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Committee on Health and Human Services- 01/11/23

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Read Time:57 Minute, 44 Second

♪ ♪ >> STARTED WITH >> PROVIDED BY OUR SENATE FISCAL STAFF AND THEN WE WILL GO TO AN OVERVIEW FROM THE MINNESOTA DEPARTMENT OF HEALTH. I'M THAT WE WOULD DIVIDE IT ABOUT APPROXIMATELY 45 MINUTES FOR IF PEOPLE HAVE QUESTIONS. I DON'T KNOW IF YOU WOULD LIKE TO TAKE QUESTIONS RIGHT AS WE MISTER, BACK TO HER. DO YOU WANT PEOPLE TO HOLD THEM? UNTIL YOU GET THROUGH? LIKE, FOR EXAMPLE, THE FIRST SECTION ABOUT DHS. >> MADAM CHAIR AND MEMBERS, I THINK QUESTIONS ALONG THE WAY WOULD BE OK, I DID LOOK AT THE PRESENTATION FROM THE DEPARTMENT OF HEALTH AND THEY HAVE A LOT OF THE INFORMATION THAT WE SO GO THROUGH THEIR PART PRETTY QUICKLY.

AND I THINK THEY A FOCUS ON PUBLIC HEALTH THAT WE DON'T I I MY INTENTION IS TO TRY AND NOT TAKE UP HALF OF THE TIME. THANK ALL RIGHT. WE HAVE YOU PROCEED HIM. >> GO AHEAD BEGIN YOUR PRESENTATION. OKAY. MADAM CHAIR AND MEMBERS, MY NAME IS FACT. I AM THE FISCAL ANALYST. THAT THIS COMMITTEE, THE HEALTH AND HUMAN SERVICES COMMITTEE. AS YOU KNOW, THE SENATE HAS DIVIDED THE BUDGET JURISDICTION OF HEALTH AND HUMAN SERVICES BETWEEN 2 COMMITTEES AND THIS YEAR WE HAVE A NEW FISCAL ANALYSTS, KYLE RAYMOND SITTING NEXT TO ME. THIS IS HIS FIRST YEAR AND OUR FIRST YEAR THESE COMMITTEES WITH 2 FISCAL ANALYSTS. I WAS HERE TODAY TO HELP ME OUT INTO IT, YOU KNOW, TO BE HAVE SOME EXPOSURE TO TO YOU ALL. BUT HE WON'T ALWAYS BE HERE IN THIS COMMITTEE. THIS IS A BUDGET OVERVIEW. THERE'S A LOT OF INFORMATION IS A VERY LARGE BUDGET AND IS COMPLEX AND HAS LOTS AND LOTS OF PROGRAMS IN IT. THESE ARE WHAT WE'RE GOING TO PRESENT. YOU ARE WHAT YOU COULD THINK OF THOSE HIGHLIGHTS. AND MAJOR IN THIS BUDGET, BUT IS BY NO MEANS MEANT THE EVERYTHING THAT YOU COULD POSSIBLY EVER KNOW.

THERE'S LOTS MORE DETAIL AND OTHER DOCUMENTS THAT ARE AVAILABLE TO YOU. THE AGENCY BUDGET BOOKS AND I KNOW THE AGENCIES ARE GOING TO BE FOLLOWING TODAY, THE DEPARTMENT OF HEALTH AND THAT NEXT WEEK, I THINK THE DEPARTMENT OF HUMAN SERVICES AND THEY WILL BE PROVIDING MORE DETAIL THAN WE ARE INTO THAT SPECIFIC ACTIVITIES. AND SOMETIMES INTO THAT SPECIFIC FUNDING MECHANISMS OF THE ACTIVITIES IN THEIR RESPECTIVE AGENCIES. IF WE GO THE NEXT LINE. THIS IS A LIST OF ALL OF THE THAT ARE IN THE OVERALL HEALTH AND HUMAN SERVICES JURISDICTION. THESE ARE NOT ALL IN THIS COMMITTEE AND WE'LL GET THAT IN A MINUTE TO HOW THEY ARE BROKEN OUT BETWEEN THE 2 SENATE COMMITTEES. BUT THIS IS HISTORICALLY WHAT HAS BEEN IN THE JURISDICTION OF THE HEALTH AND HUMAN SERVICES COMMITTEES IN THE SENATE. ON THE NEXT WE HAVE BROKEN THEM DOWN THE ACTIVITIES THIS COMMITTEE, THE HEALTH AND HUMAN SERVICES COMMITTEE AND SEN HOFFMAN'S COMMITTEE, THE HUMAN SERVICES COMMITTEE.

ONE WAY TO THINK ABOUT IT IS SENATOR COMMITTEE HAS EVERYTHING RELATED TO LONG-TERM CARE. THIS COMMITTEE HAS EVERYTHING YOU KNOW, YOU CAN SEE THERE WITH THIS COMMITTEE HAS A CENTRAL OPPOSITE. DH HAS THAT HEALTH CARE PORTION OF MEDICAL ASSISTANCE HAS THE MENTAL HEALTH QUESTION OF BEHAVIORAL HEALTH HAS ALL OF THE ECONOMIC ASSISTANCE PROGRAMS AT DHS, WHICH THERE ARE MANY SO THAT ONE POINT FIT PROGRAM. THE CHILD CARE ASSISTANCE PROGRAM, THE GENERAL ASSISTANCE PROGRAM, THE MINNESOTA SUPPLEMENTAL AID PROGRAM, HOUSING SUPPORT AND NORTHSTAR CARE, WHICH IS ADOPTION.

KINSHIP CARE. THOSE PROGRAMS ARE ALL BUT RELATIVE TO THE MA PROGRAM, THEY'RE QUITE FRANKLY, A SIGNIFICANT PORTION OF THE IN THIS BUDGET AREA. AND IN THIS COMMITTEE. THE OTHER AGENCIES. FOR THIS THEY ARE THE EMERGENCY MEDICAL SERVICES REGULATORY BOARD. >> PEART PERSON FOR FAMILIES, THE EMBERS PERSON FOR AMERICAN INDIAN FAMILIES AND THE OMBUDSPERSON FOR FOSTER YOUTH AND THE OTHER AGENCIES. AND SENATOR HOFFMAN'S COMMITTEE. ALL RIGHT. THE COUNCIL ON DISABILITY BUT IT'S MEANT FOR MENTAL HEALTH AND DEVELOPMENTAL DISABILITIES.

THE NEXT SLIDE SOS THE OFFENSE FOR ALL OF HEALTH AND HUMAN SERVICES. THIS IS ONE OF THE ONLY TIMES YOU'LL EVER SEE THAT 51.5 BILLION DOLLAR NUMBER. MUCH OF THE WORK OF THE LEGISLATURE IS FOCUSED ON THE GENERAL FUND, THE BUDGET DISCUSSION IS LARGELY ABOUT THE GENERAL FUND. SOME OF THESE FUNDS ICED WHAT WE CALL STATUTILY APPROPRIATED. SO THEY'RE NOT REALLY PART OF THE BUDGET DISCUSSION THERE. JUST APPROPRIATIONS TO THE AGEN'S FOR A VARIETY ACTIVITIES. AND YOU CAN SEE ON THE FIRST SIGN THERE TT THE GENERAL FUND IS35% 34.6% THE AHL FUND SPENDG. SO IT'S AN IMRTANT PART,BUT IT SMALLER THAN WHAIS NOWTHE 57.5% THE BUDGET THAT COMES FROTHE FEDERAL GORNMENT FOR A VAETY OF PROGRS. E MOST SUBSTANTIAOF THOSE BEINGHE THE MEDICAL ASSIANCE PROGRAM. A YOU CAN SEE AT THE VERY T THERE ALLUNDS. BUDG IS 49.2% OF T ENTIRE STATE, ALLUNDS BUDGET.

M E NEXT SLIDE WE TAKIN THIS SAMENFORMATION AND DIVIDED IT THIS COMMIEE AND THE SENATERE HOFFMAN' COITTEE. AND U CAN EE THAT OF THATTOL. 51 BILLION DOLLAR THIS COMMITTEHAS 27.0. 8 BIION A THE HUMAN SEICES COMMITTEEAS 23.7 BILLION. THIS SLIDE IS MONG WHAT E THE MAJOR PRRAMS AND ACTIVIES AND THE JURIICTION OF HEAL AND HUMAN RVICES. OBOUSLY, HEALTH CARE THE FIRST ONE.ND THAT'S THE LARGE ONE AND WILL PROBLY BE THETHE PRIMARY THG THAT IS TALKED ABOUT NEXTOULD BE ECOMIC SUPPORT PROGRA, CHD, LFARE, AND PRECTION OF VULNERABLEADULTS, DICT CARE AND TRTMENT, WHICH IPART OF SENATOR HEZ COMMITT. MANY AGENCS IN THIS JURIICTION LICENSE EHER PROVIDERS FACILITIES D THDEPARTMENTF HEALTH AMONG MANY OTHER THIN IS RESPONSIBLE R PUBLIC HEALT ANDISEASE ANMONITORING. THE NEXT SHS HOW THE GERAL FUND TO 17.8 BILLI DOLLAR GENERAL FUND BUDGET. WHICH 33% THE STATE'S GERAL FUND BUDGET. HOW IT IS ALLOCATED AMONG THE AGENCIES AND THIS JURISDICTION. IMPORTANTLY. 98% OF THE BUDGET. FOR THIS COMMITTEE IS FOR THE DEPARTMENT OF HUMAN SERVICES ARE FOR THIS JURISDICTION.

I SHOULD SAY. IT EVERYTHING AND THE JURISDICTION. AND NOT NECESSARILY IN WORK. A LARGE PART OF THAT AGAIN IS BECAUSE OF THE MEDICAL ASSISTANCE PROGRAM. AND THEN AFTER THAT, OF COURSE, IS THE DEPARTMENT OF HEALTH, WHICH IS ABOUT 317 MILLION DOLLARS FROM THE GENERAL FUND. I WILL SAY THAT OF THAT THAT 17.5 BILLION DOLLARS AND THE DEPARTMENT OF HUMAN SERVICES, 79% OF THAT BUDGET IS THE MA PROGRAM. AND THIS NEXT AGAIN SHOWS HOW THE GENERAL FUND IS DIVIDED BETWEEN.

THE 2 COMMITTEES. WITH THIS COMMITTEE HAVING 6.1 BILLION DOLLARS. AND SENATOR COMMITTEE HAVING A 11.7 BILLION. I'M THE NEXT LINE. THIS IS FOCUSING ON THE DEPARTMENT OF HUMAN SERVICES AND SOME OF THE MAJOR PROGRAMS THAT ARE THERE. OF COURSE, AGAIN, THE FIRST ONE IS THE MEDICAL ASSISTANCE PROGRAM, WHICH HAS A BASIC HEALTHCARE COMPONENT. IT FUNDS NURSING FACILITIES AND IT FUNDS WAIVER SERVICES FOR DISABLED INDIVIDUALS UNDER BASIC HEALTHCARE. THERE FAMILIES WITH CHILDREN. THERE ARE SINGLE ADULTS AND THERE ARE ELDERLY AND DISABLED PEOPLE. MINNESOTA CARE THE STATE'S BASIC HEALTH PROGRAM IS FOR INDIVIDUALS WITH INCOME UP TO 200% OF POVERTY GUIDELINE. THE. I AM FIT PROGRAM IS MINNESOTA'S TANNER PROGRAM, WHICH IS THAT TYPICALLY REFERRED TO, AS YOU THE STATE'S CASH ASSISTANCE WELFARE PROGRAM. KAREN TREATMENT PROVIDES A VARIETY OF SERVICES TO CIVILLY COMMITTED INDIVIDUALS. BEHAVIORAL HEALTH INCLUDES MENTAL HEALTH SERVICES AND SUBSTANCE USE DISORDER SERVICES AND THE DEPARTMENT OF HUMAN SERVICES. AS ALSO A RESPONSIBLE FOR CHILD WELFARE. ALONG ALL THE VAST MAJORITY OF PROGRAMS AT THE DEPARTMENT OF HUMAN SERVICES ARE COUNTY ADMINISTERED. STATE-RUN COUNTY ADMINISTERED.

