[House Report 115-315]
[From the U.S. Government Publishing Office]


115th Congress    }                                     {   Rept. 115-315
                         HOUSE OF REPRESENTATIVES
 1st Session      }                                     {      Part 1

======================================================================



 
  INCREASING OPPORTUNITY AND SUCCESS FOR CHILDREN AND PARENTS THROUGH 
                    EVIDENCE-BASED HOME VISITING ACT

                                _______
                                

 September 21, 2017.--Committed to the Committee of the Whole House on 
            the State of the Union and ordered to be printed

                                _______
                                

Mr. Brady of Texas, from the Committee on Ways and Means, submitted the 
                               following

                              R E P O R T

                             together with

                            DISSENTING VIEWS

                        [To accompany H.R. 2824]

      [Including cost estimate of the Congressional Budget Office]

    The Committee on Ways and Means, to whom was referred 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, having considered the same, report favorably thereon 
with an amendment and recommend that the bill as amended do 
pass.

                                CONTENTS

                                                                   Page
  I. SUMMARY AND BACKGROUND...........................................5
          A. Purpose and Summary.................................     5
          B. Background and Need for Legislation.................     5
          C. Legislative History.................................     6
 II. EXPLANATION OF THE BILL..........................................7
          Sections 1 and 2: Short Title and Table of Contents....     7
          Section 3: Continuing Evidence-Based Home Visiting 
              Program............................................     7
          Section 4: Continuing to Demonstrate Results to Help 
              Families...........................................     8
          Section 5: Reviewing Statewide Needs to Target 
              Resources..........................................    10
          Section 6: Improving the Likelihood of Success in High 
              Risk Communities...................................    12
          Section 7: Measuring Improvements in Family Economic 
              Self-Sufficiency...................................    13
          Section 8: Option to Fund Evidence-Based Home Visiting 
              on a Pay for Outcome Basis.........................    14
          Section 9: Strengthening Evidence-Based Home Visiting 
              Through State, Local, and Private Partnership......    15
          Section 10: Data Exchange Standards for Improved 
              Interoperability...................................    17
III. VOTES OF THE COMMITTEE..........................................19
 IV. BUDGET EFFECTS OF THE BILL......................................22
          A. Committee Estimate of Budgetary Effects.............    22
          B. Statement Regarding New Budget Authority and Tax 
              Expenditures Budget Authority......................    23
          C. Cost Estimate Prepared by the Congressional Budget 
              Office.............................................    23
  V. OTHER MATTERS TO BE DISCUSSED UNDER THE RULES OF THE HOUSE......25
          A. Committee Oversight Findings and Recommendations....    25
          B. Statement of General Performance Goals and 
              Objectives.........................................    25
          C. Information Relating to Unfunded Mandates...........    25
          D. Congressional Earmarks, Limited Tax Benefits, and 
              Limited Tariff Benefits............................    25
          E. Duplication of Federal Programs.....................    25
          F. Disclosure of Directed Rule Makings.................    26
 VI. CHANGES IN EXISTING LAW MADE BY THE BILL, AS REPORTED...........26
VII. DISSENTING VIEWS................................................41
VIII.EXCHANGES OF LETTERS WITH ADDITIONAL COMMITTEES OF REFERRAL.....43


    The amendment is as follows:
  Strike all after the enacting clause and insert the 
following:

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 (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.

                       I. SUMMARY AND BACKGROUND


                         A. Purpose and Summary

    H.R. 2824 as amended, the ``Increasing Opportunity and 
Success for Children and Parents through Evidence-Based Home 
Visiting Act,'' as ordered reported by the Committee on Ways 
and Means on September 13, 2017, amends title V of the Social 
Security Act to extend the Maternal, Infant, and Early 
Childhood Home Visiting Program.

                 B. Background and Need for Legislation

    Social services programs often are unable to demonstrate 
they achieve better outcomes for poor families. According to 
two former White House officials, ``based on our rough 
calculations, less than $1 out of every $100 of government 
spending is backed by even the most basic evidence that the 
money is being spent wisely.''\1\ In contrast, the Maternal, 
Infant, and Early Childhood Home Visiting program (MIECHV), 
first funded as a pilot program in 2008 during the George W. 
Bush Administration, only awards funds to states when they 
operate one of 18 programs that meet a specified evidence 
threshold (as confirmed by the U.S. Department of Health and 
Human Services) demonstrating the model has been subject to a 
high quality evaluation and yielded significant, positive 
outcomes in areas such as reducing child abuse and neglect, 
improving maternal and child health, and improving self-
sufficiency.
---------------------------------------------------------------------------
    \1\The Atlantic, ``Can Government Play Moneyball?,'' John 
Bridgeland and Peter Orszag, July/August 2013
---------------------------------------------------------------------------
    Begun in 2010, the federal MIECHV program was designed to 
strengthen existing maternal and child health programs, provide 
services to improve outcomes for families in at-risk 
communities, and better coordinate services. Under the MIECHV 
program, states identify at-risk communities through statewide 
assessments examining areas with concentrations of poor child 
health outcomes and other difficulties such as high poverty, 
crime, or unemployment. States then specify how they will serve 
these communities using an evidence-based home visiting model. 
While the bulk of program funding must be used to provide 
services through home visiting models with evidence of 
effectiveness as determined by HHS, up to 25 percent of total 
funding can be used to fund promising, but still unproven, 
approaches that will be evaluated ensuring continuous model 
development. States receiving federal funding are not required 
to match dollars with state or local money.
    Set to expire September 30, 2017, MIECHV is currently the 
only federal program for low-income families with children that 
ties funding to evidence of effectiveness. MIECHV should be 
extended so it can continue to deliver results for families in 
need, and other programs should be modified to work more like 
MIECHV, where funding is provided to develop and operate 
evidence-based programs and states are held accountable for 
delivering results.

                         C. Legislative History


                               BACKGROUND

    H.R. 2824, the ``Increasing Opportunity through Evidence-
Based Home Visiting Act,'' was introduced on June 8, 2017, by 
Representative Adrian Smith, Representative Michael C. Burgess, 
Representative Patrick J. Tiberi, Representative Tom Reed, 
Representative Patrick Meehan, Representative Kristi L. Noem, 
and Representative Jackie Walorski and was referred to the 
Committee on Ways and Means and Energy and Commerce.

                           COMMITTEE HEARINGS

    The Ways and Means Subcommittee on Human Resources held a 
hearing on March 15, 2017, titled ``Reauthorization of the 
Maternal, Infant, and Early Childhood Home Visiting (MIECHV) 
Program.'' The hearing examined the effectiveness of a range of 
home visiting models, reviewed how states operate and fund 
programs, and highlighted how an evidence-based home visiting 
program can produce positive outcomes for children and 
families.
    As Subcommittee Chairman Adrian Smith (R-NE) remarked 
during his opening statement:

          ``MIECHV is one of the only social programs where 
        funding is tied to proven evidence. For a home visiting 
        model to be funded, an evaluation must show the program 
        has demonstrated significant, positive outcomes in 
        areas such as reducing childhood abuse and neglect, 
        improving maternal and child health, and improving 
        economic self-sufficiency. Many of these approved 
        models are now being further studied through a rigorous 
        random assignment evaluation to better measure their 
        impacts so we know families are receiving real 
        help.''\2\

    \2\Chairman of the Ways and Means Human Resources Subcommittee 
Adrian Smith (R-NE), Opening Statement, Hearing on The Reauthorization 
of the Maternal, Infant, and Early Childhood Home Visiting (MIECHV) 
Program, March 15, 2017
---------------------------------------------------------------------------

                            COMMITTEE ACTION

    The Committee on Ways and Means marked up H.R. 2824, the 
``Increasing Opportunity and Success for Children and Parents 
through Evidence-Based Home Visiting Act,'' on September 13, 
2017. The bill was ordered favorably reported to the House of 
Representatives, as amended, by a roll call vote of 22 yays to 
15 nays.

                      II. EXPLANATION OF THE BILL


          Sections 1 and 2: Short Title and Table of Contents


                              PRESENT LAW

    No provision.

                        EXPLANATION OF PROVISION

    This Act may be cited as ``Increasing Opportunity and 
Success for Children and Parents through Evidence-Based Home 
Visiting Act.''

                           REASON FOR CHANGE

    The Committee believes that the short title and table of 
contents accurately reflect the policy actions included in the 
legislation.

                             EFFECTIVE DATE

    These provisions are effective upon enactment.

       Section 3: Continuing Evidence-Based Home Visiting Program


                              PRESENT LAW

    The MIECHV law directly appropriated five years of 
mandatory funding for the program in the MIECHV authorizing 
statute: $100 million for FY2010; $250 million for FY2011; $350 
million for FY2012; and $400 million for each of FY2013 through 
FY2017. [Section 511(j)(1) of the Social Security Act]

                        EXPLANATION OF PROVISION

    H.R. 2824, as amended, extends the appropriated, mandatory 
funding of $400 million for the MIECHV program for FY 2018 
through FY2022.

                           REASON FOR CHANGE

    The Committee believes the extension of this evidence-based 
program will help improve the lives of struggling families with 
children, and that the program can serve as a model for how 
other federal social programs can be reformed to focus on 
outcomes.

                             EFFECTIVE DATE

    This provision is effective upon enactment.

     Section 4: Continuing To Demonstrate Results To Help Families


                            BENCHMARK AREAS

                              PRESENT LAW

    Eligible entities must establish, subject to approval of 
the HHS Secretary, quantifiable and measurable benchmarks for 
demonstrating improvements for eligible families participating 
in the program in each of six areas: (1) improved maternal and 
newborn health; (2) prevention of child injuries, child abuse, 
neglect, or maltreatment, and reduction of emergency department 
visits; (3) improvements in school readiness and achievement; 
(4) reduction in crime or domestic violence; (5) improvements 
in family economic self-sufficiency; and (6) improvements in 
the coordination and referrals for other community resources 
and supports. Performance in the benchmark areas are to be 
assessed at three and five years following the start of 
program.
    Each eligible entity is required to submit a report to the 
HHS Secretary demonstrating that it has made improvements in at 
least four of the six benchmark areas during the first three 
years that it carries out the program.\3\ The report is to be 
submitted within 30 days of the end of that three-year period. 
[Section 511(d)(1) of the Social Security Act]
---------------------------------------------------------------------------
    \3\Most eligible entities had to submit the report by October 30, 
2014 to show that improvements were made between FY2012, when the 
program was fully implemented, and FY2014, the third year of 
implementation.
---------------------------------------------------------------------------
    An eligible entity must submit, as part of its grant 
application to HHS, the quantifiable and measurable benchmarks 
it has established demonstrate that the program contributes to 
improvements for eligible families in the six areas. [Section 
511(e)(5)) of the Social Security Act]

                        EXPLANATION OF PROVISION

    H.R. 2824, as amended, would require eligible entities to 
track and report, subject to the approval of the HHS Secretary, 
quantifiable and measurable benchmarks that are intended to 
demonstrate continued improvements for eligible families. These 
four or more benchmark areas would be subject to approval of 
the HHS Secretary and would include only those that the service 
delivery model, as selected by the eligible entity, are 
intended to improve. The four or more benchmark areas would 
continue to be included as part of the eligible entity's grant 
application.

