Thread by @uptakemn

Now tweeting House Human Services Finance and Policy Committee meeting (meeting began at 10:30am).

Roll call taken. Quorum present.

Chair Rep. Jennifer Schultz DFL - we'll hear 3 bills today, all health related. Our goal is to get them through here into the Health Finance committee, we'll have brief discussion today and move them on as Health finance is committee of their jurisdiction.

House File 2461 - Commissioner of human service allowed to enter into value-based purchasing arrangements with drug manufacturers.

Rep Robert Bierman DFL (bill author)

Rep Bierman- As we move toward access of quality and affordability of healthcare, we need to be innovative. It's an exciting time in healthcare but our current models for reimbursement are out of date.

Bierman - HF2461 allow DHS to create sustainable approach to financing and reimbursement for gene and cell therapies. Alternative financing approaches via outcomes based payments over time will allow DHS to realize potential of cost offsets over time.

Value based outcomes will hold manufacturers accountable to patient outcomes. Some language still being worked on with DHS but I ask for this committee's discussion.

Chair - for the record, I am moving this bill to the Health Finance and policy committee.

Rep Tony Albright (R) - Does MA cover gene therapies today? What are the costs to the state? Is DHS anticipate there'll be savings through value based purhcasing?

Chad Hope - Dept of Human Services , Deputy Director of Purchasing. Yes we do cover gene therapies. Can't disclose cost b/c of federal law.

Rep Albright (R) - How do we know if we're generating savings if we don't know the costs?

Chad Hope, Dept of Human Services (DHS) - we're working on that point. We suggest bill language be added that any values based purchasing agreement captures *at least* current costs or savings.

Rep Albright - The majority party in the House has been calling for an end for managed care for the state's drug benefit. How will your bill interact with managed care? Compliment or conflict?

Chair - That's not the bill before us but I'll give latitude to Rep Albright.

Rep Bierman - bill author - Good and big question. I come to this bill from pov of trying to reduce costs of pharmaceuticals, and any way I can help manage that. Creating more beneficial deal for us, drug best pricing.

Part of that is getting the legislature to understand the drug pricing we're actually paying so whatever we can do as a body to further that, I look for allies. Managed care, we can't change or impact things we don't know.

(A barrier is that the) Legislature can't know what these costs are -- we need to get around that and get a better handle on how to deal with these programs, our whole healthcare system of program after program based on individual need and not holistic approach. -Rep Bierman

I'm willing to work with you or any member to resolve the high costs of pharmaceuticals in MN. #hf2461

Rep Robbins (R) - I want to work with you on this. Many unanswered questions but I agree this is an important topic and bill.

Chair renews motion to renew HF 2461, votes being taken now.

11 ayes, 8 nos for HF 2461, motion prevails. It's on its way to Health and Finance Policy committee.

Now HF 2676 (another health bill) being moved to refer to Health Finance and Policy Committee by author Rep Fischer DFL.
Mobile nurse clinic in rural and urban areas funding provided, and money appropriated. For underserved communities to help address needs+ reduce costs, bring

healthcare to communities not receiving in ways they need. #hf2676

Kathleen Bartholomew, Registered Nurse now testifying.

Rural areas are feeling abandoned after nonprofit hospitals are pulling out, underserved. Mobile nurse-led clinics will also help address the healthcare provider shortage. Nurses have been trained in holistic approach.

Rep Debra Kiel (R) - I come from rural. How would this work w public health working in same regions? How would we manage when we already have public health nurses entering houses and families that need direct care? Most of the time directed by the county but also school district?

Bartholomew - This augments what public health is already doing, not replacing. There's always been a gap btwn public health + nursing. The Dept of Health would help us identify areas they want us to go to being underserved. Nurse practitioners can also provide primary care.

Rep Kiel - I've had exposure to this alternative care and have concerns how we're going to do this. I'd still encourage people to work within the physician realm. We're already having challenges with finding nurses, I think this would create a problem in our area.

Bartholomew - our clinics will be supported also with students. Nurses can address many issues. They can send the patients. We'll also work closely with the University which has also had a historical disconnect.

