medication management targeted mental health the children's therapeutic services

and support ctss the uh arm Services which uh believe it or not that's an acronym that everybody uses around here but that means adult rehabilitative Mental Health Services and then of course person centered as well as the um um uh one-on-one services that are there Federal grant helped Clues develop this model it's an aspect that's important they we've been doing this work for many many years and they do this that economically efficient and sensitivity is there because the significance funding

they get through philanthropic uh sources to improve the affordability of treatment but but now they need our help and as you know we've already experienced the big challenges in terms of responding to the huge need for chemical dependency in Mental Health Services not isolated but intersectionality together on that it's an important piece here and I think this is particularly true for low-income communities and so um what I have here is I'd like to turn it over for some brief comments from our

testifiers to really talk about why this is an important piece of our community so with that Madam chair and members thank you uh well welcome to the committee and please uh state your name for the record and begin your testimony Patricia Patron good morning Madame Cher wiland and members of the committee thank you for the opportunity to speak about Senate file 49 86 my name is Patricia Patron and I am the vice president of programs at commun unas commun Latina andio clu Senator Hoffman thank y

ou so much for authoring this bill clu is Minnesota's largest and oldest Latino lead nonprofit founded 44 years ago our mission focuses on advancing Health social and economic equity and well-being for Minnesota Latinos clu serves over 50,000 people on annual basis employs about 140 team members most of them bilingual we engage over 600 Volunteers in delivering our work and offer services in St Paul Minneapolis Wilmer and Austin our programs are culturally and linguistically responsive to commun

ity needs and this designed to empower and engage our community members from newborns to the elderly in holistic and multigenerational ways we're here to ask for your support of SF 4986 which will help us sustain our mental health and substance use disorder services for the Latino Community now I'm going to pass it to Ben welcome to the committee and please state your name for the record thank you chair wiland and committee members good morning morning and thank you to Senator Hoffman for carryi

ng our ccbhc bill we're very grateful um I'm Dr Benjamin figel I'm a psychologist and I'm the director of behavior health at Clues um in March of 2020 Clues began the process of becoming a certified community behavioral health clinic or ccbhc with a planning Grant from Minnesota DHS uh it was a very difficult moment to to start implementing a new Clinic model as the pandemic started from the beginning of this process DHS has been very supportive of Clues becoming a ccbhc which held the promise o

f a more sustainable model of providing better access to a broader array of mental health and substance use services to the Latino Community after much work uh Sweat and Tears um Clues is on the verge of receiving its ccbhc certification which would provide an enhanced insurance reimbursement through Medicaid however the financial projection for clu in year one of the ccbhc model is far from far from sustainable because clu serves a high proportion of clients or participants who are not eligible

for any healthcare insurance about 55% of our of our participants are not eligible for healthcare insurance so to be able to deliver on the ccbhc model which has stringent criteria Clues is required to have nine core Services as Senator Hoffman alluded to and have capacity for quality assurance data collection and Reporting as well as compliance infrastructure this necessitates Clues seeking out grant funding in the millions in order to survive and avoid cutting the staff and infrastructure we

work so hard to build over the last four years clu is asking for financial support from the state to be able to deliver on the promise of increased access to sustainable Behavioral Health Services for the Latino community and also to help reduce the financial and operational burden on state systems and others by preventing the need for higher levels of more expensive mental health and substance use interventions we know that community- based interventions help prevent the need for people going t

o places like inpatient unit detox um higher more expensive levels of service Clues is unique because of its challenging pay mix but most importantly because it provides culturally responsive services to the Latino Community regardless of insurance eligibility I can attest that recruiting and retaining bilingual multi Multicultural staff and Leadership is a significant challenge for a nonprofit like Clues all clu staff our bilingual and M Multicultural and reflect the community we serve thus bri

nging a sense of belonging and healing to Minnesota's Latino Community we urge your support for Clues to receive a direct appropriation of 1.5 million in funding from the state of Minnesota to ensure the sustainability and infrastructure of these essential Behavior Health Services for our vulnerable communities in Minnesota thank you thank you very much for your testimony and I also have on the list Rosa talk welcome to the committee and please state your name for the record and begin your testi