                           REASON FOR CHANGE

    During the initial years of the program, states were 
required to demonstrate improvements in specific areas for 
families receiving services. However, these requirements have 
now lapsed. This bill would renew the requirements for the 
measurement and reporting of outcomes so Congress, the families 
being served, and taxpayers funding these programs can be sure 
these programs continue to deliver real results. Specifically, 
the Committee intends that HHS continue to measure improvement 
among eligible, enrolled families as a result of MIECHV grants 
compared with families who do not receive these services. It is 
the Committee's intent that each eligible entity shall continue 
to identify at least four of the six possible benchmarks for 
which it will track and report the progress of families 
enrolled in the program. Eligible entities shall track and 
report on family progress on the measures associated with the 
selected benchmarks that the service delivery model in which 
the family is participating is intended to improve. For 
example, if reduction in child injury is not an intended 
outcome of a particular home visiting model, families receiving 
home visits through that model would not be required to be 
included in measures tracking improvements in child injury, 
although the eligible entity may choose to track this 
information.

            CORRECTIVE ACTION PLAN AND TECHNICAL ASSISTANCE

                              PRESENT LAW

    If an eligible entity fails to demonstrate improvements in 
four of the six benchmark areas within the first three years of 
program implementation, it must develop and implement a plan to 
make improvements in each of the applicable benchmark areas, 
subject to approval by the HHS Secretary. The Secretary must 
provide technical assistance (directly or through grants, 
contracts, or cooperative agreements) to the eligible entity in 
developing and implementing the plan. The HHS Secretary must 
convene an advisory panel made up of staff from the Departments 
of Health and Human Services and Education to make 
recommendations about this technical assistance. [Section 
511(d)(1) of the Social Security Act]

                        EXPLANATION OF PROVISION

    If an eligible entity does not continue to demonstrate 
ongoing improvements in at least four of the benchmark areas, 
it must develop and implement a plan to make improvements in 
each of the applicable benchmark areas (subject to approval by 
the HHS Secretary) that are applicable to the service delivery 
model selected by the entity. The improvement plan would 
include provisions for the HHS Secretary to monitor the plan's 
implementation and conduct continued oversight of the program, 
including by regular reports submitted by the eligible entity. 
The Secretary must provide technical assistance (directly or 
through grants, contracts, or cooperative agreements) to the 
eligible entity in developing and implementing the plan.

                           REASON FOR CHANGE

    During the initial years of the program, if states did not 
demonstrate improvements in specific areas for families 
receiving services, they were required to develop an 
improvement plan to address the problem. However, this 
requirement has now lapsed. This bill would renew the 
requirement that the state develop an improvement plan if they 
don't achieve results, allowing Congress, the families being 
served, and the taxpayers funding the program to have 
confidence that efforts are being made to hold states 
accountable and correct deficiencies if they arise. 
Specifically, it is the Committee's intent that, if the 
eligible entity fails to show participation in home visiting 
improves family outcomes as compared to families who do not 
receive home visiting services, the entity is required to 
develop and implement an improvement plan. It is the 
Committee's intent that eligible entities shall be held 
accountable for demonstrating that families enrolled in home 
visiting achieve improved outcomes. It is not the Committee's 
intent to penalize eligible entities that have achieved 
substantial outcomes and are unable to demonstrate further 
progress among families enrolled in home visiting as compared 
to families receiving these services in a prior year.

                         TERMINATION OF FUNDING

                              PRESENT LAW

    The HHS Secretary must terminate a jurisdiction's MIECHV 
funding if, after a period of time specified by the Secretary, 
the jurisdiction has failed to demonstrate any improvements in 
outcomes following the first three years of the program's 
implementation, or if the Secretary determines that the 
jurisdiction has failed to submit the required report on 
performance in the benchmark areas after the initial three 
years that the program is implemented. The Secretary may 
include any unexpended grant funds in grants made to nonprofit 
organizations that operate home visiting programs in states 
that had not (as of the beginning of FY2012), applied or been 
approved for a MIECHV grant. [Section 511(d)(1) of the Social 
Security Act]

                        EXPLANATION OF PROVISION

    H.R. 2824, as amended, would extend these same requirements 
for an eligible entity that does not continue to demonstrate 
ongoing improvements in at least four of the benchmark areas in 
subsequent years, or if the eligible entity has failed to 
submit the required annual report to the HHS Secretary on 
improvements made in the benchmark areas.

                           REASON FOR CHANGE

    The Committee believes renewing the requirement that HHS 
terminate MIECHV funding to a jurisdiction that has failed to 
demonstrate results will ensure federal funds are spent on 
programs that truly help those in need, instead of continuing 
to support programs that are ineffective. Renewing this 
requirement is consistent with the other efforts in this 
section to revive the set of policies that helped to establish 
MIECHV as a leading program to provide real results to 
families.

                             EFFECTIVE DATE

    These provisions in this section are effective upon 
enactment.

        Section 5: Reviewing Statewide Needs To Target Resources


                              PRESENT LAW

    As a condition of receiving funds under the Maternal and 
Child Health Services Block Grant for FY2011, states were 
required to conduct a statewide needs assessment for the MIECHV 
program.\4\ The statewide needs assessment has three purposes, 
as outlined in the law:
---------------------------------------------------------------------------
    \4\The Maternal and Child Health Block Grant, authorized under 
Title V of the Social Security Act, is a flexible source of funds that 
states use to support maternal and child health programs.
---------------------------------------------------------------------------
     Identify communities with concentrations of 
premature birth, low-birth weight infants, and infant 
mortality, including infant death due to neglect or other 
indicators of at-risk prenatal, maternal, newborn, or child 
health; poverty; crime; domestic violence; high school 
dropouts; substance abuse; unemployment; or child maltreatment.
     Determine the quality and capacity of existing 
programs or initiatives for early childhood home visitation in 
the jurisdiction, including the number and types of individuals 
and families who are receiving services under such programs or 
initiatives; gaps in early childhood home visitation in the 
jurisdiction; and the extent to which such programs and 
initiatives are meeting the needs of eligible families.
     Determine the state's capacity for providing 
substance abuse treatment and counseling services to 
individuals and families in need of such treatment or services.
    The needs assessment was to be separate from the statewide 
needs assessment required under the Maternal and Child Health 
Services Block Grant. [Section 511(b)(1) of the Social Security 
Act]

                        EXPLANATION OF PROVISION

    H.R. 2824, as amended, would require eligible entities to 
review and update their statewide needs assessment by October 
1, 2020 as a condition of receiving funds under the Maternal 
and Child Health Services Block Grant. The assessment must be 
coordinated with statewide needs assessment required under the 
Maternal and Child Health Services Block Grant, but may be 
conducted separately.

                           REASON FOR CHANGE

    In order to guide placement of home visiting programs 
funded by MIECHV in high-risk communities with the greatest 
need, states conducted needs assessments in FY 2010 before 
receiving funding for the next fiscal year. The Committee 
recognizes that those initial assessments are nearly a decade 
old and should be reviewed and updated. It is the Committee's 
intent that state needs assessments be updated no later than 
October 1, 2020 (allowing states to select the schedules as 
they see fit), and that states may exercise the option to 
coordinate with other related data collection and analysis 
efforts as they choose. States shall retain the authority to 
use the information gathered at their discretion. The 
Committee's intent in requiring the review and updating of the 
needs assessment is for states to gather more recent 
information on community needs and reaffirm that MIECHV 
programs are being operated in areas of high need. Nothing in 
this section shall be construed to require moving MIECHV-funded 
home visiting programs, defunding of programs for the sole 
purpose of moving services to other communities, or otherwise 
disrupting existing home visiting programs, their relationships 
in the community, and their services to eligible families.

                             EFFECTIVE DATE

    This provision is effective upon enactment.

Section 6: Improving the Likelihood of Success in High Risk Communities


                              PRESENT LAW

    Eligible entities must give priority for providing home 
visiting services to specified high-risk populations, including 
eligible families who (1) reside in communities in need of home 
visiting services, as identified in the statewide needs 
assessment; (2) are low income; (3) are pregnant women under 
age 21; (4) have a history of child abuse or neglect or have 
had interactions with child welfare services; (5) have a 
history of substance abuse or need substance abuse treatment; 
(6) have users of tobacco products in the home; (7) are or have 
children with low student achievement; (8) have children with 
developmental delays or disabilities; or (9) include 
individuals who are, or were, serving in the Armed Forces, 
including families with members who have multiple deployments 
outside of the United States. [Section 511(d)(4) of the Social 
Security Act]

                        EXPLANATION OF PROVISION

    H.R. 2824, as amended, would continue to give priority for 
services to those high risk families identified in the needs 
assessment, while allowing eligible entities to take into 
account additional factors--staffing, community resource, and 
other requirements of the service delivery model(s)--that the 
eligible entity may need to develop for the model to operate 
and demonstrate improvements for these eligible families.

                           REASON FOR CHANGE

    The Committee recognizes that, as states conduct updated 
needs assessments and consider the placement of home visiting 
programs in the highest need communities, they may determine a 
particular community needs additional technical assistance or 
other resources prior to launch of a home visiting program to 
increase the likelihood that the program will succeed and that 
families will benefit from home visiting. States are encouraged 
to offer such assistance to help communities prepare to 
implement a MIECHV home visiting model. States are also 
encouraged to consider the full range of MIECHV-approved models 
when determining how best to support successful home visiting 
in any given community. Nothing in this section shall be 
construed to give States the option not to support the success 
of home visiting in communities of highest risk and need.

                             EFFECTIVE DATE

    This provision is effective upon enactment.

 Section 7: Measuring Improvements in Family Economic Self-Sufficiency


                              PRESENT LAW

    One of the six benchmark areas in which program performance 
may be measured pertains to improvements in family economic 
self-sufficiency. [Section 511(d)(1)(v) of the Social Security 
Act]

                        EXPLANATION OF PROVISION

    H.R. 2824, as amended, would specify that improvements in 
family economic self-sufficiency must include measures of 
employment and earnings.

                           REASON FOR CHANGE

    Under current law, each eligible entity must establish 
quantifiable, measureable benchmarks to demonstrate that their 
MIECHV programs are resulting in improvements in at least four 
of six benchmarks, with one of these benchmarks being 
``improvements in family economic self-sufficiency.'' While the 
Committee believes the plain language in the statute is clear 
and that measuring economic self-sufficiency means measurement 
of employment and earnings, recent administrative changes have 
modified the way states track their performance relative to 
this benchmark so that employment and earnings are no longer 
considered as part of this metric.\5\ As a result, the 
Committee believes it is necessary to specify that employment 
and earnings measures be part of this benchmark area, so that 
an eligible entity who indicates they plan to improve family 
economic self-sufficiency will report this information.
---------------------------------------------------------------------------
    \5\MIECHV Form 2 Performance Indicators and Systems Outcomes Data 
Collection and Reporting Manual and Grantee Plan, updated October 2016 
describes the new indicators used to measure family economic self-
sufficiency, which are primary caregiver education and continuity of 
insurance coverage.
---------------------------------------------------------------------------
    At the same time, the Committee does not believe the home 
visitor must necessarily be the person tasked with collecting 
detailed data on employment and earnings for those they visit, 
although visitors from models intending to improve family 
economic self-sufficiency will likely be asking about and 
gathering some information on these topics. Instead, the 
Committee expects eligible entities to work with state and 
federal partners to utilize employment and earnings information 
the family already provides (such as information collected and 
used to determine eligibility for other benefits and services 
the family may be receiving) or that is available from other 
sources.
    The Committee recognizes this provision will require 
coordination between states, MIECHV models, the Administration 
for Children and Families (ACF), and the Health Resources and 
Services Administration (HRSA). The Committee further 
recognizes that the data collected under this provision may be 
incomplete until data is shared between all applicable 
departments of government, and encourages states, MIECV models, 
and HHS to provide Congress with information on how to improve 
this data sharing through legislative changes if necessary.

