SF 1665

as introduced - 83rd Legislature (2003 - 2004) Posted on 12/15/2009 12:00am

  1.1                          A bill for an act 
  1.2             relating to prevention of abortion, unintended 
  1.3             pregnancies, and sexually transmitted infection; 
  1.4             increasing access to family planning services; 
  1.5             expanding educational efforts to prevent unintended 
  1.6             pregnancies; increasing wholesome after-school 
  1.7             activities for youth; requiring development of a plan 
  1.8             to ensure comprehensive family life and sexuality 
  1.9             education; creating after-school enrichment programs; 
  1.10            requiring the provision of contraceptive information; 
  1.11            creating a family planning Web site; modifying the 
  1.12            ENABL program; establishing regional training sites 
  1.13            for comprehensive family life and sexuality education 
  1.14            in schools; requiring family planning information be 
  1.15            provided to MFIP recipients; appropriating money; 
  1.16            amending Minnesota Statutes 2002, section 145.925, 
  1.17            subdivision 9; Minnesota Statutes 2003 Supplement, 
  1.18            sections 145.4243; 145.9255, subdivisions 1, 4; 
  1.19            256J.45, subdivision 2; proposing coding for new law 
  1.20            in Minnesota Statutes, chapters 121A; 124D; 145.  
  1.21  BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA: 
  1.22     Section 1.  [PURPOSE.] 
  1.23     The legislature finds that many Minnesota women do not have 
  1.24  access to birth control and information about family planning.  
  1.25  The legislature further finds that providing access to family 
  1.26  planning information and contraception will prevent abortions 
  1.27  and unintended pregnancies and reduce the number of women who 
  1.28  need medical assistance, MFIP, and other social services.  
  1.29     The legislature further recognizes that in the most recent 
  1.30  peer-reviewed study of family planning cost-effectiveness, an 
  1.31  analysis of California's program showed that for every 
  1.32  $1,000,000 spent on family planning, over 900 unintended 
  1.33  pregnancies were prevented and more than 350 abortions were 
  2.1   avoided.  The unintended pregnancies prevented by the California 
  2.2   family planning efforts saved an estimated $4.48 in public 
  2.3   expenditures for every $1 spent.  
  2.4      Sec. 2.  [121A.231] [COMPREHENSIVE FAMILY LIFE AND 
  2.5   SEXUALITY EDUCATION.] 
  2.6      The commissioner shall develop a plan that ensures all 
  2.7   school districts provide comprehensive family life and sexuality 
  2.8   education no later than the 2008-2009 school year.  For the 
  2.9   purposes of this section, "comprehensive family life and 
  2.10  sexuality education" means education in grades kindergarten 
  2.11  through 12 that: 
  2.12     (1) respects community values and encourages family 
  2.13  communication; 
  2.14     (2) develops skills in communication, decision making, and 
  2.15  conflict resolution; 
  2.16     (3) contributes to healthy relationships; 
  2.17     (4) provides human development and sexuality education that 
  2.18  is medically accurate and age appropriate; 
  2.19     (5) promotes responsible sexual behavior, including 
  2.20  promotion of abstinence; 
  2.21     (6) addresses the use of contraception; and 
  2.22     (7) promotes individual responsibility.  
  2.23     Sec. 3.  [124D.222] [AFTER-SCHOOL ENRICHMENT PROGRAMS.] 
  2.24     Subdivision 1.  [ESTABLISHMENT.] A competitive statewide 
  2.25  after-school enrichment grant program is established to provide 
  2.26  implementation grants to community or nonprofit organizations, 
  2.27  political subdivisions, or school-based programs.  The 
  2.28  commissioner shall develop criteria for after-school enrichment 
  2.29  programs. 