mony thank you very much um chair weand and good morning again and uh to you and uh members of the committee for the record my name is Rosa to and I am the executive director of the Minnesota Council on atino Affairs thank you so much for the opportunity uh to testify this morning in support of Senate file 498 86 I'm sorry but I've been having a little bit of a problem with my throat this morning so as you heard commun Latinas or CL has a long-standing reputation and a proven record to deliver h

olistic services that are culturally and linguistically responsive in the area of mental health it is encouraging for us for the community that cles wants to bring these kinds of services to the next level as previous testifiers explained the pilot model that clu is proposing will help mitigate Behavioral Health disparities for vulnerable communities especially those that are uninsured and underinsured as um Ben explained the pilot project uh aims to demonstrate how preventive care reduces costs

related to expens re interventions and how the sustainability of their uh community behavioral health clinic will ensure access to essential Community Based Services mental health challenges continue to be prevalent in the Latino Community through our various Community listening sessions across the state there are persistent issues that we hear affect their well-being especially after the covid-19 pandemic that disproportionately affected our communities for instance access to Affordable Health

Care lack or scarcity of qualified medical interpretation and mental health concerns among children teens parents and workers also studies consistently show that barriers to mental health care for bip groups include Financial Geographic cultural and linguistic obstacles we believe that with the right culturally responsive and preventive interventions such as the ones proposed by Clues many of these barriers will be eased for vulnerable populations so for these reasons uh committee members uh th

e council strongly urges the adoption of this Innovative Bill thank you very much thank you for your testimony uh members do you have any questions or concerns or comments about the bill uh seeing no um questions Senator Hoffman um any any other thoughts that you'd like to share yeah the history of Clues is is beyond and to for them to step into the the Integrated Health the ccbhc model is just absolutely needed deeply needed here's a here's a word of thought for you madam chair in November of 2

023 there was $84 million of underspent money in the from our wonderful Department of Human Services right and then that was moved into the general fund at 84 million just think if we had a Contin ency account set up at the Department of Human Services there would be no need for clues or organizations like that to come to us requesting that that with a contingency there would be money available that already was put in there I just want to give a food for thought on there as maybe there's might b

e a theme this year on how do we capture some of that money so with that Madam chair and members thank you Dr thank you Rosa thank you for being here and thank you Senator Taurus Ray who is a big uh help in this as well so thank you yeah I really appreciate you're bringing the bill forward um I'm really um the the model and the pilot uh project and the work that's gone into setting this up is really extensive and it it it seems like a a real um meeting a real key need in our communities for more

access to the mental health and chemical abuse services but then also just the the way that you've been able to um establish a staff that is um brings the cultural competencies to it and the and the bilingual um staff is really um seems like a a really important step that we can take to to support people so uh with that um Senate file uh 4986 as amended will be laid over for possible inclusion thank you very much for coming thank thank you and Senator Hoffman thank you madam file 3372 Madam cha

ir and members um uh this is Senate file 3372 which is the county administered rural medicine um medical assistance model also known as karma and so uh I want to thank uh Senator uty Senator Nelson Senator house child and Senator kpek the Hartford Whalers for being co-authors on this bill and so members the current County based purchasing or CBP statute that was passed by a bipartisan Coalition of legislators in 1997 county-based purchasing is a successful local county-owned and operated model t

hat's been addressing the needs of public program enroles in in rural community communities while the county based purchasing plans have had legal disagreements with our department in recent years but they've also been engaging in real collaboration with the Department aimed at doing better together for the people they serve and so this bill before you reflects conversations that the county based purchasing plans the association of Minnesota counties and the department have been holding over the

past year and it requires our commissioner to work collaboratively with counties during the interim to develop details of a county administered rural medical assistance or Karma model and bring back recommendations to the legislature in 2025 including a plan and model legislation this bill is not only an opportunity to move P um recent legal disputes over current state law but I think it's an important um ability to build on the success of the county based purchasing through the greater alignme

nt and collaboration that that we have to do out there more importantly I think this bill uh gets the Innovation toward an improved and strengthened county-based model that would further integrate County Public Health and Social Services to address social determinants of health and deliver those better outcomes so I have a County Commissioner Brad Anderson is here and I think you should have a karmi handout correct Brad did you or Matt Freeman so you got Matt Freeman and Brad here but uh with th