                             EFFECTIVE DATE

    This provision is effective upon enactment.

  Section 8: Option to Fund Evidence-Based Home Visiting on a Pay for 
                             Outcome Basis


                              PRESENT LAW

    No provision.

                        EXPLANATION OF PROVISION

    H.R. 2824, as amended, would add new language to enable an 
eligible entity to use MIECHV grants for a pay-for-outcomes 
initiative that satisfy the requirements for providing 
evidence-based home visiting services.
    H.R. 2824, as amended, would separately define ``pay for 
outcome initiative'' as a performance-based grant, contract, 
cooperative agreement or other agreement awarded by a public 
entity inwhich 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 would include--
           a feasibility study that describes how the 
        proposed intervention is based on evidence of 
        effectiveness;
           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;
           an annual, publicly available report on the 
        progress of the initiative; and
           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 would not apply to 
        payments for the third-party evaluation.
    Funding for pay-for-outcomes initiatives could be expended 
by the eligible entity for up to 10 years after the funds are 
made available, and funds could be reused to fund other MIECHV 
projects if outcomes are not met and therefore payment is not 
made.

                           REASON FOR CHANGE

    The Committee recognizes that there is bipartisan support 
to use federal funds to pay for programs that produce real 
results. Groups ranging from conservative think tanks to 
liberal advocacy organizations have recommended funding 
programs on a ``pay-for-outcomes'' basis. States and local 
governments are testing this strategy now--including in 
MIEHCV--but unless Congress allows federal funds to be used to 
pay for outcomes, their opportunities are limited as a 
substantial amount of funding for evidence-based home visiting 
programs is provided by the federal government. By allowing 
MIECHV grantees to pay for outcomes, more approaches can be 
tested and evaluated to determine whether they deliver real 
results for families with children.
    A key feature of ``pay for outcomes'' financing is that the 
entity funding the project works with the service provider to 
jointly identify objective, quantifiable outcomes that must be 
met for payment to be made and an independent evaluator 
determines if the goals are met. By selecting an objective 
outcome goal instead of some other metric for payment, the 
government is less likely to pay for things that don't produce 
the outcome they are seeking (such as clients served, classes 
taught, or costs incurred). In addition, the outcome for 
individuals served will be compared with the outcomes for a 
control group to confirm the services provided are responsible 
for producing the outcome.
    ``Pay for outcomes'' financing also aligns the interests of 
the government, other funders, and service providers. In a 
traditional contract, the government agrees to pay for various 
inputs, processes, or services, which may encourage providers 
to increase those factors--regardless of whether they improve 
the outcome or not. In a ``pay for outcomes'' financing 
structure, the funder only pays if the project achieves the 
desired outcomes. As a result, service providers have a strong 
incentive to produce the positive social outcome and manage the 
project to ensure it succeeds.
    The Committee believes allowing MIECHV grantees to use 
funding to pay for outcomes will help focus more federal 
spending on programs that deliver results. The Committee heard 
about an effort currently underway in South Carolina using non-
federal funds during a March 15, 2017 hearing on 
reauthorization testing this ``pay for outcomes'' structure, 
and this provision will allow other states to test this 
approach as well. Paying for outcomes can reduce bureaucracy 
and increase local flexibility, as payment is tied to achieving 
an agreed-upon result instead of the performance of specific 
intermediate actions intended to be a proxy for outcomes. And 
because payment is tied to results, programs that are not 
successful no longer continue--meaning federal funds are 
focused on what works.

                             EFFECTIVE DATE

    This provision is effective upon enactment.

 Section 9: Strengthening Evidence-Based Home Visiting Through State, 
                     Local, and Private Partnership


                              PRESENT LAW

    MIECHV funds provided to an eligible entity must be used to 
supplement and not supplant funds from other sources for early 
childhood home visiting. [Section 511(c) of the Social Security 
Act.]

                        EXPLANATION OF PROVISION

    H.R. 2824, as amended, would require an eligible entity to 
support its MIECHV home visiting services with funds other than 
those provided under the MIECHV program. Beginning with FY2020, 
state or nonprofit organizations must support the MIECHV 
program with no less than 30% of non-MIECHV funds. This 
percentage would rise to 40% for FY2021 and to 50% for FY2022 
and succeeding years. For an Indian Tribe (or a consortium of 
that Indian Tribes), a Tribal Organization, or an Urban Indian 
Organization, there would be an additional two-year delay with 
no less than 30% of funds coming from non-MIECHV sources 
beginning in FY2022.
    These non-MIECHV funds (which could be other federal funds, 
or non-federal dollars) could be paid in cash or in kind. The 
HHS Secretary could attribute fair market value to goods, 
services, and facilities provided from non-federal sources.

                           REASON FOR CHANGE

    MIECHV programs have been shown to reduce child abuse and 
neglect, improve maternal and child health, and increase self-
sufficiency among other impacts, and these benefits--both 
social and fiscal--will accrue to the state and the federal 
government. As a result, the Committee believes states should 
be expected to contribute other resources to support MIECHV. In 
addition, the Committee believes programs are operated more 
effectively and efficiently when states are investing their own 
funds. Requiring matching funds also increases resources to the 
program, allowing it to reach at least $800 million a year in 
spending by FY2022.
    Most social programs funded by this Committee, and many 
funded by other committees, already require states to match 
federal dollars, including Medicaid (where states spent $212 
billion in state matching funds in FY 2016), foster care and 
adoption (where states spent $6 billion in state matching funds 
in FY 2015) along with other programs such as child support, 
child care, and child welfare.\6\ The requirement that states 
invest funds beyond those provided by the federal government 
should be no different for this program.
---------------------------------------------------------------------------
    \6\Medicaid and CHIP Payment and Access Commission, Exhibit 16: 
Medicaid Spending by State, Category, and Source of Funds.
    Committee on Ways and Means Green Book, 2016. Table 11-8: Title IV-
E Foster Care, Adoption Assistance, and Kinship Guardianship Assistance 
Spending by State, FY2015.
---------------------------------------------------------------------------
    In addition to making this program more consistent with 
other federal social programs requiring outside investment, 
many of the savings that result from the success of this 
program--such as decreased hospital admissions, increased 
school readiness, reduced child abuse and neglect--are savings 
realized at the state and local level. These benefits reinforce 
the idea that it is already in the best financial interest of 
states to invest in this program.
    The Congressional Budget Office projects the federal 
government will spend almost $700 billion more than it takes in 
this year, and that the U.S. now has $20 trillion in debt. 
Because of this, the Committee believes the most responsible 
way to continue this program and expand its reach is to provide 
funding for it by improving the integrity of another program to 
offset the cost [as was done in H.R. 2972, the Control of 
Unlawful Fugitive Felons (CUFF) Act, which was marked up and 
passed in conjunction with this bill], as well as create a 
strong federal-state financial partnership going forward.
    This bill gives states substantial flexibility in meeting 
the matching requirement, allowing contributions to be made in 
cash or in kind from many different sources. For example, a 
state or local government could spend their own funds or accept 
contributions from a nonprofit organization or foundation. A 
state could also support MIECHV with other federal funds 
intended for a similar purpose (such as funds from the 
Temporary Assistance for Needy Families or Social Services 
Block Grant programs). This requirement will encourage states 
to shift spending towards evidence-based approaches that 
deliver real results for families, magnifying the impact of the 
program and yielding positive outcomes for more parents and 
their children across the country.
    Taking into account the feedback from stakeholders, an 
Indian Tribe (or a consortium of that Indian Tribes), a Tribal 
Organization, or an Urban Indian Organization operating a home 
visiting program with MIECHV funds will have an additional two 
years to implement the match requirement. The Committee intends 
to continue to phase in this match requirement in a future 
reauthorization until it also reaches a 50 percent match 
requirement. The Committee found several other examples within 
its jurisdiction where tribes are expected to provide the same 
level of match as states, and believes tribes should have the 
same expectations.
    The Committee has also determined many states are likely to 
already meet or exceed a 50 percent match requirement, even 
though this level of matching will not be fully phased in until 
FY 2022. Based on preliminary and incomplete data reviewed by 
the Committee, at least $340 million is already being spent 
each year on evidence-based home visiting programs. Based on 
this information, more than a dozen states appear to exceed the 
FY 2022 match requirement today, and other states are likely to 
already meet or exceed this requirement. The Committee sees 
this as an opportunity to support and strengthen state and 
local investment dedicated to home visiting by focusing 
spending on evidence-based models that are shown to deliver 
results.
    The Committee also believes this provision should work in 
conjunction with, not in addition to, the requirement in 511(f) 
of the Social Security Act that requires eligible entities to 
maintain previous efforts with MIECHV funds used to 
``supplement, and not supplant, funds from other sources for 
early childhood home visitation programs or initiatives.''

                             EFFECTIVE DATE

    This provision is effective upon enactment.

   Section 10: Data Exchange Standards for Improved Interoperability


                              PRESENT LAW

    No provision.

                        EXPLANATION OF PROVISION

    This provision requires the head of the department or 
agency responsible for the MIECHV program (i.e., the Health 
Resources and Services Administration (HRSA) and the 
Administration for Children and Families (ACF)), per Section 
511(h) of the Social Security Act, to designate data exchange 
standards for necessary categories of information that a state 
agency operating a home visiting program is required to 
exchange with another state agency under federal law. These 
standards are to be developed in consultation with an 
interagency workgroup established by the Office of Management 
and Budget (OMB) and considering the perspectives of states. To 
the extent practicable, the data exchange standards would be 
required to be nonproprietary and interoperable and incorporate 
standards developed and maintained by three groups of 
stakeholders: (1) an international voluntary consensus 
standards body, as defined by OMB; (2) intergovernmental 
partnerships, such as the National Information Exchange Model; 
and (3) federal entities with authority over contracting and 
financial assistance.
    Also in consultation with OMB, and considering the 
perspectives of state governments, the provision directs HRSA 
and ACF to designate data exchange standards to govern federal 
reporting and data exchanges required under federal law. To the 
extent practicable, the data exchange standards would be 
required to (1) incorporate features that are widely accepted, 
nonproprietary, and searchable, and are in computer-readable 
format (such as the eXtensible Markup Language); (2) be 
consistent with and implement applicable accounting principles; 
(3) be implemented in a manner that is cost-effective and 
improves program efficiency and effectiveness; and (4) be 
capable of being continually upgraded as necessary.
    This provision includes a rule of construction to specify 
that changes in existing data standards for federal reporting 
would not require a change to standards found to be effective 
and efficient.

