PRINTER'S NO. 633
No. 200 Session of 2005
INTRODUCED BY MUNDY, BROWNE, BEBKO-JONES, BELARDI, BELFANTI,
BISHOP, BLACKWELL, BLAUM, BUNT, CALTAGIRONE, CAWLEY,
CORRIGAN, CRAHALLA, CURRY, DALEY, DALLY, DeWEESE, FABRIZIO,
FLICK, FRANKEL, FREEMAN, GERGELY, GOODMAN, GRUCELA, GRUITZA,
HARHAI, HERMAN, JAMES, JOSEPHS, W. KELLER, LaGROTTA, LEACH,
MACKERETH, MANDERINO, MANN, MARKOSEK, McCALL, NAILOR,
PALLONE, PETRARCA, PISTELLA, READSHAW, REICHLEY, ROEBUCK,
ROSS, SAINATO, SAMUELSON, SANTONI, SEMMEL, SHANER, SOLOBAY,
STABACK, STAIRS, STETLER, STURLA, SURRA, THOMAS, TIGUE,
WALKO, WANSACZ, WHEATLEY, YOUNGBLOOD, YUDICHAK, TRUE, VEON,
GERBER, SHAPIRO, D. EVANS, BIANCUCCI, DERMODY AND RAMALEY,
FEBRUARY 16, 2005
REFERRED TO COMMITTEE ON HEALTH AND HUMAN SERVICES,
FEBRUARY 16, 2005
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 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.
1 (a) Funding.--
2 (1) The General Assembly finds that family well-being is
3 critical to a child's health and development, that parenting
4 is a difficult responsibility and that most of the assistance
5 available to Pennsylvania families occurs after there is a
6 problem and often provides too little, too late. Research
7 shows that comprehensive early home visitation programs
8 prevent child abuse, help develop positive parent-child
9 interactions, help brain development of the child, have a
10 long-term savings in both public and private health care
11 costs and help avoid future social problems. In addition to
12 addressing child abuse, such programs help to ensure that
13 families' social and medical needs are met and that children
14 are ready for success in school.
15 (2) The General Assembly finds that Pennsylvania needs
16 broad implementation of a program to provide support for
17 families which need and desire assistance in establishing
18 healthy relationships and environments for their children.
19 (3) The General Assembly intends to appropriate funds to
20 the board to carry out the program.
21 (b) Intent.--It is the intent of the General Assembly to
22 establish the Ounce of Prevention Program as a collaborative
23 effort that builds on existing community-based home visiting and
24 family support resources and will not duplicate the existing
25 services. It is further the intent of the General Assembly to
26 provide the needed intensity and duration of services extending
27 beyond those available through Head Start and Early Head Start
28 programs, thus filling a major gap in the existing continuum of
29 early childhood prevention and assistance services.
30 Section 3. Definitions.
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1 The following words and phrases when used in this act shall
2 have the meanings given to them in this section unless the
3 context clearly indicates otherwise:
4 "Board." The Children's Trust Fund Board.
5 "Department." The Department of Public Welfare of the
6 Commonwealth.
7 "Program." The Ounce of Prevention Program established in
8 section 4 (relating to Ounce of Prevention Program).
9 Section 4. Ounce of Prevention Program.
10 (a) Establishment.--The Ounce of Prevention Program is
11 established as a voluntary home visiting grant program for
12 expectant mothers and newborn children and their families.
13 (b) Purpose.--The purpose of the program is to strengthen
14 families; promote early childhood growth and development;
15 improve childhood immunization rates and well-child care;
16 improve child health outcomes; improve school readiness;
17 increase family self-sufficiency; increase the involvement of
18 both parents with their children; and reduce the incidence of
19 child abuse and neglect through a primary prevention approach
20 that offers home visits and linkages to family supports for
21 families and their newborn children and continues until the
22 children reach five years of age or begin the Head Start
23 Program.
24 Section 5. Delivery of services.
25 Service delivery under this act shall be community-based and
26 collaborative. Services shall be integrated and coordinated with
27 other services provided under Head Start and Early Head Start
28 programs and by local school districts, as well as with other
29 home visiting and family support service delivery systems
30 currently in place in communities throughout this Commonwealth.
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1 Services shall be offered with the intensity and duration
2 required to prevent child abuse and neglect, improve child
3 development and child health outcomes and to promote child
4 school-readiness and educational development.
5 Section 6. Program requirements.
6 The program established under this act shall provide for
7 intensive home visits and include the following critical home
8 visiting elements:
9 (1) Initiation of services. This element provides for:
10 (i) Initiation of services prenatally or at the
11 birth of the first child.
12 (ii) Use of a standardized assessment tool to
13 systematically identify those at-risk families most in
14 need of services. The home visitor shall inform any
15 potential participant that the assessment or
16 participation in the program is purely voluntary.
17 (iii) Offering services on a purely voluntary basis
18 and use of positive, persistent outreach efforts to build
19 family trust.
20 (iv) Working with family members to identify
21 strengths and resources that can be mobilized to help
22 resolve identified family concerns.
23 (2) Service content. This element provides for:
24 (i) Offering services over the long term and
25 intensively, with well-defined criteria for increasing or
26 decreasing the intensity of the service.
27 (ii) Providing services that focus on supporting
28 first-time at-risk expectant parents and families,
29 encouraging the interaction of both parents with their
30 child, and enhancing the development of the child,
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1 including school readiness and educational development.
2 (iii) Linking at-risk families to medical providers
3 to ensure optimal health and development of the child,
4 timely childhood immunizations, well-child care that
5 provides for developmental assessment and is consistent
6 with the standards and periodicity schedules of Medicaid
7 and the American Academy of Pediatrics and additional
8 services, as needed.