  2.30     Subd. 2.  [PRIORITY NEIGHBORHOODS.] For grants in 
  2.31  Minneapolis and St. Paul, the commissioner must give priority to 
  2.32  neighborhoods listed in this subdivision.  In Minneapolis, 
  2.33  priority neighborhoods are Near North, Hawthorne, 
  2.34  Sumner-Glenwood, Harrison, Jordan, Powderhorn, Central, 
  2.35  Whittier, Cleveland, McKinley, Waite Park, Sheridan, Holland, 
  2.36  Lyndale, Folwell, and Phillips.  In St. Paul, priority 
  3.1   neighborhoods are Summit-University, Thomas-Dale, North End, 
  3.2   Payne-Phalen, Dayton's Bluff, and the West Side. 
  3.3      Subd. 3.  [PROGRAM OUTCOMES.] The expected outcomes of the 
  3.4   after-school enrichment programs are to: 
  3.5      (1) increase the number of children participating in 
  3.6   adult-supervised programs in nonschool hours; 
  3.7      (2) support academic achievement, including the areas of 
  3.8   reading and math; 
  3.9      (3) reduce the incidence of juvenile sexual activity; 
  3.10     (4) reduce the amount of juvenile crime; 
  3.11     (5) increase school attendance and reduce the number of 
  3.12  school suspensions; 
  3.13     (6) increase the number of youth engaged in community 
  3.14  service and other activities designed to support character 
  3.15  improvement, strengthen families, and instill community values; 
  3.16     (7) increase skills in technology, the arts, sports, and 
  3.17  other activities; and 
  3.18     (8) increase and support the academic achievement and 
  3.19  character development of adolescent parents. 
  3.20     Subd. 4.  [PLAN.] A grant applicant shall develop a plan 
  3.21  for an after-school enrichment program for youth.  The plan must 
  3.22  include: 
  3.23     (1) collaboration with and leverage of existing community 
  3.24  resources that have demonstrated effectiveness; 
  3.25     (2) creative outreach to children and youth; 
  3.26     (3) involvement of local governments, including park and 
  3.27  recreation boards or schools, unless no government agency is 
  3.28  appropriate; 
  3.29     (4) community control over the design of the enrichment 
  3.30  program; and 
  3.31     (5) identification of the sources of nonpublic funding. 
  3.32     Subd. 5.  [PLAN APPROVAL; GRANTS.] A grant applicant shall 
  3.33  submit a plan developed under subdivision 4 to the commissioner 
  3.34  for approval.  The commissioner shall award a grant for the 
  3.35  implementation of an approved plan. 
  3.36     Sec. 4.  [145.4125] [FAMILY PLANNING INFORMATION.] 
  4.1      Before or after an abortion is or has been performed, the 
  4.2   hospital or health care facility performing the abortion must 
  4.3   provide the woman with written information on all FDA-approved 
  4.4   methods of contraception and natural family planning and must 
  4.5   offer referral information on local community resources that 
  4.6   provide contraceptive services and family planning counseling at 
  4.7   no cost or at a reduced cost to low-income clients.  This 
  4.8   information must be provided within a reasonable time before or 
  4.9   after an abortion is to be performed. 
  4.10     Sec. 5.  Minnesota Statutes 2003 Supplement, section 
  4.11  145.4243, is amended to read: 
  4.12     145.4243 [PRINTED INFORMATION.] 
  4.13     (a) Within 90 days after July 1, 2003, the commissioner of 
  4.14  health shall cause to be published, in English and in each 
  4.15  language that is the primary language of two percent or more of 
  4.16  the state's population, and shall cause to be available on the 
  4.17  state Web site provided for under section 145.4244 the following 
  4.18  printed materials in such a way as to ensure that the 
  4.19  information is easily comprehensible: 
  4.20     (1) geographically indexed materials designed to inform the 
  4.21  female of public and private agencies and services available to 
  4.22  assist a female through pregnancy, upon childbirth, and while 
  4.23  the child is dependent, including adoption agencies, which shall 
  4.24  include a comprehensive list of the agencies available, a 
  4.25  description of the services they offer, and a description of the 
  4.26  manner, including telephone numbers, in which they might be 
  4.27  contacted or, at the option of the commissioner of health, 
  4.28  printed materials including a toll-free, 24-hours-a-day 
  4.29  telephone number that may be called to obtain, orally or by a 
  4.30  tape recorded message tailored to a zip code entered by the 
  4.31  caller, such a list and description of agencies in the locality 
  4.32  of the caller and of the services they offer; 