THIS I THINK, IS ONE OF THE MORE IMPORTANT AND PRESENTATION BECAUSE IT IS THE PERSPECTIVE OF THE SIZE OF THE BUDGET, THE PROPORTION OF THE BUDGET THAT IS ALLOCATED TO PROGRAMS THAT SERVE ELDERLY AND DISABLED INDIVIDUALS. IT'S TWO-THIRDS OF THE DEPARTMENT'S BUDGET. FOLLOWED ANOTHER 23% FOR BASIC HEALTH CARE AND CHEMICAL DEPENDENCY. AND THEN YOU CAN SEE THERE YOU KNOW, THE RELATIVES AMOUNTS THAT GO WITH SOME OF THOSE ACTIVITIES WITHIN THE DEPARTMENT OF HUMAN SERVICES. NEXT SLIDE. WE'RE GOING TO TALK A LITTLE BIT ABOUT THE MEDICAL ASSISTANCE PROGRAM. THIS IS A MINNESOTA'S MEDICAID PROGRAM >> IT IS A FEDERAL AND STATE PARTNERSHIP PROGRAM. IT'S AN ENTITLED MEANT PROGRAM FROM THE GOVERNMENT'S PERSPECTIVE AND FROM THE STATE'S PERSPECTIVE, THAT MEANS THAT IF YOU MEET THE ELIGIBILITY REQUIREMENTS, YOU ARE ELIGIBLE TO RECEIVE SERVICES THROUGH THE PROGRAM.

>> WE DO RECEIVE FEDERAL MATCHING IN THE MEDICAL ASSISTANCE PROGRAM AND THE AMOUNT OF THAT FEDERAL MATCH DEPENDS ON WHICH ELIGIBILITY CATEGORY. THE INDIVIDUAL IS IN. ELIGIBLE POPULATIONS ARE LOW INCOME PEOPLE AND FAMILIES AND ELDERLY AND DISABLED PEOPLE. THERE ARE FEDERAL REQUIREMENTS FOR ELIGIBILITY AND THE BENEFITS ET BUT THE STATES ARE ALLOWED TO EXPAND SERVICES AND MINNESOTA DOES INCLUDE A NUMBER OF SERVICES. >> THAT ARE THE FEDERAL MINIMUM REQUIREMENTS. >> THIS SIDE, THE NEXT IS INTENDED TO PUT THE MA PROGRAM AND ITS SPENDING IN PERSPECTIVE. WITH RESPECT TO THE DIFFERENT ELIGIBILITY CATEGORIES. SO ON THE LEFT-HAND SIDE. THE EXPENDITURES AND I KNOW RIGHT HAND SIDE ARE THE NUMBER OF RECIPIENTS AN AVERAGE MONTH. YOU CAN SEE THAT THOSE SORT OF AN INVERSE RELATIONSHIP BETWEEN THE NUMBER OF PEOPLE AND HOW COSTLY THEY ARE. SO THE ELDERLY AND DISABLED PEOPLE HAVEN'T OFTEN ZALICH A SNOW. 20 TO 23 BILLION DOLLARS. AN 11 BILLION DOLLAR.

SO GENERAL FUND CONTRIBUTION AND THERE ARE 200,000 OF THOSE FOLKS ON THE OTHER SIDE OF THAT CHART ARE FAMILIES WITH CHILDREN WHO ARE 800,000. RECIPIENTS WHAT THE COST OF ABOUT 8 BILLION DOLLARS AND, YOU KNOW, THE 2 4 BILLION OF THAT COMING FROM THE GENERAL FUND. IN THE MIDDLE. ARE WITHOUT THERE ARE ABOUT 250,000 OF THOSE INDIVIDUALS >> THEY ARE PRIMARILY FUNDED FEDERAL FUNDING. THAT IS A 90% FEDERAL MATCH 90% FEDERAL 10% STATE. >> ON THE NEXT SLIDE IS MINNESOTA CARE. ON THE RIGHT HAND YOU CAN SEE THE FUNDING STREAMS FOR MINNESOTA CARE AND IS CURRENTLY LARGELY A FEDERALLY FUNDED PROGRAM. >> WITH 89% OF THE BUDGET COMING FROM FEDERAL RESOURCES. MINNESOTA CARE PROVIDES COVERAGE TO PEOPLE WHO DON'T HAVE ACCESS TO AFFORDABLE COVERAGE. THEY NEED TO MEET THE INCOME GUIDELINES, WHICH AS I SAID EARLIER IS UP TO 200% OF THE FEDERAL POVERTY GUIDELINE. IF A PERSON IS ELIGIBLE FOR MEDICAL ASSISTANCE, THEY HAVE TO GO TO MEDICAL ASSISTANCE. IF THEY ARE, THEY CAN'T GO TO MINNESOTA CARE. THERE ARE PREMIUMS IN MINNESOTA CARE AND THEY'RE EXPECTED TO BE ABOUT AND ALL PARTICIPANTS EACH MONTH.

IT'S A 1.3 BILLION DOLLAR PROGRAM. AND 1.2 BILLION OF THAT COMES FROM THE FEDERAL FUND. FEDERAL FUNDING IS BASED TAX CREDITS. SO WITH THE STATE IF WE DIDN'T HAVE MINNESOTA, CAN THESE FOLKS WOULD GO AND TO THE PRIVATE MARKET AND THEY WOULD A PLAN ENSURE AND THEY WOULD RECEIVE A TAX CREDIT FOR THAT. BECAUSE WE HAVE MINNESOTA CARE OF THOSE INDIVIDUALS. IF THEY'RE ELIGIBLE HAVE TO GO INTO MINNESOTA CARE AND THE STATE RECEIVES 95% OF THE VALUE OF 2. THE TAX CREDITS THAT THE PERSON WOULD HAVE RECEIVED HAD THEY PURCHASED THEIR 2 MEN.

SURE, WHICH IS OUR STATE-BASED EXCHANGE UNDER. THE AFFORDABLE CARE ACT. NEXT SLIDE AS OFTEN REFERRED TO AS FIT PROGRAM, THE MINNESOTA FAMILY INVESTMENT PROGRAM. THIS IS THE STATE'S 10 OF PROGRAM. IT INCLUDES WHAT IS REFERRED TO AS A DIVERSIONARY WORK PROGRAM. IT PROVIDES A JOB COUNSELING, CASH ASSISTANCE AND FOOD ASSISTANCE TO ELIGIBLE FAMILIES. THERE IS A 16 MONTH LIFETIME LIMIT. THAT IS A FEDERAL REQUIREMENT FOR THE PROGRAM. AND CURRENTLY THERE ARE ABOUT 26,000 HOUSEHOLDS IN ANY GIVEN MONTH. THIS IS ALSO A PROGRAM THAT A FUNDED BY THE FEDERAL BOTH THROUGH THE TOWN THE FEDERAL TOWN, A PROGRAM WHICH IS REFERRED TO THE FEDERAL TOWN OF FUN UP THERE AND ALSO OTHER. STREAMS OF FEDERAL MONEY. THE GENERAL FUND PORTION IS ABOUT 27 AND A HALF PERCENT OF THE TOTAL. THE NEXT FOCUSES ON MENTAL HEALTH FANS. THIS IS LARGELY A STATE FUNDED ON THE ORDER OF THINGS WITHIN THE DEPARTMENT OF HUMAN SERVICES IS RELATIVELY SMALL. YOU KNOW, 250 MILLION DOLLARS. THE OPIATE RESPONSE FUND IS STATE MONEY.

BECAUSE THE FEDERAL FUNDING IS FEDERAL MONEY. THE GRANTS THIS ARE TO THE SERVICE DELIVERY INFRASTRUCTURE. CARE, COORDINATION, SORTS OF ACTIVITIES AND MENTAL HEALTH ACTIVITIES THAT ARE NOT COVERED BY MEDICAL ASSISTANCE. ANOTHER PART OF THE BEHAVIORAL HEALTH WORK AT THE DEPARTMENT IS SUBSTANCE USE DISORDER TREATMENT AND WE HAVE A SEPARATE FUND WHERE MONEY FOR THESE SERVICES IT'S CALLED THE BEHAVIORAL HEALTH FUND THAT USED TO BE CALLED RETURNING MEMBERS. THE CONSOLIDATED CHEMICAL DEPENDENCY TREATMENT FUND. IT'S THE SAME. BASKET OF MONEY SOURCES JUST WITH A DIFFERENT NAME. AND UNDER THESE PROGRAMS. INDIVIDUALS CAN RECEIVE OUTPATIENT SUBSTANCE USE DISORDER TREATMENT SERVICES. THEY GET A COMPREHENSIVE ASSESSMENT AT THE PROVIDER OF THEIR CHOICE. AND THERE ARE CURRENTLY ABOUT 58,600 ADMISSIONS. THEY WERE IN FISCAL YEAR 2021. IT'S 440 MILLION DOLLARS OR SO. THE NEXT 2 SIDES ARE THIS ONE IS FUNDING FOR CHILDREN. BUT OF ALL CHILDREN AND ADULTS. THESE ARE LARGELY. AMOUNTS THAT ARE SENT TO THE COUNTIES TO ADMINISTER THE STATE'S CHILD WELFARE PROGRAMS AND THAT RELATE TO PROTECTING VULNERABLE ADULTS AND THE NEXT SLIDE SIMILAR. FUNDING TARGETED JUST SLIGHTLY DIFFERENTLY 2, BUT ALSO PRIMARILY TO THE COUNTIES.

FOR THEM TO ADMINISTER THE STATE PROGRAMS RELATED TO. A CHILD PROTECTION. THE NEXT SLIDE IS A ABOUT DIRECT CARE AND TREATMENT. AGAIN, THIS IS A SENATOR HUFFMAN'S COMMITTEE. THIS PART FUNDS. SEVERAL. TYPES OF FACILITIES. FUNDS, PSYCHIATRIC HOSPITALS. I MET THE MAIN ONE BEING THE ANOKA FACILITY. THERE ARE 6. COMMUNITY BEHAVIORAL. I HOLD. THERE COMMUNITY ADDICTION RECOVERY, THE CARE FACILITIES THAT ARE LOCATED AROUND MINNESOTA. IT PROVIDES INPATIENT MENTAL HEALTH TREATMENT FACILITIES IN PATIENTS, SUBSTANCE ABUSE, TREATMENT FACILITIES. GROUP HOMES FOR PEOPLE WITH DEVELOPMENTAL AND INTELLECTUAL DISABILITIES. AND IT ALSO RUNS THE SEX OFFENDER PROGRAM. ABOUT 450 MILLION DOLLARS A YEAR FOR ALL OF THOSE THINGS. AND ON THE NEXT SLIDE, ONE THING THAT'S DIFFERENT ABOUT DIRECT CARE AND TREATMENT THAN MOST OTHER PARTS OF.

THE AGENCY IS THAT IN ADDITION TO THAT GENERAL FUND THE 3RD LINE, THE 4TH LINE THERE, YOU CAN SEE THERE ARE 341 MILLION DOLLARS OF ENTERPRISE FUND. SOME OF THESE PROGRAMS THAT I JUST LISTED ARE. FUNDED WITHOUT GENERAL FUND THAT'S THE TERM OF ENTERPRISE. THEY ARE PROVIDER. THEY BILL EITHER MEDICAL ASSISTANCE OF THE STATE OR OTHER. AND MONEY THAT THEY RECEIVE FOR PROVIDING ACTIVITIES THROUGH PROGRAMS AS KEPT BY THE AGENCY AND USED TO ADMINISTER RUN THOSE PROGRAMS. THAT IS THE END OF THE OVERVIEW OF THE DEPARTMENT OF HUMAN SERVICES. AND NOW MISTER RAYMOND WILL TALK ABOUT HARTMAN HEALTH AND THE OTHER AGENCIES AND THIS JURISDICTION BEFORE YOU BEGIN A MYSTERY MAN. I JUST WANTED LET PEOPLE KNOW THAT. I MEAN, WE WILL HAVE PRESENTATION BY DHS. >> NEXT WEEK WITH, YOU KNOW, THEY'LL GO INTO MORE DETAIL AND IN SOME OF THESE PROGRAMS.

BUT EVEN EVEN WITH THAT, YOU PROBABLY WILL HAVE QUESTIONS ABOUT HOW DOES THIS WORK OR, YOU KNOW, IS. PROGRAM AREAS ARE ARE VERY COMPLEX AND SO I ENCOURAGE YOU IF YOU SEE SOMETHING THAT YOU WOULD LIKE TO KNOW MORE AND WANT TO HAVE MORE DETAILED INFORMATION. LET ME KNOW. AND WE CAN TRYING TO FIGURE OUT A WAY EITHER. BROADLY IN THE COMMITTEE OR I CAN POINT TO 2 PEOPLE WHO COULD GIVE YOU MORE INFORMATION SO YOU CAN DELVE INTO IT FURTHER WE WANTED TO GET KIND OF A HIGH LEVEL AND MEDIUM LEVEL BACKS.

