69–006 

110TH CONGRESS REPT. 110–818 " ! HOUSE OF REPRESENTATIVES 2d Session Part 1 

EDUCATION BEGINS AT HOME ACT OF 2008 

AUGUST 1, 2008.—Ordered to be printed 

Mr. GEORGE MILLER of California, from the Committee on 

Education and Labor, submitted the following 

R E P O R T 

together with 

MINORITY VIEWS 

[To accompany H.R. 2343] 

[Including cost estimate of the Congressional Budget Office] 

The Committee on Education and Labor, to whom was referred 

the bill (H.R. 2343) to expand quality programs of early childhood 

home visitation that increase school readiness, child abuse and neglect prevention, and early identification of developmental and 

health delays, including potential mental health concerns, and for 

other purposes, having considered the same, report favorably thereon with an amendment and recommend that the bill as amended 

do pass. 

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 ‘‘Education Begins at Home Act of 2008’’. 

SEC. 2. FINDINGS AND PURPOSES. 

(a) FINDINGS.—Congress finds that— 

(1) the home is the first and most important learning environment for children, and parents are their children’s first and most influential teacher; 

(2) parent education and family support can promote parents’ ability to enhance their children’s development from birth until entry into kindergarten, 

thereby helping parents to prepare their children for success in school; 

(3) undiagnosed and unaddressed developmental and health problems can impede overall child development and school readiness; 

(4) all parents deserve and can benefit from— 

(A) research-based information regarding child development; 

(B) enrichment opportunities with their children; and 

(C) early opportunities to become involved with their communities and 

schools; and 


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(5) early childhood home visitation leads to positive outcomes for children and 

families, including readiness for school, improved child health and development, 

positive parenting practices, and reductions in child maltreatment. 

(b) PURPOSES.—The purposes of this Act are as follows: 

(1) To enable States, Indian tribes, tribal organizations, territories, or possessions to deliver quality programs of early childhood home visitation to pregnant 

women and parents of children from birth until entry into kindergarten in order 

to promote positive outcomes for children and families including: readiness for 

school, improved child health and development, positive parenting practices, reductions in child maltreatment, and enhanced parenting abilities to support 

their children’s optimal cognitive, language, social-emotional, and physical development. 

(2) To expand quality programs of early childhood home visitation so as to 

more effectively reach and serve families with English language learners. 

(3) To expand quality programs of early childhood home visitation so as to 

more effectively reach and serve families serving in the military. 

(4) To establish a public education and awareness campaign concerning the 

importance of the proper care of infants and young children. 

SEC. 3. DEFINITIONS. 

In this Act: 

(1) 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 under the age of entry into 

kindergarten, including grandparents or other relatives of the child, and 

foster parents (including kinship caregivers), who are serving as the primary caregiver, including a noncustodial parent who has an on-going relationship with and, at times, provides physical care for such child. 

(2) ENGLISH LANGUAGE LEARNER.—The term ‘‘English language learner’’, used 

with respect to an individual, means an individual— (A) who— (i) was not born in the United States or whose native language is a 

language other than English; 

(ii)(I) is a Native American (as defined in section 9101 of the Elementary and Secondary Education Act of 1965 (20 U.S.C. 7801)), an Alaska 

Native, or a native resident of an outlying area (as defined in such section 9101); and 

(II) comes from an environment where a language other than English 

has had a significant impact on the individual’s level of English language proficiency; or 

(iii) is migratory, whose native language is a language other than 

English, and who comes from an environment where a language other 

than English is dominant; and 

(B) whose difficulties in speaking or understanding the English language 

may be sufficient to deny such individual—

(i) the ability to successfully achieve in a classroom in which the language of instruction is English; or 

(ii) the opportunity to participate fully in society. 

(3) HOME VISITATION.—The term ‘‘home visitation’’ means services provided in 

the permanent or temporary residence, or in a mutually agreed upon location 

in the community, of the individual receiving such services. 

(4) INDIAN TRIBE.—The term ‘‘Indian tribe’’ has the meaning given such term 

in section 4(e) of the Indian Self-Determination and Education Assistance Act 

(25 U.S.C. 450b). 

(5) SECRETARY.—Except as provided in section 6, the term ‘‘Secretary’’ means 

the Secretary of Health and Human Services. 

(6) STATE.—The term ‘‘State’’ means each of the 50 States, the District of Columbia, and the Commonwealth of Puerto Rico. 

(7) TERRITORIES AND POSSESSIONS.—The term ‘‘territories and possessions’’

shall include American Samoa, the Commonwealth of the Northern Mariana Islands, Guam, and the United States Virgin Islands. 

