[Congressional Record Volume 163, Number 154 (Tuesday, September 26, 2017)]
[House]
[Pages H7506-H7514]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]
INCREASING OPPORTUNITY AND SUCCESS FOR CHILDREN AND PARENTS THROUGH
EVIDENCE-BASED HOME VISITING ACT
General Leave
Mr. SMITH of Nebraska. Mr. Speaker, I ask unanimous consent that all
Members may have 5 legislative days within which to revise and extend
their remarks and include extraneous material on H.R. 2824.
The SPEAKER pro tempore. Is there objection to the request of the
gentleman from Nebraska?
There was no objection.
The SPEAKER pro tempore. Pursuant to House Resolution 533 and rule
XVIII, the Chair declares the House in the Committee of the Whole House
on the state of the Union for the consideration of the bill, H.R. 2824.
The Chair appoints the gentlewoman from Alabama (Mrs. Roby) to
preside over the Committee of the Whole.
{time} 1347
In the Committee of the Whole
Accordingly, the House resolved itself into the Committee of the
Whole House on the state of the Union for the consideration of the bill
(H.R. 2824) to amend title V of the Social Security Act to extend the
Maternal, Infant, and Early Childhood Home Visiting Program, with Mrs.
Roby in the chair.
The Clerk read the title of the bill.
The CHAIR. Pursuant to the rule, the bill is considered read the
first time.
The gentleman from Nebraska (Mr. Smith) and the gentleman from
Illinois (Mr. Danny K. Davis) each will control 30 minutes.
The Chair recognizes the gentleman from Nebraska.
Mr. SMITH of Nebraska. Madam Chair, I yield myself such time as I may
consume.
Madam Chair, I rise in support of H.R. 2824, the Increasing
Opportunity and Success for Children and Parents Through Evidence-Based
Home Visiting Act. This bill would reauthorize the Maternal, Infant,
and Early Childhood Home Visiting Program, known as MIECHV, for 5 years
and make sure the program continues to focus on results.
I would like to note, this bill represents the first full
reauthorization proposal Congress has considered for this program.
The Ways and Means Human Resources Subcommittee, which I chair, held
a hearing on the program earlier this year. We solicited feedback from
stakeholders, marked up a bill in committee, and today we are debating
this bill on the floor. This is how Congress is supposed to work, and
this bill is an example of Congress getting its work done.
The MIECHV Program helps support State and local efforts to provide
voluntary, evidence-based home visiting services to parents and
children living in communities that put them at risk of poor social and
health outcomes, including in rural areas like those I represent.
Unlike many other programs that focus on money spent or people
served, this program focuses on achieving real results for families.
Specifically, this program promotes school readiness of young children,
increases economic self-sufficiency of families, improves prenatal
health and birth outcomes, and prevents childhood abuse and neglect.
Madam Chair, I have had the opportunity to see firsthand what home
visiting looks like. In March, I spent time in Nebraska with the
Panhandle Public Health District's Healthy Families America program in
western Nebraska. The program focuses on improving the economic success
and school readiness of vulnerable children and families in three
Nebraska counties: Scotts Bluff, Morrill, and Box Butte.
During my visit, I met with Dawn, one of the program participants,
who told me what it was like for her to work with a home visitor. Her
home visitor helped her find a stable home and a steady income to
provide for her growing family. These are the types of outcomes we
should be expecting when we have programs to help those who are
struggling to get ahead.
MIECHV works because funding is tied to evidence. Unfortunately,
MIECHV is the exception, as few Federal social programs have been
evaluated at all, and almost none condition funding on evidence of
whether the program actually works.
In the Better Way agenda put forward by House Republicans last year,
we proposed doing more of what MIECHV does: measuring how well programs
are working to focus funding on those which produce real results. When
we spend limited taxpayer dollars to help those in need, we must make
sure we are spending money on effective programs. To do otherwise is a
disservice to both taxpayers as well as those we are seeking to help.
On March 15 of this year, the Human Resources Subcommittee held a
hearing on MIECHV. In the hearing, we heard from those with firsthand
experience with home visiting programs, and their input was invaluable
as we developed this proposal.
Both before and after the hearing, we sought input from States and
others about how the program was working and how it could be improved
and strengthened. These conversations also informed the bill before us
today.
I should also note, there is broad bipartisan support for MIECHV,
including from dozens of national organizations and hundreds of State
and local organizations, including business leaders, law enforcement
officers, faith-based groups, healthcare providers, child welfare
advocacy organizations, and early education providers.
While I understand some of my colleagues would like to continue this
program or even increase its funding without an offset, under the rules
that govern this Chamber and our current deficits, it would be
irresponsible and against the rules of this Chamber to fund this
program without finding ways to reduce spending elsewhere. That is why
we are considering this as part of a package of two bills today: this
bill and the Control Unlawful Fugitive Felons Act of 2017, which will
be considered later this week during its own debate.
Instead of increasing our Nation's debt, we should be doing more of
what we are doing here today: prioritizing Federal spending and
focusing on what works by improving the integrity of one program to
provide funding for another.
Madam Chair, I am grateful for the time we are spending here today to
consider the reauthorization of this important program, and I
appreciate the opportunity to stand in support of this bill today.
I reserve the balance of my time.
House of Representatives,
Committee on Energy and Commerce,
Washington, DC, September 18, 2017.
Hon. Kevin Brady,
Chairman, Committee on Ways and Means,
Washington, DC.
Dear Chairman Brady: I write concerning H.R. 2824,
Increasing Opportunity through
[[Page H7507]]
Evidence-Based Home Visiting Act, which was additionally
referred to the Committee on Energy and Commerce.
I wanted to notify you that the Committee will forgo action
on H.R. 2824 so that it may proceed expeditiously to the
House floor for consideration. This is done with the
understanding that the Committee's jurisdictional interests
over this and similar legislation are in no way diminished or
altered. In addition, the Committee reserves the right to
seek conferees on H.R. 2824 and requests your support when
such a request is made.
I would appreciate your response confirming this
understanding with respect to H.R. 2824 and ask that a copy
of our exchange of letters on this matter be included in the
Congressional Record during consideration of the bill on the
House floor.
Sincerely,
Greg Walden,
Chairman.
____
House of Representatives,
Committee on Ways and Means,
Washington, DC, September 18, 2017.
Hon. Greg Walden,
Chairman, Committee on Energy and Commerce,
Washington, DC.
Dear Chairman Walden: Thank you for your letter concerning
H.R. 2824, the ``Increasing Opportunity through Evidence-
Based Home Visiting Act,'' on which the Energy and Commerce
Committee was granted an additional referral.
I am most appreciative of your decision to waive formal
consideration of H.R. 2824 so that it may proceed
expeditiously to the House floor. I acknowledge that although
you waived formal consideration of the bill, the Energy and
Commerce Committee is in no way waiving its jurisdiction over
the subject matter contained in those provisions of the bill
that fall within your Rule X jurisdiction. I would support
your effort to seek appointment of an appropriate number of
conferees on any House-Senate conference involving this
legislation.
I will include a copy of our letters in our committee
report and in the Congressional Record during consideration
of this legislation on the House floor.
Sincerely,
Kevin Brady,
Chairman.
Mr. DANNY K. DAVIS of Illinois. Madam Chair, I yield myself such time
as I may consume.
Madam Chair, following the wisdom of Frederick Douglass, who said it
is easier to build strong families, strong children, than to repair
broken men, I introduced my first bipartisan home visiting bill over a
decade ago, in 2005. Since 2005, home visiting has been uniquely
bipartisan--until today.