AND MISTER AMMONS PRESENTATION. BUT WE KNOW THAT, YOU KNOW, THERE'S THERE'S A LOT MORE DETAIL BELOW THAT AND AND THE DEPARTMENT OF HEALTH WILL GET INTO THAT. THERE'S THEIR AREA MORE AND MORE DETAIL TO TODAY. MADAM CHAIR. I DON'T THINK I'LL BE DOING MY JOB IF I DIDN'T POINT OUT THAT THERE. >> IT IS VERY HELPFUL 100 PAGE. SEVERAL 100 PAGE DOCUMENT THAT AGENCY BASE BUDGET FOLKS THAT CONTAINED A LOT MORE INFORMATION, INCLUDING ALL OF THIS FUNDING INFORMATION. SURE, BUT I JUST WANT ENDORSE THAT PACKAGE. IT IS. >> IT ACTUALLY GOES TO THE PAST FUTURE FUNDING STREAMS AND ITS VERY USEFUL HELP. PEOPLE UNDERSTAND THE FINANCE STUFF. ASSIST ME. MAYBE. AND I THINK THAT'S GOOD. A GOOD SUGGESTION. YEAH. THANK GO AHEAD, MISTER RAYMOND, IF YOU CHRISTINE. >> THANK YOU, MADAM CHAIR. AND GOOD MORNING. MEMBERS OF THE AND KYLE RAYMOND FISCAL ANALYSTS TO THE HUMAN SERVICES COMMITTEE. SO AS DENNIS MENTIONED, I'LL BE COVERING THAT. THE REMAINDER OF THE PRESENTATIONS. WE'LL START BY PROVIDING AN OVERVIEW OF ALL DEPARTMENT OF HEALTH FUNDS BEFORE HIGHLIGHTING A FEW DEPARTMENT OF HEALTH BUDGET ACTIVITIES AND THEN CONCLUDING BY SOME HEALTH AGENCIES AND BOARDS.

AND AS AS DENNIS MENTIONED AT THE BEGINNING OF THE PRESENTATION, BE BUT BECAUSE OF THE OVERLAP WITH THE DEPARTMENT OF HEALTH, A COUPLE OF THE FIRST PORTION ALL PROBABLY GO QUICKLY, BUT CERTAINLY HAPPY TO ANSWER ANY QUESTIONS THAT MEMBERS HAVE. FIRST, THIS SLIDE SHOWS THE PROJECTED SPENDING TOTALS FOR ALL A DEPARTMENT HEALTH OVER THE 24. 25 BIENNIUM. AS A SHOW AT THE BOTTOM OF THE MIDDLE COLUMN OF THE TABLE, THAT WHOLE PROJECTED SPENDING OUT FOR THE PART OF HEALTH IS JUST OVER 1.0, 5, 6 BILLION AND OF ABOUT 787 MILLION. IT'S FROM FEDERAL FUND. ENDS UP BEING THAT JUST OVER 50% OF ALL FUNDS. AND ALSO NOTE THE DEPARTMENT HEALTH GENERAL FUND PROJECTED SPENDING IS ABOUT 316.8 MILLION, WHICH COMPRISES ABOUT 22.2% OF ALL AS SHOWN IN THE RIGHT HAND COLUMN. AND NOW NOW COVERED THE PROJECTED SPENDING TOTALS FOR A FEW TO PART OF HEALTH BUDGET ACTIVITIES. SO I WANT TO BE CLEAR THAT THESE ARE JUST A FEW BUDGET ACTIVITIES THE DOES A LOT OF OTHER PORT OUTSIDE OF THIS.

SO DON'T WANT GIVE THAT FALSE PERCEPTION. BEGINNING WITH A CHILD AND FAMILY HEALTH BUDGET JUST PROVIDE A SENSE OF THE SERVICES PROVIDED UNDER THIS ACTIVITY. THIS ACTIVITY PROMOTES A MATERNAL AND CHILD HEALTH THROUGH A NUTRITIONAL HEALTH CARE SUPPORT AND INCLUDES ACCESS TO FAMILY, PLANNING SERVICES AND AVOIDING PREGNANCIES FOR TEENS AMONG OTHER SERVICES. SO THE SO THE TOTAL PROJECTED SPENDING FOR THE SUBJECTIVITY 438.6 MILLION FOR THE 24. 25 BY MGM A 343 MILLION OF THIS IS FROM THE FEDERAL FUND. SO A SUBSTANTIAL PORTION OF THIS FEDERAL FUNDING IS IS FOR THE WIC PROGRAM. THE WOMEN'S WOMEN, INFANTS AND CHILDREN PROGRAM. SO NEXT, THE ENVIRONMENTAL HEALTH BUDGET ACTIVITY. SO THIS INCLUDES A FOOD AND DRINKING WATER PROTECTION, ENVIRONMENTAL SURVEILLANCE REGULATION OF INDOOR ENVIRONMENTS AND WELL MANAGEMENT. AND IN ADDITION TO OTHER SERVICES, THE TOTAL PROJECTED SPENDING FOR THIS BUDGET ACTIVITY IS A 97.8 MILLION FOR THE 24. 25 BIENNIUM JUST OVER 9.4 FROM THE GENERAL FUND AND 61 MILLION FROM THE STATE GOVERNMENT. SPECIAL REVENUE I'LL JUST NOTE THAT THAT THAT STATE GOVERNMENT SPECIAL REVENUE FUND NOW IS DRIVEN BY A FEES.

SO FOR THE HEALTH PROMOTION AND CHRONIC DISEASES ACTIVITY HPC D PARTNERS WITH COMMUNITY BASED IN STATEWIDE ORGANIZATIONS TOO, MONITOR CHRONIC DISEASES AND INJURIES PROVIDE DATA AND TECHNICAL ASSISTANCE, PROVIDE INFORMATION TO THE PUBLIC AMONG OTHER SERVICES. SO THE TOTAL PROJECTED SPENDING FOR THIS BUDGET ACTIVITY IS 110.9 MILLION OVER THE 24. 25 BUYING IT. AM 29.6 OF THIS FOR THE GENERAL FUND AND A FROM THE FEDERAL FUND. SO MOVING TO THE NEXT ACTIVITY THAT THE HEALTH REGULATION, BUT ACTIVITY INVOLVES THE REGULATION OF HEALTHCARE PROFESSIONALS, FACILITIES AND OTHER ORGANIZATIONS THE THE SERVICES INCLUDE STATE LICENSING, FEDERAL CERTIFICATIONS, INVESTIGATIONS, A COMPLAINT ENFORCEMENT ACTIVITIES, PUBLIC INFORMATION AMONG OTHER SERVICES. SO THIS PROJECT IS FORECAST HAVE A TOTAL PROJECTED SPENDING OF A 143.1 MILLION. THE 24 25 AND WITH A 28.0. 8 MILLION OF THIS TOTAL. FROM THE GENERAL FUND. SO THE THE PART OF HEALTH PROJECT TO VIDEO COVERS INFECTIOUS DISEASE AND MONITORING ACTIVITY, WHICH INVOLVES SERVICES RELATED TO THE PREVENTION IDENTIFICATION AND MITIGATION OF INFECTIOUS DISEASES. SO THIS PROJECT, IS FORECASTED TO HAVE A PROJECTED SPENDING OF JUST OVER 20 TO 30 MILLION FOR THE 24 25 BIENNIUM AND 8.5 MILLION OF THIS TOTAL IS TO THE GENERAL FUND.

AND ONE THING I WANT TO KNOW WITH THIS THAT THE SPLIT IN THE FEDERAL BETWEEN 2024 AND 2025. IN 2024 JUST OVER, EXCUSE ME, JUST UNDER 177 MILLION. AND THEN IT DROPS IN 2025. TO 44 MILLION. SO JUST TO NOT GIVE A FALSE PERCEPTION THAT THE SPENDING WILL BE GREATER THAN IT ACTUALLY IS JUST WANTED TO POINT THAT OUT. COVER THE FUND ALLOCATION OF OTHER HEALTH RELATED AGENCIES BEFORE CONCLUDING WITH OTHER HEALTH-RELATED BOARDS. SO DENNIS ALREADY TOUCHED ON ON ON SO GO TO THE NEXT SLIDE FOR THE OTHER AGENCIES THAT WHOLE PROJECTED SPENDING FOR ALL FUNDS JUST UNDER 19.5 MILLION FOR THE 24. 25 BIENNIUM 18 MILLION OF WHICH IS GENERAL FUND. SO TO PROVIDE A LITTLE BIT MORE DETAIL.

AND GENERAL FUND TOTAL THE FOLLOWING SLIDE SHOWS A BREAKDOWN OF GENERAL FUND PROJECTED SPENDING THESE OTHER HEALTH RELATED WITH THE EMERGENCY MEDICAL SERVICES, REGULATORY BOARD HAVING THE HIGHEST A PANEL PROTECT SPENDING TOTAL AT SOME 0.5 MAKING UP ABOUT 42% OF THAT 18 MILLION DOLLAR TOTAL. SO NOW ALL CONCLUDE BY HEALTH-RELATED BOARDS OF THE NEXT FEW SLIDES SO THE SLIDE SHOWS THE TOTAL PROJECTED SPENDING FOR THESE 4 WORDS, WHICH IS ALSO BROKEN DOWN BY THE STATE GOVERNMENT SPECIAL REVENUE THE SPECIAL REVENUE FUND IN THE 3RD CATEGORY OF OTHER FUNDS. AND I'LL JUST NOTE THAT PHARMACY IS THE ONLY BOARD HAVING OTHER FUNDS. AND THAT IS WHICH INCLUDES THE COMBINED TOTAL OF THAT FEDERAL FUND, HEALTH CARE ACCESS FUNDING, OPIATE RESPONSE FUNDS AND ALSO NOTE HERE THAT THAT STATE A SPECIAL REVENUE FUND AMOUNTS FUNDED BY LICENSING FEES COLLECTED BY THE LICENSING BOARD.

SO AS SHOWN IN THE TABLE, THE MEDICAL PRACTICE SPORT HAS THE HIGHEST BIENNIAL COMBINED PROJECTED SPENDING TOTAL OF JUST OVER 11 POINT 8 MILLION WITH THE NURSING BOARD AT 11.4 AND THEN THE PHARMACY BOARD, TOTAL OF ABOUT 10.7 MILLION. AND THERE ARE SOME ADDITIONAL UP, DENNIS, BUT AHEAD TO THE NEXT SLIDE. THE SLIDE HAS THE TOTAL PROJECTED SPENDING FOR THESE HEALTH-RELATED BOARDS OF 40 OR 54.2 MILLION. AND THAT CONCLUDES OUR PRESENTATION CERTAINLY HAVE TO TAKE ANY QUESTIONS. THANK YOU VERY MUCH. ONE NOTE ON THE HEALTH-RELATED BOARDS WERE GOING. >> TRY I'M TRYING TO SEE IF WE CAN PROVIDE SUMMARY DOCUMENT THERE. SO THERE ARE SO MANY BOARDS, BUT IF WE COULD PROVIDE SOME KIND OF A SUMMARY DOCUMENT TO MEMBERS. SO YOU HAVE A LITTLE BIT MORE INFORMATION ABOUT ALL OF THE BOARDS THAT ARE INCLUDED AND WHERE TO FIND INFORMATION AND HOW THEY'RE STRUCTURED. SO.

SO THAT WILL BE WILL WORK ON THAT. SENATOR THANK YOU. MADAM CHAIR, DO YOU PLAN ON GETTING? >> INFORMATION DOING ALL THE LICENSING, SOME SCOPE OF PRACTICE STUFF THAT'S THAT'S OUT THERE TO YOU GETTING INS FEEDBACK, 18 IMPORTANT PEOPLE WANTING TO ADDRESS THAT THIS YEAR WITH YOU. >> WELL, I'M I'M CERTAINLY GETTING FEEDBACK THAT THERE ARE PEOPLE LIKE TO HAVE THINGS ADDRESS THIS YOU KNOW, WE HAVEN'T WE HAVEN'T ADDRESSED SOME OF THE THE PROPOSALS THAT HAVE BEEN BROUGHT FORWARD FOR.

VARYING AMOUNTS OF TIME. AND SO THERE ARE A LOT OF PEOPLE WHO ARE INTERESTED IN THAT. I AM GOING TO WORK REPRESENTATIVE LIEBLING ON. DEVELOPING KIND OF A STANDARD PROCESS THAT WE WILL TAKEN AND THEN WE'RE GOING TO HAVE TO EVALUATE JUST KNOWING HOW MUCH WORK WE HAVE TO DEAL WITH IN THIS COMMITTEE AND THE BUDGET DEVELOPMENT PROCESS. I'M GOING TO HAVE TO LOOK AT THAT VERSUS, YOU KNOW HOW MUCH TIME IT WOULD TAKE TO EVALUATE AND AND HEAR PROPOSALS FOR, YOU KNOW, THOSE TYPES OF CHANGES. SO THAT'S TO BE DETERMINED. BUT IT IS IT IS ON THEM TIRADE ARE A SENATOR A BLUR THAT SAME SOME OF THE WORST EXPERIENCES I'VE WHERE YOU'RE COUNTING VOTES.