at commissioner Anderson so thank you thank you very much for coming today commissioner Anderson please state your name for the record and begin your testimony chair Wickman and committee members and uh Senator Hoffman thank you for the opportunity to address this bill I'm Brad Anderson in my 10th year as a goody county commissioner and my 10th year as a South Country Board member I serve on the finance committee quality assurance committee UTI utilization management committee at South Country t

o say Commissioners are passionate about this work is an understatement I want to touch on three points related to this bill first why counties why this bill now rural Health outcomes are unique require a unique approach and add to address the social determinant of Health it requires integration of the health plan with the County Public Health and Human Services programs this collaborative coordinated and integrated work between the group between the between groups of counties and the health pla

n ensure all needs of the enroles are addressed whether that is access to local providers with the the health plan works with or it is um addressing housing food security or Transportation or any of the 40 or 50 programs that the County Public Health and Human Service Department deliver for the state of Minnesota and the federal departments yes we are in investing in our citizens in so many ways we've been doing this work for 40 years at the county level and yes we care that's why we are here we

strive for a person- centered Continuum of Care and the integration with the health plan is a large part of that Worth County based purchasing litigation I've done it I don't want to continue to be in the position to have to choose it again it is not fun it is not the way our citizens want government to work I'm convinced no one truly wins in litigation it's a waste of valuable resources let's address the issues and move forward finally this bill is outcome driven with the right people at the t

able the bill is looking at opportunities for better outcomes not focusing on barriers I applaud the recent mediation team for initi initiating the framework to build on and commissioner harpstead for supporting this endeavor we have individual counties groups of counties AMC and DHS all working over the past year to move this forward beyond that group CMS will be involved as we collectively and collabora collaboratively work through this initiative the counties State departments state legislato

rs legislator and federal agencies working collaborative collaboratively is what our constituents and our County citizens want on so many important issues we got this I'm confident this will yield positive results and build a better path forward so after a year of meeting we are here looking to you as Leaders to support this effort and take this to the next level and build for the future of rural Health Care please support this bill by initiating and embracing this the collaboration of our units

of government thank you thank you very much uh Mr Freeman please state your name for the record and begin thank you chair Wickland uh chair Hoffman and members of the committee my name is Matt Freeman I'm here to testify on behalf of the association of Minnesota counties where I serve as the Human Service po policy analyst AMC on behalf of Minnesota's 87 counties wants to urge you to support caile 3372 the county administered rural medicine medical assistance uh or Karma development Bill while

not as flashy as the Taylor Swift song Karma we think it can be very impactful uh the bill offers the opportunity to collaboratively flesh out the details of a new and improved County based model um the legislation is a result of a year-long process of collaboration as you've heard between AMC CBP plans and cooperation with Department of Human Services AMC and the County Commissioners who managed these plans are excited about working with DHS on this and we're hopeful that the final proposal wil

l really highlight and build on 40 Years of success of cbps at Innovation responsiveness transparency reinvestment in rural Health Care infrastructure increasing access to care achieving better outcomes for enroles and administering managed medical assistance in a costeffective manner amcn Commissioners know the importance of local county-based care delivery of integration with County Services and partnering with our local providers and supporting our local communities it makes for great care an

d outstanding out comes for those we serve so to quote Taylor Swift me and Karma Vibe like that and we appreciate your consideration and your support for Senate file 3372 I'm loveing that that's a great that thank you thank you Mr Freeman um uh members any questions or comments about the bill Senator aty thank you madam chair and uh I'm not going to even touch the references Taylor Swift because I can't compete um but anyhow uh just thank all involved for uh bringing this forward it's uh it's ni

ce to see that we're moving something like this in a positive direction um County based purchasing has done such a great job for us in rur Minnesota and uh they've been over the years working with a number of challenges that uh weren't really needed but at least at this point um we're see seeing a positive path forward and that's great news because they not only are involved in just the medical care or limited care they're involved in uh the total spectrum of care um so it in our rural areas it'

s uh I mean without them we would uh we'd be missing a lot so um most of it's been covered I just thank you guys for what you've been doing and uh hopefully we can find a way through I guess I did have one question for uh uh Senator hofman under the Appropriations do we know yet what uh we're looking at Senator Hoffman M Madam chair members I think the the department uh to facilitate the process there's going to be a cost for facilitators 100,000 something right I think that's that it's about $1

