A bill to amend title V of the Social Security Act to provide grants to establish or expand quality programs providing home visitation for low-income pregnant women and low-income families with young children, and for other purposes.

Summary: Evidence-Based Home Visitation Act of 2009 - Amends title V (Maternal and Child Health Services) of the Social Security Act (SSA) to direct the Secretary of Health and Human Services (HHS) to award competitive planning and operating grants to local agencies to provide home visitation services to low-income pregnant women and low-income families with young children.

Amends SSA title XIX (Medicaid) to give states the option of providing for simplified billing by approved home visitation agencies.

SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Evidence-Based Home Visitation Act 
of 2009''.

SEC. 2. GRANTS FOR QUALITY HOME VISITATION PROGRAMS FOR LOW-INCOME 
              PREGNANT WOMEN AND LOW-INCOME FAMILIES WITH YOUNG 
              CHILDREN.

    Title V of the Social Security Act (42 U.S.C. 701 et seq.) is 
amended by adding at the end the following:

``SEC. 511. SEPARATE PROGRAM OF HOME VISITATION FOR LOW-INCOME PREGNANT 
              WOMEN AND LOW-INCOME FAMILIES WITH YOUNG CHILDREN.

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

SEC. 3. MEDICAID OPTION FOR SIMPLIFIED BILLING BY APPROVED HOME 
              VISITATION AGENCIES.

    (a) State Plan Amendment.--Section 1902(a) of the Social Security 
Act (42 U.S.C. 1396a(a)) is amended--
            (1) in paragraph (72), by striking ``and'' at the end;
            (2) in paragraph (73), by striking the period at the end 
        and inserting ``; and''; and
            (3) by inserting after paragraph (73) the following:
            ``(74) at the option of the State, provide for simplified 
        billing by approved home visitation agencies under section 
        1943.''.
    (b) Simplified Billing by Approved Home Visitation Agencies.--Title 
XIX of such Act is amended by adding at the end the following:
    ``Sec. 1943. Simplified Billing by Approved Home Visitation 
Agencies.--
    ``(a) In General.--A State electing the option described in this 
Section may permit an approved home visitation agency to use a 
simplified method to submit claims for payment for home visitation 
services, but only to the extent that such services are covered under 
the State plan.
    ``(b) Definitions.--In this section:
            ``(1) Approved home visitation agency.--The term `approved 
        home visitation agency' means a local agency with an operating 
        grant under section 511(b)(2).
            ``(2) Home visitation services.--The term `home visitation 
        services' means services provided consistently with the 
        approved model of home visitation services that is being 
        implemented by the local agency described in paragraph (1) and 
        that are covered under the State plan.
            ``(3) Simplified method to submit claims for payment.--The 
        term `simplified method to submit claims for payment' means a 
        billing method through which an approved home visitation agency 
        submits claims based on the weighted average cost per visit of 
        providing, through the approved model of home visitation 
        services being implemented by such agency, home visitation 
        services.
    ``(c) No Expansion of Covered Services.--Nothing in this section 
shall be construed to authorize the provision of, or payment for, home 
visitation or other services under this title that are not covered 
under the State plan.''.