II 111th CONGRESS 1st Session S. 1267 IN THE SENATE OF THE UNITED STATES June 16, 2009 Mr. Menendez (for himself and Mr. Casey) introduced the following bill; which was read twice and referred to the Committee on Finance A BILL To amend title V of the Social Security Act to provide grants to establish or expand quality programs providing home visitation for low-income pregnant women and low-income families with young children, and for other purposes.
1.
Short title
This Act may be cited as the Evidence-Based Home Visitation Act of 2009.
2.
Grants for quality home visitation programs for low-income pregnant women and low-income families with young children
Title V of the Social Security Act (42 U.S.C. 701 et seq.) is amended by adding at the end the following:
511.
Separate program of home visitation for low-income pregnant women and low-income families with young children
(a)
Purpose
The purpose of this section is to improve the well-being and development of children by enabling the establishment and expansion of quality programs providing voluntary home visitation services to low-income pregnant women and low-income families with young children. (b)
Activities
The Secretary shall take all necessary steps to accomplish the purposes of this section, including the following: (1)
Competitive planning grants
The Secretary shall award planning and start-up grants to local agencies to help them qualify for operating grants described in paragraph (2). (2)
Competitive operating grants
The Secretary shall award operating grants to local agencies to provide home visitation services to low-income pregnant women or low-income families with young children, consistent with the following: (A)
Eligibility
To receive an operating grant, a local agency must meet all requirements established by the Secretary, including the following: (i)
Implementation of an approved model
The local agency shall provide services consistent with a model of home visitation that the Secretary has approved as having demonstrated significant positive effects on important program-determined child and parent outcomes, such as reducing abuse and neglect, improving prenatal health, improving child health and development, improving school readiness, reducing juvenile delinquency, and improving family economic self-sufficiency. (ii)
Accreditation
If the local agency proposes to implement an approved model of home visitation, the local agency must abide by the requirements, if any, of the national or regional home visitation program model identified by the Secretary, to ensure the agency is capable of providing services consistent with the model. (iii)
State or local match
The Secretary shall have the authority to establish State or local matching requirements as a condition for receiving a grant under this section, which may include in-kind contributions and payments made to the State under section 1903(a) for providing home visitation services (as defined in section 1943(b)(2)) under the State plan under title XIX, and may include a waiver based on economic hardship. (B)
Allocation
(i)
Priority funding for programs with strongest evidence
In awarding operating grants during a fiscal year, the Secretary shall allot the largest feasible percentage of grant funding to local agencies that implement home visitation models that are supported by the strongest evidence of effectiveness. (ii)
Distribution
In awarding operating grants, the Secretary shall take into account the distribution of low-income families with young children by geography. (3)
Model approach
The Secretary, acting through the Director of the Centers for Disease Control and Prevention, shall determine whether to approve a model of home visitation services as qualifying in either or both of the following categories: (A)Meeting the requirements for Secretarial approval described in paragraph (2)(A)(i). (B)Being supported by the strongest evidence of effectiveness. (4)
Research
(A)
In general
The Secretary shall fund an ongoing program of research to accomplish the following goals: (i)Establishing the strongest evidence of effectiveness for a home visitation model that has not yet been found to have such evidence. (ii)In the case of an approved home visitation model, furthering improvements of such model, facilitating effective and efficient replication of the model, and facilitating adaptations of the model. (B)
Requirement
Evaluations funded under clauses (i) and (ii) of subparagraph (A) shall be specific to each approved model of home visitation and shall include evaluations of program outcomes for each home visitation program model separately. (5)
Administration
The Secretary shall perform, either directly or through a private contractor, the following administrative functions described in subparagraph (A): (A)
Administrative functions
The administrative functions described in this subparagraph shall include— (i)helping a local agency that receives a planning grant qualify for an operating grant; (ii)providing training and technical assistance to local agencies that receive planning or operating grants; and (iii)conducting quality assurance and quality improvement activities with respect to local agencies that receive planning or operating grants. (B)
Contracting requirements
In electing whether to employ a contractor and in selecting a contractor— (i)the Secretary shall make such election and selection separately with respect to each approved model of home visitation; and (ii)the Secretary shall contract with a private organization to perform the function if, for a fixed amount of administrative dollars, greater fidelity to the approved model of home visitation is likely to result than if the responsibilities are carried out by the Secretary directly. (c)