Research is clear. Home visiting makes kids and families stronger,
healthier, and safer. In my home State of Illinois, MIECHV improved
program coordination, reinforced the emphasis on proven models, and
expanded availability of services. Unfortunately, the majority's
approach has rejected bipartisanship and made timely reauthorization of
home visiting less likely.
H.R. 2824 presents substantial cuts to home visiting and threatens
the effectiveness of services for vulnerable children and families.
Equally bad, the rule under which we are considering this bill
conditions home visiting help to vulnerable families on harming seniors
and persons with disabilities. Although we are not voting on that
provision today, the rule we are considering this bill under makes it
an inescapable part of it.
I join with over 110 civil rights, disability, and aging agencies to
strongly oppose the Republican effort to pay for home visiting services
that strengthen vulnerable children by stripping certain low-income
seniors and those with severe disabilities of basic income they need to
survive.
H.R. 2824 also is inconsistent with bipartisan Senate legislation
introduced last week, which rejected the most controversial and
problematic changes in H.R. 2824 in order to keep what works.
So what should the House have done instead of H.R. 2824?
826 organizations urged the House and Senate leaders to ``reauthorize
this important program for 5 years, with a doubling of funding from
$400 million, annually, to $800 million, annually, to allow States,
territories, and Tribes to expand these services to more children and
families.'' Yet H.R. 2824 fails to increase funding by even one penny.
Currently, MIECHV dollars serve only about 6 percent of eligible
families and less than 50 percent of eligible Tribes. I tried to offer
a fully paid-for alternative to double funding for home visiting over 5
years without harmful policy changes but was not allowed a vote in
committee or on the floor.
One of the most harmful policy changes is a new ``State match''
requirement, which would be in addition to the ``maintenance of
effort'' requirement already in law. Just as with their failed
healthcare bill, this Republican bill pushes their fight to make States
pay more for services, while harming vulnerable children and families
as collateral damage. There is no doubt that the State match in this
bill will reduce home visiting in many States and Tribes, cut services,
and harm families.
The Republican bill further undermines successful home visiting by
changing it from a program to improve child development and parent-
child relationships to a failed jobs program. Defining a core outcome
of MIECHV as increased employment and earnings will gut Federal home
visiting. Not one--not one--of the evidence-based models is a job
training program. Not one.
This bill says, if any program wants to improve economic self-
sufficiency, it shall include employment and earnings. Further, the
bill applies stringent, unrealistic outcome standards.
H.R. 2824 is failure by design for home visiting. Later today, I urge
my colleagues to support Congressman Pascrell's amendment to strike
this change.
After a decade of bipartisan efforts to increase Federal funds for
home visiting, I am deeply saddened that H.R. 2824 now is the House
Republican priority list for cutting funding, reducing services, and
undermining the infrastructure that so many have worked to build. I
unequivocally oppose this harmful bill and its discriminatory pay-for,
joining the good company of the NAACP, the American Academy of
Pediatrics, Justice in Aging, National Women's Law Center, and the Arc
of the United States, to name just a few.
I urge my colleagues to oppose H.R. 2824 so that we can move quickly
on to a bipartisan approach which builds on home visiting's
considerable strength.
Madam Chair, I reserve the balance of my time.
{time} 1400
Mr. SMITH of Nebraska. Madam Chair, I yield 3 minutes to the
gentleman from Pennsylvania (Mr. Meehan).
Mr. MEEHAN. Madam Chair, I thank the gentleman for yielding, and I
want to express my deep appreciation for the opportunity to join in
this advocacy for this very important bill.
One of the great frustrations I know I share is when we have to make
choices, and I see people come to me and they want us to increase the
funding for those who are on the front lines fighting for our country,
to increase the funding for those who are suffering from diseases, to
increase the funding to protect senior citizens in various capacities,
and every one of them tears at your heartstrings.
That is why, to me, it is such an incredible accomplishment when you
are able, at this particular period of time, with huge deficits, to be
able to fight to make sure that we can retain the funding to drive a
fundamental program. The chairman has done that in this case, and I
find the arguments to double that to be just a Trojan horse, an
impediment to helping us take a meaningful program and make sure that
it is authorized and supported.
In April, I visited the Crozer-Keystone Community Foundation in my
own district. The foundation operates MIECHV and uses the Nurse-Family
Partnership model to serve women and families in Delaware County. The
model enables nurses to conduct regular home visits for first-time
mothers and their children who are less than 2-years-old. It is
designed to improve prenatal health and outcomes, improve child health
and development, and improve families' economic self-sufficiency.
The success is evident to the experience of the women and families in
the programs. In fact, the Nurse-Family Partnership model has been
shown to reduce child abuse by 48 percent, reduce emergency room visits
for accidents and poisonings by 58 percent, and reduce behavioral and
intellectual problems by age 6 by 67 percent.
A study found that $6 is returned to the community for every dollar
it invests in the program. Did you hear that? For every dollar the
community invests, they will get $6; so it is not wrong to ask our
partners in the States to match this commitment. In fact, my own State
of Pennsylvania, I am proud to say it has actually exceeded the
[[Page H7508]]
matching because they know it works and it makes a true partnership
with the States.
So I want to, once again, conclude by applauding the efforts of the
chairman to position this in such a way for us to be able to move
forward, to create the opportunity for this genuine partnership, to
move on, on behalf of the--not programs just like the Nurse-Family
Partnership, but the broad spectrum that are supported.
Mr. DANNY K. DAVIS of Illinois. Madam Chair, I yield 2 minutes to the
gentleman from Michigan (Mr. Levin).
(Mr. LEVIN asked and was given permission to revise and extend his
remarks.)
Mr. LEVIN. Madam Chair, I am disappointed that this bill, H.R. 2824,
injects needless controversy into reauthorizing the Maternal, Infant,
and Early Childhood Home Visiting Program.
Home visiting is an evidence-based approach that connects pregnant
women and families with young children to nurses, social workers, and
other professionals. Through these programs, parents learn skills that
help reduce abuse and neglect and improve child development during the
crucial early years of life.
Most importantly, home visiting is backed by strong evidence that
shows these programs are an effective way to improve outcomes for at-
risk families. Unfortunately, H.R. 2824 ignores the proven successes of
home visiting in favor of harmful, partisan changes to the law. In
particular, I am troubled by language in this bill that would cut off
funding to States and Tribal organizations that are unable to match
Federal spending on home visiting. The bipartisan bill in the Senate
does not do that; you do.
Advocates are concerned that this could cause States to scale back or
even end their programs altogether. In addition, this bill makes a
number of ill-advised changes that have little or no apparent
justification. Research shows that home visiting programs are working
well, yet only 6 percent of eligible individuals currently participate.
We should be looking at expanding, not undermining, access to home
visiting.
We need, at the very least, a clean bill that reauthorizes the home
visiting program in a bipartisan way. Unfortunately, H.R. 2824 is not
that bill, and, for that reason, I urge that we vote ``no.''
Mr. SMITH of Nebraska. Madam Chair, I yield 4 minutes to the
gentleman from Michigan (Mr. Bishop).
Mr. BISHOP of Michigan. Madam Chair, I thank Chairman Smith for
yielding and for his hard work and leadership on this matter.
Madam Chair, I rise today to support H.R. 2824, which would
reauthorize the Maternal, Infant, and Early Childhood Home Visiting
Program. At its core, MIECHV improve the lives of families in at-risk
communities, focusing on the first years of a child's life.
Like the chairman, I, too, have seen firsthand its successes. I
recently traveled to a Nurse-Family Partnership facility, which is a
nonprofit that arranges home visits from registered nurses to low-
income, first-time mothers.
