1.1.................... moves to amend H. F. No. 1047 as follows:
1.2Delete everything after the enacting clause and insert:


1.5    Section 1. Minnesota Statutes 2012, section 145.906, is amended to read:
1.6145.906 POSTPARTUM DEPRESSION EDUCATION AND INFORMATION.
1.7(a) The commissioner of health shall work with health care facilities, licensed health
1.8and mental health care professionals, the women, infants, and children (WIC) program,
1.9mental health advocates, consumers, and families in the state to develop materials and
1.10information about postpartum depression, including treatment resources, and develop
1.11policies and procedures to comply with this section.
1.12(b) Physicians, traditional midwives, and other licensed health care professionals
1.13providing prenatal care to women must have available to women and their families
1.14information about postpartum depression.
1.15(c) Hospitals and other health care facilities in the state must provide departing new
1.16mothers and fathers and other family members, as appropriate, with written information
1.17about postpartum depression, including its symptoms, methods of coping with the illness,
1.18and treatment resources.
1.19(d) Information about postpartum depression, including its symptoms, potential
1.20impact on families, and treatment resources, must be available at WIC sites.
1.21(e) The commissioner of health, in collaboration with the commissioner of human
1.22services, shall reduce the racial disparity gap in knowledge of maternal and postpartum
1.23depression, as measured by the Pregnancy Risk Assessment and Monitoring System
1.24(PRAMS) and other survey data collected by the commissioner of health, to the extent
1.25that it is available.

2.1    Sec. 2. [145.907] MATERNAL DEPRESSION; DEFINITION.
2.2"Maternal depression" means depression or other perinatal mood or anxiety disorder
2.3experienced by a woman during pregnancy or during the first year following the birth of
2.4her child.

2.5    Sec. 3. Minnesota Statutes 2012, section 145A.17, subdivision 1, is amended to read:
2.6    Subdivision 1. Establishment; goals. The commissioner shall establish a program
2.7to fund family home visiting programs designed to foster healthy beginnings, improve
2.8pregnancy outcomes, promote school readiness, prevent child abuse and neglect, reduce
2.9juvenile delinquency, promote positive parenting and resiliency in children, and promote
2.10family health and economic self-sufficiency for children and families. The commissioner
2.11shall promote partnerships, collaboration, and multidisciplinary visiting done by teams of
2.12professionals and paraprofessionals from the fields of public health nursing, social work,
2.13and early childhood education. A program funded under this section must serve families
2.14at or below 200 percent of the federal poverty guidelines, and other families determined
2.15to be at risk, including but not limited to being at risk for child abuse, child neglect, or
2.16juvenile delinquency. Programs must begin prenatally whenever possible and must be
2.17targeted to families with:
2.18    (1) adolescent parents;
2.19    (2) a history of alcohol or other drug abuse;
2.20    (3) a history of child abuse, domestic abuse, or other types of violence;
2.21    (4) a history of domestic abuse, rape, or other forms of victimization;
2.22    (5) reduced cognitive functioning;
2.23    (6) a lack of knowledge of child growth and development stages;
2.24    (7) low resiliency to adversities and environmental stresses;
2.25    (8) insufficient financial resources to meet family needs;
2.26    (9) a history of homelessness;
2.27    (10) a risk of long-term welfare dependence or family instability due to employment
2.28barriers; or
2.29(11) a serious mental health disorder, including maternal depression as defined in
2.30section 145.907; or
2.31    (11) (12) other risk factors as determined by the commissioner.

2.32    Sec. 4. Minnesota Statutes 2012, section 256B.04, is amended by adding a subdivision
2.33to read:
3.1    Subd. 22. Maternal depression screening and referral. (a) The commissioner
3.2shall provide technical assistance to health care providers to improve maternal depression
3.3screening and referral rates for medical assistance and MinnesotaCare enrollees. The
3.4technical assistance must include, but is not limited to, the provision of information on
3.5culturally competent practice, administrative and legal liability issues, and best practices
3.6for discussing mental health issues with patients.
3.7(b) The commissioner, in consultation with the commissioners of health and
3.8education, shall monitor: (1) maternal depression screening, to the extent possible, and
3.9referral rates based on medical assistance and MinnesotaCare claims and Pregnancy
3.10Risk Assessment Monitoring System (PRAMS) survey findings; and (2) the impact of
3.11improved screening.
3.12(c) For purposes of this subdivision, "maternal depression" has the meaning provided
3.13in section 145.907.