>> AND WHO CAN DO WHAT TO WHOM AND WHERE THEY CAN PUT THEIR FINGER IN THEIR MOUTH OR NOT. AND THEN IT'S THE NIGHTTIME GENESIS. ALL THAT. SO A COUNCIL TO AND AS PEOPLE COME FORWARD AND YOU AS A CHAIR, HAVE A GREAT DEAL OF INFLUENCE ON HOW THESE GROUPS ACTUALLY SIT DOWN AND CONVERSE. SOME GROUPS THINK THEY GOT THE VOTES AND I HAVE TO TALK TO THEIR COUNTERPARTS WITH WHOM THEY'RE GOING TO JURISDICTIONS. AND WE DO WANT PEOPLE TO WORK AT THE TOP OF THEIR LICENSE. THAT'S KIND OF THE THE GENERAL THOUGHT. BUT IN THAT THERE'S THERE'S SOME REASONS THAT PEOPLE DON'T DO THINGS. NO LICENSE BECAUSE THEY'RE NOT REALLY GOOD AT IT. BUT THEY WANT TO DO IT. AND SO JUST JUST COUNCIL, IF YOU COULD JUST KIND OF REQUIRE THAT PEOPLE HAVE A PROCEDURE THAT THEY WANT TO CHANGE THE NEED TO HAVE DONE THEIR BEST.

ACTUALLY TRULY SIT DOWN WITH THE GROUP THAT THEY'RE GOING TO BE. INFRINGING UPON. SO JUST ADVICE. AND THE BILLS BECOME MUCH BETTER AND WE DON'T SPEND 3 HOURS AND GET LOBBIED BY. EVER-INCREASING NUMBERS OF GROUPS AND AND WE THANK THANK I I DO. >> I KNOW FROM PAST EXPERIENCE THAT, YOU KNOW, WE HAVE HAD HEARINGS WHERE SPENT A LOT OF TIME IN THE HEARING AND THEN YOU DON'T ACCOMPLISH.

AND SO PREPARATION AND COLLABORATION IS DIFFERENT. DEFINITELY IMPORTANT BEFORE THEY GET THE COMMITTEE. SO. SO THANK THERE. ANY OTHER QUESTIONS FOR MISTER ALBRECHT OR MISTER RAYMOND? FOR RIGHT NOW? I'M SURE THERE WILL BE QUESTIONS THAT COME UP. BUT I I REALLY APPRECIATE YOU PUTTING THIS TOGETHER FOR US TODAY. AS PEOPLE OF QUESTIONS, WE WILL DEFINITELY LET YOU KNOW. SO THANK YOU, MADAM CHAIR AND MEMBERS.

I WOULD JUST LIKE TO POINT OUT ONE THING THAT I PROBABLY IS I PROBABLY SHOULD HAVE DONE. WE STARTED. THE LEGISLATURE TRACKS ALL OF HIS MONEY AND THOUSANDS OF DOLLARS. AND SO AT THE TOP OF ALL OF THESE SLIDES WITH THAT. >> 3 ZEROES IN IF YOU ARE CONFUSED AT ALL ABOUT SAYING BILLION WHEN IT LOOKED LIKE MILLION, THAT'S WHY I NOTICED IN THE DEPARTMENT OF PRESENTATION, THEY HAVE GONE A LITTLE BIT FURTHER AND EXPRESSED A LOT OF AMOUNTS IN MILLIONS BUT AT LEAST WHEN I GLANCED AT IT QUICKLY, YOU KNOW, THEY'RE THEY'RE ALL CLOSE ENOUGH TO MATCH UP TO 2 HOUR PRESENTATION.

BUT THEY ARE GOING LOOK A LITTLE BIT DIFFERENT. >> THAT'S GOOD TO KNOW. TAKES A LITTLE WHILE TO GET USED TO LOOKING. THE NUMBERS AN AND WHAT WE'RE TALKING ABOUT. SO, YEAH, THANKS FOR POINTING THAT OUT. AND NOW WE'LL SWITCH OVER AND HAVE THE DEPARTMENT OF HEALTH. THE COMMISSIONERS HERE TO PRESENT TO US AND HER. MEMBERS OF HER STAFF. KNOW IF THERE IS A DO YOU KNOW THE PROCESS TO GET GREAT.

GREAT. THAT'S GREAT. WHEN THE TECHNOLOGY WORKS, JUST LIKE THAT, WELCOME COMMISSIONER AGAIN TO THE COMMITTEE COMMISSIONER BECOMING CUTTING INTRODUCE YOURSELF FEEL FREE TO PROCEED. THANK YOU SO MUCH. AIR WITH GLENN MEMBERS OF THE COMMITTEE. BROOK CUNNINGHAM. >> A NEW COMMISSIONER OF HEALTH PREVIOUSLY ASSISTANT COMMISSIONER FOR HEALTH EQUITY AND THE AGENCY. I'M HAPPY TO BE HERE TODAY, TOO. GIVE YOU OVERVIEW OF HIM DH AND IN OUR ACTIVITIES TO BUILD A PINE. THE OAK VIEW THAT YOU JUST GOT AROUND THE BUDGET. SO IN DH OUR MISSION IS TO PROTECT, MAINTAIN, IMPROVE THE HEALTH MINNESOTANS. AND SO AGAIN TODAY, I WANT TO TALK ABOUT WHAT WE DO, BUT I ALSO REALLY WANT TO DRIVE HOME WHY IT'S IMPORTANT. AND AND THAT'S WHERE I WANT TO START TODAY. WE KNOW THAT WE SPEND A LOT OF MONEY. AGAIN, WE JUST DID THE BUDGET REVIEW ON ON CLINICAL CARE. A LOT OF OUR FOCUS WHEN WE THINK ABOUT HEALTH REALLY FOCUSES ON BILL, THE DIRECT DELIVERY OF HEALTHCARE SERVICES AS A PHYSICIAN REALLY FOCUSES ON JEANS AND AND BIOLOGY.

BUT WE KNOW THAT MAIN DRIVERS OF OF HEALTH OUTCOMES ARE THE SOCIAL ECONOMIC FACTORS. SO WHEN YOU LOOK AT THIS PIE CHART THAT BIG, DARK BLUE PURPLE. PIECE OF THE PIE IS ABOUT THOSE SOCIAL AND ECONOMIC FACTORS. IT'S ABOUT EDUCATION. IT'S ABOUT A LIVING WAGE, A DECENT INCOME. IT'S ABOUT FAMILY AND COMMUNITY CONNECTEDNESS AND ALL OF THOSE THINGS ARE MAIN DETERMINANTS OF HEALTH. AND THAT'S REALLY THE SPACE THAT FINDS ITSELF TRYING TO DO MOST OF ITS WORK. WHY DO I TALK ABOUT THIS? I WANT TO LIFT UP FOR US REALLY NATIONALLY.

OUR CONTACTS AROUND SORT OF HEALTH AND WELL-BEING AND SORT OF THINK ABOUT OURSELVES IN THE GLOBAL LANDSCAPE. YOU SEE THAT RED CIRCLE. THAT'S THE THAT'S UNITED STATES. AND THIS IS A LITTLE BIT OF A DAY TO SLIDE. BUT BUT CURRENT DATE, IT TRACKS ALONG WITH THIS SHOWING THAT WE SPEND RELATIVE TO OTHER COUNTRIES THAT WE COMPARE OURSELVES TO THE VAST PROPORTION OF OUR RESOURCES ON MEDICAL CARE AND EXPENDITURES. THAT'S THAT TEAL PIECE OF THE BAR GRAPH.

THE GREEN IS LOWER FOR THE UNITED STATES COMPARED TO OTHER COUNTRIES. AND THAT'S PUBLIC HEALTH AND SOCIAL SERVICES. SO WHEN YOU LOOK ON GLOBAL LANDSCAPE, OTHER COUNTRIES FOR EVERY ONE DOLLAR THAT THEY SPEND ON HEALTH CARE, THEY'LL SPEND ABOUT $2 ON PREVENTION AND SOCIAL SERVICES AND THE UNITED STATES FOR EVERY ONE DOLLAR THAT WE SPEND ON ON HEALTH CARE. WE ONLY SPENT ABOUT $0.55 ON PREVENTION AND SOCIAL SERVICES. AND WHAT ARE WE GETTING FOR THIS MONEY, RIGHT? WHAT ARE WE GETTING FOR THIS OUTLAY OF RESOURCES THAT SEEMS TO CONTINUE TO GROW YEAR BY YEAR. THIS CHART IS REALLY TO TO HAVE YOU A LOOK AT THAT. BOTTOM GREEN BAR. AND AND WHAT THAT SHOWS IS AGAIN ON ON THAT LEFT SIDE. OUR BAR IS SMALLER AND THE BARS ACROSS THOSE OTHER COUNTRIES RIGHTS ARE LIFE EXPECTANCY IS LOWER, BUT OUR OUTLAY OF RESOURCES.

WHEN WE LOOK AT THE RIGHT IS AGAIN, MUCH HIGHER FOR HEALTH SPENDING. AND WE'RE THINKING ABOUT LIFE EXPECTANCY OVER TIME. MOST RECENTLY WE HAVE SEEN D CLIMBS DESPITE SIGNIFICANT INVESTMENTS IN HEALTH CARE. AND YOU MIGHT SAY, WELL, YOU KNOW, DOCTOR CUNNINGHAM, THIS IS, OF COURSE, DUE TO COVID. AND YES, CERTAINLY THIS IS IN PART DUE TO COVID. BUT IT OTHER COUNTRIES ARE SEEING A REBOUND AND THEIR LIFE INSPECTED SCENE. SO WE MUST ASK OURSELVES, IS THAT IN PART RELATED TO HOW THEY INVEST AND HEALTH? AND LOOKING AT THE NATIONAL LANDSCAPE NATIONALLY. WHEN YOU LOOK AT MEDICAL CARE THAT DARK BLUE AND PUBLIC HEALTH WE ONLY SPENT ABOUT 5% OF OUR RESOURCES NATIONALLY. TYPICALLY ON THE PUBLIC HEALTH PEACE AND MINNESOTA IS SLIGHTLY LESS AT AROUND 3% OF OUR RESOURCES. AND SO WHEN WE THINK ABOUT WHY THIS IS IMPORTANT AND WHAT THAT IS IN THE 8 DO AND PUBLIC HEALTH DO I LIKE TO I LIKE THIS LIGHT BECAUSE IT'S A GOOD CONTRAST, RIGHT? SO ON THE LEFT, WE HAVE PUBLIC HEALTH ON THE RIGHT.

WE HAVE HEALTH CARE AND WHAT I REALLY LIKE TO LIFT UP ABOUT THIS LIGHT IS REALLY THE GRAPHIC WHERE YOU SEE THE PEOPLE ALL TOGETHER AND THE PUBLIC HEALTH. SO THEY'RE ABOUT 5 PEOPLE UP THERE RIGHT? AND ON THE HEALTH CARE SIDE, THERE'S ONE PERSON. BECAUSE ON THE PUBLIC HEALTH SIDE, WE'RE REALLY THINKING ABOUT COMMUNITIES. WHAT CREATES THE CONDITIONS FOR HEALTHY COMMUNITIES. WHAT CREATES THE CONDITIONS THAT ENABLE PEOPLE TO MAKE HEALTHY CHOICES. WHAT WE THINK ABOUT THE SOCIAL ECONOMIC FACTORS THAT AFFECT US ALL LIVING TOGETHER.

WE THINK ABOUT COMMUNITY CONNECTEDNESS. WE THINK ABOUT POPULATION HEALTH COMMUNITY HEALTH. HEALTH CARE IS MOVING MORE IN THAT DIRECTION. BUT HISTORICALLY HAS REALLY THOUGHT ABOUT THE INDIVIDUAL. WHAT'S BEST FOR THE INDIVIDUAL WHO SHOWS UP FOR THEIR CARE. SO THEIR TREATMENT, THEIR INDIVIDUAL CONDITIONS IN THEIR HOME, THEIR INDIVIDUAL HEALTH, INDIVIDUAL, QUALITY OF LIFE. AND SO TO ILLUSTRATE THIS FOR THEIR, I'M JUST GOING TO MAKE A COUPLE OF CONTRASTS AGAIN, WE THINK ABOUT PUBLIC HEALTH VERSUS WHEN WE THINK ABOUT HEALTH CARE AND SO WAS THINK ABOUT HEALTH CARE HEALTH CARE DHS PROVIDES COVERAGE FOR A CHILD WITH MEASLES AND IM DH ON THE PUBLIC HEALTH SIDE. WE'LL PROVIDE INFORMATION TO PARENTS, HEALTH EDUCATION, ABOUT THE VALUE OF IMMUNIZATIONS.