I had the opportunity to meet the nurses and the women who currently
are enrolled in the program. NFP facilities transform the lives of
vulnerable first-time moms and their babies, empowering them to build
brighter futures and stronger families, none of which would be possible
without MIECHV funding.
I am proud to note that, like my previous speaker, my home State of
Michigan has already taken the initiative to invest significant funding
for the NFP facilities and other organizations, in addition to MIECHV
funds, to the extent that Michigan would now already meet the
requirement proposed in the bill.
I am particularly thankful for the chairman's transparent engagement
process within the committee, specifically, early on. I raised the
concern that the addition of new evidence standards, along with
substantial evidence standards already in place, might be problematic,
and I wanted to ensure that home visitors were not overly burdened by
data collecting so that they can care for the mothers and the babies.
Both of these concerns were addressed with the amendments contained
in the chairman's amendment, and I want to thank Chairman Smith and
Chairman Brady for their leadership in addressing these concerns and
other concerns.
I want to thank the chairman for all of his hard work, and I want to
join him and my colleagues in supporting H.R. 2824.
Mr. DANNY K. DAVIS of Illinois. Madam Chair, I yield 5 minutes to the
gentleman from Texas (Mr. Doggett), who has long been a champion on
these issues.
Mr. DOGGETT. Madam Chair, across our country, there are thousands of
children, thousands of families, that have a really big stake in what
happens with this bill.
I support evidence-based home visiting programs, and I support them
not just by talking about them, but by providing them the resources
they need to reach more children and make a difference in their lives.
This whole program, ``home visiting,'' is a little bit of a misnomer.
This is not about going out to pay a social visit, to join a club or
something. This is about skilled professionals working with young
parents to help them be the parents they want to be. It is about family
values. It is about strengthening and protecting families, particularly
disadvantaged families.
Our home visiting programs give these families the tools that they
need. I have seen how successful they have been in San Antonio, in San
Marcos, in Austin, and across Texas.
A story was shared with me recently when I met with Alaska and Jimmy
Martinez from San Antonio. During their first year in college, Alaska
became pregnant. She felt she was going to have to drop out of school,
and then they met with Susan, with the Nurse-Family Partnership there
in San Antonio, and she gave them some referrals and some assistance.
They were able to learn more about the development of their child and
how they could prepare their family for that child's arrival.
Now, Alaska is about to finish her associate's degree. Jimmy is
pursuing his business degree, and they are happy to have a beautiful 2-
year-old son.
That is the way this program is supposed to work so people don't sink
into poverty. They are lifted up and so are their children. This is
just one of thousands of success stories from across the country--the
family that unexpectedly finds they have a child with severe
disabilities, or maybe just the more common experience of the family
that has a baby who cries all night long, and they don't know what to
do about it.
Too often, that is the kind of thing that ends up in a slap here, a
slap there, and child abuse. Too often, it ends up with that child just
being put in front of the television set instead of working with the
child to deal with these real-life problems.
Some reforms were mentioned, alleged reforms, in this bill. I have
served on this subcommittee through a number of terms of Congress. We
have had some excellent witnesses, Republican and Democratic, and I
have yet to hear a single witness call for a single one of the changes
that they are proposing to impose on this program as obstacles to its
success.
We haven't had an academic expert. We haven't had a stakeholder. We
haven't had a single witness come forward and say: Please change this
program so it cannot achieve the success that it is having today.
This is an evidence-based program. What does that mean? It means it
is based on fact, not just on hope or good intention, as a number of
our programs are. It means there is peer-reviewed data showing that
this program works to reduce child abuse and to solve other problems.
The chairman, the advocate for this bill, tells me that they
recognize this in the great Republican blueprint, and they want to do
more of this. Well, if they want to do more of this, why are they
creating one obstacle after another and causing one group after another
to oppose those changes?
What about the resources to get the job done? As so many of the
Republican witnesses before our subcommittee have acknowledged, we are
helping a fraction of the children who are eligible for these kind of
services.
I think you could call this bill the Republican 6 percent solution,
because about 94 percent of eligible families in America don't get a
penny of assistance out of this program. This program
[[Page H7509]]
that they say is so good, they want to praise it as an evidence-based
program--and well they should, and well they have in the course of the
several years I have served on the committee--this program is frozen at
the same amount of funds that it had 5 years ago.
Though the need has grown, though the fraction of children who are
served is minuscule compared with the need, they refuse to provide the
resources to help other families like Alaska and Jimmy's.
It is clear, we can't just throw money at this problem or any other,
but sometimes the only substitute that I hear from my Republican
colleagues is to throw words at the problem like we have heard today:
caring, soothing, empathetic words, but words that are no substitute
for meaningful action.
Indeed, it is great to hear about support for an evidence-based
program. Where is the evidence for these changes?
The CHAIR. The time of the gentleman has expired.
Mr. DANNY K. DAVIS of Illinois. Madam Chair, I yield an additional 1
minute to the gentleman from Texas.
Mr. DOGGETT. Madam Chair, where is the evidence today? It couldn't be
produced in committee. Where is the evidence for one of these changes?
Where is the evidence for freezing this funding?
We proposed to fully fund it, and I proposed to do it with a simple
tax compliance measure that wouldn't have raised taxes on anyone, but
it would have provided the resources for this home visiting program to
do its intended purpose.
This measure, as proposed, should be rejected, and we ought to
support genuine home visiting that reaches more American families and
protects them, just as it has for so many families in Texas.
Mr. SMITH of Nebraska. Madam Chair, I yield 2 minutes to the
gentleman from Kansas (Mr. Estes).
Mr. ESTES of Kansas. Madam Chair, I rise today in support of H.R.
2824, the Increasing Opportunity and Success for Children and Parents
through Evidence-Based Home Visiting Act.
We need more support for early childhood, and to support families in
that effort. They need to be evidence-based programs to ensure that we
get more of the right beneficial programs implemented.
This bill seeks to strengthen the home visiting services to families
in at-risk communities, and that is important because it will help
reduce infant abuse and neglect across America.
The law's six benchmark areas will improve maternal and newborn
health and will increase families' economic self-sufficiency. It also
looks to better the coordination between community resources.
I would like to thank Chairman Brady and Chairman Smith for putting
forth this piece of legislation.
{time} 1415
Mr. DANNY K. DAVIS of Illinois. Madam Chair, I yield 3 minutes to the
gentleman from California (Mr. Thompson).
Mr. THOMPSON of California. Madam Chair, I thank the gentleman for
yielding. I thank Mr. Davis for his great leadership on this issue.
Madam Chair, I rise today in opposition to this bill.
Since its inception, MIECHV has been universally hailed as a
tremendous success. It works, and it is cost effective. Participants
like it; State and local governments like it; Democrats like it; and
Republicans like it. It helps young families get off to a running start
and makes sure that kids get the hand they need to stay on track.
I have seen this program work. The Nurse-Family Partnership program
in Solano County, in my district, helps moms get the care and the
support they need to have a healthy pregnancy and to learn to care for
their babies. Home visits teach these new young moms the basics of
raising healthy kids, helping them become more self-sufficient.
But instead of building on these successes and giving community
programs the support they have been asking for, today the Republicans
are focusing on undermining a great record of progress. Take, for
instance, the new matching requirements in this bill.
When Congress created MIECHV, we authorized money for Tribes that
don't have the resources to build home visiting programs on their own.
This bill would force those Tribes to attribute matching money--which
they don't have--to keep their program going. That is a death sentence
to Tribal programs like the one in my district in Lake County,
California.
With the passage of this bill, we are shortchanging hundreds of
vulnerable families that rely on these programs. In addition, poor
communities--not just Tribal communities, but poor communities across
the country--have the same funding challenges, and these are most often
the areas that benefit the most from MIECHV. This bill hurts people in
those communities.