(8) TRIBAL ORGANIZATION.—The term ‘‘tribal organization’’ has the meaning 

given the term in section 4(l) of the Indian Self-Determination and Education 

Assistance Act (25 U.S.C. 450b). 

SEC. 4. GRANTS FOR EARLY CHILDHOOD HOME VISITATION. 

(a) AUTHORIZATION.—The Secretary, in consultation with the Secretary of Education, shall make grants to States, Indian tribes, tribal organizations, territories 

and possessions to enable States, Indian tribes, tribal organizations, territories and 


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possessions to establish or expand quality programs of early childhood home visitation as specified under subsection (e). Each grant shall consist of the allotment determined under subsection (b). 

(b) DETERMINATION OF RESERVATIONS; AMOUNT OF ALLOTMENTS; AUTHORIZATION

OF APPROPRIATIONS.— (1) RESERVATIONS FROM APPROPRIATIONS.—From the total amount made available to carry out this section for a fiscal year, the Secretary shall reserve— (A) 3 percent for an independent evaluation of the activities carried out 

under this Act, as specified in section 7; 

(B) not more than 3 percent for Federal administrative costs; 

(C) not more than 2 percent of the funds appropriated for any fiscal year 

for payments to Indian tribes or tribal organizations with an approved application under this section; 

(D) not more than 1⁄2 of 1 percent of the funds appropriated for any fiscal 

year for payments to territories and possessions with an approved application under this section; and 

(E) 2 percent for training and technical assistance for States. 

(2) STATE ALLOTMENTS FOR EARLY CHILDHOOD HOME VISITATION.— (A) IN GENERAL.—In accordance with subparagraph (B), the Secretary 

shall allot among each of the eligible States the total amount made available to carry out this section for any fiscal year and not reserved under 

paragraph (1), to support early childhood home visitation programs in accordance with this section. 

(B) DETERMINATION OF STATE ALLOTMENTS.—The Secretary shall allot the 

amount made available under subparagraph (A) for a fiscal year among the 

eligible States in proportion to the number of children, aged from birth 

through 5 years from families whose income is below the poverty line, who 

reside within the State, compared to the number of such individuals who 

reside in all such States for that fiscal year. 

(3) PAYMENTS TO TRIBES AND TERRITORIES.— 

(A) Out of the funds reserved under paragraph (1)(C), the Secretary shall 

provide funds to each Indian tribe or tribal organization with an approved 

application under this section in accordance with the respective needs described in that application. 

(B) Out of the funds reserved under paragraph (1)(D), the Secretary shall 

provide funds to each territory or possession with an approved application 

under this section in accordance with the respective needs described in that 

application. 

(4) APPLICATIONS OF INDIAN TRIBES, TRIBAL ORGANIZATIONS, TERRITORIES, OR

POSSESSIONS.— 

(A) Subject to subparagraph (B), the Secretary shall approve an application of an Indian tribe, tribal organization, territory, or possession based on 

the quality of the application. 

(B) The Secretary may exempt an application submitted by an Indian 

tribe, tribal organization, territory, or possession from any requirement of 

this section that the Secretary determines would be inappropriate to apply 

taking into account the resources, needs, and other circumstances of the Indian tribe, tribal organization territory, or possession with the exception of 

the provision of quality early childhood home visitation and participation in 

the independent evaluation outlined in section 7. 

(5) AUTHORIZATION OF APPROPRIATIONS.—There are authorized to be appropriated to carry out this section $150,000,000 for fiscal year 2009 and such 

sums as may be necessary for fiscal years 2010 through 2013. 

(c) GRANT APPLICATIONS.—A State, Indian tribe, tribal organization, territory, or 

possession that desires to receive a grant under this section shall submit an application to the Secretary at such time, in such manner, and containing such information 

as the Secretary may require. For the purposes of this subsection, the term ‘‘State’’ 

includes Indian tribes, tribal organizations, territories, or possessions. The application shall contain the following information: 

(1) An assurance that the Governor of the State has designated a lead State 

agency, such as the State educational agency or the State health and human 

services agency, to carry out the activities under this section. 

(2) An assurance that the State will reserve 3 percent of such grant for evaluation and will participate in the independent evaluation under section 7. 

(3) An assurance that the State will reserve 10 percent of the grant funds for 

training and technical assistance to programs of early childhood home visitation. 

(4) An assurance that the State will authorize child care resource and referral 

agencies to refer parents seeking home visitation services. 