TYPICALLY. HEALTH CARE ON THE HEALTH CARE SIDE. PEOPLE ASK, WELL, I'M SURE THAT PEOPLE HAVE HEALTH INSURANCE ACCESS, CHRONIC DISEASE AND THAT PUBLIC HEALTH SIDE, WE WORK WITH LOCAL GOVERNMENTS TO REDUCE THE PREVALENCE OF CHRONIC DISEASE. AND WE ALSO WORK WITH COMMUNITY-BASED ORGANIZATIONS ON THE HEALTH CARE SIDE. AND AGAIN, WE JUST HEARD ABOUT A LOT OF BEHAVIORAL HEALTH AT DHS PREVITE SOAP, RIGHT COVERAGE IN TREATMENT FOR PEOPLE WITH ADDICTION OR OVERDOSE ON THE PUBLIC HEALTH SIDE, WE REALLY THINK ABOUT THE CONDITIONS THAT LEAD TO OUR CONTRIBUTE TO ADDICTION OVER DOSE. WHAT WE OFTEN CALL THE DISEASES OF DESPAIR. AND DOES THIS BECOMES? I'M SORRY TO I I JUST I FORGOT TO ASK HIM. >> AT THE BEGINNING OF THE MEMBERS, IF YOU HAVE IS IT OKAY? IF WE ASK QUESTIONS THAT OK, PLEASE OTHERWISE. MADAM CHAIR, I CAN WAIT TILL THE END AND THEN BUT AS A SPECIFIC SPECIFIC TO A NEW TALKING ABOUT PUBLIC HEALTH, YOU TALK ABOUT THERE'S A THERE'S A LITTLE KNOWN THING FOR THE LAST 86 YEARS CALLED TITLE 5 RIGHT IN THE JOURNAL.

CHILD HEALTH BUREAU REALLY GETS INTO THOSE INDICATORS OF OF HEALTH IN THE STATE AND SO WHEN YOU'RE TALKING ABOUT THE PUBLIC HEALTH SIDE, YOU'RE ALSO TALKING ABOUT HOW YOU'RE LEVERAGING THOSE FEDERAL DOLLARS TO MAKE SURE YOU'RE DOING A COORDINATED. COMPREHENSIVE SYSTEM WHEN IT COMES TO THE PUBLIC HEALTH DOMAIN, SPECIFICALLY ON THOSE USING 11 INDICATORS, 18 INDICATORS. WOULD YOU GUYS DOING TO ADDRESS THAT? AND MY ASSUMPTION AND TO DOCTOR COMMISSIONER IS THAT IT'S ALL IN BAD IT INTO THE INTO THE OVERALL PICTURE THAT YOU'RE TALKING ABOUT.

IS THAT CORRECT? CUTTING HIM? >> YES, THANK YOU, CHAIR WITH PLAN A SENATOR. YES, WE WE DEFINITELY WITH PARTNERS IN DIFFERENT DOMAINS AND I HAVE A SLIGHT SUBSEQUENT TOWARDS THE BACK OF OUR OF OUR DECK. THIS SORT OF COVERS THE THE KEY DOMAINS IN WHICH WE WHICH WE WORK. GETTING BACK TO WHAT THIS IS COSTING THE STATE BECAUSE IN ADDITION TO HAVING HEALTHY COMMUNITIES RIGHT. WE ALSO WANT A HEALTHY STATE ECONOMICALLY AND A LOT OF THAT CONVERSATION ABOUT HEALTH AND HEALTH CARE BOTH NATIONALLY AND LOCALLY RIGHT ABOUT HOW HEALTH CARE COSTS ARE DRIVING. I'M SORT OF OUR GDP AND AND THE SECTOR. AND SO THIS SLIDE IS ABOUT MINNESOTA, SPECIFICALLY.

AND WHEN I WANT TO DRAW ATTENTION FOR IT TO YOU ALL IS THE S****. AND THESE ARE THE PROJECTED COST OVER THE NEXT 10 YEARS FOR A NUMBER OF TOP OF CHRONIC DISEASE. THE PROJECTED INCREASE. AND SO WHAT YOU'LL SEE IS THE PROJECTED INCREASES IN DEMENTIA CARE COVERAGE 67% PROJECTED INCREASE IN COSTS AND HYPERTENSION AND DIABETES. 59 51% INCREASE PROJECTED COSTS RESPECTIVELY. VERY COMMON, CHRONIC CONDITIONS INDEED, ACTUALLY, A 40% OF MINNESOTANS HAVE AT LEAST ONE CHRONIC CONDITION AND AND HALF OF THOSE 20% HAVE MORE THAN ONE CHRONIC CONDITION. AND SO AGAIN, PART OF WHAT I AM TRYING TO DRIVE HOME TODAY IS THAT WE CAN WE REALLY CAN'T AFFORD TO TREAT OUR WAY, TREAT OUR WAY TO HEALTH. WE HAVE TO MOVE UPSTREAM AND THINK ABOUT THE FACTORS THAT CONTRIBUTE TO THOSE DOWNSTREAM HEALTH OUTCOMES. AND THOSE FACTORS ARE NOT SIMPLY SORT OF HEALTH BEHAVIORS ARE CLINICAL CARE TO REALLY CHRONIC CONDITIONS LIKE LOATS TYLEE TOO. WHERE YOU LIVE WORK AND PLAY OUR CULTURE AND OUR DAILY ACTIVITIES. DO YOU HAVE ACCESS? DO YOU HAVE ACCESS TO NOT ONLY HEALTH CARE BUT A MEANINGFUL WORK? ARE YOU LIVING IN ENVIRONMENT THAT'S FREE FROM STRESS FROM DISCRIMINATION AND RACISM? DO YOU HAVE HEALTHY AIR TO BREATHE CLEAN WATER, CLEAN AIR, ALL OF THESE ARE SPACES AND WHICH PUBLIC HEALTH WORKS.

AND DESPITE BEING AMONG THE HEALTHIEST STATES ON AVERAGE, WE ALSO KNOW THAT MINNESOTA HAS SOME OF THE NATION'S WORSE HEALTH DISPARITIES. THAT IS NOT NEWS TO ANYONE IN THIS ROOM, BUT COMPARED TO WHITES, MINNESOTA'S POPULATIONS OF COLORED AMERICAN INDIANS EXPERIENCE SHORTER. LIFE SPANS HIGHER RATES OF INFANT MORTALITY, HIGHER RATES OF THOSE CHRONIC DISEASES THAT I JUST SPOKE TO YOU ALL ABOUT. >> AND OVERALL, POOR GENERAL HEALTH AND I JUST WANTED TO LIFT UP. WELL, I HAD YOUR TIME AND ATTENTION. A COUPLE CORE STATISTICS TO FURTHER ILLUSTRATE THIS. BLACK WOMEN ARE 2.5 TIMES MORE LIKELY THAN WHITE WOMEN TO DIE OF THEIR B***** CANCER WITHIN 5 YEARS OF DIAGNOSIS. IN 2021. AMERICAN INDIANS WERE 10 TIMES MORE LIKELY AND BLACKS 4 TIMES MORE LIKELY THAN WHITES TO BE TREATED IN THE HOSPITAL FOR A NON-FATAL OVERDOSE. AND MINNESOTA. DEATH A DAY TO SHOW HIGHER HEART DISEASE RATES IN YOUNG AND MIDDLE AGED BLACK ADULTS COMPARED TO THE MINNESOTA AVERAGE APPROXIMATELY TWICE AS HIGH FOR THE 35 TO 64 YEAR-OLD AGE GROUP AND 50% HIGHER FOR 65 TO 74 YEAR.

AGE GROUP. ALMOST TWO-THIRDS OF ALL NEW HIV. CASES ARE IN COMMUNITIES OF COLOR. AND THE ASTHMA DEATH RATE FOR AFRICAN AMERICANS UNDER THE 80'S UNDER AGE. 65 WAS 3 TIMES HIGHER AND FOR WHITE MINNESOTANS. AND SO. WE KNOW THAT WE ALSO SAW THESE DISPARITIES PLAY OUT AGAIN AND THE COVID-19 PANDEMIC. AND AT INDY 8 AS WE WERE TASKED WITH RESPONDING TO THE PANDEMIC, WE STOOD UP TESTING SITES, VACCINATION CLINICS AND TREATMENTS REFERRALS FOR THERAPEUTICS. AND A NATIONALLY RECOGNIZED DATA AND PUBLICLY PRESENTATION OF DATA AND DASHBOARDS. WE PARTNER WITH COMMUNITY-BASED ORGANIZATIONS, TREAT THE HARDEST HIT COMMUNITIES. WE PROVIDE A STAFFING RESOURCES FOR LONG-TERM CARE IN HOSPITALS.

WE PROVIDED EXPANDED ACCESS TO COVID-19 TREATMENTS. AS I SAID, AND STOOD UP A HOTLINE FOR THE PUBLIC TO GET THEIR QUESTIONS ANSWERED. DO HAVE A COUPLE NUMBERS THAT HAVE TO TAKE YOU, MADAM CHAIR AND THANK YOU, COMMISSIONER. >> AND IN THE CONVERSATION WHEN YOU'RE LOOKING AT THE CATEGORICAL DISCUSSION JUST HAD. IS YOUR AGENCY IN PARKING IN IN THE DISCUSSION OF INTERSECTIONALITY? BECAUSE WHEN YOU START. THANK YOU. I WISH SHE WOULD. HERE'S THE THING. HERE'S THE WISH TO THE WISHES IN THE SHED RIGHT? I WISH OUR AGENCIES WOULD REALLY HIGHLIGHT THAT BECAUSE WHEN YOU LOOK AT CATEGORICALLY, THEN YOU START TO ADD DISABILITY INTO THAT. THOSE NUMBERS JUST ABSOLUTELY GO THROUGH THE ROOF, BUT TOO MANY TIMES FOR YEARS, WE'VE ALWAYS PUT DISABILITY OUTSIDE OF THAT AND NOT ON THE INTERSECTIONALITY PIECE. AND SO WE PLEASE HELP US UNDERSTAND THE ESSENCE OF THAT WHOLE WHOLE SIDE OF INTERSECTIONALITY. COMMISSIONER COMING IN.

AND THANK YOU CHAIR WITH SENATOR. >> IS IS VERY IMPORTANT TO ME AND I GET BACK TO YOU ON THE SPECIFICS OF HOW WE MIGHT BE DOING IT TODAY. BUT I WITH ME AS COMMISSIONER, IT'S SOMETHING IN TERMS OF I'M LOOKING PARTICULARLY AT RACE DATA THAT IS CRITICALLY IMPORTANT INTERSECTIONALITY RACE CROSS WITH BEST IN US AFTER CITY. SO WE DISAGGREGATE THAT INTERSECTIONALITY WITH GENDER WITH DISABILITY STATUS THERE'S SO MANY OPPORTUNITIES FOR US TO THINKING CREATIVE AND INNOVATIVE WAYS SO THAT WE ARE MORE EFFECTIVE AND TARGET ARE PROGRAMS. AND SO THAT IS SOMETHING THAT I HAVE ALREADY BEEN IN MY PREVIOUS ROLE AS ASSISTANT COMMISSIONER OF HEALTH EQUITY, RECOGNIZING THAT WITHIN THESE BIG GROUPS, PEOPLE'S EXPERIENCES VARY BY ALL OF THE IDENTITIES AND RISK FACTORS THAT THEY CARRY. THANK YOU, MADAM CHAIR. THANK YOU, COMMISSIONER FOR THAT. SO WHEN WE LOOK AT ONE IN 5 PEOPLE IN MINNESOTA LIVE WITH A >> DISABILITY OR CATEGORICAL NEED, IT'S ALL THE WAY FROM ASTHMA ON THE WAY UP TO AUTISM SPECTRUM RIGHT? ONE IN 10 CHRONIC AND LOOKING AT YOUR LINE THAT SHOWS THE 60% BUMP, YOU KNOW, ESPECIALLY ON THE 65 AND ON THE CHRONIC.

WE REALLY START TO LOOK AT HOW THAT'S GOING TO AFFECT OUR SYSTEMS AND IN IN SEEING HOW WE'RE UNDERFUNDING OUR SYSTEMS IN THE STATE OF MINNESOTA BRINGS ME A LOT OF RIGHT? BUT IT GIVES ME JOY TO HEAR YOU TALK ABOUT INTERSECTIONALITY TOO MANY TIMES YOU JUST SEE COMPARABLE TO ONE CATEGORY TO ANOTHER CATEGORY. AND THERE'S NEVER THAT DEEP DIVE ABOUT WE'VE GOT TO INCLUDE THE DISCUSSION SECTION ALISO. LOOK FORWARD TO SEEING MORE AND MORE OF YOUR STUFF AND THANK YOU FOR LETTING ME TAKE YOUR QUESTIONS. THANK YOU, SENATOR. SENATOR, ABLE GET YOU. WE I THINK YOU AND I THINK, COMMISSIONER, IT'S NICE TO MEET YOU.