                           REASON FOR CHANGE

    The Committee believes the programs within its jurisdiction 
should, from an information technology standpoint, operate 
consistently within and across programs. By beginning the 
process of data standardization and the use of common reporting 
mechanisms in this section, the Committee is achieving three 
goals: better preventing and identifying fraud and abuse; 
increasing the efficiency of administrative resources; and 
producing program savings for U.S. taxpayers. The private 
sector is decades ahead in its ability to use data efficiently 
to seamlessly provide better service as well as detect patterns 
of fraud, such as when credit cards are lost or stolen, and 
streamlining backend data processing. The public sector needs 
to review those best practices to better improve the operation 
of social service programs, prevent and identify fraud and 
abuse, and improve recovery of misspent taxpayer funds. The 
first step is organizing the data, as this section directs the 
Secretary to do with the MIECHV program.
    The Subcommittee on Human Resources has previously received 
testimony confirming cooperation and collaboration between 
social services programs is not only hindered by the programs 
themselves operating in different silos, but also because the 
accompanying data is not easily shared or used to better 
understand the services individuals are receiving. The 
Committee supports consistent data standards that are non-
proprietary and that promote the interoperability of data 
across various information technology platforms, including 
state legacy systems. Improved data standards will help 
increase the efficiency of data exchanges to use and reuse data 
within and across programs, and consistent data standards will 
allow states to automate the exchange of participant data, 
reducing delays and improving the availability of information 
on outcomes. It will also help to automate application forms by 
pre-populating them with reliable and verified data, which can 
reduce the burden on staff and allow them more time to engage 
individuals in services, all while reducing error.
    Programs already covered by this language include other 
systems that home visiting families are likely to be engaged 
with, increasing the overall effectiveness of this provision, 
including: child welfare, Temporary Assistance for Needy 
Families, Child Support Enforcement, Unemployment Insurance, 
and Supplemental Nutrition Assistance.

                             EFFECTIVE DATE

    This provision is effective 2 years following the date of 
enactment.

                      III. VOTES OF THE COMMITTEE

    In compliance with the Rules of the House of 
Representatives, the following statement is made concerning the 
vote of the Committee on Ways and Means during the markup 
consideration of H.R. 2824, ``Increasing Opportunity and 
Success for Children and Parents through Evidence-Based Home 
Visiting Act'' on September 13, 2017.
    An amendment in the nature of a substitute was offered by 
Chairman Brady and adopted by voice vote (with a quorum being 
present).
    The amendment offered by Mr. Pascrell to the amendment in 
the nature of a substitute to H.R. 2824, which would strike 
Section 9, which strengthens state, local, and private 
investments in home visiting, was not agreed to by a roll call 
vote of 21 nays to 13 yeas (with a quorum being present). The 
vote was as follows:

----------------------------------------------------------------------------------------------------------------
          Representative             Yea      Nay     Present      Representative      Yea      Nay     Present
----------------------------------------------------------------------------------------------------------------
Mr. Brady........................  .......       X   .........  Mr. Neal...........       X   .......  .........
Mr. Johnson......................  .......       X   .........  Mr. Levin..........       X   .......  .........
Mr. Nunes........................  .......       X   .........  Mr. Lewis..........       X   .......  .........
Mr. Tiberi.......................  .......  .......  .........  Mr. Doggett........       X   .......  .........
Mr. Reichert.....................  .......       X   .........  Mr. Thompson.......       X   .......  .........
Mr. Roskam.......................  .......       X   .........  Mr. Larson.........       X   .......  .........
Mr. Buchanan.....................  .......  .......  .........  Mr. Blumenauer.....  .......  .......  .........
Mr. Smith (NE)...................  .......       X   .........  Mr. Kind...........       X   .......  .........
Ms. Jenkins......................  .......       X   .........  Mr. Pascrell.......       X   .......  .........
Mr. Paulsen......................  .......       X   .........  Mr. Crowley........       X   .......  .........
Mr. Marchant.....................  .......       X   .........  Mr. Davis..........       X   .......  .........
Ms. Black........................  .......       X   .........  Ms. Sanchez........  .......  .......  .........
Mr. Reed.........................  .......       X   .........  Mr. Higgins........       X   .......  .........
Mr. Kelly........................  .......       X   .........  Ms. Sewell.........       X   .......  .........
Mr. Renacci......................  .......       X   .........  Ms. DelBene........       X   .......  .........
Mr. Meehan.......................  .......       X   .........  Ms. Chu............  .......  .......  .........
Ms. Noem.........................  .......       X   .........
Mr. Holding......................  .......       X   .........
Mr. Smith (MO)...................  .......       X   .........
Mr. Rice.........................  .......       X   .........
Mr. Schweikert...................  .......       X   .........
Ms. Walorski.....................  .......       X   .........
Mr. Curbelo......................  .......  .......  .........
Mr. Bishop.......................  .......       X   .........
----------------------------------------------------------------------------------------------------------------

    The vote on Mr. Roskam's motion to table Mr. Doggett's 
appeal of the ruling of the Chair was agreed to by a roll call 
vote of 21 yeas to 15 nays (with a quorum being present). The 
vote was as follows:

----------------------------------------------------------------------------------------------------------------
          Representative             Yea      Nay     Present      Representative      Yea      Nay     Present
----------------------------------------------------------------------------------------------------------------
Mr. Brady........................  .......       X   .........  Mr. Neal...........       X   .......  .........
Mr. Johnson......................  .......       X   .........  Mr. Levin..........       X   .......  .........
Mr. Nunes........................  .......       X   .........  Mr. Lewis..........       X   .......  .........
Mr. Tiberi.......................  .......  .......  .........  Mr. Doggett........       X   .......  .........
Mr. Reichert.....................  .......       X   .........  Mr. Thompson.......       X   .......  .........
Mr. Roskam.......................  .......       X   .........  Mr. Larson.........  .......  .......  .........
Mr. Buchanan.....................  .......       X   .........  Mr. Blumenauer.....       X   .......  .........
Mr. Smith (NE)...................  .......       X   .........  Mr. Kind...........       X   .......  .........
Ms. Jenkins......................  .......       X   .........  Mr. Pascrell.......       X   .......  .........
Mr. Paulsen......................  .......       X   .........  Mr. Crowley........       X   .......  .........
Mr. Marchant.....................  .......       X   .........  Mr. Davis..........       X   .......  .........
Ms. Black........................  .......  .......  .........  Ms. Sanchez........       X   .......  .........
Mr. Reed.........................  .......       X   .........  Mr. Higgins........       X   .......  .........
Mr. Kelly........................  .......       X   .........  Ms. Sewell.........       X   .......  .........
Mr. Renacci......................  .......       X   .........  Ms. DelBene........       X   .......  .........
Mr. Meehan.......................  .......       X   .........  Ms. Chu............       X   .......  .........
Ms. Noem.........................  .......       X   .........
Mr. Holding......................  .......       X   .........
Mr. Smith (MO)...................  .......  .......  .........
Mr. Rice.........................  .......       X   .........
Mr. Schweikert...................  .......       X   .........
Ms. Walorski.....................  .......       X   .........
Mr. Curbelo......................  .......       X   .........
Mr. Bishop.......................  .......       X   .........
----------------------------------------------------------------------------------------------------------------

    The vote on Mr. Reichert's motion to table Mr. Davis' 
appeal of the ruling of the Chair was agreed to by a roll call 
vote of 21 yeas to 15 nays (with a quorum being present). The 
vote was as follows:

----------------------------------------------------------------------------------------------------------------
          Representative             Yea      Nay     Present      Representative      Yea      Nay     Present
----------------------------------------------------------------------------------------------------------------
Mr. Brady........................  .......       X   .........  Mr. Neal...........       X   .......  .........
Mr. Johnson......................  .......       X   .........  Mr. Levin..........       X   .......  .........
Mr. Nunes........................  .......       X   .........  Mr. Lewis..........       X   .......  .........
Mr. Tiberi.......................  .......  .......  .........  Mr. Doggett........       X   .......  .........
Mr. Reichert.....................  .......       X   .........  Mr. Thompson.......       X   .......  .........
Mr. Roskam.......................  .......       X   .........  Mr. Larson.........  .......  .......  .........
Mr. Buchanan.....................  .......       X   .........  Mr. Blumenauer.....       X   .......  .........
Mr. Smith (NE)...................  .......       X   .........  Mr. Kind...........       X   .......  .........
Ms. Jenkins......................  .......       X   .........  Mr. Pascrell.......       X   .......  .........
Mr. Paulsen......................  .......       X   .........  Mr. Crowley........       X   .......  .........
Mr. Marchant.....................  .......       X   .........  Mr. Davis..........       X   .......  .........
Ms. Black........................  .......  .......  .........  Ms. Sanchez........       X   .......  .........
Mr. Reed.........................  .......       X   .........  Mr. Higgins........       X   .......  .........
Mr. Kelly........................  .......       X   .........  Ms. Sewell.........       X   .......  .........
Mr. Renacci......................  .......       X   .........  Ms. DelBene........       X   .......  .........
Mr. Meehan.......................  .......       X   .........  Ms. Chu............       X   .......  .........
Ms. Noem.........................  .......       X   .........
Mr. Holding......................  .......       X   .........
Mr. Smith (MO)...................  .......  .......  .........
Mr. Rice.........................  .......       X   .........
Mr. Schweikert...................  .......       X   .........
Ms. Walorski.....................  .......       X   .........
Mr. Curbelo......................  .......       X   .........
Mr. Bishop.......................  .......       X   .........
----------------------------------------------------------------------------------------------------------------

    The amendment offered by Mr. Davis to the amendment in the 
nature of a substitute to H.R. 2824, which would increase 
spending on MIECHV without offsetting the increase with 
reductions in other spending, was not agreed to by a roll call 
vote of 21 nays to 15 yeas (with a quorum being present). The 
vote was as follows:

----------------------------------------------------------------------------------------------------------------
          Representative             Yea      Nay     Present      Representative      Yea      Nay     Present
----------------------------------------------------------------------------------------------------------------
Mr. Brady........................  .......       X   .........  Mr. Neal...........       X   .......  .........
Mr. Johnson......................  .......       X   .........  Mr. Levin..........       X   .......  .........
Mr. Nunes........................  .......       X   .........  Mr. Lewis..........       X   .......  .........
Mr. Tiberi.......................  .......  .......  .........  Mr. Doggett........       X   .......  .........
Mr. Reichert.....................  .......       X   .........  Mr. Thompson.......       X   .......  .........
Mr. Roskam.......................  .......       X   .........  Mr. Larson.........  .......  .......  .........
Mr. Buchanan.....................  .......       X   .........  Mr. Blumenauer.....       X   .......  .........
Mr. Smith (NE)...................  .......       X   .........  Mr. Kind...........       X   .......  .........
Ms. Jenkins......................  .......       X   .........  Mr. Pascrell.......       X   .......  .........
Mr. Paulsen......................  .......       X   .........  Mr. Crowley........       X   .......  .........
Mr. Marchant.....................  .......       X   .........  Mr. Davis..........       X   .......  .........
Ms. Black........................  .......  .......  .........  Ms. Sanchez........       X   .......  .........
Mr. Reed.........................  .......       X   .........  Mr. Higgins........       X   .......  .........
Mr. Kelly........................  .......       X   .........  Ms. Sewell.........       X   .......  .........
Mr. Renacci......................  .......       X   .........  Ms. DelBene........       X   .......  .........
Mr. Meehan.......................  .......       X   .........  Ms. Chu............       X   .......  .........
Ms. Noem.........................  .......       X   .........
Mr. Holding......................  .......       X   .........
Mr. Smith (MO)...................  .......  .......  .........
Mr. Rice.........................  .......       X   .........
Mr. Schweikert...................  .......       X   .........
Ms. Walorski.....................  .......       X   .........
Mr. Curbelo......................  .......       X   .........
Mr. Bishop.......................  .......       X   .........
----------------------------------------------------------------------------------------------------------------

