PRINTER'S NO. 2296
No. 1771 Session of 2003
INTRODUCED BY MUNDY, BROWNE, BEBKO-JONES, BELARDI, BELFANTI,
BISHOP, BLAUM, BUXTON, CAWLEY, CORRIGAN, COSTA, COY, CRUZ,
DALLY, EACHUS, FLICK, FRANKEL, FREEMAN, GORDNER, GRUITZA,
HANNA, HORSEY, JAMES, LAUGHLIN, MACKERETH, LEACH, LEVDANSKY,
MANN, McCALL, MELIO, NAILOR, PRESTON, ROSS, SAINATO, SANTONI,
SEMMEL, SOLOBAY, STABACK, STURLA, TANGRETTI, THOMAS, TIGUE,
SAMUELSON, WALKO, WANSACZ, YOUNGBLOOD, YUDICHAK, PISTELLA,
JOSEPHS, DeLUCA, GERGELY, SHANER, MANDERINO, CURRY,
WASHINGTON AND PALLONE, JUNE 30, 2003
REFERRED TO COMMITTEE ON CHILDREN AND YOUTH, JUNE 30, 2003
AN ACT
1 Providing for the strengthening and enrichment of children and
2 families by promoting safe, healthy and nurturing home
3 environments, for the educational and supportive services of
4 home visiting programs in this Commonwealth, for the Ounce of
5 Prevention grant program and for integrated community-based
6 delivery of services; specifying program requirements;
7 designating an oversight board; providing for
8 responsibilities of the board and the Department of Public
9 Welfare; specifying criteria for community program grant
10 funding; requiring training and an independent evaluation
11 process; and providing for quality assurance.
12 The General Assembly of the Commonwealth of Pennsylvania
13 hereby enacts as follows:
14 Section 1. Short title.
15 This act shall be known and may be cited as the Ounce of
16 Prevention Act.
17 Section 2. Legislative intent.
18 The General Assembly finds and declares as follows:
19 (a) Funding.--The General Assembly finds that family well-
1 being is critical to a child's health and development, that
2 parenting is a difficult responsibility and that most of the
3 assistance available to Pennsylvania families occurs after there
4 is a problem and often provides too little, too late. Research
5 shows that comprehensive early home visitation programs prevent
6 child abuse, help develop positive parent-child interactions,
7 help brain development of the child, have a long-term savings in
8 both public and private health care costs and help avoid future
9 social problems. In addition to addressing child abuse, such
10 programs help to ensure that families' social and medical needs
11 are met and that children are ready for success in school. The
12 General Assembly finds that Pennsylvania needs broad
13 implementation of a program to provide support for families
14 which need and desire assistance in establishing healthy
15 relationships and environments for their children.
16 (b) Intent.--It is the intent of the General Assembly to
17 establish the Ounce of Prevention Program as a collaborative
18 effort that builds on existing community-based home visiting and
19 family support resources and will not duplicate the existing
20 services. It is further the intent of the General Assembly to
21 provide the needed intensity and duration of services extending
22 beyond those available through Head Start and Early Head Start
23 programs, thus filling a major gap in the existing continuum of
24 early childhood prevention and assistance services.
25 Section 3. Definitions.
26 The following words and phrases when used in this act shall
27 have the meanings given to them in this section unless the
28 context clearly indicates otherwise:
29 "Board." The Children's Trust Fund Board.
30 "Program." The Ounce of Prevention Program established in
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1 section 4.
2 Section 4. Ounce of Prevention Program.
3 (a) Establishment.--The Ounce of Prevention Program is
4 established as a voluntary home visiting grant program for
5 expectant mothers and newborn children and their families.