With this bill, we are not empowering communities to raise healthy
children; we are undermining a great bipartisan program, and for that I
stand in opposition to this piece of legislation.
Mr. SMITH of Nebraska. Madam Chair, I yield 3 minutes to the
gentlewoman from Indiana (Mrs. Walorski).
Mrs. WALORSKI. Madam Chair, I appreciate Chairman Smith's support and
the work he has done on this bill.
Madam Chair, I rise in strong support of the Increasing Opportunity
and Success for Children and Parents Through Evidence-Based Home
Visiting Act. In my home State of Indiana, three of the nine counties
eligible for MIECHV funds are in my district.
In April, I had the pleasure of visiting with Healthy Families St.
Joseph County to hear firsthand the good work they are doing in
Indiana's Second District. I heard from a single mom who had no job, no
place to live, and very little money when she gave birth to her son;
but with the help of Healthy Families, she turned long odds into
success. The mother gained confidence to raise her son, and her son
gained a shot at a thriving life that he may not have had without this
program.
Home visitors helped over 2,600 Hoosier families in situations like
this in Indiana last year.
MIECHV is a program that gets results. It works. We know this because
of the statistics, but we hear it in the stories that they share with
us. Parents get the tools and the confidence they need to raise their
children. This improves outcomes for their children in the really early
critical years and sets them on a better path as they grow up. The
program helps to root out deeper issues like drug abuse and domestic
violence that destroy families and hinder a child's development.
If there is one thing I have learned as I have heard from people in
my district who successfully broke the cycle of poverty, it is this: It
is one thing to provide money, but if that money comes on a one-size-
fits-all basis, people cannot break the cycle. Checking a box doesn't
break the cycle. Human interaction, looking at each person as an
individual and not just a number, resolving underlying issues unique to
each person's situation, and having a person coming alongside, saying,
``I am with you; let's do this together'' breaks the cycle. MIECHV is a
great example of a program that does this.
Madam Chair, I urge my colleagues to support this bill.
Mr. DANNY K. DAVIS of Illinois. Madam Chair, I yield 2 minutes to the
gentlewoman from Florida (Ms. Castor).
Ms. CASTOR of Florida. Madam Chair, I thank Mr. Davis for his
outstanding advocacy on behalf of families all across America.
Madam Chair, I rise in opposition to H.R. 2824 because this
Republican bill throws up unnecessary bureaucratic hoops and roadblocks
to the progress we have made under the Maternal, Infant, and Early
Childhood Home Visiting initiative.
It is smart policy to target resources and community experts to
families who are most at risk back home. I have seen it in action back
home in Tampa, Florida, where experts simply go to the home and explain
to parents the importance of reading to your young child to get them
ready for school, the importance of sleep, healthy habits, turning off
the TV, and focusing on being a family unit. That is why it is so
unfortunate that the Republicans are targeting the progress we have
made.
We are smarter now. We understand what is successful, and,
unfortunately, H.R. 2824 would undermine successful home visiting
initiatives by making policy changes that no expert has
[[Page H7510]]
asked for. Indeed, I checked with my folks back home at the University
of South Florida and on the ground there across the Tampa Bay area, and
they say that, no, this bill will jeopardize the progress that we are
making right now. In fact, they think that the match requirement will
bring to an end the progress that we have been able to make because of
the pressure on our State budget.
The way forward is through the bill that my colleagues--Mr. Davis,
Mr. Doggett, Ms. DeGette--and I have charted under H.R. 3525, which is
a fairly clean reauthorization that doubles down on what works and
doesn't invest in the bureaucratic red tape that simply is not going to
help a family succeed.
So, Madam Chair, I urge the House to defeat this bill and, instead,
to work in a bipartisan fashion.
The CHAIR. The time of the gentlewoman has expired.
Mr. DANNY K. DAVIS of Illinois. Madam Chairwoman, I yield the
gentlewoman an additional 15 seconds.
Ms. CASTOR of Florida. Madam Chair, instead, I urge the House to
defeat this bill that is not recommended by anyone in the field.
Instead, let's work in a bipartisan way on what works, what saves
taxpayers' money in the long run, and, most importantly, what truly
boosts families.
Mr. SMITH of Nebraska. Madam Chair, I just want to add for the Record
that the State of Florida matches their funds more than 2 to 1 already,
so I am anxious to present the data here as it becomes necessary and is
helpful to the exchange here.
Madam Chair, I reserve the balance of my time.
Mr. DANNY K. DAVIS of Illinois. Madam Chair, I yield myself the
balance of my time to close.
Madam Chair, we know that home visiting works. There is no doubt
about it. It is evidence based. Nobody has spoken anything that one
would say it was not needed. It works for families and children in
communities across our country. We agree about that on a bipartisan
basis.
So we should not be here today debating a partisan bill, a bill that
home visiting experts say poses a risk to the program's survival. We
should be moving forward on a bipartisan bill without policy changes
that might shut down home visiting in some communities or set it up for
failure.
I hope that my colleagues will vote for the amendments being offered
today that will improve the bill, but I also have some concerns about
the State match.
No matter what we say, think of States and territories that have just
been devastated by the floods and hurricanes. It is going to be very
difficult for them to come up with the match money to keep some
programs alive.
So I hope that my colleagues will vote for the amendments being
offered today that will improve the bill. I regret that there will not
be enough of them to make this the bill that we had hoped it would be.
Madam Chairwoman, I urge a ``no'' vote, and I yield back the balance
of my time.
Mr. SMITH of Nebraska. Madam Chair, I yield myself such time as I may
consume.
Again, I would like to take this time to thank my colleagues for
taking the time to consider the reauthorization of this important
program.
The MIECHV Program has bipartisan support due to its focus on
achieving real results for families. This program works because its
funding is tied to real evidence. It is imperative that we continue
this program in a responsible way, partnering with States to increase
the program's success.
I might repeat that for emphasis. It is imperative that we continue
this program in a responsible way--a reasonable way, I will add--as we
partner with States to increase the program's success. This bill shows
how we can prioritize our Federal spending, focusing on programs with
evidence that shows they actually work.
I look forward to moving this bill forward to reauthorize the MIECHV
Program so more Americans can get the help they need to get ahead.
Madam Chair, I yield back the balance of my time.
The CHAIR. All time for general debate has expired.
Pursuant to the rule, the bill shall be considered for amendment
under the 5-minute rule.
In lieu of the amendment in the nature of a substitute recommended by
the Committee on Ways and Means, printed in the bill, it shall be in
order to consider as an original bill for the purpose of amendment
under the 5-minute rule an amendment in the nature of a substitute
consisting of the text of Rules Committee Print 115-33. That amendment
in the nature of a substitute shall be considered as read.
The text of the amendment in the nature of a substitute is as
follows:
H.R. 2824
Be it enacted by the Senate and House of Representatives of
the United States of America in Congress assembled,
SECTION 1. SHORT TITLE.
This Act may be cited as the ``Increasing Opportunity and
Success for Children and Parents through Evidence-Based Home
Visiting Act''.
SEC. 2. TABLE OF CONTENTS.
The table of contents of this Act is as follows:
Sec. 1. Short title.
Sec. 2. Table of contents.
Sec. 3. Continuing evidence-based home visiting program.
Sec. 4. Continuing to demonstrate results to help families.
Sec. 5. Reviewing statewide needs to target resources.
Sec. 6. Improving the likelihood of success in high-risk communities.
Sec. 7. Measuring improvements in family economic self-sufficiency.
Sec. 8. Option to fund evidence-based home visiting on a pay for
outcome basis.
Sec. 9. Strengthening evidence-based home visiting through state,
local, and private partnerships.