    The amendment offered by Mr. Pascrell to the amendment in 
the nature of a substitute to H.R. 2824, which would eliminate 
the requirement that states measure employment and earnings 
when they choose to achieve improvements in family and economic 
self-sufficiency, was not agreed to by a roll call vote of 22 
nays to 15 yeas (with a quorum being present). The vote was as 
follows:

----------------------------------------------------------------------------------------------------------------
          Representative             Yea      Nay     Present      Representative      Yea      Nay     Present
----------------------------------------------------------------------------------------------------------------
Mr. Brady........................  .......       X   .........  Mr. Neal...........       X   .......  .........
Mr. Johnson......................  .......       X   .........  Mr. Levin..........       X   .......  .........
Mr. Nunes........................  .......       X   .........  Mr. Lewis..........       X   .......  .........
Mr. Tiberi.......................  .......  .......  .........  Mr. Doggett........       X   .......  .........
Mr. Reichert.....................  .......       X   .........  Mr. Thompson.......       X   .......  .........
Mr. Roskam.......................  .......       X   .........  Mr. Larson.........  .......  .......  .........
Mr. Buchanan.....................  .......       X   .........  Mr. Blumenauer.....       X   .......  .........
Mr. Smith (NE)...................  .......       X   .........  Mr. Kind...........       X   .......  .........
Ms. Jenkins......................  .......       X   .........  Mr. Pascrell.......       X   .......  .........
Mr. Paulsen......................  .......       X   .........  Mr. Crowley........       X   .......  .........
Mr. Marchant.....................  .......       X   .........  Mr. Davis..........       X   .......  .........
Ms. Black........................  .......  .......  .........  Ms. Sanchez........       X   .......  .........
Mr. Reed.........................  .......       X   .........  Mr. Higgins........       X   .......  .........
Mr. Kelly........................  .......       X   .........  Ms. Sewell.........       X   .......  .........
Mr. Renacci......................  .......       X   .........  Ms. DelBene........       X   .......  .........
Mr. Meehan.......................  .......       X   .........  Ms. Chu............       X   .......  .........
Ms. Noem.........................  .......       X   .........
Mr. Holding......................  .......       X   .........
Mr. Smith (MO)...................  .......       X   .........
Mr. Rice.........................  .......       X   .........
Mr. Schweikert...................  .......       X   .........
Ms. Walorski.....................  .......       X   .........
Mr. Curbelo......................  .......       X   .........
Mr. Bishop.......................  .......       X   .........
----------------------------------------------------------------------------------------------------------------

    The amendment offered by Ms. DelBene to the amendment in 
the nature of a substitute to H.R. 2824, which would eliminate 
the requirement that states direct additional resources to 
MIECHV beginning in FY 2020 and increase funding for tribes 
without offsetting the increase with reductions in other 
spending, was not agreed to by a roll call vote of 22 nays to 
15 yeas (with a quorum being present). The vote was as follows:

----------------------------------------------------------------------------------------------------------------
          Representative             Yea      Nay     Present      Representative      Yea      Nay     Present
----------------------------------------------------------------------------------------------------------------
Mr. Brady........................  .......       X   .........  Mr. Neal...........       X   .......  .........
Mr. Johnson......................  .......       X   .........  Mr. Levin..........       X   .......  .........
Mr. Nunes........................  .......       X   .........  Mr. Lewis..........       X   .......  .........
Mr. Tiberi.......................  .......  .......  .........  Mr. Doggett........       X   .......  .........
Mr. Reichert.....................  .......       X   .........  Mr. Thompson.......       X   .......  .........
Mr. Roskam.......................  .......       X   .........  Mr. Larson.........  .......  .......  .........
Mr. Buchanan.....................  .......       X   .........  Mr. Blumenauer.....       X   .......  .........
Mr. Smith (NE)...................  .......       X   .........  Mr. Kind...........       X   .......  .........
Ms. Jenkins......................  .......       X   .........  Mr. Pascrell.......       X   .......  .........
Mr. Paulsen......................  .......       X   .........  Mr. Crowley........       X   .......  .........
Mr. Marchant.....................  .......       X   .........  Mr. Davis..........       X   .......  .........
Ms. Black........................  .......  .......  .........  Ms. Sanchez........       X   .......  .........
Mr. Reed.........................  .......       X   .........  Mr. Higgins........       X   .......  .........
Mr. Kelly........................  .......       X   .........  Ms. Sewell.........       X   .......  .........
Mr. Renacci......................  .......       X   .........  Ms. DelBene........       X   .......  .........
Mr. Meehan.......................  .......       X   .........  Ms. Chu............       X   .......  .........
Ms. Noem.........................  .......       X   .........
Mr. Holding......................  .......       X   .........
Mr. Smith (MO)...................  .......       X   .........
Mr. Rice.........................  .......       X   .........
Mr. Schweikert...................  .......       X   .........
Ms. Walorski.....................  .......       X   .........
Mr. Curbelo......................  .......       X   .........
Mr. Bishop.......................  .......       X   .........
----------------------------------------------------------------------------------------------------------------

    H.R. 2842 as ordered favorably reported to the House of 
Representatives as amended by a roll call vote of 22 yeas to 15 
nays (with a quorum being present). The vote was as follows:

----------------------------------------------------------------------------------------------------------------
          Representative             Yea      Nay     Present      Representative      Yea      Nay     Present
----------------------------------------------------------------------------------------------------------------
Mr. Brady........................  .......       X   .........  Mr. Neal...........       X   .......  .........
Mr. Johnson......................  .......       X   .........  Mr. Levin..........       X   .......  .........
Mr. Nunes........................  .......       X   .........  Mr. Lewis..........       X   .......  .........
Mr. Tiberi.......................  .......  .......  .........  Mr. Doggett........       X   .......  .........
Mr. Reichert.....................  .......       X   .........  Mr. Thompson.......       X   .......  .........
Mr. Roskam.......................  .......       X   .........  Mr. Larson.........  .......  .......  .........
Mr. Buchanan.....................  .......       X   .........  Mr. Blumenauer.....       X   .......  .........
Mr. Smith (NE)...................  .......       X   .........  Mr. Kind...........       X   .......  .........
Ms. Jenkins......................  .......       X   .........  Mr. Pascrell.......       X   .......  .........
Mr. Paulsen......................  .......       X   .........  Mr. Crowley........       X   .......  .........
Mr. Marchant.....................  .......       X   .........  Mr. Davis..........       X   .......  .........
Ms. Black........................  .......  .......  .........  Ms. Sanchez........       X   .......  .........
Mr. Reed.........................  .......       X   .........  Mr. Higgins........       X   .......  .........
Mr. Kelly........................  .......       X   .........  Ms. Sewell.........       X   .......  .........
Mr. Renacci......................  .......       X   .........  Ms. DelBene........       X   .......  .........
Mr. Meehan.......................  .......       X   .........  Ms. Chu............       X   .......  .........
Ms. Noem.........................  .......       X   .........
Mr. Holding......................  .......       X   .........
Mr. Smith (MO)...................  .......       X   .........
Mr. Rice.........................  .......       X   .........
Mr. Schweikert...................  .......       X   .........
Ms. Walorski.....................  .......       X   .........
Mr. Curbelo......................  .......       X   .........
Mr. Bishop.......................  .......       X   .........
----------------------------------------------------------------------------------------------------------------

                     IV. BUDGET EFFECTS OF THE BILL


               A. Committee Estimate of Budgetary Effects

    In compliance with clause 3(d) of rule XIII of the Rules of 
the House of Representatives, the following statement is made 
concerning the effects on the budget of the bill, H.R. 2824, as 
reported. The Committee agrees with the estimate prepared by 
the Congressional Budget Office (CBO), which is included below.

B. Statement Regarding New Budget Authority and Tax Expenditures Budget 
                               Authority

    In compliance with clause 3(c)(2) of rule XIII of the Rules 
of the House of Representatives, the Committee states that the 
bill would create new budget authority to fund the MIECHV 
program through FY 2022, but is intended to be accompanied by 
H.R. 2972, the Control of Unlawful Fugitive Felons (CUFF) Act, 
which will more than offset increase in budget authority in 
this bill. The Committee states further that the bill involves 
no new or increased tax expenditures.

      C. Cost Estimate Prepared by the Congressional Budget Office

    In compliance with clause 3(c)(3) of rule XIII of the Rules 
of the House of Representatives, requiring a cost estimate 
prepared by the CBO, the following statement by CBO is 
provided.

                                     U.S. Congress,
                               Congressional Budget Office,
                                Washington, DC, September 20, 2017.
Hon. Kevin Brady,
Chairman, Committee on Ways and Means,
House of Representatives, Washington, DC.
    Dear Mr. Chairman: The Congressional Budget Office has 
prepared the enclosed cost estimate for H.R. 2824, the 
Increasing Opportunity and Success for Children and Parents 
through Evidence-Based Home Visiting Act.
    If you wish further details on this estimate, we will be 
pleased to provide them. The CBO staff contact is Lisa Ramirez-
Branum.
            Sincerely,
                                              Keith Hall, Director.
    Enclosure.

H.R. 2824--Increasing Opportunity and Success for Children and Parents 
        Through Evidence-Based Home Visiting Act

    Summary: H.R. 2824 would reauthorize the Maternal, Infant, 
and Early Childhood Home Visiting (MIECHV) program through 
fiscal year 2022 and would directly appropriate $400 million 
for each fiscal year 2018 through 2022 for the program. CBO 
estimates that enacting the bill would cost about $2 billion 
over the 2017-2027 period.
    Pay-as-you-go procedures apply because enacting the bill 
would affect direct spending. H.R. 2824 would not affect 
revenues.
    CBO estimates that enacting the bill would not increase net 
direct spending or on-budget deficits in any of the four 
consecutive 10-year periods beginning in 2028.
    H.R. 2824 contains no intergovernmental or private-sector 
mandates as defined in the Unfunded Mandates Reform Act (UMRA).
    Estimated cost to the Federal Government: The estimated 
budgetary effect of H.R. 2824 is shown in the following table. 
The costs of this legislation fall within budget function 550 
(health).