6 (b) Purpose.--The purpose of the program is to strengthen
7 families; promote early childhood growth and development;
8 improve childhood immunization rates and well-child care;
9 improve child health outcomes; improve school readiness;
10 increase family self-sufficiency; increase the involvement of
11 both parents with their children; and reduce the incidence of
12 child abuse and neglect through a primary prevention approach
13 that offers home visits and linkages to family supports for
14 families and their newborn children and continues until the
15 children reach five years of age or begin the Head Start
16 Program.
17 Section 5. Delivery of services.
18 Service delivery under this act shall be community-based and
19 collaborative. Services shall be integrated and coordinated with
20 other services provided under Head Start and Early Head Start
21 programs and by local school districts, as well as with other
22 home visiting and family support service delivery systems
23 currently in place in communities throughout this Commonwealth.
24 Services shall be offered with the intensity and duration
25 required to prevent child abuse and neglect, improve child
26 development and child health outcomes and to promote child
27 school-readiness and educational development.
28 Section 6. Program requirements.
29 The program created under this act shall provide for
30 intensive home visits and include the following critical home
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1 visiting elements:
2 (1) Initiation of services. This element provides for:
3 (i) Initiation of services prenatally or at the
4 birth of the first child.
5 (ii) Use of a standardized assessment tool to
6 systematically identify those at-risk families most in
7 need of services. The home visitor shall inform any
8 potential participant that the assessment or
9 participation in the program is purely voluntary.
10 (iii) Offering services on a purely voluntary basis
11 and use of positive, persistent outreach efforts to build
12 family trust.
13 (iv) Working with family members to identify
14 strengths and resources that can be mobilized to help
15 resolve identified family concerns.
16 (2) Service content. This element provides for:
17 (i) Offering services over the long term and
18 intensively, with well-defined criteria for increasing or
19 decreasing the intensity of the service.
20 (ii) Providing services that focus on supporting
21 first-time at-risk expectant parents and families,
22 encouraging the interaction of both parents with their
23 child, and enhancing the development of the child,
24 including school readiness and educational development.
25 (iii) Linking at-risk families to medical providers
26 to ensure optimal health and development of the child,
27 timely childhood immunizations, well-child care that
28 provides for developmental assessment and is consistent
29 with the standards and periodicity schedules of Medicaid
30 and the American Academy of Pediatrics and additional
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1 services, as needed.
2 (iv) Ensuring confidentiality and privacy for
3 families.
4 (v) Having periodic evaluations of program
5 effectiveness.
6 (vi) Having established mechanisms in place to refer
7 first-time at-risk expectant parents and families for
8 other intervention services available in the community.
9 (3) Qualifications and training of home visitors. This
10 element provides for:
11 (i) Ensuring that home visitors have basic training
12 in areas, including substance abuse, child abuse,
13 domestic violence, drug-exposed infants and parents,
14 child development, services available in the community,
15 infant care and early childhood development, school
16 readiness and parenting.
17 (ii) Ensuring that home visitors conducting home
18 visits are certified registered nurses or are qualified
19 home visitors under 45 CFR § 1304.52(e) (relating to home
20 visitor qualifications under the Head Start and Early
21 Head Start Programs).
22 (iii) Ensuring that home visitors have preservice
23 and ongoing training that is specific to their job
24 requirements.
25 (iv) Ensuring that home visit providers receive
26 ongoing reviews and direct and intensive supervision.
27 (v) Ensuring that home visitors are qualified
28 community-based private, not-for-profit or public
29 organizations that have strong community support and the
30 social and fiscal capacity to provide the service.
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1 Section 7. Children's Trust Fund Board.
2 (a) Designation.--The board is designated as an oversight
3 board.
4 (b) Powers and duties.--The board has the following powers
5 and duties:
6 (1) To develop measurable outcomes consistent with
7 established home visiting programs operating in this
8 Commonwealth.
9 (2) To establish assessment and credentialing standards
10 for home visitation programs receiving grant funding under
11 this act.
12 (3) To review grant applications and award grants for
13 home visiting programs. No nongovernmental member may:
14 (i) Review grant applications or vote to award
15 grants to entities by which they are employed or with
16 which they are directly affiliated.