  4.33     (2) materials designed to inform the female of the probable 
  4.34  anatomical and physiological characteristics of the unborn child 
  4.35  at two-week gestational increments from the time when a female 
  4.36  can be known to be pregnant to full term, including any relevant 
  5.1   information on the possibility of the unborn child's survival 
  5.2   and pictures or drawings representing the development of unborn 
  5.3   children at two-week gestational increments, provided that any 
  5.4   such pictures or drawings must contain the dimensions of the 
  5.5   fetus and must be realistic and appropriate for the stage of 
  5.6   pregnancy depicted.  The materials shall be objective, 
  5.7   nonjudgmental, and designed to convey only accurate scientific 
  5.8   information about the unborn child at the various gestational 
  5.9   ages.  The material shall also contain objective information 
  5.10  describing the methods of abortion procedures commonly employed, 
  5.11  the medical risks commonly associated with each procedure, the 
  5.12  possible detrimental psychological effects of abortion, and the 
  5.13  medical risks commonly associated with carrying a child to term; 
  5.14  and 
  5.15     (3) materials with the following information concerning an 
  5.16  unborn child of 20 weeks gestational age and at two weeks 
  5.17  gestational increments thereafter in such a way as to ensure 
  5.18  that the information is easily comprehensible: 
  5.19     (i) the development of the nervous system of the unborn 
  5.20  child; 
  5.21     (ii) fetal responsiveness to adverse stimuli and other 
  5.22  indications of capacity to experience organic pain; and 
  5.23     (iii) the impact on fetal organic pain of each of the 
  5.24  methods of abortion procedures commonly employed at this stage 
  5.25  of pregnancy; and 
  5.26     (4) materials on all FDA-approved methods of contraception 
  5.27  and natural family planning and referral information on public 
  5.28  and private agencies and community resources that provide 
  5.29  contraceptive services and counseling at no cost or at a reduced 
  5.30  cost to low-income clients. 
  5.31     The material under this clause shall be objective, 
  5.32  nonjudgmental, and designed to convey only accurate scientific 
  5.33  information. 
  5.34     (b) The materials referred to in this section must be 
  5.35  printed in a typeface large enough to be clearly legible.  The 
  5.36  Web site provided for under section 145.4244 shall be maintained 
  6.1   at a minimum resolution of 70 DPI (dots per inch).  All pictures 
  6.2   appearing on the Web site shall be a minimum of 200x300 pixels.  
  6.3   All letters on the Web site shall be a minimum of 11-point 
  6.4   font.  All information and pictures shall be accessible with an 
  6.5   industry standard browser, requiring no additional plug-ins.  
  6.6   The materials required under this section must be available at 
  6.7   no cost from the commissioner of health upon request and in 
  6.8   appropriate number to any person, facility, or hospital. 
  6.9      Sec. 6.  [145.426] [FAMILY PLANNING WEB SITE.] 
  6.10     The commissioner of health shall develop and maintain, as 
  6.11  part of the department's Web site, information on family 
  6.12  planning and referrals to local community resources to assist 
  6.13  women and families in preventing unintended pregnancies.  The 
  6.14  Web site must provide information on: 
  6.15     (1) family planning methods, including all FDA-approved 
  6.16  methods of contraception and natural family planning; 
  6.17     (2) basic preventive reproductive health services, 
  6.18  including breast and pelvic examinations; cervical cancer; 
  6.19  screenings for sexually transmitted diseases (STD) and human 
  6.20  immunodeficiency virus (HIV); and pregnancy diagnosis and 
  6.21  counseling; and 
  6.22     (3) referrals to local community providers and resources, 
  6.23  including subsidized family planning providers, that provide 
  6.24  family planning services and counseling and basic preventive 
  6.25  reproductive health services. 
  6.26     Sec. 7.  Minnesota Statutes 2002, section 145.925, 
  6.27  subdivision 9, is amended to read: 
  6.28     Subd. 9.  [AMOUNT OF GRANT; RULES.] Notwithstanding any 
  6.29  rules to the contrary, including rules proposed in the State 
  6.30  Register on April 1, 1991, the commissioner, in allocating grant 
  6.31  funds for family planning special projects, shall not limit the 
  6.32  total amount of funds that can be allocated to an organization.  