WE HAVE BEEN HERE PRETTY LONG. WE'VE BEEN TALKING ABOUT HEALTH DISPARITIES FOR AS LONG AS I'VE BEEN HERE. SOMETIMES WE'VE BEEN SO GREAT. WE THOUGHT WE WOULD DECIDE OURSELVES HOW WE HANDLE DISPARITIES FOR GROUPS THAT HAVE BEEN OFFERING US ADVICE ABOUT HOW TO HANDLE THE DISPARITIES. BUT WE HAVE ADDED PROGRAM AFTER PROGRAM. TO ADDRESS DISPARITIES AND YOU LOOK AT WHAT'S HAPPENED IN THE LAST 2 DECADES. WE HAVE EXPANDED OUR COVERAGE. WEAVE THROUGH THE AFFORDABLE CARE ACT THROUGH COVERING SINGLE ADULTS THROUGH SO MANY WAYS AND SOWED. GRIEVED BY THE DATA YOU JUST BROUGHT US TODAY. WHY WAS RUSTY ON NUANCE? I'M GLAD YOU BRING THAT TO THE COMMITTEE. >> BUT SOMEHOW WE'RE NOT SUCCEEDING. AND I'M CURIOUS AS YOU AS WE NOT TO ANSWER NOW, BE ON WHAT YOU KNOW. JUST FOR TIME REASONS, I SUPPOSE. BUT GIVEN THE IDEA ABOUT THOSE DISPARATE GROUPS, ARE THEY I'M SURE MEDICAL FOR SUMMER AND JUST TRADITIONAL HEALTHCARE.

SOMEBODY UP THROUGH ENSURE. I'M CURIOUS ABOUT LAKE. IT'S A SIGHT. IT'S HARD TO IMAGINE THE COVERAGE ISSUE, BUT SO MAYBE THEY'RE SO SOME PEOPLE THAT ARE UNINSURED. THE DON'T HAVE MEDICAL HOME. WE TALKED ABOUT THAT AS A WAY TO TRY TO FIX THIS WITH THE DRESS THAT. AND BOOSTING DO THEY HAVE COVERAGE AND THEY DON'T USE IT IS THE MEDICAL ASSISTANCE PROGRAMS THAT WE'VE. THAT WE SPEND SPEND A GREAT DEAL MONEY ON NOT WORKING COMPARED TO MORE TRADITIONAL HEALTH PLAN AGAINST, YOU KNOW WHAT? WHO'S GETTING THE BETTER CARE? WE DON'T PAY VERY WELL AND MEDICAL ASSISTANCE.

SO THEY. CAN YOU NOT GET APPOINTMENTS AND DENTISTRY, YOU'LL FIND HORRIBLE EXPERIENCE THERE FROM EVERYBODY'S GOT STATE FUNDED PROGRAMS BECAUSE THE DENTIST CAN AFFORD TO WORK ON THOSE BELOW COST. PRICE IS. AND SO I I THINK YOU BRING ARE FRESH. FOR US. LET'S GET GOING ON THIS. BUT I THINK IT'S WORTH A LOOK. AND YOU YOU HAVE MORE RESOURCES AND I WILL EVER HAVE TO HELP DECIDE. HOW DO YOU REALLY GET AFTER THIS? IF IT'S SIMPLY THAT THE PEOPLE ARE COMPLYING BECAUSE THEY JUST DON'T SEEM TO BE INTERESTED. THAT'S MAKE THEM INTERESTED. BUT IF THEY'RE INTERESTED THERE ARE UNABLE TO GET THE CARE THEY WANT. OR NEED AND OR IF THE CONDITIONS JUST CAN'T AFFORD TO TREAT THEM IN A LARGER NUMBER THAN WE NEED.

I THINK THAT'S SOMETHING WE NEED TO KNOW. AS WE GO FORWARD, PARTICULARLY, YOU KNOW, THAT THE SLOGAN IS WITH ALL THIS MONEY WE SPEND. WE JUST HAVE TO SPEND LIKE CLOSE TO 40 BILLION DOLLARS OF AN AND STATE AND FEDERAL MONEY IN THIS IN THESE 2 COMMITTEES. THOSE OUTCOMES. I JUST THINK THAT'S I DON'T KNOW. IT'S NOT A CENT, BUT IT'S JUST LIKE NOTHING WE WANT TO KEEP ON WITH. SO I WILL BE HAPPY TO CHAT WITH YOU FURTHER PRIVATELY AND AT THESE MEETINGS. BUT AND MADAM CHAIR, I THINK AS WE WE ALWAYS HAVE AN IDEA.

ALWAYS A NEW BILL TO PASS A PROGRAM IS THE FEE FOR SERVICE WORKING BETTER THAN THE MANAGE PLANS? I MEAN, THOSE ARE THINGS THAT WE NEED TO KNOW BECAUSE WE JUST TRUST THAT THE PLANS OF DOING SOMETHING. THINK THAT ANYTHING MOSI MAYBE YOU CARE DOES SOMETHING. BUT I THINK THOSE ARE QUESTIONS. WE WANT TO ASK HIM AND TO TRULY MAKE A DIFFERENCE. SO OF STOP. BUT I THANK YOU AND THANK YOU SO MUCH FOR PROVOKING MY THINKING.

>> COMMISSIONER, I I WOULD LIKE TO ADD TO THAT EYE. I THINK AS YOU'RE DISCUSSING, MAYBE NOT AS MUCH TODAY, BUT IN THE SHORT TERM, WHEN YOU START TALKING YOUR BUDGET PROPOSALS COMING FORWARD AND MAYBE TODAY AS WELL. BUT HOW HOW DOES THE WORK THAT THE DEPARTMENT HAS BEEN DOING ON RESEARCHING SOME OF QUESTIONS THAT PLAYERS RAISED HOW HAS THAT THE PROPOSALS THAT YOU MIGHT BRING FORWARD TO? THROUGH THE GOVERNOR'S BUDGET OR TO US, YOU KNOW, TO SAY, HERE'S WHERE YOU SEE VALUE AND, YOU KNOW, USING THIS LEVER BECAUSE WE CAN SEE THESE THAT TYPE OF THING. I WOULD JUST APPRECIATE IF WE CAN HEAR MORE ABOUT SENATOR MANDATE TO HAVE A QUESTION RIGHT AT THIS POINT.

OKAY. AND IF YOU WANT TO RESPOND TO THAT. >> SO SO THANK YOU. ONE FOR THE INVITATION TO AND SHARE WITH YOU ALL ARE THINKING ABOUT THE EQUITY IMPLICATIONS WITH OUR BUDGET PROPOSALS. >> I CHAIR WITH GLENN AS SENATOR, WE STILL NEED TO ASK. WE NEED TO CONTINUE TO ASK QUESTIONS I AGREE HEALTH DISPARITIES ARE A STUBBORN AND ACADEMIC DISCOURSE IN POLITICS SOMETIMES CALLED A WICKED PROBLEM. BUT IT'S IN PART BECAUSE THEY ARE SO TOUGH.

THEY REQUIRE ALIGNMENT OF A NUMBER OF GROUPS TO HAVE TO MAKE EFFECTIVE CHANGE. IT'S MORE THAN JUST ACCESS TO TO HEALTH CARE. ACCESS IS INCREDIBLY IMPORTANT. BUT IT'S ALSO LIKE ONCE YOU GET IN TO THE HEALTH CARE SYSTEM. THERE WAS A SEMINAL REPORT IN 2003 CALLED UNEQUAL TREATMENT. THEY CAME OUT FROM THE MEN INSTITUTE OF MEDICINE ABOUT HEALTH INEQUITIES. AND REALLY IT WAS ABOUT ONCE YOU GET IN, THEY CONTROLLED FOR INSURANCE AND COVERAGE AND THEY REALLY THOUGHT THEY REALLY THAT DEEP INTO THE CARE EXPERIENCE IN TERMS OF PATIENTS FROM ALL BACKGROUNDS BEING GIVEN THE SAME OPTIONS IN TERMS OF THEIR HEALTH CARE, THE SAME INFORMATION TO MAKE A DECISION. THAT WAS THE BEST DECISION FOR THEM. BUT IT'S ALSO A LINE AS WE TALK ABOUT THE UPSTREAM FACTORS. AND SO WE HAVE TO ALIGN WITH OUR PARTNERS ACROSS THE STATE ENTERPRISE TO REALLY THINK ABOUT THOSE UPSTREAM FACTORS THAT RELEASED GARY FOR MINNESOTANS BY BY RACE ETHNICITY IN AT THERE STATUS.

THANK SENATOR MAN. THANK YOU. MADAM CHAIR. >> I SOMETHING THAT WE HEAR OFTEN TOO, IS THAT. WE HAVE GREAT INSURANCE COVERAGE IN THE STATE AND THAT PEOPLE ARE NOT ON INSURED. AND THAT'S JUST NOT TRUE. RESPECT. WE HAVE ABOUT A QUARTER MILLION PEOPLE THAT HAVE 0 HEALTH INSURANCE AND WE HAVE HOW MANY MORE HUNDREDS OF THOUSANDS OF PEOPLE WHO HAVE INSURANCE BUT CANNOT AFFORD TO ACTUALLY USE IT BECAUSE THEY CAN'T AFFORD A COPAY. THEY CAN'T AFFORD THE DEDUCTIBLE. THEY CANNOT IT UNUSABLE INSURANCE. AND SO BUT AGAIN, ONCE IT'S NOT JUST THAT ACCESS TO THE HEALTH CARE, WE HAVE PEOPLE, THEY DON'T HAVE ACCESS PERIOD. ONCE YOU HAVE THAT ACCESS, YOU KNOW, AGAIN, WE CAN'T TREAT ARE WAY OUT OF THESE HEALTH DISPARITIES. WE NEED TO START INVESTING IN PUBLIC HEALTH IN PREVENTION, WHICH WE'RE NOT DOING. FOR EXAMPLE, WE'VE BEEN WATCHING WOMEN DIE. IN IN BIRTH AND IN PREGNANCY FOR THE LAST 20 YEARS. WE'VE BEEN WATCHING THAT NUMBER GO UP FOR 20 YEARS. WE'VE BEEN WATCHING BLACK WOMEN DIE AND A VERY SIGNIFICANTLY HIGHER RATE FOR 20 YEARS. AND JUST LAST YEAR WE EXPANDED CARE. OR IN THE POSTPARTUM PERIOD.

SO WE'RE NOT MAKING THE APPROPRIATE INVESTMENTS. TO TO CURB THE ISSUES THAT WE'RE SEEING. SENATOR MORRISON, DID YOU? THANK YOU. I I'M JUMPING IN BECAUSE I'M I'M GETTING THE FEELING THAT YOU MIGHT BE DONE PRESENTATION. THANK YOU, MADAM CHAIR. BUT I DO WANT TO JUST TAKE A MOMENT. COMMISSIONER. >> TO THANK YOU FOR BEING WILLING TO TAKE ON THIS ROLE. I WANT TO PUBLICLY THANK YOU AND YOUR COLLEAGUES IN PUBLIC HEALTH FOR ALL THAT THEY YOU AND THEY HAVE DONE FOR OUR STATE AND OUR COUNTRY AND FOR WEATHERING THE IMPORTANT TREATMENT DURING THE COVID PANDEMIC THAT OUR PUBLIC HEALTH PROFESSIONALS AND ORD. AND I DO WANT ADD ON TO A DOCTOR, A MAN WAS SAYING ABOUT. IN FACT AND WHAT YOU REFER TO TERMS OF UPSTREAM INVESTMENTS. I THINK THAT THIS SLIDE SAYS IT ALL TOTAL INVESTMENT IN HEALTH AND HUMAN SERVICES.

AND WE HAVE THESE THERE'S LITTLE TINY BAR AND PUBLIC HEALTH AND HUGE EXPENDITURES AND HEALTH CARE AFTER WE ALREADY HAVE THE PROBLEMS. SO I THINK THAT ANSWERS A LOT OF WHAT YOU'RE LOOKING FOR. SENATOR, A BLUR. WE NEED TO REACH SHIFT OUR FOCUS TO FOREVER GOING TO MAKE INROADS INTO OUR DISPARITIES. I ALSO JUST WANT TO FLAG WATER ISSUES. I THINK IN THE ERA OF ACCELERATING CLIMATE CHANGE, INCREASING WATER SCARCITY ACROSS THE COUNTRY HERE IN MINNESOTA, WE SIT ON THIS WEALTH OF FRESH WATER. WE HAVE TO BE VERY CAREFUL STEWARDS, INTERVAL AND OF OUR WATER.