 
--------------------------------------------------------------------------------------------------------------------------------------------------------
                                                                              By fiscal year, in millions of dollars--
                                           -------------------------------------------------------------------------------------------------------------
                                             2017    2018    2019    2020    2021    2022    2023    2024    2025    2026    2027   2017-2022  2017-2027
--------------------------------------------------------------------------------------------------------------------------------------------------------
                                                              INCREASES IN DIRECT SPENDING
 
Budget Authority..........................       0     400     400     400     400     400       0       0       0       0       0     2,000      2,000
Estimated Outlays.........................       0      12     140     300     396     396     384     256      96       0       0     1,244      1,980
--------------------------------------------------------------------------------------------------------------------------------------------------------

    Basis of estimate: The Health Resources and Services 
Administration (HRSA) administers the MIECHV grant program. The 
funds are distributed to states, territories, and tribal 
entities to develop and implement evidence-based, voluntary 
programs that aim to improve maternal and child health, prevent 
child abuse and neglect, encourage positive parenting, and 
promote child development and school readiness. In fiscal year 
2017, the MIECHV program received $372 million, after 
accounting for sequestration. The program expires at the end of 
fiscal year 2017.
    H.R. 2824 would appropriate $400 million for each fiscal 
year 2018 through 2022 for the MIECHV program and would make 
several other programmatic changes. The bill would:
           Require states to review and update 
        assessments on statewide needs and identify at-risk 
        communities by October 1, 2020;
           Set standards for data exchange with state 
        agencies;
           Authorize a grantee to use funds for pay-
        for-outcomes initiatives;
           Alter several reporting and benchmark 
        requirements; and
           Require grantees, starting in 2020, to 
        provide matching funds. Grantees could count spending 
        on relevant activities from other federal funds or by 
        third parties toward the matching requirement.
    Based on historical spending patterns, CBO estimates 
enacting H.R. 2824 would cost about $2 billion over the 2018-
2027 period.
    Pay-As-You-Go considerations: The Statutory Pay-As-You-Go 
Act of 2010 establishes budget-reporting and enforcement 
procedures for legislation affecting direct spending or 
revenues. The net changes in outlays that are subject to those 
pay-as-you-go procedures are shown in the following table.

         CBO ESTIMATE OF PAY-AS-YOU-GO EFFECTS FOR H.R. 2824, AS ORDERED REPORTED BY THE HOUSE COMMITTEE ON WAYS AND MEANS ON SEPTEMBER 13, 2017
--------------------------------------------------------------------------------------------------------------------------------------------------------
                                                                              By fiscal year, in millions of dollars--
                                                --------------------------------------------------------------------------------------------------
                                                  2017   2018   2019   2020   2021   2022   2023   2024   2025   2026   2027  2017-2022  2017-2027
--------------------------------------------------------------------------------------------------------------------------------------------------
                                                               NET INCREASE IN THE DEFICIT
 
Statutory Pay-As-You-Go Impact.................      0     12    140    300    396    396    384    256     96      0      0    1,244       1,980
--------------------------------------------------------------------------------------------------------------------------------------------------------

    Increase in long-term direct spending and deficits: CBO 
estimates that enacting the legislation would not increase net 
direct spending or on-budget deficits in any of the four 
consecutive 10-year periods beginning in 2028.
    Intergovernmental and private-sector impact: H.R. 2824 
contains no intergovernmental or private-sector mandates as 
defined in UMRA.
    Estimate prepared by: Federal costs: Lisa Ramirez-Branum, 
Ellen Werble, and Emily King; Impact on state, local, and 
tribal governments; Zachary Byrum; Impact on the Private 
Sector: Amy Petz.
    Estimate approved by: H. Samuel Papenfuss, Deputy Assistant 
Director for Budget Analysis.

     V. OTHER MATTERS TO BE DISCUSSED UNDER THE RULES OF THE HOUSE


          A. Committee Oversight Findings and Recommendations

    With respect to clause 3(c)(1) of rule XIII of the Rules of 
the House of Representatives, the Committee made findings and 
recommendations that are reflected in this report.

        B. Statement of General Performance Goals and Objectives

    With respect to clause 3(c)(4) of rule XIII of the Rules of 
the House of Representatives, Committee establishes the 
following performance related goals and objectives for this 
legislation: To fund evidence-based programs that improve the 
lives of families in at-risk communities by reducing child 
abuse and neglect, improving maternal and child health, and 
improving self-sufficiency.

              C. Information Relating to Unfunded Mandates

    This information is provided in accordance with section 423 
of the Unfunded Mandates Reform Act of 1995 (Pub. L. No. 104-
4). The Committee has determined that the bill does not contain 
Federal mandates on the private sector. The Committee has 
determined that the bill does not impose a Federal 
intergovernmental mandate on State, local, or tribal 
governments.

  D. Congressional Earmarks, Limited Tax Benefits, and Limited Tariff 
                                Benefits

    With respect to clause 9 of rule XXI of the Rules of the 
House of Representatives, the Committee has carefully reviewed 
the provisions of the bill, and states that the provisions of 
the bill do not contain any congressional earmarks, limited tax 
benefits, or limited tariff benefits within the meaning of the 
rule.

                   E. Duplication of Federal Programs

    In compliance with clause 3(c)(5) of rule XIII of the Rules 
of the House of Representatives, the Committee states that no 
provision of the bill establishes or reauthorizes: (1) a 
program of the Federal Government known to be duplicative of 
another Federal program; (2) a program included in any report 
from the Government Accountability Office to Congress pursuant 
to section 21 of Public Law 111-139; or (3) a program related 
to a program identified in the most recent Catalog of Federal 
Domestic Assistance, published pursuant to the Federal Program 
Information Act (Pub. L. No. 95-220, as amended by Pub. L. No. 
98-169).

                 F. Disclosure of Directed Rule Makings

    In compliance with Sec. 3(i) of H. Res. 5 (115th Congress), 
the following statement is made concerning directed rule 
makings: The Committee advises that the bill requires no 
directed rulemakings within the meaning of such section.

       VI. CHANGES IN EXISTING LAW MADE BY THE BILL, AS REPORTED

    In compliance with clause 3(e) of rule XIII of the Rules of 
the House of Representatives, changes in existing law made by 
the bill, as reported, are shown as follows (new matter in 
printed in italic and existing law in which no change is 
proposed is shown in roman):

         Changes in Existing Law Made by the Bill, as Reported

  In compliance with clause 3(e) of rule XIII of the Rules of 
the House of Representatives, changes in existing law made by 
the bill, as reported, are shown as follows (existing law 
proposed to be omitted is enclosed in black brackets, new 
matter is printed in italic, and existing law in which no 
change is proposed is shown in roman):

                          SOCIAL SECURITY ACT



           *       *       *       *       *       *       *
TITLE V--MATERNAL AND CHILD HEALTH SERVICES BLOCK GRANT

           *       *       *       *       *       *       *


SEC. 511. MATERNAL, INFANT, AND EARLY CHILDHOOD HOME VISITING PROGRAMS.