Other provisions
(1)
Regulations
The Secretary shall promulgate such regulations or guidance as the Secretary determines necessary for the effective implementation of this section not later than 1 year following the date of enactment of this Act. (2)
National advisory board
The Secretary shall establish and meet periodically with a national advisory board to seek advice about major policy issues involved in implementing this section. (3)
Treatment of assistance
No funding or services provided to low-income families under this section shall be considered— (A)taxable income to the families who receive services; or (B)income or resources countable in determining eligibility for, or the amount of, any public benefit provided under Federal law or the law of any State or political subdivision thereof. (4)
Evaluation
The Secretary shall conduct, by grant, contract, or interagency agreement, a comprehensive, independent evaluation of the services provided with grants awarded under this section, including the cost and effectiveness of such services. The independent evaluation conducted under this section shall be specific to each approved program model of home visitation and shall include program outcomes for each home visitation model separately. By not later than 3 years after the date of enactment of this section, the Secretary shall submit to Congress a report on such evaluation. (d)
Definitions
In this section: (1)
Local agency
The term local agency may include a unit of State, local, county, or city government, an Indian tribe or tribal organization, or a non-governmental organization. (2)
Low-income
The term low-income means individuals whose family income does not exceed 200 percent of the poverty line for a family of the size involved. Low-income shall also include children and families whose income did not exceed 200 percent of the Federal poverty level for a family of the size involved when they began receiving a course of home visitation services but whose income exceeded the allowable amount during the course of receiving home visitation services. (3)
Poverty line
The term poverty line has the meaning given such term in section 673(2) of the Community Services Block Grant Act (42 U.S.C. 9902(2)), including any revision required by such section. (4)
Strongest evidence of effectiveness
The term strongest evidence of effectiveness means, with respect to a model of home visitation, that rigorous, scientific evaluations demonstrate sizable, sustained effects on important outcomes in at least 3 of the following 5 areas: (A)Prenatal, maternal, and newborn health. (B)Child health and development (including prevention of injuries and maltreatment). (C)School readiness and academic achievement. (D)Juvenile delinquency. (E)Family economic self-sufficiency. (5)
Indian tribe; tribal organization
The terms Indian tribe and tribal organization have the meanings given such terms in section 4 of the Indian Self-Determination and Education Assistance Act (25 U.S.C. 450b). (e)
Appropriations
Out of any money in the Treasury not otherwise appropriated, there is appropriated to the Secretary to carry out this section— (1)$100,000,000 for fiscal year 2010; (2)$250,000,000 for fiscal year 2011; (3)$400,000,000 for fiscal year 2012; (4)$550,000,000 for fiscal year 2013; and (5)$700,000,000 for fiscal year 2014.
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3.
Medicaid option for simplified billing by approved home visitation agencies
(a)
State plan amendment
Section 1902(a) of the Social Security Act (42 U.S.C. 1396a(a)) is amended— (1)in paragraph (72), by striking and at the end; (2)in paragraph (73), by striking the period at the end and inserting ; and; and (3)by inserting after paragraph (73) the following: (74)at the option of the State, provide for simplified billing by approved home visitation agencies under section 1943. . (b)
Simplified billing by approved home visitation agencies
Title XIX of such Act is amended by adding at the end the following:
1943.
Simplified billing by approved home visitation agencies
(a)
In general
A State electing the option described in this Section may permit an approved home visitation agency to use a simplified method to submit claims for payment for home visitation services, but only to the extent that such services are covered under the State plan. (b)
Definitions
In this section: (1)
Approved home visitation agency
The term approved home visitation agency means a local agency with an operating grant under section 511(b)(2). (2)
Home visitation services
The term home visitation services means services provided consistently with the approved model of home visitation services that is being implemented by the local agency described in paragraph (1) and that are covered under the State plan. (3)
Simplified method to submit claims for payment
The term simplified method to submit claims for payment means a billing method through which an approved home visitation agency submits claims based on the weighted average cost per visit of providing, through the approved model of home visitation services being implemented by such agency, home visitation services. (c)
No expansion of covered services
Nothing in this section shall be construed to authorize the provision of, or payment for, home visitation or other services under this title that are not covered under the State plan.
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