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(5) An assurance that in supporting early childhood home visitation programs 

under this section the State shall identify and prioritize serving communities 

that are in high need of such services, such as communities with—

(A) low student achievement; 

(B) high rates of teen pregnancy; 

(C) high proportions of low income families; 

(D) high incidences of child abuse; 

(E) high rates of children with developmental delays or disabilities; 

(F) large concentrations of individuals who are English language learners; 

(G) large concentrations of individuals currently serving in the Armed 

Forces; and 

(H) large concentrations of individuals who formerly served in the Armed 

Forces. 

(6) The results of a statewide needs assessment that describes—

(A) the quality and capacity of existing programs of early childhood home 

visitation in the State; 

(B) the number and types of eligible families who are receiving services 

under such programs; and 

(C) the gaps in early childhood home visitation in the State, including 

identification of communities that are in high need of such services. 

(7) A State plan containing the following: 

(A) A description of the State’s plan to prioritize establishing or expanding high quality programs of early childhood home visitation programs in 

communities that are in high need of such programs. 

(B) A description of the high quality programs of early childhood home 

visitation that will be supported by a grant under this section. 

(C) A description of how the proposed program of early childhood home 

visitation will promote positive parenting skills and children’s early learning and development. 

(D) A description of how the proposed program of early childhood home 

visitation will incorporate the authorized activities described in subsection 

(e). 

(E) How the lead State agency will build on and promote coordination 

among existing programs of early childhood home visitation in an effort to 

promote an array of home visitation programs to ensure more eligible families are being served and are getting the most appropriate services to meet 

their needs. 

(F) How the lead State agency will promote collaboration among a broad 

range of child- and family-serving programs, including—

(i) early childhood home visitation programs, including targeted 

grants awarded under sections 5 and 6; 

(ii) early childhood care and education programs; 

(iii) activities carried out under part C of the Individuals with Disabilities Education Act (20 U.S.C. 1431 et seq.) and section 619 of the 

Individuals with Disabilities Education Act (20 U.S.C. 1419); 

(iv) child abuse prevention and treatment programs, and State and 

local child protection systems; 

(v) Medicaid and State Children’s Health Insurance programs; 

(vi) nutrition assistance programs; 

(vii) parental substance abuse and mental health prevention and 

treatment programs; 

(viii) domestic and family violence prevention programs; 

(ix) child support enforcement programs; 

(x) workforce development programs; 

(xi) the State Temporary Assistance to Needy Families program; 

(xii) early childhood intervention programs, such as mental health 

prevention and treatment services; 

(xiii) State and local educational agencies; and 

(xiv) other appropriate child-serving programs in the State in order 

to facilitate the coordinated delivery of services for eligible families. 

(G) How the lead State agency will provide for the training and technical 

assistance to programs of early childhood home visitation involved in activities under this section to more effectively meet the needs of the eligible 

families served, with sensitivity to cultural variations in attitudes toward 

formal support services and parenting norms. 

(H) How the lead State agency will evaluate the activities supported 

under this section in order to assess outcomes including, but not limited 

to—


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(i) parental outcomes related to child health and development, including parent knowledge of early learning and development; 

(ii) child health, cognitive, language, social-emotional, and physical 

development; 

(iii) child maltreatment; 

(iv) school readiness; and 

(v) links to community services. 

(I) A description of how the lead State agency will ensure home visitation 

programs prioritize outreach activities to target fathers and include fathers 

in the program where safe and appropriate. 

(J) A description of how the lead State agency will ensure that services 

are made available under the program to grandparents, other relatives or 

foster parents, of a child from birth through age 5 who serve as the primary 

caregiver of the child. 

(K) Such other information as the Secretary may require. 

(d) APPROVAL OF APPLICATIONS.— (1) IN GENERAL.—The Secretary shall approve an application under this section based on the recommendations of a peer review panel, as described in paragraph (2). 

(2) PEER REVIEW PANEL.—The peer review panel shall include individuals 

with experience in varying models of home visitation, including not fewer 

than—

(A) 3 individuals who are experts in the field of home visitation; 

(B) 2 individuals who are experts in early childhood development; 

(C) 1 individual with expertise implementing a statewide program of 

early childhood home visitation; 

(D) 1 individual who is a board certified pediatrician or a developmental 

pediatrician; and 

(E) 1 individual with experience in administering public or private (including community-based) child maltreatment prevention programs. 