  (a) Purposes.--The purposes of this section are--
          (1) to strengthen and improve the programs and 
        activities carried out under this title;
          (2) to improve coordination of services for at risk 
        communities; and
          (3) to identify and provide comprehensive services to 
        improve outcomes for families who reside in at risk 
        communities.
  (b) Requirement for All States To Assess Statewide Needs and 
Identify at Risk Communities.--
          (1) In general.--[Not later than 6 months after the 
        date of enactment of this section, each State shall, as 
        a condition of receiving payments from an allotment for 
        the State under section 502 for fiscal year 2011, 
        conduct a statewide needs assessment (which shall be 
        separate from the statewide] 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 (which may be separate from but in coordination 
        with the statewide needs assessment required under 
        section 505(a)) that identifies--
                  (A) communities with concentrations of--
                          (i) premature birth, low-birth weight 
                        infants, and infant mortality, 
                        including infant death due to neglect, 
                        or other indicators of at-risk 
                        prenatal, maternal, newborn, or child 
                        health;
                          (ii) poverty;
                          (iii) crime;
                          (iv) domestic violence;
                          (v) high rates of high-school drop-
                        outs;
                          (vi) substance abuse;
                          (vii) unemployment; or
                          (viii) child maltreatment;
                  (B) the quality and capacity of existing 
                programs or initiatives for early childhood 
                home visitation in the State including--
                          (i) the number and types of 
                        individuals and families who are 
                        receiving services under such programs 
                        or initiatives;
                          (ii) the gaps in early childhood home 
                        visitation in the State; and
                          (iii) the extent to which such 
                        programs or initiatives are meeting the 
                        needs of eligible families described in 
                        subsection (k)(2); and
                  (C) the State's capacity for providing 
                substance abuse treatment and counseling 
                services to individuals and families in need of 
                such treatment or services.
          (2) Coordination with other assessments.--In 
        conducting the statewide needs assessment required 
        under paragraph (1), the State shall coordinate with, 
        and take into account, other appropriate needs 
        assessments conducted by the State, as determined by 
        the Secretary, including the needs assessment required 
        under section 505(a) (both the most recently completed 
        assessment and any such assessment in progress), the 
        communitywide strategic planning and needs assessments 
        conducted in accordance with section 640(g)(1)(C) of 
        the Head Start Act, and the inventory of current unmet 
        needs and current community-based and prevention-
        focused programs and activities to prevent child abuse 
        and neglect, and other family resource services 
        operating in the State required under section 205(3) of 
        the Child Abuse Prevention and Treatment Act.
          (3) Submission to the secretary.--Each State shall 
        submit to the Secretary, in such form and manner as the 
        Secretary shall require--
                  (A) the results of the statewide needs 
                assessment required under paragraph (1); and
                  (B) a description of how the State intends to 
                address needs identified by the assessment, 
                particularly with respect to communities 
                identified under paragraph (1)(A), which may 
                include applying for a grant to conduct an 
                early childhood home visitation program in 
                accordance with the requirements of this 
                section.
  (c) Grants for Early Childhood Home Visitation Programs.--
          (1) Authority to make grants.--In addition to any 
        other payments made under this title to a State, the 
        Secretary shall make grants to eligible entities to 
        enable the entities to deliver services under early 
        childhood home visitation programs that satisfy the 
        requirements of subsection (d) to eligible families in 
        order to promote improvements in maternal and prenatal 
        health, infant health, child health and development, 
        parenting related to child development outcomes, school 
        readiness, and the socioeconomic status of such 
        families, and reductions in child abuse, neglect, and 
        injuries.
          (2) Authority to use initial grant funds for planning 
        or implementation.--An eligible entity that receives a 
        grant under paragraph (1) may use a portion of the 
        funds made available to the entity during the first 6 
        months of the period for which the grant is made for 
        planning or implementation activities to assist with 
        the establishment of early childhood home visitation 
        programs that satisfy the requirements of subsection 
        (d).
          (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.
          [(3)] (4) Grant duration.--The Secretary shall 
        determine the period of years for which a grant is made 
        to an eligible entity under paragraph (1).
          [(4)] (5) Technical assistance.--The Secretary shall 
        provide an eligible entity that receives a grant under 
        paragraph (1) with technical assistance in 
        administering programs or activities conducted in whole 
        or in part with grant funds.
  (d) Requirements.--The requirements of this subsection for an 
early childhood home visitation program conducted with a grant 
made under this section are as follows:
          (1) Quantifiable, measurable improvement in benchmark 
        areas.--
                  (A) In general.--The eligible entity 
                establishes, subject to the approval of the 
                Secretary, quantifiable, measurable 3- and 5-
                year benchmarks for demonstrating that the 
                program results in improvements for the 
                eligible families participating in the program 
                in [each of] the following areas:
                          (i) Improved maternal and newborn 
                        health.
                          (ii) Prevention of child injuries, 
                        child abuse, neglect, or maltreatment, 
                        and reduction of emergency department 
                        visits.
                          (iii) Improvement in school readiness 
                        and achievement.
                          (iv) Reduction in crime or domestic 
                        violence.
                          (v) Improvements in family economic 
                        self-sufficiency (which shall include 
                        measures of employment and earnings).
                          (vi) Improvements in the coordination 
                        and referrals for other community 
                        resources and supports.
                  (B) Demonstration of improvements after 3 
                years.--
                          (i) Report to the secretary.--Not 
                        later than 30 days after the end of the 
                        3rd year in which the eligible entity 
                        conducts the program, the entity 
                        submits to the Secretary a report 
                        demonstrating improvement in at least 4 
                        of the areas specified in subparagraph 
                        (A).
                          (ii) Corrective action plan.--If the 
                        report submitted by the eligible entity 
                        under clause (i) 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), 
                        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.--
                                  (I) In general.--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.
                                  (II) Advisory panel.--The 
                                Secretary shall establish an 
                                advisory panel for purposes of 
                                obtaining recommendations 
                                regarding the technical 
                                assistance provided to entities 
                                in accordance with subclause 
                                (I).
                          (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 the areas specified in subparagraph 
                        (A), or if the Secretary determines 
                        that an eligible entity has failed to 
                        submit the report required under clause 
                        (i), the Secretary shall terminate the 
                        entity's grant and may include any 
                        unexpended grant funds in grants made 
                        to nonprofit organizations under 
                        subsection (h)(2)(B).
                  (C) Final report.--Not later than December 
                31, 2015, the eligible entity shall submit a 
                report to the Secretary demonstrating 
                improvements (if any) in each of the areas 
                specified in subparagraph (A).
                  (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).
          (2) Improvements in outcomes for individual 
        families.--
                  (A) In general.--The program is designed, 
                with respect to an eligible family 
                participating in the program, to result in the 
                participant outcomes described in subparagraph 
                (B) that the eligible entity identifies on the 
                basis of an individualized assessment of the 
                family, are relevant for that family.
                  (B) Participant outcomes.--The participant 
                outcomes described in this subparagraph are the 
                following:
                          (i) Improvements in prenatal, 
                        maternal, and newborn health, including 
                        improved pregnancy outcomes
                          (ii) Improvements in child health and 
                        development, including the prevention 
                        of child injuries and maltreatment and 
                        improvements in cognitive, language, 
                        social-emotional, and physical 
                        developmental indicators.
                          (iii) Improvements in parenting 
                        skills.
                          (iv) Improvements in school readiness 
                        and child academic achievement.
                          (v) Reductions in crime or domestic 
                        violence.
                          (vi) Improvements in family economic 
                        self-sufficiency.
                          (vii) Improvements in the 
                        coordination of referrals for, and the 
                        provision of, other community resources 
                        and supports for eligible families, 
                        consistent with State child welfare 
                        agency training.
          (3) Core components.--The program includes the 
        following core components:
                  (A) Service delivery model or models.--
                          (i) In general.--Subject to clause 
                        (ii), the program is conducted using 1 
                        or more of the service delivery models 
                        described in item (aa) or (bb) of 
                        subclause (I) or in subclause (II) 
                        selected by the eligible entity:
                                  (I) The model conforms to a 
                                clear consistent home 
                                visitation model that has been 
                                in existence for at least 3 
                                years and is research-based, 
                                grounded in relevant 
                                empirically-based knowledge, 
                                linked to program determined 
                                outcomes, associated with a 
                                national organization or 
                                institution of higher education 
                                that has comprehensive home 
                                visitation program standards 
                                that ensure high quality 
                                service delivery and continuous 
                                program quality improvement, 
                                and has demonstrated 
                                significant, (and in the case 
                                of the service delivery model 
                                described in item (aa), 
                                sustained) positive outcomes, 
                                as described in the benchmark 
                                areas specified in paragraph 
                                (1)(A) and the participant 
                                outcomes described in paragraph 
                                (2)(B), when evaluated using 
                                well-designed and rigorous--
                                          (aa) randomized 
                                        controlled research 
                                        designs, and the 
                                        evaluation results have 
                                        been published in a 
                                        peer-reviewed journal; 
                                        or
                                          (bb) quasi-
                                        experimental research 
                                        designs.
                                  (II) The model conforms to a 
                                promising and new approach to 
                                achieving the benchmark areas 
                                specified in paragraph (1)(A) 
                                and the participant outcomes 
                                described in paragraph (2)(B), 
                                has been developed or 
                                identified by a national 
                                organization or institution of 
                                higher education, and will be 
                                evaluated through well-designed 
                                and rigorous process.
                          (ii) Majority of grant funds used for 
                        evidence-based models.--An eligible 
                        entity shall use not more than 25 
                        percent of the amount of the grant paid 
                        to the entity for a fiscal year for 
                        purposes of conducting a program using 
                        the service delivery model described in 
                        clause (i)(II).
                          (iii) Criteria for evidence of 
                        effectiveness of models.--The Secretary 
                        shall establish criteria for evidence 
                        of effectiveness of the service 
                        delivery models and shall ensure that 
                        the process for establishing the 
                        criteria is transparent and provides 
                        the opportunity for public comment.
                  (B) Additional requirements.--
                          (i) The program adheres to a clear, 
                        consistent model that satisfies the 
                        requirements of being grounded in 
                        empirically-based knowledge related to 
                        home visiting and linked to the 
                        benchmark areas specified in paragraph 
                        (1)(A) and the participant outcomes 
                        described in paragraph (2)(B) related 
                        to the purposes of the program.
                          (ii) The program employs well-trained 
                        and competent staff, as demonstrated by 
                        education or training, such as nurses, 
                        social workers, educators, child 
                        development specialists, or other well-
                        trained and competent staff, and 
                        provides ongoing and specific training 
                        on the model being delivered.
                          (iii) The program maintains high 
                        quality supervision to establish home 
                        visitor competencies.
                          (iv) The program demonstrates strong 
                        organizational capacity to implement 
                        the activities involved.
                          (v) The program establishes 
                        appropriate linkages and referral 
                        networks to other community resources 
                        and supports for eligible families.
                          (vi) The program monitors the 
                        fidelity of program implementation to 
                        ensure that services are delivered 
                        pursuant to the specified model.
          (4) Priority for serving high-risk populations.--The 
        eligible entity gives priority to providing services 
        under the program to the following:
                  (A) Eligible families who reside in 
                communities in need of such services, as 
                identified in the statewide needs assessment 
                required under subsection (b)(1)(A), 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.
                  (B) Low-income eligible families.
                  (C) Eligible families who are pregnant women 
                who have not attained age 21.
                  (D) Eligible families that have a history of 
                child abuse or neglect or have had interactions 
                with child welfare services.
                  (E) Eligible families that have a history of 
                substance abuse or need substance abuse 
                treatment.
                  (F) Eligible families that have users of 
                tobacco products in the home.
                  (G) Eligible families that are or have 
                children with low student achievement.
                  (H) Eligible families with children with 
                developmental delays or disabilities.
                  (I) Eligible families who, or that include 
                individuals who, are serving or formerly served 
                in the Armed Forces, including such families 
                that have members of the Armed Forces who have 
                had multiple deployments outside of the United 
                States.
  (e) Application Requirements.--An eligible entity desiring a 
grant under this section shall submit an application to the 
Secretary for approval, in such manner as the Secretary may 
require, that includes the following:
          (1) A description of the populations to be served by 
        the entity, including specific information regarding 
        how the entity will serve high risk populations 
        described in subsection (d)(4).
          (2) An assurance that the entity will give priority 
        to serving low-income eligible families and eligible 
        families who reside in at risk communities identified 
        in the statewide needs assessment required under 
        subsection (b)(1)(A).
          (3) The service delivery model or models described in 
        subsection (d)(3)(A) that the entity will use under the 
        program and the basis for the selection of the model or 
        models.
          (4) A statement identifying how the selection of the 
        populations to be served and the service delivery model 
        or models that the entity will use under the program 
        for such populations is consistent with the results of 
        the statewide needs assessment conducted under 
        subsection (b).
          (5) The quantifiable, measurable benchmarks 
        established by the State to demonstrate that the 
        program contributes to improvements in the areas 
        specified in subsection (d)(1)(A) that the service 
        delivery model or models, selected by the entity, 
        intend to improve.
          (6) An assurance that the entity will obtain and 
        submit documentation or other appropriate evidence from 
        the organization or entity that developed the service 
        delivery model or models used under the program to 
        verify that the program is implemented and services are 
        delivered according to the model specifications.
          (7) Assurances that the entity will establish 
        procedures to ensure that--
                  (A) the participation of each eligible family 
                in the program is voluntary; and
                  (B) services are provided to an eligible 
                family in accordance with the individual 
                assessment for that family.
          (8) Assurances that the entity will--
                  (A) submit annual reports to the Secretary 
                regarding the program and activities carried 
                out under the program that include such 
                information and data as the Secretary shall 
                require; and
                  (B) participate in, and cooperate with, data 
                and information collection necessary for the 
                evaluation required under subsection (g)(2) and 
                other research and evaluation activities 
                carried out under subsection (h)(3).
          (9) A description of other State programs that 
        include home visitation services, including, if 
        applicable to the State, other programs carried out 
        under this title with funds made available from 
        allotments under section 502(c), programs funded under 
        title IV, title II of the Child Abuse Prevention and 
        Treatment Act (relating to community-based grants for 
        the prevention of child abuse and neglect), and section 
        645A of the Head Start Act (relating to Early Head 
        Start programs).
          (10) Other information as required by the Secretary.
  (f) Maintenance of Effort.--Funds provided to an eligible 
entity receiving a grant under this section shall supplement, 
and not supplant, funds from other sources for early childhood 
home visitation programs or initiatives.
  (g) Evaluation.--
          (1) Independent, expert advisory panel.--The 
        Secretary, in accordance with subsection (h)(1)(A), 
        shall appoint an independent advisory panel consisting 
        of experts in program evaluation and research, 
        education, and early childhood development--
                  (A) to review, and make recommendations on, 
                the design and plan for the evaluation required 
                under paragraph (2) within 1 year after the 
                date of enactment of this section;
                  (B) to maintain and advise the Secretary 
                regarding the progress of the evaluation; and
                  (C) to comment, if the panel so desires, on 
                the report submitted under paragraph (3).
          (2) Authority to conduct evaluation.--On the basis of 
        the recommendations of the advisory panel under 
        paragraph (1), the Secretary shall, by grant, contract, 
        or interagency agreement, conduct an evaluation of the 
        statewide needs assessments submitted under subsection 
        (b) and the grants made under subsections (c) and 
        (h)(3)(B). The evaluation shall include--
                  (A) an analysis, on a State-by-State basis, 
                of the results of such assessments, including 
                indicators of maternal and prenatal health and 
                infant health and mortality, and State actions 
                in response to the assessments; and
                  (B) an assessment of--
                          (i) the effect of early childhood 
                        home visitation programs on child and 
                        parent outcomes, including with respect 
                        to each of the benchmark areas 
                        specified in subsection (d)(1)(A) and 
                        the participant outcomes described in 
                        subsection (d)(2)(B);
                          (ii) the effectiveness of such 
                        programs on different populations, 
                        including the extent to which the 
                        ability of programs to improve 
                        participant outcomes varies across 
                        programs and populations; and
                          (iii) the potential for the 
                        activities conducted under such 
                        programs, if scaled broadly, to improve 
                        health care practices, eliminate health 
                        disparities, and improve health care 
                        system quality, efficiencies, and 
                        reduce costs.
          (3) Report.--Not later than March 31, 2015, the 
        Secretary shall submit a report to Congress on the 
        results of the evaluation conducted under paragraph (2) 
        and shall make the report publicly available.
  (h) Other Provisions.--
          (1) Intra-agency collaboration.--The Secretary shall 
        ensure that the Maternal and Child Health Bureau and 
        the Administration for Children and Families 
        collaborate with respect to carrying out this section, 
        including with respect to--
                  (A) reviewing and analyzing the statewide 
                needs assessments required under subsection 
                (b), the awarding and oversight of grants 
                awarded under this section, the establishment 
                of the advisory panels required under 
                subsections (d)(1)(B)(iii)(II) and (g)(1), and 
                the evaluation and report required under 
                subsection (g); and
                  (B) consulting with other Federal agencies 
                with responsibility for administering or 
                evaluating programs that serve eligible 
                families to coordinate and collaborate with 
                respect to research related to such programs 
                and families, including the Office of the 
                Assistant Secretary for Planning and Evaluation 
                of the Department of Health and Human Services, 
                the Centers for Disease Control and Prevention, 
                the National Institute of Child Health and 
                Human Development of the National Institutes of 
                Health, the Office of Juvenile Justice and 
                Delinquency Prevention of the Department of 
                Justice, and the Institute of Education 
                Sciences of the Department of Education.
          (2) Grants to eligible entities that are not 
        states.--
                  (A) Indian tribes, tribal organizations, or 
                urban indian organizations.--The Secretary 
                shall specify requirements for eligible 
                entities that are Indian Tribes (or a 
                consortium of Indian Tribes), Tribal 
                Organizations, or Urban Indian Organizations to 
                apply for and conduct an early childhood home 
                visitation program with a grant under this 
                section. [Such] Except as provided in 
                subsection (l)(1), such requirements shall, to 
                the greatest extent practicable, be consistent 
                with the requirements applicable to eligible 
                entities that are States and shall require an 
                Indian Tribe (or consortium), Tribal 
                Organization, or Urban Indian Organization to--
                          (i) conduct a needs assessment 
                        similar to the assessment required for 
                        all States under subsection (b); and
                          (ii) establish quantifiable, 
                        measurable 3- and 5-year benchmarks 
                        consistent with subsection (d)(1)(A).
                  (B) Nonprofit organizations.--If, as of the 
                beginning of fiscal year 2012, a State has not 
                applied or been approved for a grant under this 
                section, the Secretary may use amounts 
                appropriated under paragraph (1) of subsection 
                (j) that are available for expenditure under 
                paragraph (3) of that subsection to make a 
                grant to an eligible entity that is a nonprofit 
                organization described in subsection (k)(1)(B) 
                to conduct an early childhood home visitation 
                program in the State. The Secretary shall 
                specify the requirements for such an 
                organization to apply for and conduct the 
                program which shall, to the greatest extent 
                practicable, be consistent with the 
                requirements applicable to eligible entities 
                that are States and shall require the 
                organization to--
                          (i) carry out the program based on 
                        the needs assessment conducted by the 
                        State under subsection (b); and
                          (ii) establish quantifiable, 
                        measurable 3- and 5-year benchmarks 
                        consistent with subsection (d)(1)(A).
          (3) Research and other evaluation activities.--
                  (A) In general.--The Secretary shall carry 
                out a continuous program of research and 
                evaluation activities in order to increase 
                knowledge about the implementation and 
                effectiveness of home visiting programs, using 
                random assignment designs to the maximum extent 
                feasible. The Secretary may carry out such 
                activities directly, or through grants, 
                cooperative agreements, or contracts.
                  (B) Requirements.--The Secretary shall ensure 
                that--
                          (i) evaluation of a specific program 
                        or project is conducted by persons or 
                        individuals not directly involved in 
                        the operation of such program or 
                        project; and
                          (ii) the conduct of research and 
                        evaluation activities includes 
                        consultation with independent 
                        researchers, State officials, and 
                        developers and providers of home 
                        visiting programs on topics including 
                        research design and administrative data 
                        matching.
          (4) Report and recommendation.--Not later than 
        December 31, 2015, the Secretary shall submit a report 
        to Congress regarding the programs conducted with 
        grants under this section. The report required under 
        this paragraph shall include--
                  (A) information regarding the extent to which 
                eligible entities receiving grants under this 
                section demonstrated improvements in [each of] 
                the areas specified in subsection (d)(1)(A);
                  (B) information regarding any technical 
                assistance provided under subsection 
                (d)(1)(B)(iii)(I), including the type of any 
                such assistance provided; and
                  (C) recommendations for such legislative or 
                administrative action as the Secretary 
                determines appropriate.
          (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.
  (i) Application of Other Provisions of Title.--
          (1) In general.--Except as provided in paragraph (2), 
        the other provisions of this title shall not apply to a 
        grant made under this section.
          (2) Exceptions.--The following provisions of this 
        title shall apply to a grant made under this section to 
        the same extent and in the same manner as such 
        provisions apply to allotments made under section 
        502(c):
                  (A) Section 504(b)(6) (relating to 
                prohibition on payments to excluded individuals 
                and entities).
                  (B) Section 504(c) (relating to the use of 
                funds for the purchase of technical 
                assistance).
                  (C) Section 504(d) (relating to a limitation 
                on administrative expenditures).
                  (D) Section 506 (relating to reports and 
                audits), but only to the extent determined by 
                the Secretary to be appropriate for grants made 
                under this section.
                  (E) Section 507 (relating to penalties for 
                false statements).
                  (F) Section 508 (relating to 
                nondiscrimination).
                  (G) Section 509(a) (relating to the 
                administration of the grant program).
  (j) Appropriations.--
          (1) In general.--Out of any funds in the Treasury not 
        otherwise appropriated, there are appropriated to the 
        Secretary to carry out this section--
                  (A) $100,000,000 for fiscal year 2010;
                  (B) $250,000,000 for fiscal year 2011;
                  (C) $350,000,000 for fiscal year 2012;
                  (D) $400,000,000 for fiscal year 2013;
                  (E) $400,000,000 for fiscal year 2014;
                  (F) for fiscal year 2015, $400,000,000;
                  (G) for fiscal year 2016, $400,000,000; and
                  (H) for [fiscal year 2017] each of fiscal 
                years 2017 through 2022, $400,000,000.
          (2) Reservations.--Of the amount appropriated under 
        this subsection for a fiscal year (or portion of a 
        fiscal year), the Secretary shall reserve--
                  (A) 3 percent of such amount for purposes of 
                making grants to eligible entities that are 
                Indian Tribes (or a consortium of Indian 
                Tribes), Tribal Organizations, or Urban Indian 
                Organizations; and
                  (B) 3 percent of such amount for purposes of 
                carrying out subsections (d)(1)(B)(iii), (g), 
                and (h)(3).
          [(3) Availability.--Funds]
          (3) Availability._
                  (A) In general._Except as provided in 
                subparagraph (B), funds  made available to an 
                eligible entity under this section for a fiscal 
                year (or portion of a fiscal year) shall remain 
                available for expenditure by the eligible 
                entity through the end of the second succeeding 
                fiscal year after award. Any funds that are not 
                expended by the eligible entity during the 
                period in which the funds are available under 
                the preceding sentence may be used for grants 
                to nonprofit organizations under subsection 
                (h)(2)(B).
                  (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.
  (k) Definitions.--In this section:
          (1) Eligible entity.--
                  (A) In general.--The term ``eligible entity'' 
                means a State, an Indian Tribe, Tribal 
                Organization, or Urban Indian Organization, 
                Puerto Rico, Guam, the Virgin Islands, the 
                Northern Mariana Islands, and American Samoa.
                  (B) Nonprofit organizations.--Only for 
                purposes of awarding grants under subsection 
                (h)(2)(B), such term shall include a nonprofit 
                organization with an established record of 
                providing early childhood home visitation 
                programs or initiatives in a State or several 
                States.
          (2) Eligible family.--The term ``eligible family'' 
        means--
                  (A) a woman who is pregnant, and the father 
                of the child if the father is available; or
                  (B) a parent or primary caregiver of a child, 
                including grandparents or other relatives of 
                the child, and foster parents, who are serving 
                as the child's primary caregiver from birth to 
                kindergarten entry, and including a 
                noncustodial parent who has an ongoing 
                relationship with, and at times provides 
                physical care for, the child.
          (3) Indian tribe; tribal organization.--The terms 
        ``Indian Tribe'' and ``Tribal Organization'', and 
        ``Urban Indian Organization'' have the meanings given 
        such terms in section 4 of the Indian Health Care 
        Improvement Act.
          (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).
  (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.