00,000 might be $150,000 will cost of a facilitator Madam yeah figuring out what the the cost are thank you madam chair it's uh hopefully we can find a way to get this off the table and move forward so thank you thank you any other questions or comments Senator AER thanks BR a good s the based people sorry had that off um it's a really good bill uh and it I think it will make uh quite a difference um as we try to put more gas on the fire of uh County based purchasing Madam chair I had occasion t

o go to a meeting last night and start contrast where ala is uh choosing to close a Pediatrics thing at Mercy and close the o the ICU I mean okay it's supposed to be a business decision and it's all going to be great um but they never talked to the doctors and the nurses beforehand and when they were queried on at this town hall meeting they said well did you doctors there are more doctors than nurses that came to be concerned about this where they saw the loss of of capacity wow and when uh thi

s doctor said I we never had a meeting with you and they and uh and they said well we were required to inform you uh you've been informed and so that would never happen at the county base level and so as we try to build a system and think where are we going uh particularly in the medical assistance population and Minnesota care and all that where they can get everything together that's the model we want I think and not just a get over it kind of thing which I see happening and as we get more and

more consolidation so thank you madam chair thank you any other questions or comments Senator Hoffman any M Madam chair and members the the person with the checkbook at the department is saying that I was wrong on the numbers and I think that we'll we'll figure that out um then again as long as we're informing people I wonder if if Matt Freeman came by Madam chair and and made reference to Taylor Swift because in Canon Falls in good Hugh County Nirvana was the famous band that got a picture tak

en at pader music studi one of the top 100 music studios in the in the nation and so I wonder Brad is that why you got Matt Freeman to do that but with that no in all seriousness the county based stuff Madam chair is is a good thing and I'm glad we're hearing this bill and I'm glad we're having this conversation and thank you commissioner and thank you Mr Freeman thank you uh for presenting the bill and thank you for bringing it Forward um I think it is something we need to continue having discu

ssions about you know ways to improve our our U overall health care system in the state and so I I appreciate the ideas brought forward and that the department is working with the counties and there's this this active effort going on so we will get more money or get more um information about the money needed for it before we decide on um our omnus bill so with that um Senate file 3372 is laid over for possible inclusion and next we have Senator koek Senate file 4341 Senator copek u i see that th

ere is a A1 Amendment would you like to move the A1 amendment I would Madam chair I'd move the A1 Amendment members all those in favor of the A1 Amendment please signify by saying I I any opposed the A1 amendment is adopted thank you go ahead thanks Madam chair and the A1 Amendment um while it is a delete all it is just kind of a technical fix and working with Council that was just easier to kind of do it this way so um that is why and the amendment just kind of gets in line uh after talking to

the uh Department um just some wording that they thought would clarify things so that's what the amendment goes to so uh what we have here before us incen file 40 uh 341 uh will provide resources to ensure that child care providers in Minnesota are trained to deliver quality Child Care programs and to ensure that minnesotans have the best daycare experience uh they have after listening to Providers uh they say that staff development is one of the biggest challenges uh besides the funding need uh

for wages to work and retain their quality staff so this would provide grants to those Child Care Centers to uh provide further education for their employees great and I have uh there's a testifier who is on Zoom um Nicole flick if you can state your name for the record and begin your testimony thank you my name is Nicole flick and I own abc123 child enrichment center in Dilworth and I am a leader with kids count on us on behalf of child care center directors across the state we want to thank s

enator cupc for his overwhelming support for child care and our littlest motans we are begging people to come and work in child care for little money no benefits and very long hours most of the weeks with overtime we have offered incentive after incentive to get educated people to choose our industry but they don't they choose the public school or private Nanny why higher pay benefits tuition reimbursement or forgiveness and resources for children who need help with mental social or physical dev