(3) RECOMMENDATIONS.—The panel shall recommend applicants to the Secretary based on the quality of their applications. In addition to ensuring that 

the application is complete, the panel shall consider—

(A) the quality of the statewide needs assessment, described in subsection 

(c)(6); 

(B) the quality of the programs to be funded by the grant, described in 

subsection (c)(7)(B), and the capacity of such programs to establish or expand high quality home visitation services; 

(C) the plan to enhance and improve services in the State through collaboration described in subsections (c)(7)(E) and (c)(7)(F); 

(D) the State’s plan to prioritize serving communities in high need of 

home visitation programs; and 

(E) the State’s plan for delivering effective training and technical assistance. 

(e) STATE USES OF FUNDS.—Each State that receives a grant under this section 

shall—

(1) provide to as many eligible families in the State as practicable, voluntary 

early childhood home visitation, on not less frequently than a monthly basis 

with greater frequency of services for those eligible families identified with additional needs, through the implementation of high quality programs of early 

childhood home visitation that—

(A) adopt a clear, consistent model that—

(i) is research-based; 

(ii) is grounded in empirically-based knowledge related to home visiting and child health or child development; 

(iii) is linked to program-determined outcomes; 

(iv) is associated with a national organization or institution of higher 

education (as defined under section 101 of the Higher Education Act of 

1965), that has comprehensive home visitation program standards, including standardized training and on-going professional development, 

that ensure high quality service delivery and continuous program quality improvement; 

(v) has been evaluated, and the results of the evaluation have been 

published in a peer-reviewed journal; and 

(vi) has been in existence at least 3 consecutive years prior to the 

program being funded under this Act; 

(B) employ well-trained and competent staff, as demonstrated by education or training, and the provision of ongoing and specific training on the 

model being delivered; 


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(C) maintain high quality supervision that supports home visitor competencies; 

(D) show strong organizational capacity to implement the program involved; 

(E) establish appropriate linkages and referral networks to other community resources and supports; 

(F) monitor fidelity of program implementation to assure that services are 

delivered according to the specified model; 

(G) establish procedures to promote participation of fathers, where safe 

and appropriate; 

(H) are research-based and provide parents with—

(i) knowledge of age-appropriate child development in cognitive, language, social-emotional, and motor domains (including knowledge of 

second language acquisition, in the case of English language learners); 

(ii) knowledge of realistic expectations of age-appropriate child behaviors; 

(iii) knowledge of health and wellness issues for children and parents; 

(iv) modeling, consulting, and coaching on parenting practices; 

(v) skills to interact with their child to enhance age-appropriate development; 

(vi) skills to recognize and seek help for issues related to health, developmental delays, and social, emotional, and behavioral skills; 

(vii) activities designed to help parents become full partners in the 

education of their children; and 

(viii) relevant information, consistent with State child welfare agency 

training, concerning child welfare and protective services resources if 

appropriate; 

(I) ascertain what health and developmental services the family receives 

and works with providers of such services to eliminate gaps in service by 

offering annual health, vision, hearing, and developmental screening for 

children from birth to entry into kindergarten, when not otherwise provided; 

(J) provide referrals for eligible families, as needed, to additional resources available in the community, such as center-based early education 

programs, child care services, health or mental health services, family literacy programs, employment agencies, social services, fatherhood programs, 

and child care resource and referral agencies; and 

(K) offer group meetings (at program discretion) for eligible families 

that—

(i) further enhance the information, activities, and skill-building addressed during home visitation; and 

(ii) offer opportunities for parents to meet with and support each 

other. 

(2) reserve 10 percent of the grant funds to provide training and technical assistance, directly or through contract, to early childhood home visitation programs relating to—

(A) effective methods of implementing parent education, conducting home 

visiting, and promoting positive early childhood development; 

(B) the relationship of health and well-being of pregnant women to prenatal and early childhood development; 

(C) early childhood development with respect to children from birth until 

entry into kindergarten; 

(D) methods to help parents promote emergent literacy, including second 

language acquisition for English language learners, in their children from 

birth until entry into kindergarten; 

(E) health, vision, hearing, and developmental screenings; 

(F) strategies for helping eligible families with special needs or those eligible families coping with crisis; 

(G) recruiting, supervising, and retaining qualified staff; 

(H) increasing services for underserved populations; 

(I) methods to help parents effectively respond to their children’s needs 

and behaviors; 

(J) implementation of ongoing program quality improvement and evaluation of activities and outcomes; 

(K) relevant issues related to child welfare and protective services, with 

information provided being consistent with State or local child welfare 

agency training; 


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(L) effective methods of successfully engaging fathers in programs for parents; and 

(M) the relationship of father involvement to the health and well-being 

of pregnant women and to prenatal and early childhood development; 

(3) ensure representatives from high quality programs of early childhood 

home visitation operating in the State are included in an existing State-level 

early childhood coordinating body, such as the State Advisory Council on Early 

Childhood Care and Education (as defined in section 642B(b) of the Head Start 

Act), that meets regularly to address policy and implementation issues that will 

improve the coordination and effectiveness of a range of services for children 

and families; and 

(4) use not more than 5 percent of the amount of grant funds received under 

this section for the administration of the grant, including planning, administration, and annual reporting. 