           *       *       *       *       *       *       *


                         VII. DISSENTING VIEWS

    Democrats strongly support moving quickly to reauthorize 
the Maternal, Infant, and Early Childhood Home Visiting Program 
(MIECHV) before it expires on September 30, 2017. We are 
concerned that by advancing a partisan bill with policy changes 
not supported by home visiting experts, the Majority has made a 
timely reauthorization more difficult. A delay in 
reauthorization could disrupt successful and effective programs 
in our districts and across the country.
    H.R. 2824 does not provide a single penny of new funding, 
despite abundant evidence that MIECHV makes a real, measurable 
difference in the lives of children and families served by home 
visiting. At the current funding levels, only six percent of 
eligible families are getting this life-changing help, and less 
than one-third of our counties have MIECHV home visiting. We 
offered an amendment to double funding over the next five 
years, which was unfortunately rejected by the Majority.
    Our understanding, both from our Committee hearings and 
from our own experience at home, is that MIECHV is working. 
However, H.R. 2824 makes policy changes to MIECHV that were not 
requested by any home visiting program or expert. We offered a 
number of amendments to remove or revise policies that we, and 
home visiting experts and advocates, believe would reduce the 
number of states and communities operating successful home 
visiting programs or undermine the programs that are currently 
helping families. We were disappointed that none of these 
amendments were accepted.
    We also are concerned that the Majority plans to offset the 
budget impact of reauthorizing MIECHV by combining this bill 
with H.R. 2792, a bill to cut Supplemental Security Income 
(SSI). We unequivocally reject the idea that the only way to 
continue home visiting is to cut benefits for vulnerable 
seniors and Americans with severe disabilities. During our 
markup, we offered several amendments providing better ways to 
pay for the bill, which the Chairman ruled were not in order.
    We continue to hope the Majority will reconsider their 
approach, and return to our long policy of bipartisan action to 
expand and strengthen home visiting for the families and 
communities that need it.
                                   Richrd E. Neal.
                                   John Lewis.
                                   Mike Thompson.
                                   Ron Kind.
                                   Joseph Crowley.
                                   Linda T. Sanchez.
                                   Suzan DelBene.
                                   Sander M. Levin.
                                   Lloyd Doggett.
                                   Earl Blumenauer.
                                   Bill Pascrell, Jr.
                                   Danny K. Davis.
                                   Terri Sewell.
                                   Judy Chu.
                                   Brian Higgins.
                              ----------                              


    Mr. Chairman: On H.R. 2824, I am in full agreement with the 
dissenting views of my Democratic colleagues. Had I been 
present for the votes on the amendments submitted by my 
Democratic colleagues, I would have supported them.
    Had I been present for the vote on reporting H.R. 2824 out 
of the Committee, I would have voted No.
                                            John B. Larson,
                                                Member of Congress.

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