9 (iv) Ensuring confidentiality and privacy for
10 families.
11 (v) Having periodic evaluations of program
12 effectiveness.
13 (vi) Having established mechanisms in place to refer
14 first-time at-risk expectant parents and families for
15 other intervention services available in the community.
16 (3) Qualifications and training of home visitors. This
17 element provides for:
18 (i) Ensuring that home visitors have basic training
19 in areas, including substance abuse, child abuse,
20 domestic violence, drug-exposed infants and parents,
21 child development, services available in the community,
22 infant care and early childhood development, school
23 readiness and parenting.
24 (ii) Ensuring that home visitors conducting home
25 visits are certified registered nurses or are qualified
26 home visitors under 45 CFR § 1304.52(e) (relating to
27 human resources management).
28 (iii) Ensuring that home visitors have preservice
29 and ongoing training that is specific to their job
30 requirements.
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1 (iv) Ensuring that home visit providers receive
2 ongoing reviews and direct and intensive supervision.
3 (v) Ensuring that home visitors are qualified
4 community-based private, not-for-profit or public
5 organizations that have strong community support and the
6 social and fiscal capacity to provide the service.
7 Section 7. Children's Trust Fund Board.
8 (a) Designation.--The board is designated as an oversight
9 board.
10 (b) Powers and duties.--The board has the following powers
11 and duties:
12 (1) To develop measurable outcomes consistent with
13 established home visiting programs operating in this
14 Commonwealth.
15 (2) To establish assessment and credentialing standards
16 for home visitation programs receiving grant funding under
17 this act.
18 (3) To review grant applications and award grants for
19 home visiting programs. No nongovernmental member may:
20 (i) Review grant applications or vote to award
21 grants to entities by which they are employed or with
22 which they are directly affiliated.
23 (ii) Be a lobbyist as defined under 65 Pa.C.S. Ch.
24 13 (relating to lobby regulation and disclosure).
25 (4) Grants for home visiting programs shall be awarded
26 on a three-year basis. The board may rescind a portion of the
27 grant not yet allocated if it determines through outcome,
28 expenditure and performance data submitted by the grantees
29 under section 8 (relating to implementation) that the funds
30 are not being properly utilized.
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1 (5) Develop an assessment tool to identify at-risk
2 families who are eligible for home visiting grants under this
3 act. The assessment tool shall be a mechanism to identify
4 risk factors that may lead to child abuse or neglect or other
5 poor childhood outcomes.
6 (6) Establish policies for the development,
7 implementation and administration of the program.
8 Section 8. Implementation.
9 The board shall do all of the following:
10 (1) Implement a community-based home visiting program
11 for first-time at-risk expectant parents and families in this
12 Commonwealth using the criteria set forth in this section.
13 (2) Develop a grant application and award grants under
14 this program in accordance with the following requirements:
15 (i) Grants shall be awarded in accordance with
16 weighted criteria based on population demographics,
17 factors associated with child abuse and neglect and other
18 appropriate criteria developed by the board.
19 (ii) Cash or in-kind matching funds in the amount of
20 25% of the total program cost shall be required.
21 (iii) If a program is not able to meet the 25% match
22 requirement, justification must be included in the grant
23 application providing a detailed explanation of the
24 reasons why this match cannot be met and the percentage
25 of the match that can be met. A determination will be
26 made by the board as to the merit of the justification.
27 (3) Develop a plan of implementation to equitably
28 distribute funds throughout this Commonwealth.
29 (4) Require that, in addition to the program
30 requirements outlined in section 6 (relating to program
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1 requirements), the following criteria be used in selecting
2 recipients of grant funds:
3 (i) Preference for grant awards shall be given to
4 community-based entities that have broad representation
5 and have the fiscal and administrative capacity to
6 successfully implement the program.
7 (ii) Home visiting programs that receive grants
8 should collaborate with other home visiting and family
9 support programs in the community to avoid duplication
10 and complement and integrate with existing services.
11 (iii) Each applicant shall use the standardized
12 assessment tool developed by the board under section 7
13 (relating to Children's Trust Fund Board).
14 (iv) Each applicant must provide outcome,
15 expenditure and performance data in the format and the
16 frequency specified by the board.
17 (v) Each applicant must identify local resources
18 available for implementation.
19 (vi) Implementation design must include service
20 delivery strategies which, when appropriate, involve both
21 parents if they have shared parental responsibility,
22 regardless of residential custody arrangements.
23 (5) Evaluate and approve grant applications and local
24 implementation plans for service delivery.
25 (6) Encourage applicants to coordinate service delivery
26 with Head Start, Early Head Start, Parents as Teachers,
27 family centers, school districts and other existing home
28 visiting programs operating in communities in the various
29 regions of this Commonwealth.
30 (7) Identify qualified trainers and training
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1 opportunities which will assure adequate opportunities for
2 grantees and their communities to provide preservice and in-
3 service training. Funds for training may be incorporated into
4 the grants.
5 (8) Develop and implement a quality assurance and
6 improvement process for the program.
7 (9) Identify and seek Federal matching funding for the
8 program.
9 (10) Identify existing State funding streams that could
10 be used to fund home visiting programs in this Commonwealth.
11 (11) Provide for an annual independent review which
12 evaluates both the progress and effectiveness of community
13 programs receiving grants and the overall progress and
14 achievement of the designated outcomes of the programs. The
15 board shall provide the review to the Governor, the Senate
16 and the House of Representatives on an annual basis.
17 Section 9. Responsibilities of Department of Public Welfare.
18 The department shall allocate the staff and financial
19 resources necessary to assist the board in the implementation
20 and administration of the program.
21 Section 20. Effective date.
22 This act shall take effect immediately.
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