17 (ii) Be a lobbyist as defined under 65 Pa.C.S. Ch.
18 13 (relating to lobby regulation and disclosure).
19 (4) Grants for home visiting programs shall be awarded
20 on a three-year basis. The board may rescind a portion of the
21 grant not yet allocated if it determines through outcome,
22 expenditure and performance data submitted by the grantees
23 under section 8 that the funds are not being properly
24 utilized.
25 (5) Develop an assessment tool to identify at-risk
26 families who are eligible for home visiting grants under this
27 act. The assessment tool shall be a mechanism to identify
28 risk factors that may lead to child abuse or neglect or other
29 poor childhood outcomes.
30 (6) Establish policies for the development,
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1 implementation and administration of the program.
2 Section 8. Implementation.
3 The board shall do all of the following:
4 (1) Implement a community-based home visiting program
5 for first-time at-risk expectant parents and families in this
6 Commonwealth using the criteria set forth in this section.
7 (2) Develop a grant application and award grants under
8 this program in accordance with the following requirements:
9 (i) Grants shall be awarded in accordance with
10 weighted criteria based on population demographics,
11 factors associated with child abuse and neglect and other
12 appropriate criteria developed by the board.
13 (ii) Cash or in-kind matching funds in the amount of
14 25% of the total program cost shall be required.
15 (iii) If a program is not able to meet the 25% match
16 requirement, justification must be included in the grant
17 application providing a detailed explanation of the
18 reasons why this match cannot be met and the percentage
19 of the match that can be met. A determination will be
20 made by the board as to the merit of the justification.
21 (3) Develop a plan of implementation to equitably
22 distribute funds throughout this Commonwealth.
23 (4) Require that, in addition to the program
24 requirements outlined in section 6, the following criteria be
25 used in selecting recipients of grant funds:
26 (i) Preference for grant awards shall be given to
27 community-based entities that have broad representation
28 and have the fiscal and administrative capacity to
29 successfully implement the program.
30 (ii) Home visiting programs that receive grants
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1 should collaborate with other home visiting and family
2 support programs in the community to avoid duplication
3 and complement and integrate with existing services.
4 (iii) Each applicant shall use the standardized
5 assessment tool developed by the board under section 7.
6 (iv) Each applicant must provide outcome,
7 expenditure and performance data in the format and the
8 frequency specified by the board.
9 (v) Each applicant must identify local resources
10 available for implementation.
11 (vi) Implementation design must include service
12 delivery strategies which, when appropriate, involve both
13 parents if they have shared parental responsibility,
14 regardless of residential custody arrangements.
15 (5) Evaluate and approve grant applications and local
16 implementation plans for service delivery.
17 (6) Encourage applicants to coordinate service delivery
18 with Head Start, Early Head Start, Parents as Teachers,
19 family centers, school districts and other existing home
20 visiting programs operating in communities in the various
21 regions of this Commonwealth.
22 (7) Identify qualified trainers and training
23 opportunities which will assure adequate opportunities for
24 grantees and their communities to provide preservice and in-
25 service training. Funds for training may be incorporated into
26 the grants.
27 (8) Develop and implement a quality assurance and
28 improvement process for the program.
29 (9) Identify and seek Federal matching funding for the
30 program.
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1 (10) Identify existing State funding streams that could
2 be used to fund home visiting programs in this Commonwealth.
3 (11) Provide for an annual independent review which
4 evaluates both the progress and effectiveness of community
5 programs receiving grants and the overall progress and
6 achievement of the designated outcomes of the programs. The
7 board shall provide the review to the Governor, the Senate
8 and the House of Representatives on an annual basis.
9 Section 9. Responsibilities of Department of Public Welfare.
10 The Department of Public Welfare shall allocate the staff and
11 financial resources necessary to assist the board in the
12 implementation and administration of the program.
13 Section 20. Effective date.
14 This act shall take effect immediately.
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