Sec. 10. Data exchange standards for improved interoperability.
SEC. 3. CONTINUING EVIDENCE-BASED HOME VISITING PROGRAM.
Section 511(j)(1)(H) of the Social Security Act (42 U.S.C.
711(j)(1)(H)) is amended by striking ``fiscal year 2017'' and
inserting ``each of fiscal years 2017 through 2022''.
SEC. 4. CONTINUING TO DEMONSTRATE RESULTS TO HELP FAMILIES.
(a) Require Service Delivery Models to Demonstrate
Improvement in Applicable Benchmark Areas.--Section 511 of
the Social Security Act (42 U.S.C. 711) is amended in each of
subsections (d)(1)(A) and (h)(4)(A) by striking ``each of''.
(b) Demonstration of Improvements in Subsequent Years.--
Section 511(d)(1) of such Act (42 U.S.C. 711(d)(1)) is
amended by adding at the end the following:
``(D) Demonstration of improvements in subsequent years.--
``(i) Continued measurement of improvement in applicable
benchmark areas.--The eligible entity, after demonstrating
improvements for eligible families as specified in
subparagraphs (A) and (B), shall continue to track and report
not later than 30 days after the end of fiscal year 2020 and
every three years thereafter, information demonstrating that
the program results in improvements for the eligible families
participating in the program in at least 4 of the areas
specified in subparagraph (A) that the service delivery model
or models, selected by the entity, intend to improve.
``(ii) Corrective action plan.--If the eligible entity
fails to demonstrate improvement in at least 4 of the areas
specified in subparagraph (A), the entity shall develop and
implement a plan to improve outcomes in each of the areas
specified in subparagraph (A) that the service delivery model
or models, selected by the entity, intend to improve, subject
to approval by the Secretary. The plan shall include
provisions for the Secretary to monitor implementation of the
plan and conduct continued oversight of the program,
including through submission by the entity of regular reports
to the Secretary.
``(iii) Technical assistance.--The Secretary shall provide
an eligible entity required to develop and implement an
improvement plan under clause (ii) with technical assistance
to develop and implement the plan. The Secretary may provide
the technical assistance directly or through grants,
contracts, or cooperative agreements.
``(iv) No improvement or failure to submit report.--If the
Secretary determines after a period of time specified by the
Secretary that an eligible entity implementing an improvement
plan under clause (ii) has failed to demonstrate any
improvement in at least 4 of the areas specified in
subparagraph (A) that the service delivery model or models
intend to improve, or if the Secretary determines that an
eligible entity has failed to submit the report required by
clause (i), the Secretary shall terminate the grant made to
the entity under this section and may include any unexpended
grant funds in grants made to nonprofit organizations under
subsection (h)(2)(B).''.
(c) Including Information on Applicable Benchmarks in
Application.--Section 511(e)(5) of such Act (42 U.S.C.
711(e)(5)) is amended by inserting ``that the service
delivery model or models, selected by the entity, intend to
improve'' before the period at the end.
SEC. 5. REVIEWING STATEWIDE NEEDS TO TARGET RESOURCES.
Section 511(b)(1) of the Social Security Act (42 U.S.C.
711(b)(1)) is amended by striking ``Not later than'' and all
that follows through ``statewide'' the 2nd place it appears
and inserting ``Each State shall, as a condition of receiving
payments from an allotment for the State under section 502,
review and update the statewide needs assessment not later
than October 1, 2020
[[Page H7511]]
(which may be separate from but in coordination with the
statewide''.
SEC. 6. IMPROVING THE LIKELIHOOD OF SUCCESS IN HIGH-RISK
COMMUNITIES.
Section 511(d)(4)(A) of the Social Security Act (42 U.S.C.
711(d)(4)(A)) is amended by inserting ``, taking into account
the staffing, community resource, and other requirements of
the service delivery model or models that the eligible entity
may need to develop for the model to operate and demonstrate
improvements for eligible families'' before the period.
SEC. 7. MEASURING IMPROVEMENTS IN FAMILY ECONOMIC SELF-
SUFFICIENCY.
Section 511(d)(1)(A)(v) of the Social Security Act (42
U.S.C. 711(d)(1)(A)(v)) is amended by inserting ``(which
shall include measures of employment and earnings)'' before
the period.
SEC. 8. OPTION TO FUND EVIDENCE-BASED HOME VISITING ON A PAY
FOR OUTCOME BASIS.
(a) In General.--Section 511(c) of the Social Security Act
(42 U.S.C. 711(c)) is amended by redesignating paragraphs (3)
and (4) as paragraphs (4) and (5), respectively, and by
inserting after paragraph (2) the following:
``(3) Authority to use grant for a pay for outcomes
initiative.--An eligible entity to which a grant is made
under paragraph (1) may use the grant to pay for the results
of a pay for outcomes initiative that satisfies the
requirements of subsection (d) and that will not result in a
reduction of funding for services delivered under this
section while an eligible entity develops or operates such an
initiative.''.
(b) Definition of Pay for Outcomes Initiative.--Section
511(k) of such Act (42 U.S.C. 711(k)) is amended by adding at
the end the following:
``(4) Pay for outcomes initiative.--The term `pay for
outcomes initiative' means a performance-based grant,
contract, cooperative agreement, or other agreement awarded
by a public entity in which a commitment is made to pay for
improved outcomes that result in social benefit and direct
cost savings or cost avoidance to the public sector. Such an
initiative shall include--
``(A) a feasibility study that describes how the proposed
intervention is based on evidence of effectiveness;
``(B) a rigorous, third-party evaluation that uses
experimental or quasi-experimental design or other research
methodologies that allow for the strongest possible causal
inferences to determine whether the initiative has met its
proposed outcomes;
``(C) an annual, publicly available report on the progress
of the initiative; and
``(D) a requirement that payments are made to the recipient
of a grant, contract, or cooperative agreement only when
agreed upon outcomes are achieved, except that this
requirement shall not apply with respect to payments to a
third party conducting the evaluation described in
subparagraph (B).''.
(c) Extended Availability of Funds.--Section 511(j)(3) of
such Act (42 U.S.C. 711(j)(3)) is amended--
(1) by striking ``(3) Availability.--Funds'' and inserting
the following:
``(3) Availability.--
``(A) In general.--Except as provided in subparagraph (B),
funds''; and
(2) by adding at the end the following:
``(B) Funds for pay for outcomes initiatives.--Funds made
available to an eligible entity under this section for a
fiscal year (or portion of a fiscal year) for a pay for
outcomes initiative shall remain available for expenditure by
the eligible entity for not more than 10 years after the
funds are so made available.''.
SEC. 9. STRENGTHENING EVIDENCE-BASED HOME VISITING THROUGH
STATE, LOCAL, AND PRIVATE PARTNERSHIPS.
(a) In General.--Section 511 of the Social Security Act (42
U.S.C. 711) is amended by adding at the end the following:
``(l) Matching Requirement.--
``(1) Program home visiting share.--
``(A) In general.--An eligible entity to which a grant is
made under this section for fiscal year 2020 or any
succeeding fiscal year shall not use the grant to cover more
than the applicable percentage of the costs of providing
services or conducting activities under this section during
the fiscal year.
``(B) Applicable percentage.--In subparagraph (A), the term
`applicable percentage' means, with respect to a fiscal
year--
``(i) in the case of an eligible entity that is a State or
nonprofit organization--
``(I) 70 percent, in the case of fiscal year 2020;
``(II) 60 percent, in the case of fiscal year 2021; or
``(III) 50 percent, in the case of fiscal year 2022 or any
succeeding fiscal year; or
``(ii) in the case of an eligible entity that is an Indian
Tribe (or a consortium of Indian Tribes), a Tribal
Organization, or an Urban Indian Organization--
``(I) 100 percent, in the case of fiscal year 2020 or 2021;
or
``(II) 70 percent, in the case of fiscal year 2022 or any
succeeding fiscal year.