elopment when parents bear the burden of paying the entire cost of care the resources are few and far between in the childcare industry the pipeline for qualified teachers is extinct until this industry is treated like a career and we attract professionals we will always have a child care crisis and no qualified teachers to employ this bill is one small step to invest in our current teachers and give them an education that is not only approved by the state of Minnesota and DHS but also the abili

ty to learn the best practices for working with children in this era of mental illness PTSD from covid and children with behaviors it takes years to learn how to best cope with a classroom full of three to 5-year-olds who each have their own development developmental setback such as speech delay fine motor large motor or developmental delays the average length of employment at my Center is 4 months why not not enough education or resources on how to handle the severe behaviors of the children in

their care the CDA which is a Child Development Associate credential is a method that teachers can become leader lead teachers in a classroom without a college degree it includes 120 hours of training in classes the completion of a professional portfolio work with a trainer learning or trainer or learning coordinator to get Hands-On feedback in addition to a final exam hiring qualified staff who are educated to perform the critical tasks of child care is increasingly difficult and expensive it'

s the number one reason for weight lists in centers we simply do not have enough trained and well-compensated staff to provide care and learning cdas do not have standard costs but generally are in the range of $1,000 per teacher with possible additional expenses and ongoing cost to renew the credential while this may seem inexpensive in a field where the operating margins are extremely low cdas are actually very costly and are being borne by the providers and sometimes teachers themselves here'

s a snapshot of the numbers from three different providers last year I spent $3,700 to help staff cover CDA costs another provider in the Metro has six staff paying right now to get all their cdas at cost of families of $1,000 per person when you include the testing once they have their CDA it needs to be renewed every other year at also at a cost another provider in the Metro includes staff who do not speak English as their first language and are required to do additional classes to get their c

das and they need interpreters that cost $35 an hour that provider has spent over $20,000 to get teachers their cdas grant money to pay these costs would enable us to save the money we are currently spending on this to be used for our kids and families as you can tell the per person cost to help fund this is a small investment from the state but a big deal for teachers and providers even a modest investment from the state will come with significant returns for the staff and the children they tea

ch and care for every day it is with great certainty that I recommend this bill to be passed and money appropriated in the hopes of making the child care industry a career and furthermore not making parents pay for this via higher tuition with already outrageous child care cost I appreciate your time thank you you thank you very much Miss flick I really appreciate you're taking time out of your day to to U present your testimony um Senator koek I think that that there's another resource in the r

oom if we have questions um but members do you have any questions about the bill Senator atkey thank you madam chair and uh just a question Senator cek on the amendment because when with the bill the original statute that it affected was uh it covered both center-based and uh family child carees in home child care and now the new section seems to be more school age um just kind of wondering the thought process there because it seems like a lot of our shortages is with the younger children findin

g a place for the from the basic babies up through three-year-old um and this now is moving that to the older kids maybe we can uh draw on our resource um Ann McCully is here um Miss McCully if you could state your name for the record and answer the question thank you good morning uh chair Wickland and Senator um utki my name is Ann McCully and I'm with childcare Weare of Minnesota we are the implementers of what's currently the CDA scholarship program Senator I don't think it changes the age gr

oup what it the original bill was drafted to go out through the regional child care resource and referral or Child Care aware agencies and this particular grant program is funel just through one agency which is our office but it's still we currently do fund both centers and family child care programs and funding infants and toddlers all the way up through prek so I don't know why the reference necessarily says school age but it's it's the it's the statute that allows this funding to pass through

to that program and maybe somebody from the Department can answer better than that but senatori thank you madam chair and then uh just one final question uh we all fully realize we've need all the help we can get uh for additional child care um what type of it's still got an open appropriation what is the targeted amount or the hopeful amount for this bill Senator cek do you have um any estimate or is this a scalable proposal it's scalable and I think I you know um in the realization of you kno

w that this is not a budget year I think it was kind of left open for discussion so I can just give one piece of context which is that the current program is funded with Federal childcare Development Fund uh money and we spend about only about 40,000 a year so it could definitely use more but it is scalable in the infrastructure so you were so kind last year as to pass funding for both the teach Early Learning scholarships and the retain grants the CDA scholar ships come out of the same group of

people so we've got the infrastructure to hit the ground running it's just the the dollars to be able to support more providers like Miss fck thank you Senator thanks any other questions um I don't see any um thank you for that information um it does seem like a really critical need um we if providers are not making salaries where they are going to go out on their own and and um gain additional skills that their own cost um which doesn't make sense um I really think you know this type of Bill w

here we could help more people attain those uh credentials would be really worthwhile so thank you um any other thoughts Senator CC before we lay the bill over sure Madam chair I would just say it's uh just one more little just tiny piece in the whole puzzle of uh trying to you know get adequate Child Care funding for the state of Minnesota thank you thank you and uh with that uh Senate file 4341 as amended is laid over for possible inclusion thank you and then Senator koek you have Senate file