  6.33  The commissioner shall allocate to an organization receiving 
  6.34  grant funds on July 1, 1997, at least the same amount of grant 
  6.35  funds for the 1998 to 1999 grant cycle as the organization 
  6.36  received for the 1996 to 1997 grant cycle, provided the 
  7.1   organization submits an application that meets grant funding 
  7.2   criteria.  In allocating the grant funds, the commissioner shall 
  7.3   ensure that grant funds for family planning special projects are 
  7.4   available in every county.  This subdivision does not affect any 
  7.5   procedure established in rule for allocating special project 
  7.6   money to the different regions.  The commissioner shall revise 
  7.7   the rules for family planning special project grants so that 
  7.8   they conform to the requirements of this subdivision.  In 
  7.9   adopting these revisions, the commissioner is not subject to the 
  7.10  rulemaking provisions of chapter 14, but is bound by section 
  7.11  14.386, paragraph (a), clauses (1) and (3).  Section 14.386, 
  7.12  paragraph (b), does not apply to these rules. 
  7.13     Sec. 8.  Minnesota Statutes 2003 Supplement, section 
  7.14  145.9255, subdivision 1, is amended to read: 
  7.15     Subdivision 1.  [ESTABLISHMENT.] The commissioner of 
  7.16  health, in consultation with a representative from Minnesota 
  7.17  planning, the commissioner of human services, and the 
  7.18  commissioner of education, shall develop and implement the 
  7.19  Minnesota education now and babies later (MN ENABL) program, 
  7.20  targeted to adolescents ages 12 to 14, with the goal of reducing 
  7.21  the incidence of adolescent pregnancy in the state and promoting 
  7.22  abstinence until marriage through comprehensive sexuality 
  7.23  education that promotes abstinence and promotes male sexual 
  7.24  responsibility.  The program must provide a multifaceted, 
  7.25  primary prevention, community health promotion approach to 
  7.26  educating and supporting adolescents in the decision to postpone 
  7.27  sexual involvement modeled after the ENABL program in 
  7.28  California.  The commissioner of health shall consult with the 
  7.29  chief of the health education section of the California 
  7.30  Department of Health Services for general guidance in developing 
  7.31  and implementing the program. 
  7.32     Sec. 9.  Minnesota Statutes 2003 Supplement, section 
  7.33  145.9255, subdivision 4, is amended to read: 
  7.34     Subd. 4.  [PROGRAM COMPONENTS.] The program must include 
  7.35  the following four major components: 
  7.36     (a) A community organization component in which the 
  8.1   community-based local contractors shall include: 
  8.2      (1) use of a postponing sexual involvement comprehensive 
  8.3   sexuality education curriculum that promotes abstinence and 
  8.4   promotes male sexual responsibility targeted to boys and girls 
  8.5   ages 12 to 14 in schools and/or community settings; 
  8.6      (2) planning and implementing community organization 
  8.7   strategies to convey and reinforce the MN ENABL message of 
  8.8   postponing sexual involvement, including activities promoting 
  8.9   awareness and involvement of parents and other primary 
  8.10  caregivers/significant adults, schools, and community; and 
  8.11     (3) development of local media linkages.  
  8.12     (b) A statewide, comprehensive media and public relations 
  8.13  campaign to promote changes in sexual attitudes and behaviors, 
  8.14  and reinforce the message of postponing adolescent sexual 
  8.15  involvement and promoting abstinence from sexual activity until 
  8.16  marriage and promoting male sexual responsibility.  Nothing in 
  8.17  this paragraph shall be construed to prevent the commissioner 
  8.18  from targeting populations that historically have had a high 
  8.19  incidence of adolescent pregnancy with culturally appropriate 
  8.20  messages on abstinence from sexual activity. 
  8.21     The commissioner of health, in consultation with the 
  8.22  commissioner of education, shall develop and implement the media 
  8.23  and public relations campaign.  In developing the campaign, the 
  8.24  commissioner of health shall coordinate and consult with 
  8.25  representatives from ethnic and local communities to maximize 
  8.26  effectiveness of the social marketing approach to health 
  8.27  promotion among the culturally diverse population of the state.  
  8.28  The commissioner may continue to use any campaign materials or 
  8.29  media messages developed or produced prior to July 1, 1999. 
  8.30     The local community-based contractors shall collaborate and 
  8.31  coordinate efforts with other community organizations and 
  8.32  interested persons to provide school and community-wide 
  8.33  promotional activities that support and reinforce the message of 
  8.34  the MN ENABL curriculum. 
  8.35     (c) An evaluation component which evaluates the process and 
  8.36  the impact of the program. 