``(2) Non-program home visiting share.--The share of the
costs of providing services or conducting activities under
this section not covered by grant funds may include--
``(A) State expenditures of Federal funds made available
other than under this section expended for activities under
this section;
``(B) State expenditures of State funds expended for
activities under this section as a condition of receiving
Federal funds other than under this section; and
``(C) contributions made for activities under this section
from any other source, paid in cash or in kind, valued at the
fair market value of such contribution.''.
(b) Conforming Amendment.--Section 511(h)(2)(A) of such Act
(42 U.S.C. 711(h)(2)(A)) is amended in the 2nd sentence by
striking ``Such'' and inserting ``Except as provided in
subsection (l)(1), such''.
SEC. 10. DATA EXCHANGE STANDARDS FOR IMPROVED
INTEROPERABILITY.
(a) In General.--Section 511(h) of the Social Security Act
(42 U.S.C. 711(h)) is amended by adding at the end the
following:
``(5) Data exchange standards for improved
interoperability.--
``(A) Designation and use of data exchange standards.--
``(i) Designation.--The head of the department or agency
responsible for administering a program funded under this
section shall, in consultation with an interagency work group
established by the Office of Management and Budget and
considering State government perspectives, designate data
exchange standards for necessary categories of information
that a State agency operating the program is required to
electronically exchange with another State agency under
applicable Federal law.
``(ii) Data exchange standards must be nonproprietary and
interoperable.--The data exchange standards designated under
clause (i) shall, to the extent practicable, be
nonproprietary and interoperable.
``(iii) Other requirements.--In designating data exchange
standards under this paragraph, the Secretary shall, to the
extent practicable, incorporate--
``(I) interoperable standards developed and maintained by
an international voluntary consensus standards body, as
defined by the Office of Management and Budget;
``(II) interoperable standards developed and maintained by
intergovernmental partnerships, such as the National
Information Exchange Model; and
``(III) interoperable standards developed and maintained by
Federal entities with authority over contracting and
financial assistance.
``(B) Data exchange standards for federal reporting.--
``(i) Designation.--The head of the department or agency
responsible for administering a program referred to in this
section shall, in consultation with an interagency work group
established by the Office of Management and Budget, and
considering State government perspectives, designate data
exchange standards to govern Federal reporting and exchange
requirements under applicable Federal law.
``(ii) Requirements.--The data exchange reporting standards
required by clause (i) shall, to the extent practicable--
``(I) incorporate a widely accepted, nonproprietary,
searchable, computer-readable format;
``(II) be consistent with and implement applicable
accounting principles;
``(III) be implemented in a manner that is cost-effective
and improves program efficiency and effectiveness; and
``(IV) be capable of being continually upgraded as
necessary.
``(iii) Incorporation of nonproprietary standards.--In
designating data exchange standards under this paragraph, the
Secretary shall, to the extent practicable, incorporate
existing nonproprietary standards, such as the eXtensible
Mark up Language.
``(iv) Rule of construction.--Nothing in this paragraph
shall be construed to require a change to existing data
exchange standards for Federal reporting about a program
referred to in this section, if the head of the department or
agency responsible for administering the program finds the
standards to be effective and efficient.''.
(b) Effective Date.--The amendments made by this section
shall take effect 2 years after the date of the enactment of
this Act.
The CHAIR. No amendment to that amendment in the nature of a
substitute shall be in order except those printed in House Report 115-
331. Each such amendment may be offered only in the order printed in
the report, by a Member designated in the report, shall be considered
as read, shall be debatable for the time specified in the report
equally divided and controlled by the proponent and an opponent, shall
not be subject to amendment, and shall not be subject to a demand for
division of the question.
Amendment No. 1 Offered by Mr. Smith of Nebraska
The CHAIR. It is now in order to consider amendment No. 1 printed in
House Report 115-331.
Mr. SMITH of Nebraska. Madam Chair, I have an amendment at the desk.
The CHAIR. The Clerk will designate the amendment.
The text of the amendment is as follows:
Page 5, beginning on line 17, strike ``of the service
delivery model or models that the eligible entity may need to
develop for the model to operate'' and inserting ``to operate
at least 1 approved model of home visiting''.
The CHAIR. Pursuant to House Resolution 533, the gentleman from
Nebraska (Mr. Smith) and a Member opposed each will control 5 minutes.
The Chair recognizes the gentleman from Nebraska.
Mr. SMITH of Nebraska. Madam Chair, I yield myself such time as I may
consume.
Madam Chair, this amendment seeks to establish a careful balance
between two competing views in regards to where and how home visiting
programs
[[Page H7512]]
should be operated. The law requires States to operate home visiting
programs in areas of highest need. However, some States expressed
concern that they have been required to operate home visiting programs
in areas where they were likely to fail, as they were not permitted to
take into account staff and community resources and other requirements
of a home visiting model when choosing where to operate.
In the bill I introduced with my colleagues, we allowed States to
take these considerations into account, and States were generally
pleased with this change. However, since the introduction of the bill,
we have received additional feedback that some changes might be needed
to make sure States could take into account these factors but not
simply avoid serving actual areas with the highest need, including
rural areas and remote areas that I represent, as well as others.
During the Ways and Means markup of this bill, Representative Sewell
offered an amendment to address this problem. Although we did not
include her actual amendment in the reported bill, as we did not have
enough time to review it and consider any unintended consequences,
Representative Sewell and I have been able to review her proposal since
the markup and discuss its implications. I am pleased today to offer
this bipartisan amendment to address the concerns she and others have
raised.
Specifically, this amendment, combined with the language in the
underlying bill, allows States to take into account staffing, community
resources, and other requirements when determining how to operate their
home visiting programs, while requiring that they operate at least one
home visiting model in those communities with a high need for services.
This ensures States do not shy away from some of the most difficult
areas, which are often those that need home visiting services the most.
I am glad we have been able to work together on this bipartisan
amendment, and I urge my colleagues to support the amendment as well as
the underlying bill.
Mr. Chairman, I reserve the balance of my time.
Ms. SEWELL of Alabama. Mr. Chairman, I claim the time in opposition,
although I am not opposed to the amendment.
The Acting CHAIR (Mr. Simpson). Without objection, the gentlewoman is
recognized for 5 minutes.
There was no objection.
Ms. SEWELL of Alabama. First, I would like to thank Chairman Brady as
well as Chairman Smith for honoring their commitment to work with me to
ensure that the most needy rural communities are not neglected in this
bill.
I am glad to see that the language I proposed during the committee
markup last week has been included in the Smith amendment.
{time} 1430
Both my friend from Nebraska and I represent rural America, and we
understand the obstacles that our rural constituents confront on a
daily basis. Moreover, we both believe in the mission of the MIECHV
Program, and we see how effective it has been in both rural and urban
communities.
One of the reasons why the MIECHV Program is good policy is because
of the program's flexibility. While models like the Nurse-Family
Partnership can be successful in urban and suburban areas, other
evidence-based models like HIPPY--or Home Instruction for Parents of
Preschool Youngsters--can be incredibly effective in rural areas that
tend to have fewer resources.
This amendment language, which I offered during the committee markup,
ensures that rural communities with little resources are not skipped
over. This is a simple and commonsense fix that has bipartisan support
as well as the support from the Home Visiting Coalition.