AND I KNOW AND DH HAS AN IMPORTANT ROLE AND IN THAT AREA AS WELL. SO I LOOK FORWARD TO COLLABORATING. THANK YOU SO MUCH FOR YOUR SERVICE. THANK YOU, COMMISSIONER. YOU CAN PROCEED. >> THANK YOU. I DO HAVE THANK YOU SO THANK YOU. CHAIR WITH SENATOR. I DO HAVE A FEW MORE SLIDES AND THIS REALLY GETS TO WET MEMBERS OF THE COMMITTEE HAVE JUST SAID ABOUT PREVENTION.

PUBLIC HEALTH IS ABOUT PREVENTION. PREVENTION IS OFTEN INVISIBLE, BUT WE HAVE TO INVEST IN FOR MENTION NOW TO REDUCE DOWNSTREAM COSTS. LEADER SO IT'S ABOUT RIGHT NOW. BUT IT'S ALSO ABOUT THE FUTURE MINNESOTA. AND TO GET TO ONE OF THE MEMBERS QUESTIONS PREVIOUSLY, I WANTED TO JUST REVIEW THIS NATIONAL FRAMEWORK ABOUT THE FOUNDATIONS OF PUBLIC HEALTH WITH YOU ALL IF WHEN YOU LOOK AT THE SLIGHT THEIR THEIR 5 FOUNDATIONAL AREAS THAT PEOPLE NATIONALLY WILL TALK ABOUT COMMUNICABLE DISEASE, DISEASE CONTROL, SUCH AS CONTROLLING COVID CHRONIC DISEASE AND INJURY PREVENTION, PARTICULARLY WHEN WE THINK ABOUT SORT OF SUICIDE, THE CRISIS IN MENTAL HEALTH GUN VIOLENCE, IT'S WITHIN THERE AS WELL AS THOSE CHRONIC DISEASES THAT I TALKED ABOUT BEFORE. WHEN WE THINK ENVIRONMENTAL PUBLIC HEALTH, AS WE WERE JUST TALKING ABOUT IN TERMS OF WATER IN TERMS OF PREVENTING A FOOD BORNE ILLNESS. WE THINK ABOUT MATERNAL CHILD AND FAMILY HEALTH AND TITLE 5, AS WAS MENTIONED EARLIER. AND THEN WE THINK ABOUT ACCESS TO IN LINKAGE WITH CLINICAL CARE AND AND LINK IT WITH LOCAL CARE IS A REALLY IMPORTANT PIECE OF OF PUBLIC HEALTH, BUT ALSO IS FILLING THE GAPS, WHICH IS WHAT WE DID AND IN THE COVID PANDEMIC.

AND SO THESE FOUNDATIONAL CAPACITIES, THESE FOUNDATIONAL AIRS IN THE FOUNDATIONAL CAPABILITIES WHICH ARE BELOW THOSE AREAS, WHICH ARE REALLY THE NESS AND BOLTS OF HOW REALLY ADDRESS THOSE FOUNDATIONAL AREAS ABOVE. I'M REALLY NEED TO BE EMBEDDED ACROSS THE STATE RIGHT AT COUNTY AND REGIONAL LEVEL. SO THAT ALL MINNESOTANS HAVE ACCESS TO PUBLIC HEALTH SERVICES AND IN 2021, THE LEGISLATURE ALLOW ALLOCATED RESOURCES TO SUPPORT THE FIRST STEPS OF PUBLIC HEALTH SYSTEM TRANSFORMATION TO BUILD THAT CAPACITY AND CAPABILITY ACROSS THE STATE. THE LANGUAGE DIRECTED IN DH TO ASSESS THE CURRENT STATE OF THE GOVERNMENTAL PUBLIC HEALTH SYSTEM GIVE GRANTS TO COMMUNITY HEALTH BOARDS TO TEST NEW MODELS OF PUBLIC HEALTH SERVICE DELIVERY, DEVELOP RECOMMENDATIONS FOR LONG-TERM SYSTEM CHANGE AND REPORT BACK TO THE LEGISLATURE IN 2023, WHICH WE JUST DID A FEW WEEKS AGO. AND SO I WILL ENCOURAGE YOU TO LOOK AT THE REPORT.

IT REFLECTS SHARES ANALYSIS, ACTION AND RECOMMENDATIONS OF OF MDH. THE STATE COMMUNITY. HEALTH SERVICES ADVISORY COMMITTEE SHAQ AND THE LOCAL PUBLIC HEALTH ASSOCIATION. I WILL AND I PROMISE NOT TO, QUOTE AT PAPERS EVERY TIME I COME IN HERE. BUT I WILL QUOTE FROM THAT REPORT. TRANSFORMING MINNESOTA'S PUBLIC HEALTH SYSTEM ON PAGE 5. I JUST WANT TO LIFT UP A COUPLE THINGS. MINNESOTA'S QUALITY OF LIFE DEPENDS ON HEALTHY, VIBRANT COMMUNITIES, THE COMMUNITIES WHERE PEOPLE LIVE PROVIDE THE BUILDING BLOCKS FOR LONG-TERM HEALTH AND WELL-BEING INCLUDE PROTECTION FROM THE SPREAD OF INFECTIOUS DISEASES AND ENVIRONMENTAL THREATS, CLEAN WATER, STRONG SCHOOLS SUSTAINING JOBS, COMMUNITY CONNECTEDNESS, AND ACCESS TO HEALTH CARE AND OTHER IMPORTANT COMMUNITY SUPPORT. MINNESOTA, STATEWIDE PUBLIC HEALTH SYSTEM MUST BE ABLE TO DIAGNOSE THE HEALTH OF EACH COMMUNITY BY LISTENING TO PEOPLE WHO LIVE THERE AND THEN USE DATA EVIDENCE AND OFFER SOLUTIONS, INVESTIGATE EVERYTHING THAT AFFECTS HEALTH TO PREVENT HEALTH PROBLEMS BEFORE THEY START AND RAPIDLY DETECTING CONTAIN THE SPREAD OF PARTICULAR HEALTH THREATS LIKE INFECTIOUS DISEASE AND ENVIRONMENTAL CONTAMINANTS AND CONVENE A CAR PER WEEK.

COMMUNITY PARTNERS TO RESPOND TO COMMUNITY HEALTH NEEDS AND PRIORITIES. AND I LIFT THAT UP FOR 4. A COUPLE OF REASONS. AND ONE THING COMES TO MIND AS MY WORK AS A PRIMARY CARE PROVIDER ONE OF PATIENT ASSET OR MEDICAL HOMES. BUT THERE'S A OLDER WHO ARE TIRED ABOUT 5 YEARS OF THE WORKING, WHO CAN HE SAID OF THE BEST THE PRESIDENT WAS A GOOD JOB, RIGHT? AND SO THAT REALLY BRINGS IT BRINGS IT HOME. AND SO I CAN RUN THE BUDGET. SNAPSHOT REALLY QUICKLY. I KNOW YOU ALL HAVE HAD EYES ON THIS ALREADY THIS MORNING TO SOME DEGREE. I WANT TO ALSO LIFT UP ANOTHER THING, ANOTHER QUOTE THAT I DON'T FORGET FOR MY COMMISSIONER MALCOLM, WHO'S A HONOR TO SERVE AFTER HER B***. SHE ALWAYS USED TO SAY THE PUBLIC HEALTH SYSTEM WENT FROM PANIC TO NEGLECT. RIGHT? AND SO WHAT WE SEE IS WE CRISIS LIKE LIKE COVID AND THAT'S THOSE MIDDLE BARS THERE IN AND MUCH MORE MONEY COMES IN TO THE PUBLIC HEALTH SYSTEM.

BUTHEN WE RECEIVED BACK TO THOSE BLUE BARS. THO SORT OF BAIT BASE LEL FUNDING IT. SO PART OF WHAT OUR ENGAMENT HERE WITH WITH YOU ALL WITH THE LEGISLATURE WILL BE ABT HOW DO WE REALLY INVEST IN OURUBLIC HEALTH SYSTEM. SO WE'RE N GOING BACK AND FORTH IN THIS VICIOUS CIRCLEPAC AND NEGLE. AND I'M SURE. SENATOR SENATOR JUST BRFLY, I JUSCURIOUS GOING FORWARIF THERE'S A STATE. >> INDERSTAND DIFFENT COUNTRIES AND ERE'S SO MY REONS THAT THEY BETTER AND NOT 10. ALL RIGHT. I AGREE WITH YOUHAT WE'RE NOT ING VE WELL IN THIS CNTRY FOR WHOLE LOT OF REASONS. BUT IS ERE A STATE? ATER? YOU CAN. IS TRE A STATE THAS DOING BETTER THAN USHAT WE COU LEN SETHING FROAS WE DEAL WITHHE UNIQUE THINGS AND TH COUNTRY. AND THANK Y, CHAIR WAKEMAN SENU KNOW, I WILL BE ASKING MY COEAGUES. IT'S ONE ING THAT I ALREA STARTED TO DO. KNOW WE ARE.

OUR DEPARTNT IS IS CELEBRED ACROSS THE COUNTRY FOR TO EERTISE FOR IT.AN INSION. BUT I THINWE'RE ALL SO HUMBLENGH WITHIN THE DEPAMENT TO KNOW TT WE CAN LEARN OM OTHERS, RIG? D AND LKS GO TO CONFENCES AND HAVE NETWORKS ANINFORMATION. IS A SHOR CUTO TO CLOSE. IS THISORT OF COST GAP OF OFHANGE. SO I WILL AING PEOP TO TO REALLY THINKBOUT WHAT THEY E HAPPENINNATIONALLY, TH AT WE CANBORROWING IMPLENT HERE AT THE STATAS WELL. THANKSINCE AUGUS THANK YOU. 'S AGN, JUST PIGGYBACNG OFF OF THIS MORNING'PRESENTATION IN TES OF THSOURCES OFUR FUNDS, MOST OFUR FUNDS COME FROM FEDERALRANTS. YOSEE THAT 54OF OUR SOURCES OF OUR FUNDARE DERAL OTHERWE ALSO GET FUNDSFROM T GENERAL FUND OM FEES, THE HEALTHARE ACCESSFUN, OTHER STATE FUNDS, THE FEDERAL, THE PRORTION OF BETWE SORT OF FEDERAL INGENERAFUND STAYS RELATIVELY STABLE BIENNIUM TO BUY ANY M AND WI FEDERAL GRANTS ALWAYS RRESENTING THE RGEST SHARE OF OUR OF R BUET.

WE CRENTLY HAVE OVER FU-TIME EQUIVALENT STAFF AND MA DIFFERENT ROLES FROM SCIENTIFIC AND THEM PROGRAM EXPERTS TO ATHE JUST NURSES, ECONOMISTS, DATA ALYSIS, COMMUNITY HEALTH SPECIALIST ENGINEERS AND AND FOLKS WHO WORK IN THE LABORATORY. AND AGAIN, MOST OF OUR JUST GIVEN HOW ARE FUNDING WRECKS OF 45% OF OUR EMPLOYEES ARE FUNDING ON FEDERAL GRANTS WITH ONLY 13% SUPPORTED BY THE GENERAL FUND. AND WE THINK ABOUT OUR FEDERAL RESOURCES. I JUST LIFT UP HERE WHERE MOST OF OUR MONEY COMES FROM AND COMES FROM THIS CENTER FOR DISEASE CONTROL AND PREVENTION, WHICH REALLY, AS YOU ALL KNOW, FOCUSES ON INFECTIOUS DISEASE CHRONIC DISEASE. AND FOR SO 46% OF OUR MONEYS COME FROM M FOLLOWED BY THE U.S. DEPARTMENT OF AGRICULTURE. AND THAT REALLY MAPS TO THE WIC PROGRAMS, THE SO THE WOMEN INCIDENT, CHILDREN'S NUTRITION PROGRAMS. AND HERE'S ANOTHER PIE GRAPH JUST TO SORT OF SHOW HOW WE USE THOSE MONIES.

45% OF THE MONIES GO OUT SO WE GET FUNDING FROM THAT. THE FEDERAL GOVERNMENT, WE GET FUNDING FROM THE STATE. IT AND WE MOVE MUCH OF THAT MONEY OUT THROUGH GRANTS, AIDS AND SUBSIDIES OUT INTO THE COMMUNITY TO SUPPORT LOCAL PUBLIC HEALTH, TO SUPPORT TRIBAL HEALTH, TO SUPPORT OF OTHER COMMUNITY PARTNERS, A LOWER AMOUNT GOES TO COVER OPERATING EXPENSES, 29% AND 26% TO EMPLOYEE TIME SENSATION. AND THEN THE BREAKDOWN BY SORT TOPIC AREA IN TERMS OF SPENDING BY BUDGET ACTIVITY IS HE IS HERE FOR YOUR REVIEW. BUT THIS IS THIS IS MY LAST SIDE.