  9.1      The "process evaluation" must provide information to the 
  9.2   state on the breadth and scope of the program.  The evaluation 
  9.3   must identify program areas that might need modification and 
  9.4   identify local MN ENABL contractor strategies and procedures 
  9.5   which are particularly effective.  Contractors must keep 
  9.6   complete records on the demographics of clients served, number 
  9.7   of direct education sessions delivered and other appropriate 
  9.8   statistics, and must document exactly how the program was 
  9.9   implemented.  The commissioner may select contractor sites for 
  9.10  more in-depth case studies. 
  9.11     The "impact evaluation" must provide information to the 
  9.12  state on the impact of the different components of the MN ENABL 
  9.13  program and an assessment of the impact of the program on 
  9.14  adolescents' related sexual knowledge, attitudes, and 
  9.15  risk-taking behavior. 
  9.16     The commissioner shall compare the MN ENABL evaluation 
  9.17  information and data with similar evaluation data from other 
  9.18  states pursuing a similar adolescent pregnancy prevention 
  9.19  program modeled after ENABL and use the information to improve 
  9.20  MN ENABL and build on aspects of the program that have 
  9.21  demonstrated a delay in adolescent sexual involvement. 
  9.22     (d) A training component requiring the commissioner of 
  9.23  health, in consultation with the commissioner of education, to 
  9.24  provide comprehensive uniform training to the local MN ENABL 
  9.25  community-based local contractors and the direct education 
  9.26  program staff.  
  9.27     The local community-based contractors may use adolescent 
  9.28  leaders slightly older than the adolescents in the program to 
  9.29  impart the message to postpone sexual involvement provided: 
  9.30     (1) the contractor follows a protocol for adult 
  9.31  mentors/leaders and older adolescent leaders established by the 
  9.32  commissioner of health; 
  9.33     (2) the older adolescent leader is accompanied by an adult 
  9.34  leader; and 
  9.35     (3) the contractor uses the curriculum as directed and 
  9.36  required by the commissioner of the Department of Health to 
 10.1   implement this part of the program.  The commissioner of health 
 10.2   shall provide technical assistance to community-based local 
 10.3   contractors. 
 10.4      Sec. 10.  Minnesota Statutes 2003 Supplement, section 
 10.5   256J.45, subdivision 2, is amended to read: 
 10.6      Subd. 2.  [GENERAL INFORMATION.] The MFIP orientation must 
 10.7   consist of a presentation that informs caregivers of: 
 10.8      (1) the necessity to obtain immediate employment; 
 10.9      (2) the work incentives under MFIP, including the 
 10.10  availability of the federal earned income tax credit and the 
 10.11  Minnesota working family tax credit; 
 10.12     (3) the requirement to comply with the employment plan and 
 10.13  other requirements of the employment and training services 
 10.14  component of MFIP, including a description of the range of work 
 10.15  and training activities that are allowable under MFIP to meet 
 10.16  the individual needs of participants; 
 10.17     (4) the consequences for failing to comply with the 
 10.18  employment plan and other program requirements, and that the 
 10.19  county agency may not impose a sanction when failure to comply 
 10.20  is due to the unavailability of child care or other 
 10.21  circumstances where the participant has good cause under 
 10.22  subdivision 3; 
 10.23     (5) the rights, responsibilities, and obligations of 
 10.24  participants; 
 10.25     (6) the types and locations of child care services 
 10.26  available through the county agency; 
 10.27     (7) the availability and the benefits of the early 
 10.28  childhood health and developmental screening under sections 
 10.29  121A.16 to 121A.19; 123B.02, subdivision 16; and 123B.10; 
 10.30     (8) the caregiver's eligibility for transition year child 
 10.31  care assistance under section 119B.05; 
 10.32     (9) the availability of all health care programs, including 
 10.33  transitional medical assistance; 
 10.34     (10) the caregiver's option to choose an employment and 
 10.35  training provider and information about each provider, including 
 10.36  but not limited to, services offered, program components, job 
 11.1   placement rates, job placement wages, and job retention rates; 
 11.2      (11) the caregiver's option to request approval of an 
 11.3   education and training plan according to section 256J.53; 
 11.4      (12) the work study programs available under the higher 
 11.5   education system; and 
 11.6      (13) information about the 60-month time limit exemptions 
 11.7   under the family violence waiver and referral information about 
 11.8   shelters and programs for victims of family violence; and 
 11.9      (14) information on family planning and referral to local 
 11.10  community providers and resources that provide family planning 
 11.11  services and counseling at no cost or at a reduced cost and to 
 11.12  the Department of Health's Web site established under section 
 11.13  145.426. 