3.14    Sec. 5. Minnesota Statutes 2012, section 256B.055, subdivision 5, is amended to read:
3.15    Subd. 5. Pregnant women; dependent unborn child. Medical assistance may be
3.16paid for a pregnant woman who has written verification of a positive pregnancy test from
3.17a physician or licensed registered nurse, who meets the other eligibility criteria of this
3.18section and who would be categorically eligible for assistance under the state's AFDC
3.19plan in effect as of July 16, 1996, as required by the Personal Responsibility and Work
3.20Opportunity Reconciliation Act of 1996 (PRWORA), Public Law 104-193, if the child
3.21had been born and was living with the woman. For purposes of this subdivision, a woman
3.22is considered pregnant for 60 days the first year postpartum.
3.23EFFECTIVE DATE.This section is effective July 1, 2013, or upon federal
3.24approval, whichever is later.

3.25    Sec. 6. Minnesota Statutes 2012, section 256B.055, subdivision 6, is amended to read:
3.26    Subd. 6. Pregnant women; needy unborn child. Medical assistance may be paid
3.27for a pregnant woman who has written verification of a positive pregnancy test from a
3.28physician or licensed registered nurse, who meets the other eligibility criteria of this
3.29section and whose unborn child would be eligible as a needy child under subdivision 10 if
3.30born and living with the woman. For purposes of this subdivision, a woman is considered
3.31pregnant for 60 days the first year postpartum.
3.32EFFECTIVE DATE.This section is effective July 1, 2013, or upon federal
3.33approval, whichever is later.

4.1    Sec. 7. Minnesota Statutes 2012, section 256B.057, subdivision 1, is amended to read:
4.2    Subdivision 1. Infants and pregnant women. (a)(1) An infant less than one year of
4.3age or a pregnant woman who has written verification of a positive pregnancy test from
4.4a physician or licensed registered nurse is eligible for medical assistance if countable
4.5family income is equal to or less than 275 percent of the federal poverty guideline for the
4.6same family size. For purposes of this subdivision, "countable family income" means the
4.7amount of income considered available using the methodology of the AFDC program
4.8under the state's AFDC plan as of July 16, 1996, as required by the Personal Responsibility
4.9and Work Opportunity Reconciliation Act of 1996 (PRWORA), Public Law 104-193,
4.10except for the earned income disregard and employment deductions.
4.11    (2) For applications processed within one calendar month prior to the effective date,
4.12eligibility shall be determined by applying the income standards and methodologies in
4.13effect prior to the effective date for any months in the six-month budget period before
4.14that date and the income standards and methodologies in effect on the effective date for
4.15any months in the six-month budget period on or after that date. The income standards
4.16for each month shall be added together and compared to the applicant's total countable
4.17income for the six-month budget period to determine eligibility.
4.18    (b)(1) [Expired, 1Sp2003 c 14 art 12 s 19]
4.19    (2) For applications processed within one calendar month prior to July 1, 2003,
4.20eligibility shall be determined by applying the income standards and methodologies in
4.21effect prior to July 1, 2003, for any months in the six-month budget period before July 1,
4.222003, and the income standards and methodologies in effect on the expiration date for any
4.23months in the six-month budget period on or after July 1, 2003. The income standards
4.24for each month shall be added together and compared to the applicant's total countable
4.25income for the six-month budget period to determine eligibility.
4.26    (3) An amount equal to the amount of earned income exceeding 275 percent of
4.27the federal poverty guideline, up to a maximum of the amount by which the combined
4.28total of 185 percent of the federal poverty guideline plus the earned income disregards
4.29and deductions allowed under the state's AFDC plan as of July 16, 1996, as required
4.30by the Personal Responsibility and Work Opportunity Act of 1996 (PRWORA), Public
4.31Law 104-193, exceeds 275 percent of the federal poverty guideline will be deducted for
4.32pregnant women and infants less than one year of age.
4.33    (c) Dependent care and child support paid under court order shall be deducted from
4.34the countable income of pregnant women.
5.1    (d) An infant born to a woman who was eligible for and receiving medical assistance
5.2on the date of the child's birth shall continue to be eligible for medical assistance without
5.3redetermination until the child's first second birthday.
5.4EFFECTIVE DATE.This section is effective July 1, 2013, or upon federal
5.5approval, whichever is later.