AGAIN, CHILD AND FAMILY HEALTH IS UP THERE AT THE TOP JUST BECAUSE WHIC IS SUCH A A BIG INVESTMENT FOR US. SO YOU'LL HAVE MORE TOWARDS THE BACK OF THE DECK. BUT I'M GOING TO STOP HERE. HAPPY TO TAKE ANY OTHER QUESTIONS. THANK YOU SO MUCH FOR YOUR TIME TODAY. I'M JOINED UP HERE. I DON'T KNOW INTRODUCED TO MARKET, BUT OUR DEPUTY COMMISSIONER MARGARET KELLY AND AGAIN, WE'RE BOTH HAPPY TO ANY ADDITIONAL QUESTIONS THAT YOU ONLY HAVE. THANK YOU, COMMISSIONER WELCOME TO THE COMMITTEE. MARGARET ARE MISSKELLEY TOO. >> DO MEMBERS HAVE ANY OTHER QUESTIONS TODAY AT THIS TIME? SENATOR BURR? >> WELL, THANKS AND REALLY APPRECIATE YOU COMING CHAIR. APPRECIATE COMING TODAY. AND A LOT OF THINGS SO FAR. WE YOU KIND OF FOCUSING ON PUBLIC HEALTH AND I APPRECIATE THAT. AND I THINK THAT'S IMPORTANT. I HAVE YOU ANNEX THE HEALTH AND HMO'S AND AND THERE'S ISSUES THAT HAVE COME UP REPEATEDLY ON SOME OF THOSE MATTERS ABOUT ACCESS AND 30 MILES 60 MILE RADIUS, WHICH CONTINUES TO BE AN ISSUE IN GREATER MINNESOTA, IN PARTICULAR AND AND I AM BROUGHT THIS UP SOME YEARS AGO, WAY BEFORE YOUR UP AND BUT THAT YOU PREFER FALLS, HAD TO GO FROM THERE, DRIVE PAST MANY CLINICS AND THEN FUN, IT WAS BLUE CROSS DEAL WITH SANFORD.

IT'S GOT A NOTE BACK FROM SANFORD AS I WAS TALKING ABOUT THIS MERGER WHICH MAYBE WILL TALK ABOUT OR NOT. BUT THE SANFORD WRITERS SAID, WELL, THE DEPARTMENT APPROVED THAT AND LIKE WHAT? AND SO THEN COME TO FIND OUT THAT THE DEPARTMENT APPROVES A PACKAGE. TO PUT IT, HERE'S THE HERE'S WHAT WE'RE GOING TO PROVIDE. AND IT INCLUDES THIS SCUZZY ACCESS ISSUE IF THE DRIVER FROM, BUT AT THE FUTURE OF FALLS TO GET YOUR PRENATAL CARE AND A BLIZZARD, UNLIKE REALLY AND SOLD.

I THINK THAT'S HORRIBLE. I WAS A SURPRISE THAT CAME TO MIND WAS ABLE TO BE A NO DEFENDING WHY IT SHOULD BE EMERGING AND THAT YOU WOULD APPROVE THIS THAT YOU THERE. YOUR YOUR PEERS AND I DON'T ALWAYS KNOW IF WE GET WHAT WE THINK WE'RE GETTING. WHEN PEOPLE THINK THEY HAVE A HEALTH PLAN AND IF THINGS ARE DONE WITH REASON AND IT SITS IN A PREVIEW OF THIS COMMITTEE TO FIND SOME WAYS TO GIVE YOU THE POWER YOU NEED TO SAY NO, WE'RE GOING THE PACKAGE, BUT NOT THIS PART, AS I WAS JUST TOLD US TO OR WHAT AND SO. I MEAN, YOU'RE AT THE PERFECT TIME. YOU'RE YOU'RE KIND OF BRAND NEW. IT'S A NEW LEGISLATURE, ITS NEW LEADERS GET SOME MONEY. SO I'M JUST EAGER TO HELP. MAKE THAT WORK I BEEN 44 YEARS IN PRACTICE AND DURING SOME OF THAT ON THE CONSERVATIVE SIDE DEALING WITH PEOPLE AT SOME LEVELS YOU WOULD LIKE US TO BE DEALING WITH IN PREVENTION AND NUTRITION AND WHAT DO YOU DO? A DAILY AND ALL THAT SORT OF THING ANYWAY.

SO I'M HAPPY HERE, BUT I WANTED TO RAISE THAT POINT TO YOU AS YOU GO BACK AND TALK TO YOUR EAR HEALTH PLAN, PEOPLE AND SOMETHING ELSE IS TO CHALLENGE YOU EVERS BUSINESSES, NOBODY'S BUSINESS. 3 AGENCIES OVERSEE HMO'S YOU D H S AND COMMERCE. AND SO THEY KIND OF FIND THEIR WAYS TO FALL UNDER THE RADAR, ONE OF THE OTHER. AND THEN NOBODY WATCHES. AND SO JUST A THOUGHT THAT OCCURS TO ME IS THAT. I DON'T KNOW WHO IT SHOULD BE IF IT'S HEALTH OR COMMERCE, I WOULDN'T THINK DHS WOULD BE THE ONE SUITED FOR REGULATORY OVERSIGHT THAT I THINK IT SHOULD BE AT ONE PLACE AND THEN SOMEBODY IS ACCOUNTABLE. AND SO ALL THOSE BILLIONS, WE'RE GETTING THEM IN THE END, THE PROGRAMS, BUT ALSO IN THE REGULAR COMMERCIAL PROGRAMS WOULD ACTUALLY BE WELL SPENT AND THEY DON'T HAVE A PLAN THAT THEY CAN'T AFFORD TO USE. AND THE TRAGEDIES THAT COME OUT OF THAT. SO THAT'S MY ENCOURAGEMENT TO YOU AND HAPPY TO BE A PART OF THAT.

THANK YOU. THANK YOU, COMMISSIONER, TO ANYTHING TO SAY. >> RESPONSE TO THAT. SO SO SO THANK YOU, CHAIR WITH CLAN. SENATOR. I KNOW WE DO OWES. I KNOW THAT THERE. >> ONGOING CONVERSATIONS ABOUT PROVIDER ABOUT NETWORK ADEQUACY, FOR FOR PLANS. AND SO I THINK YOU FOR LIFTING THAT UP ASSISTANT COMMISSIONER FOR A HEALTH SYSTEM, SPIRITS AN AUDIENCE AND AND LISTENING TO THAT AS WELL. AND SO CERTAINLY WE HAVE OUR EYES ON THAT SPACE. BUT PEOPLE ARE ASKING SIMILAR QUESTIONS. AND I AND I'VE HEARD THOSE EVEN IN MY ROLE AS ASSISTANT COMMISSIONER. THANK SENATOR THANK YOU. THANK YOU, MADAM CHAIR. I'M GLAD THIS CONVERSATION IS HAPPENING BECAUSE THERE'S A >> THERE'S AN INTEGRATION OF THOSE DIFFERENT AGENCIES. AND IN ONE FALLS IN 2 POINTS, ANYTHING IN THE ONE. 44 G CONVERSATION RIGHT, LICENSED BY THE DEPARTMENT OF HEALTH TO GET THE SERVICES PROVIDED ARE GOING TO BE 2.45. A T G RIGHT. THE OTHER ONE IS IN THE SUBSTANCE USE AND MENTAL HEALTH. YOU HAVE. >> THE STATE SETS THE. >> HOW THE REIMBURSEMENT RATE IS PER UNIT. 15 $1 PER UNIT MAXIMUM OF 2 HOURS. BOTH IN THAT IN THE THAT THE HEALTH AND SUBSTANCE USE.

DON'T ASK ME THE STATUTE BECAUSE ALL GET IT IN 5 MINUTES. BUT HMO'S CAN KIND OF DICTATE THEIR OWN. WE AFTER AFTER THE STATE ESTABLISHES THAT THAT THE HMO'S OR SEALS SET THEIR OWN PIECE ON IT AND THERE ISN'T A CONSISTENCY ON HOW IF THE STATE ALREADY SAYS HE A GOOD JOB RIGHT? WHY IS IT THAT ORGANIZATIONS THAT ARE DOING LIFESAVING WORK? HAVE TO WAIT 12, 14 MONTHS FOR SOME OF THE AND CEOS TO 2 THERE OWN SIDE OF IT. SO I MEAN, TO THAT POINT, IT WOULD BE GOOD TO HAVE THAT CONVERSATION HERE, TOO, IS HOW YOU GET SOME CONSISTENCY. AND WHAT SENATOR EYLER SIDE COMMERCE HEALTH AND DHS. AND SO I LOOK FORWARD TO. CREATING CONSISTENCY ON THAT REALLY GOT 120 DAYS TO DO YOU KNOW, BRING A >> THANK YOU, SENATOR. I DO THINK THAT THAT IS TOPIC, YOU UNDER THE BROAD TOPIC OF HEALTH CARE COVERAGE AND AND HOW HOW WE CAN INFLUENCE IT IN MINNESOTA. AND I THINK THERE ARE MANY ASPECTS TO THAT.

AND PART OF IT IS, YOU KNOW, PART OF IT IS ACCESS INDIVIDUALS HAVE TO MAKE USE OF THEIR HEALTH CARE AND THAT'S INFLUENCED BY A NUMBER OF THINGS. BUT I THINK THAT WILL BE A TOPIC THAT I'M YOU KNOW, IT'S A PRIORITY FOR ME FOR THIS COMMITTEE. TAKE TO GET INTO THESE DIFFERENT AREAS AND LOOK AT, YOU KNOW, HOW THEY INTERSECT WITH OTHER COMMITTEES BECAUSE THAT'S THE WAY WORKS, THAT IT WILL INVOLVE MULTIPLE COMMITTEES AND ANY AGENCIES.

AND JUST IN CLOSING, I MEAN, I I MEAN, NOTE OF A FEW ITEMS THAT, YOU KNOW, ARE. AREAS OF INTEREST FOR A COMMITTEE. I WILL MY MINISTER FORWARD THE THE PUBLIC PUBLIC HEALTH SYSTEM REPORT THAT CAME I KNOW WE RECEIVED A WEEK OR SO AGO. A NOTICE OF FLORIDA TO THE COMMITTEE MEMBER. SEE, YOU HAVE THAT INFORMATION AND CAN START TO TAKE. SO TAKE A LOOK AT THAT REPORT BECAUSE I KNOW IT HAS RECOMMENDATIONS IN IT AS WELL.

SO WE WILL GET THAT OUT. AND IF YOU THINK OF OTHER ITEMS THAT YOU THINK THAT THE COMMITTEE WOULD BENEFIT FROM. I APPRECIATE IT. YOU KNOW, HEARING FROM YOUR DEPARTMENT AND I LEE SAYS VERY GOOD ABOUT PROVIDING INFORMATION TO US DIRECTLY. SO. MEMBERS THAT THERE AREN'T ANY OTHER QUESTIONS. WE WILL CLOSED FOR TODAY. THANK YOU VERY AGAIN, VERY MUCH FOR YOUR TIME AND THANK YOU TO THE ALL THE STAFF THAT WORKED PREPARING A PRESENTATION ENCOURAGING LET'S TAKE A LOOK. MEMBERS OUT THERE, OTHER DETAILED SHEETS, THERE MIGHT BE AREAS. THE DEPARTMENT THAT YOU'D LIKE TO KNOW MORE ABOUT IT. SO THANK YOU AGAIN FOR COMING TODAY. THANK YOU, CHAIR WEEKLY. THANK YOU. MEMBERS OF THE COMMITTEE. MEMBERS. WE WILL WE WILL NOT HAVE A MEETING COMMISSIONER OF DHS IS NOT AVAILABLE TO. WE CAN'T KIND OF PROCEED INTO A AN OVERVIEW OF DHS, WHICH I'D LIKE TO DO NEXT. AND SO WE WILL MEET AGAIN ON TUESDAY NEXT WEEK. AND A HALF MEN CHAIR. WE'RE GOING DHS IS DOING TO DHS 1, 1, FOR THEIR TOMORROW. WEIGHT. >> WAS IT GETS TODAY? IT'S 2 DAYS AFTER IF FOLKS WANT TO COME TO THAT, WE HAVE WE SHOULD NEVER LET THE TABLE SO.

>> THANK YOU. I THINK THAT, YOU KNOW, HEARING IT, IT'S IT'S A COMPLEX ORGANIZATION AND HEARING THE INFORMATION MORE THAN ONCE IS IS PROBABLY A HELPFUL THING. IF YOU WANT TO TAKE A LOOK AT THAT AT 3 O'CLOCK TODAY. SO THANK YOU, MEMBERS SEEING NO FURTHER COMMITTEE IS ADJOURNED.

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