While I appreciate my colleagues on the other side of the aisle for
working with me to fix this language, I have to say that I am
disappointed that none of the other commonsense amendments offered by
my Democratic colleagues were accepted during the markup.
For years, the MIECHV Program has enjoyed bipartisan support, but I
am afraid that Republican changes in the underlying legislation we are
considering today, I believe, will hurt the MIECHV recipients in the
long-term viability of the program.
While I oppose the final passage of the underlying bill, I, again,
want to thank my friend from Nebraska, as well as Chairman Brady, for
accepting my markup amendment language, and I urge my colleagues to
support the Smith amendment.
Mr. Chairman, I yield back the balance of my time.
Mr. SMITH of Nebraska. Mr. Chairman, again, I am grateful that Ms.
Sewell and I could work together to come up with this amendment. I
certainly urge its adoption as we do move forward with the bill.
Mr. Chairman, I yield back the balance of my time.
The Acting CHAIR. The question is on the amendment offered by the
gentleman from Nebraska (Mr. Smith).
The amendment was agreed to.
Amendment No. 2 Offered by Mr. Pascrell
The Acting CHAIR. It is now in order to consider amendment No. 2
printed in House Report 115-331.
Mr. PASCRELL. Mr. Chairman, I have an amendment at the desk.
The Acting CHAIR. The Clerk will designate the amendment.
The text of the amendment is as follows:
Page 5, strike lines 21 through 26.
The Acting CHAIR. Pursuant to House Resolution 533, the gentleman
from New Jersey (Mr. Pascrell) and a Member opposed each will control 5
minutes.
The Chair recognizes the gentleman from New Jersey.
Mr. PASCRELL. Mr. Chair, this amendment would strike the provision in
the bill that would add increasing employment and earnings to the
Maternal, Infant, and Early Childhood Home Visiting Program, or MIECHV,
as it is generally referred to.
I, obviously, share the goal of increasing employment and earnings
across the country. However, home visiting is not an employment
program. It is a program to strengthen families to make kids healthier,
safer, and more ready to learn when they start school. Those are the
outcomes home visiting models strive for, and those are the outcomes
they achieve.
I mentioned the other day in the Ways and Means Committee that I know
the good that these programs do firsthand. In Passaic County--because
most of these programs are run through counties throughout America--our
home visiting program worked with a pregnant mom expecting a child with
a heart defect.
The baby required open heart surgery shortly after being born last
July. After the surgery, the newborn continued to have health
complications. At times, his mom felt depressed and hopeless and feared
that her child was not going to survive.
The home visiting program's family support worker was able to assist
the mom by connecting her to services, providing her with emotional
support, and acting as a liaison with the hospital where her son was.
We know the negative impact that postpartum depression can have on
new moms and their babies. The home visiting program was able to
connect this mom to supportive services and resources and alleviate her
depression so that she could be a healthy and pleasant mom. I am happy
to report that, after nearly 3 months in the hospital, this little boy
was finally able to go home, and his mother continues to work with the
home visiting program in northern New Jersey.
I don't think anyone can hear that story and not see value in the
services that were provided. The home visiting program helped a mom,
like so many other mothers across America, navigate her newborn son's
healthcare crisis and manage the mental health issues associated with
it.
But under the provision that my amendment is seeking to strike from
the bill, this outcome would not be measured as a success. There is
something wrong with that.
Most home visiting models focus on families with newborns or very
small children and focus on building a parent-child bond. That is a
fact. Many home visiting programs focus on teen parents and young
mothers, and the priority is to keep them in school and make sure they
continue their education.
There are currently 18 evidence-based home visiting models. None of
them
[[Page H7513]]
provide employment services, none of them measure employment and
earnings.
Home visitors have raised concerns that having to ask families about
employment and earnings would be intrusive when you know what the focus
of the program is, and would undermine the relationship they are trying
to build with families.
Even if the data is collected without specifically asking families
for it, knowing their performance is being measured based on their
client's labor force participation--here is the kernel of the issue--
will likely make home visitors feel they have to press their clients to
work even if, like in the case of the mom in Passaic County, that
should not be the main object.
Additionally, this bill provides no new funding. We are not asking
for any new money here. Any resources devoted to supporting work would
have to be diverted from MIECHV's core purposes.
I urge my colleagues, Mr. Chairman, to support this amendment to make
sure children and families served by this program get the support and
service that they truly need.
Mr. Chairman, I reserve the balance of my time.
Mr. SMITH of Nebraska. Mr. Chairman, I claim the time in opposition
to the amendment.
The Acting CHAIR. The gentleman is recognized for 5 minutes.
Mr. SMITH of Nebraska. Mr. Chairman, since the creation of the MIECHV
Program, States have been required to demonstrate their home visiting
programs result in measurable improvements in six benchmark areas
specified in the law.
One of the benchmark areas States can choose to focus on is
``improvements in family economic self-sufficiency.'' Yet, as the
result of changes made last year under the prior Presidential
administration, ``economic self-sufficiency'' no longer means what you
think it means--increasing work and earnings. Instead, it was defined
as whether you have health insurance or are in school.
Clearly, this is not what Congress meant when the program was created
and included the concept of economic self-sufficiency. So this bill
would make sure that States, if they choose to focus on family economic
self-sufficiency as one of the four benchmarks of the six, would
measure employment and earnings as a part of that metric.
Again, States can choose among six different benchmarks when they
decide which home visiting programs to operate and what goals they
would like to achieve within those previously established by Congress.
They don't have to choose this metric, as I mentioned earlier. However,
when they do explicitly set out to increase economic self-sufficiency--
emphasis on the economic--information on work and earnings must be part
of what is measured to determine whether they have achieved their goal.
I believe it is absolutely critical that this intent be restored in the
law.
Mr. Chairman, I urge my colleagues to oppose this amendment and
support the underlying bill, and I reserve the balance of my time.
Mr. PASCRELL. Mr. Chairman, as I said, there are currently 18
evidence-based home visiting models. Also, there is nothing added to
the budget; no extra currency I am asking for.
I would ask the sponsor of the bill what he would tell this woman
from Passaic County, New Jersey, one of many examples that I have. I
ask him what his answer would be to that woman.
Mr. Chairman, I yield back the balance of my time.
Mr. SMITH of Nebraska. Mr. Chairman, again, I urge my colleagues to
oppose the amendment as well as support the underlying bill, and I
yield back the balance of my time.
The Acting CHAIR. The question is on the amendment offered by the
gentleman from New Jersey (Mr. Pascrell).
The question was taken; and the Acting Chair announced that the noes
appeared to have it.
Mr. PASCRELL. Mr. Chair, I demand a recorded vote.
The Acting CHAIR. Pursuant to clause 6 of rule XVIII, further
proceedings on the amendment offered by the gentleman from New Jersey
will be postponed.
Amendment No. 3 Offered by Ms. DelBene
The Acting CHAIR. It is now in order to consider amendment No. 3
printed in House Report 115-331.
Ms. DelBENE. Mr. Chairman, I have an amendment at the desk.
The Acting CHAIR. The Clerk will designate the amendment.
The text of the amendment is as follows:
Page 9, line 16, strike ``Organization'' and all that
follows through line 21 and insert ``Organization, 100
percent.''.
The Acting CHAIR. Pursuant to House Resolution 533, the gentlewoman
from Washington (Ms. DelBene) and a Member opposed each will control 5
minutes.
The Chair recognizes the gentlewoman from Washington.
Ms. DelBENE. Mr. Chairman, my amendment would eliminate the dangerous
cuts to Tribes who don't meet the bill's match requirement. I urge all
of my colleagues to support it.
I am proud to represent a number of Tribal communities in the Puget
Sound region that each have a rich history, identity, and culture. But
they face unique challenges.