4390 yes thank you madam chair we'll shift uh shift gears here a little bit this uh has to do with uh technology uh for our counties so uh as you know last year we uh we did a whole lot to help improve um the technology at the state level for DHS uh for a lot of their programs I remember sitting here uh listening to testimony about um the program was 1991 that was being masked with a gooey um so so we provided some money to help uh upgrade that but uh that also has to trickle then down uh certai

nly down to the uh county level as well so our current Human Services uh Information Technology complex uh is somewhat fragmented and and burdensome too often it prevents outcomes of Minnesota's need for their critical Human Services Program uh unfortunately modernization efforts have not kept up with that rapid changing technology uh and as I mentioned the last session we provided a lot of money this file Senate file 4390 as a natural next step to the DHS Service delivery transformation we fund

ed last year article one would provide $5 million to cover County cost uh of aligning with new St systems and require the state to develop a framework that offsets those County costs for the implementation of future it or Service delivery article two allocates $50 million in one-time funding for counties to modernize their technology platforms and encourage collaborative projects uh understand these are big numbers to be throwing around in a year that is uh not much funding available but I hope

uh this hearing at least will shed some light on that and also U provide in the context too that a lot of when I talk to you know the people who are out doing the work um a lot of the part that they find the most frustrating is the paperwork part of it and if we can improve the technology to allow them to make that part of the job easier um it is a big reason that they go uh I've had enough I just want to help people I don't want to fill out paperwork so uh if we can streamline that in any way s

hape or form I think that's a good step forward thank you and welcome to the committee if you can uh please state your name for the record and begin your your testimony thank you chairman W luckland and um members of this committee I am Jody Brennan I am Scott County Commissioner I'm also uh the mother of an adult who receiv receives Services um so I know um both sides of this um and and both the public and private um privately um so um uh on behalf of the association of Minnesota counties I'm p

leased to be here to testify in support of Senate file 43 390 which you as heard from Senator cic would make critical investment in County technology systems I want to stress that this request does not reflect nice to haves updates nice to have updates for the counties these resources are needed to bring County programs up to a basic level level of operability County it modernization has been identified as a top priority for the association of Minnesota counties because that touches on some of t

he most critical issues facing counties today Chief among those is Workforce requiring County Employees to navigate green screens and manually enter data for hours does not lead to high satisfaction or retention rates for individuals who have studied and whose passions in working directly with Children and Families recruiting our next generation of Workforce becomes even more difficult when our techn Technologies systems predate the birth of our new workers even more importantly these outdated s

ystems created a cumbersome and inflexible experience that is simply incompatible with how families indivi indiv individuals live their lives asking individuals or in my case myself to fill out separate multi-page forms for duplicate information for SNAP housing assistant health care and child care all become because their live they live on different technology platforms when the rest of the world can autofill by to buy a car rent an apartment or pair of shoes it just seems that there's no bette

r way there there has to be a better way finally County workers spend hours entering information on children individuals and families why is this in theory it is so that we as elected officials can analyze an effective effectiveness of programs and feel confident in our investments um I'm preparing for this for coming here today I asked my staff um how many people that we serve and that information which you would think would be very basic was actually very difficult to obtain because different

different systems had to go in they had to go into and figure out how many people they had duplicated throughout those systems so a real comprehensive easy answer was very difficult to get um many counties if they are able have developed their own way to work around this Scott County invests millions of dollars in staff training document management software and other Last Mile solutions to try to give consumers and workers the best experience possible this legislature um has made significant inv