 11.14     Sec. 11.  [REGIONAL TRAINING SITES FOR COMPREHENSIVE FAMILY 
 11.15  LIFE AND SEXUALITY EDUCATION IN SCHOOLS.] 
 11.16     The commissioner of education shall establish eight 
 11.17  regional training centers in partnership with school districts 
 11.18  outside of the cities of Minneapolis and St. Paul to implement 
 11.19  comprehensive curriculum and programs to prevent and reduce the 
 11.20  risk of HIV/AIDS and unintended pregnancy as required under 
 11.21  Minnesota Statutes, sections 121A.23 and 121A.231.  The 
 11.22  commissioner shall provide technical and financial assistance to 
 11.23  each school district to identify policy, curriculum, and service 
 11.24  gaps, to purchase curriculum and materials and to provide 
 11.25  training or services to fill these gaps, to identify 
 11.26  opportunities to coordinate HIV and sexuality education with 
 11.27  other special curriculum offerings, and to assess the 
 11.28  effectiveness of curriculum and services.  Each regional 
 11.29  training center shall provide programs and services to nearby 
 11.30  school districts to meet the requirements of Minnesota Statutes, 
 11.31  sections 121A.23 and 121A.231.  The commissioner and each school 
 11.32  district shall work with a community advisory committee to 
 11.33  establish and review the operation of each training center.  
 11.34     Sec. 12.  [APPROPRIATION.] 
 11.35     Subdivision 1.  [DEPARTMENT OF EDUCATION.] The sums 
 11.36  indicated in subdivisions 2 and 3 are appropriated from the 
 12.1   general fund to the Department of Education for the fiscal years 
 12.2   designated.  
 12.3      Subd. 2.  [REGIONAL TRAINING SITES FOR COMPREHENSIVE FAMILY 
 12.4   LIFE AND SEXUALITY EDUCATION.] For regional training sites for 
 12.5   comprehensive family life and sexuality education: 
 12.6        $3,000,000     .....     2005 
 12.7      Any balance remaining in fiscal year 2005 does not cancel 
 12.8   but is available in fiscal year 2006.  
 12.9      Subd. 3.  [AFTER-SCHOOL ENRICHMENT GRANTS.] For 
 12.10  after-school enrichment grants under Minnesota Statutes, section 
 12.11  124D.222: 
 12.12       $5,510,000     .....     2005 
 12.13     Any balance in the first year does not cancel but is 
 12.14  available in the second year. 
 12.15     Subd. 4.  [DEPARTMENT OF HEALTH.] (a) $1,200,000 is 
 12.16  appropriated for fiscal year 2005 from the general fund to the 
 12.17  commissioner of health for purposes of the ENABL program under 
 12.18  Minnesota Statutes, section 145.9255.  
 12.19     (b) $100,000 is appropriated for fiscal year 2005 from the 
 12.20  general fund to the commissioner of health for public education 
 12.21  to promote the awareness and proper usage of emergency 
 12.22  contraception.  This appropriation shall only be used if the 
 12.23  United States Food and Drug Administration approves the 
 12.24  over-the-counter sale of emergency contraception.  
 12.25     (c) $2,000,000 is appropriated for fiscal year 2005 from 
 12.26  the general fund to the commissioner of health to provide grants 
 12.27  to government or nonprofit entities operating a school-based 
 12.28  clinic serving students in middle or high school that provides 
 12.29  reproductive health services, including FDA-approved 
 12.30  contraceptive methods, testing and treatment of sexually 
 12.31  transmitted diseases, and sexual health education.  Grant 
 12.32  allocations must be based on a formula developed by the 
 12.33  commissioner that recognizes the percentage of students served 
 12.34  by each clinic who are uninsured. 
 12.35     (d) $20,000,000 is appropriated for fiscal year 2005 from 
 12.36  the general fund to the commissioner of health for family 
 13.1   planning special project grants under section 145.925, and shall 
 13.2   be added to the Department of Health's base funding for the 
 13.3   biennium beginning July 1, 2005.  If a federal Medicaid family 
 13.4   planning waiver is obtained, this amount is reduced to 
 13.5   $5,000,000.