Rep Albright (R) - You're asking for government to declare a healthcare republic utility and then expand the role of nurses. It seems healthcare will be run by state-based regional councils, adding a layer of bureaucracy that would tend towards a govt provided healthcare system.

Bartholomew - healthcare is like a train headed the wrong direction, illness and disease. Over 40% deal with chronic disease. You can't stop the train, it's too large, entrenched, hierarchical. How do we switch to prevention? Create switch tracks.

by creating primary care to make sure every American has a primary care doctor or nurse practitioner. That's our goal. Those nurses are trained to look at the social determinants of health. We want to switch the tracks to focus on prevention and wellness.

Chair renews Rep Fischer's motion to refer HF 2676 to Health Finance committee. Roll being taken.

11 ayes, 8 nays. Motion prevails and #HF2676 on its way to Health Finance and Policy committee.

Now Chair moves for HF 3368 to be referred to Health Finance committee.

Author - Rep Rena Moran (DFL)

Rep Moran - 1/2 of Black workers in MN were laid off during pandemic and applied for unemployment. For whites it was 25%. Women of color especially hit hard.

Unemployment for Black workers still remained high at 10%, for whites 5%.

Trauma, affects us based on our experiences.

Rep Moran - We'd like to focus on wellness and healing from traumas and shootings in St. Paul, create peace in Twin Cities. HF3368 called "Guns Down Love Up" focuses on restorative practices and prevention in Black community. Creates programs for healing.

and prevents future retaliation. Works w/ families, communities, and religious organizations to promote the message of ending gun violence and promoting love. Requests $800,000 over 5 years

Rep Albright - How has this organization been funded prior and organizational structure?

Rep Moran - Organization has been around since 2018. The goal is to decrease gun violence in MN and Twin Cities through media messaging, conflict resolution activities with community, and educate community on traumas of gun violence on our community and quality of life in MN.

Budget is broken down in a 5-year plan. A youth gun violence conference, in school peer communication. School and community is connected. Community healing center and engagement/outreach.

Rep Novotny - where does this stand on 2nd amendment rights?

Rep Moran - has nothing to do with 2nd amendment rights and the right to carry. There are many in the Black committee who are permit holders and support it.

Rep Novotny - What is the current annual budget of this organization and current # of people they;re serving now?

Rep Moran - I can do a follow up, don't have this info on me right now.

HF3368 motion prevails and bill is on its way to Health Finance policy committee.

HF 3159 - Author is Rep Athena Hollins DFL.

Chair: To be referred to Judiciary Finance committee as amended.

Rep Hollins - 3159: permanency disposition law purpose modified when child can't be placed w/parents.

Hannah Burton - Institute to Transfer Child Protection. Under current law when court decides a child can't return home, there's a preference for terminating parental rights and creates a barrier such as permanent transfer of custody to relative or kin.

Children of color are more likely to have their parents rights be terminated but also less likely to be adopted than white children = more children of color in foster care.

This bill preserves and expands a childs circle of support rather than defaulting to dissolving their already existing family/friend relationships. This bill would require permanency options to relatives before non relatives.

Michelle Chalmers - Cofounder of Ampersand Families now testifying

Rep Albright - are there times when placement with relatives is not best for child?

Burton (testifier) - Yes there are, that's why we say "best interest for the child."

Rep Liebling asks question about how the money follows the child.

Burton: 10 or more states state in their court policies for preference of placement with their relatives/kin.

Roll call taken and motion prevails. HF3159 as amended will move on to Judiciary Finance and Civil Law committee.

HF 2820 - motion is to lay over for possible inclusion in Human Services and Finance omnibus bill.

Authored by Rep Jeff Backer (R) - to build an intermediate care facility for adults. They receive lowest imbursement in the state

Stacey Karels testifying - program director of Monarch Heights. Facility for adults with disabilities, lowest funded well below the state average. Will allow our residents to thrive and not just survive. Building maintenance and repairs. Updates. Recreational activities.

Rep. Backer (R) closing remarks on HF 2820: what they're asking for is below the state average. They do a lot with less.

Chair lays bill over for possible inclusion in human services omnibus bill. Meeting adjourned.