estments in state level technology modernization for Human Services System however counties cannot access these funds counties and individuals we serve need State investment to create a Level Playing Field for All Counties and to be able to serve people better create reliable data sources for lawmakers to evaluate programs and better protect the data for all motans thank you so much for your time this morning and consideration of this vital issue thank you very much and Mr Jensen if you can um s

tate your name for the record and again your testimony thank you uh Madam chair thank you uh Senators uh my name is Dan Jensen I'm the associate director for County family support and assistance thank you for the opportunity to testify in support of SF 4390 on behalf of the association of Minnesota counties the Minnesota Association of County Social Service administrators the Minnesota Intercounty Association and Olstead County collectively these organizations recognize that modern ing State Tec

hnology and developing local systems are a top priority in order to support our Workforce and the people we serve while we had a similar legislative priority last year we chose as counties to focus on supporting the and advocating for the $200 million investment that was made in state level it systems for that we thank you as a tri chair of Max's modernization committee the Human Service it alignment group co-founder um and past year of M C's Human Service user group we have used these platforms

to strengthen our Partnerships with dhes and collectively we are emphasizing a person centered approach to systems modernization unfortunately along with the state software needing modernizations counties lack several core systems and that results in a significant imbalance between what's happening at the state and the last mile of Service delivery at the local level counties um lack systems that coordinate cross program services this the most simplest what's an unduplicated client count what's

the average number of uh cases or programs our clients are on how long have they been on our programs what's the first program they come into what are the outcomes we can't answer those basic questions because of how our systems are designed and set up at this point we um also lack the ability to communicate effective ly using modern um approaches with our clients coordinate we can't coordinate inbound applications and we can't measure the service impact and Effectiveness and as you heard last

year's funding while it was a great step forward cannot be used to address these County needs there is a handout in your pack packet showing the technologies that are County operated and County funding exacerbating the state to count imbalance is a county to count digital disparity individual County develop tools we share them but it's really difficult to implement them because of the differences in our in our systems in our local systems our local um security and the software we use all of thos

e things make that very difficult to develop something in one County and then share that and re uh redeploy that in another County this funding will assist us in executing several multi-county projects that are in design and even some that are shovel ready um but lack funding to execute in conclusion we recognize that state resources are limited however modest onetime investments will make the difference to reduce the state to count imbalance and Bridge the county to count digital disparity and

create that Foundation that we can start to begin off to build off of thank you for your time thank you very much for your testimony and thank you for the the handout I think it really does illustrate the complexity of what the counties are dealing with um uh members do you have any questions comments Senator abler well thanks uh Madam chair and Senator kopac and to the testifiers it's this is a really a a big need um just I have advice if you're I if you're going to find this kind of money I yo

ur target doesn't seem quite that big but um if Senator kupek if you keep beating this uh drum when I hope you do um I think the language needs to be clarified a bit this gives a with all respect to the department it doesn't discuss uh what they're going to what their percentage would be to administer this how complex it would be uh and I would suggest if you're going to bring this forward that you tell them what you would like and I don't think they'll mind that um so if you give a formula and

then out it goes with much less stuff otherwise you have rfps delays for any amount of time and and all it does is aggravate both the department and the people as they're waiting for the money to go out and so um you know you could decide if you wanted bigger counties get more there's a certain B like what's what's worked well in the past is is like a base amount that some little County go like w that's a lot of money and a big County goes like really uh and then you you do this little base amou

nt a per capita or something but you're on the track this has to get done um and so good luck on that thank you madam chair thank you Senator e any other comments um yeah I'll I'll just add I I mean I think it is essential that we really helping children and families so um I appreciate you bring bringing the bill forward and we'll continue to look at it um see if there's any possible way this year but um hopefully you'll keep working on it too so we can um keep keep it moving forward so thank yo

u again for um Coming to testify any other comments any other final thoughts sen thanks thanks Madam chair thanks committee it is not uh certainly not a a super glamorous issue but um I think he gets at the base of you know where all our workers out in the field uh what we could do to make their lives easier and modernize things um and get also data that we need uh it's crucial so thank you right thank you and with that um Senate file 4390 is laid over for possible inclusion thank thanks for and

with that members we've reached the end of our agenda and we are adjourned thank you [Music]