The need for home visiting services is particularly high among
American Indians and Alaska Natives. Young people who live on
reservations are twice as likely to become teen parents. Nearly three-
fourths of the parents served by Tribal home visiting services live
below the Federal poverty level. And the majority of Tribal
beneficiaries have less than a high school diploma.
The good news is that Tribes are already using home visiting
resources to implement evidence-based models that have decreased
depression, substance abuse, and stress among parents, while improving
health among children.
Seventy-seven percent of Tribal home visiting programs have improved
family outcomes in at least four different areas, such as improving
maternal and newborn health, increasing school readiness, reducing
domestic violence, and strengthening parents' economic self-
sufficiency.
The bad news is the need for help in Indian Country has far exceeded
the limited funding available through the home visiting program. In
fact, less than half of qualified applications for Tribal home visiting
can be granted under the current funding levels.
Some States have tried to address these shortages with State
resources, like my home State of Washington, which has voluntarily used
State funding to meet the needs of Tribal families. But it is not
enough.
The underlying bill provides no new resources to address the
nationwide shortfall in Tribal funding. Instead, it adds a match
requirement that could be the end of home visiting on reservations
altogether.
Most Indian Tribes struggle economically and already face challenges
providing help to families. I understand that Tribal administrators
have said almost none of them could meet the match requirement in this
legislation.
Indian Tribes have also generally considered Federal match
requirements to be a violation of Tribal sovereignty. As such, they may
have to refuse the funds and shut down home visiting programs if the
bill is enacted with the match requirement.
I appreciate that the chairman has delayed the implementation of the
Tribal match and reduced it to 30 percent. But, realistically, the
effect will be simply to give Tribes more time to shut down their home
visiting programs. The match requirement will still be completely
unworkable for them in 2022.
The Federal Government has a responsibility to our Tribal communities
to do everything we can to support their people, strengthen their
families, and expand economic opportunity.
Mr. Chairman, the underlying bill takes a dangerous step in the wrong
direction for our Tribes, but we still have the opportunity to stop it.
Mr. Chairman, I urge my colleagues to vote ``yes'' on my amendment,
and I yield back the balance of my time.
The Acting CHAIR. The question is on the amendment offered by the
gentlewoman from Washington (Ms. DelBene).
The amendment was agreed to.
{time} 1445
Amendment No. 4 Offered by Mrs. Murphy of Florida
The Acting CHAIR. It is now in order to consider amendment No. 4
printed in House Report 115-331.
[[Page H7514]]
Mrs. MURPHY of Florida. Mr. Chairman, I have an amendment at the
desk.
The Acting CHAIR. The Clerk will designate the amendment.
The text of the amendment is as follows:
Page 14, after line 9, insert the following:
SEC. 11. ALLOCATION OF FUNDS.
Section 511(j) of the Social Security Act (42 U.S.C.
711(j)) is amended by adding at the end the following:
``(4) Allocation of funds.--To the extent that the grant
amount awarded under this section to an eligible entity is
determined on the basis of relative population or poverty
considerations, the Secretary shall make the determination
using the most accurate Federal data available for the
eligible entity.''.
The Acting CHAIR. Pursuant to House Resolution 533, the gentlewoman
from Florida (Mrs. Murphy) and a Member opposed each will control 5
minutes.
The Chair recognizes the gentlewoman from Florida.
Mrs. MURPHY of Florida. Mr. Chairman, I rise in support of my
bipartisan amendment, which is cosponsored by Congresswoman Jenniffer
Gonzalez-Colon from Puerto Rico and Congresswoman Nydia Velazquez from
New York.
The American citizens in Puerto Rico and the neighboring U.S. Virgin
Islands are enduring an incredibly difficult situation in the aftermath
of Hurricane Irma and Hurricane Maria.
As a Member whose central Florida district is home to over 100,000
individuals of Puerto Rican heritage, I join my colleagues on both
sides of the aisle who have made crystal clear to our brothers and
sisters in Puerto Rico and the U.S. Virgin Islands that they will
receive all the Federal support they need to stabilize the situation in
the short term, to rebuild in the medium term, and to emerge stronger
in the long term.
We are part of one American family. And like any close-knit family,
we always have each other's backs, especially when times are tough.
My amendment will ensure that Puerto Rico and the other U.S.
territories are treated equally under the Maternal, Infant, and Early
Childhood Home Visiting Program, which the underlying bill
reauthorizes. The amendment will implement a recommendation made by the
bipartisan, bicameral Congressional Task Force on Economic Growth in
Puerto Rico.
This Federal program provides annual grants to States and territories
to fund home visiting services for families with young children. Visits
are conducted by social workers and other professionals. They provide
parenting education and other support services with a goal of helping
at-risk families succeed. It is a great program that invests in
children and families, helps lift them out of poverty, and increases
the chance that they will become productive and successful members of
society.
In theory, the program treats States and territories equally when it
comes to the distribution of grant funding. In practice, however,
Puerto Rico is treated unfairly. The Department of Health and Human
Services makes allocations based, in part, on a U.S. Census Bureau data
product on childhood poverty, but that data does not include
information on Puerto Rico or the other territories. Therefore, Puerto
Rico always receives the minimum grant allowed by the law, even though
the island of 3.4 million has a high rate of childhood poverty.
My amendment would simply require HHS, when making grants, to use the
best Federal data available for every State and territory and to use an
appropriate alternative data source, if necessary, in the case of
Puerto Rico. This will ensure that Puerto Rico receives its fair share
of funding and not one penny more and not one penny less.
I hope my colleagues will support this amendment and that we will
continue to do everything possible to help our fellow citizens in
Puerto Rico.
Mr. Chairman, I reserve the balance of my time.
Mr. SMITH of Nebraska. Mr. Chairman, I claim the time in opposition
to the amendment, even though I am not opposed to it.
The Acting CHAIR. Without objection, the gentleman is recognized for
5 minutes.
There was no objection.
Mr. SMITH of Nebraska. Mr. Chairman, I support this amendment, the
Maternal, Infant, and Early Childhood Home Visiting Program, that is
designed to serve families with young children living in communities at
risk of a range of negative outcomes.
Today, HHS allocates money for MIECHV based on the share of children
under age 5 in families at or below 100 percent of the Federal poverty
line living in each State and territory.
It is imperative that the distribution of funds is done using the
most accurate and up-to-date information so we can use our limited
resources to target those most in need.
I thank the sponsors of this amendment, Representatives Murphy,
Gonzalez-Colon, and Velazquez, for bringing this issue to our attention
and for offering this amendment.
Mr. Chair, I reserve the balance of my time.
Mrs. MURPHY of Florida. Mr. Chairman, in closing, I would simply
reiterate my hope that my colleagues on both sides of the aisle will
support this amendment.
Mr. Chairman, I yield back the balance of my time.
Mr. SMITH of Nebraska. Mr. Chairman, I urge support of this amendment
and the underlying bill so that we can help children.
Mr. Chairman, I yield back the balance of my time.
The Acting CHAIR. The question is on the amendment offered by the
gentlewoman from Florida (Mrs. Murphy).
The amendment was agreed to.
Mr. SMITH of Nebraska. Mr. Chair, I move that the Committee do now
rise.
The motion was agreed to.
Accordingly, the Committee rose; and the Speaker pro tempore (Mr.
Rice of South Carolina) having assumed the chair, Mr. Simpson, Acting
Chair of the Committee of the Whole House on the state of the Union,
reported that that Committee, having had under consideration the bill
(H.R. 2824) to amend title V of the Social Security Act to extend the
Maternal, Infant, and Early Childhood Home Visiting Program, had come
to no resolution thereon.
____________________