5.6    Sec. 8. Minnesota Statutes 2012, section 256B.0623, subdivision 2, is amended to read:
5.7    Subd. 2. Definitions. For purposes of this section, the following terms have the
5.8meanings given them.
5.9(a) "Adult rehabilitative mental health services" means mental health services
5.10which are rehabilitative and enable the recipient to develop and enhance psychiatric
5.11stability, social competencies, personal and emotional adjustment, and independent living,
5.12parenting skills, and community skills, when these abilities are impaired by the symptoms
5.13of mental illness. Adult rehabilitative mental health services are also appropriate when
5.14provided to enable a recipient to retain stability and functioning, if the recipient would
5.15be at risk of significant functional decompensation or more restrictive service settings
5.16without these services.
5.17(1) Adult rehabilitative mental health services instruct, assist, and support the
5.18recipient in areas such as: interpersonal communication skills, community resource
5.19utilization and integration skills, crisis assistance, relapse prevention skills, health care
5.20directives, budgeting and shopping skills, healthy lifestyle skills and practices, cooking
5.21and nutrition skills, transportation skills, medication education and monitoring, mental
5.22illness symptom management skills, household management skills, employment-related
5.23skills, parenting skills, and transition to community living services.
5.24(2) These services shall be provided to the recipient on a one-to-one basis in the
5.25recipient's home or another community setting or in groups.
5.26(b) "Medication education services" means services provided individually or in
5.27groups which focus on educating the recipient about mental illness and symptoms; the role
5.28and effects of medications in treating symptoms of mental illness; and the side effects of
5.29medications. Medication education is coordinated with medication management services
5.30and does not duplicate it. Medication education services are provided by physicians,
5.31pharmacists, physician's assistants, or registered nurses.
5.32(c) "Transition to community living services" means services which maintain
5.33continuity of contact between the rehabilitation services provider and the recipient and
5.34which facilitate discharge from a hospital, residential treatment program under Minnesota
5.35Rules, chapter 9505, board and lodging facility, or nursing home. Transition to community
6.1living services are not intended to provide other areas of adult rehabilitative mental health
6.2services.


6.5    Section 1. Minnesota Statutes 2012, section 214.12, is amended by adding a
6.6subdivision to read:
6.7    Subd. 4. Parental depression. The health-related licensing boards that regulate
6.8professions that serve caregivers at risk of depression, or their children, including
6.9behavioral health and therapy, chiropractic, marriage and family therapy, medical practice,
6.10nursing, psychology, and social work, shall require that licensees receive continuing
6.11education on the subject of parental depression and its potential effects on children if
6.12unaddressed, including how to:
6.13(1) screen mothers for depression;
6.14(2) identify children who are affected by their mother's depression; and
6.15(3) provide treatment or referral information on needed services.

6.16    Sec. 2. INSTRUCTIONS TO COMMISSIONERS; PLAN.
6.17(a) By September 1, 2014, the commissioners of human services, health, and
6.18education shall develop a joint plan to reduce the prevalence of parental depression and
6.19other serious mental illness and the potential impact of unaddressed parental mental
6.20illness on children. The plan must include specific goals, outcomes, and recommended
6.21measures to determine the impact of interventions on the incidence of parental depression
6.22and child well-being, including early childhood screening and the school readiness of
6.23high-risk children. The plan shall address ways to encourage a multigenerational approach
6.24to adult mental health and child well-being in public health, health care, adult and child
6.25mental health, child welfare, and other relevant programs and policies, and include
6.26recommendations to increase public awareness about untreated parental depression and
6.27its potential harmful impact on children.
6.28(b) To identify key goals and objectives to be included in the plan, the commissioners
6.29may consult with multisector, multidisciplinary stakeholders including but not be limited
6.30to, local public health agencies, health providers, mental health providers, researchers,
6.31early childhood professionals, and advocates. The commissioners may use the findings
6.32and recommendations of the visible child work group established in Laws 2012, chapter
6.33247, article 3, section 27, in developing its recommendations.
7.1(c) Jointly prepared biennial reports must be submitted to the legislature beginning
7.2December 15, 2015. The reports must address progress on plan implementation, budget
7.3and policy recommendations, and data on access to relevant services and resources
7.4reported by race, geography, and income. The reports must address progress in achieving
7.5goals established by Minnesota Milestones or other relevant statewide goals.
7.6(d) The Department of Human Services, Children's Mental Health Division, is the
7.7lead agency and is responsible for compiling data; coordinating development of joint
7.8performance measures; and convening the agencies and divisions in order to implement
7.9the plan developed under paragraph (a), aimed at reducing the prevalence of maternal
7.10depression and its adverse impact on child development. The Children's Mental Health
7.11Division is responsible for submitting the initial and biennial plans.


7.14    Section 1. MENTAL HEALTH CONSULTATION.
7.15$....... in fiscal year 2014 and $....... in fiscal year 2015 are appropriated from the
7.16general fund to the commissioner of human services to provide mental health consultation
7.17to early Head Start and Head Start programs, child care centers, family day care providers,
7.18and legally unlicensed family child care providers in order to reduce the number of children
7.19expelled from these programs due to behavioral, emotional, and developmental issues.

7.20    Sec. 2. CHILDREN'S MENTAL HEALTH GRANTS.
7.21$....... in fiscal year 2014 and $....... in fiscal year 2015 are appropriated from the
7.22general fund to the commissioner of human services for children's mental health grants.

7.23    Sec. 3. HOME VISITING PROGRAMS.
7.24$....... in fiscal year 2014 and $....... in fiscal year 2015 are appropriated from the
7.25general fund to the commissioner of health for grants to local public health agencies to
7.26implement evidence-based family home visiting programs for high-risk families under
7.27Minnesota Statutes, section 145A.17."
7.28Amend the title accordingly