(f) MAINTENANCE OF EFFORT.—A State is entitled to receive its full allotment of 

funds under this section for any fiscal year if the Secretary finds that the aggregate 

expenditures within the State for quality programs of early childhood home visitation for the fiscal year preceding the fiscal year for which the determination is made 

was not less than 100 percent of such aggregate expenditures for the second fiscal 

year preceding the fiscal year for which the determination is made. 

(g)(1) STATE MATCH.—In order to receive an allotment under subsection (b)(2), a 

State shall match the amount of such allotment with funds not derived from other 

Federal sources on the following basis: 

(A) 10 percent of such allotment for fiscal year 2011; 

(B) 20 percent of such allotment for fiscal year 2012; and 

(C) 30 percent of such allotment for fiscal year 2013. 

(2) MATCH REQUIREMENT.—The funds resulting from the requirement in paragraph (1) shall be exported in accordance with the requirements of this section. 

(h) REPORTING REQUIREMENTS.—Each State that receives a grant under this section shall submit an annual report to the Secretary regarding the State’s progress 

in addressing the purposes of this Act. Such report shall include, at a minimum, 

a description of—

(1) actual service delivery provided under the grant including—

(A) program characteristics, including descriptive information on the 

service model used and actual program performance; 

(B) provider characteristics, including staff qualifications, work experience, and demographic characteristics; and 

(C) recipient characteristics, including number, demographic characteristics, and family retention; 

(2) recipient outcomes that are consistent with program goals, including, 

where appropriate given the program being evaluated—

(A) parent knowledge of early learning and development; 

(B) child health, cognitive, language, social-emotional, and physical developmental indicators; 

(C) child maltreatment indicators; 

(D) school readiness indicators; and 

(E) links to community services; 

(3) the research-based instruction, materials, and activities being used in the 

activities funded under the grant; 

(4) the training and technical assistance, including ongoing professional development, provided to programs supported under the grant; 

(5) beginning at the end of the second year of the grant, the results of evaluations described in subsection (c)(7)(H); and 

(6) the annual program implementation costs, including the cost per family 

served under the program. 

SEC. 5. TARGETED GRANTS FOR EARLY CHILDHOOD HOME VISITATION FOR FAMILIES WITH 

ENGLISH LANGUAGE LEARNERS. 

(a) IN GENERAL.—The Secretary, in consultation with the Secretary of Education, 

shall make grants, on a competitive basis, to eligible applicants to enable such applicants to support and expand local efforts to deliver services through quality programs of early childhood home visitation to eligible families with English language 

learners. 

(b) ELIGIBLE APPLICANT.—In this section, the term ‘‘eligible applicant’’ means—

(1) 1 or more local educational agencies (as defined in section 9101 of the Elementary and Secondary Education Act of 1965 (20 U.S.C. 7801)); and 

(2) 1 or more public or private community-based organizations or agencies 

that serve eligible families and are capable of establishing and implementing 

high quality programs of early childhood home visitation. 


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(c) APPLICATIONS.—An eligible applicant that desires to receive a grant under this 

section shall submit an application to the Secretary at such time, in such manner, 

and containing such information as the Secretary may require. The application shall 

include a description of— (1) the results of a communitywide needs assessment that demonstrates the 

need for services to eligible families with English language learners and describes—

(A) community demographics; 

(B) the quality and capacity of existing programs of early childhood home 

visitation for eligible families with English language learners in the community; 

(C) the gaps in programs of early childhood home visitation for eligible 

families with English language learners in the community; and 

(D) the type of program of early childhood home visitation necessary to 

address the gaps identified; 

(2) the program of early childhood home visitation that will be supported by 

the grant under this section; 

(3) how the proposed program of early childhood home visitation will promote 

positive parenting skills and children’s early learning and development; 

(4) how the proposed program of early childhood home visitation will incorporate the authorized activities described in subsection (e); 

(5) how services provided through a grant under this section will use materials that are appropriate for eligible families with English language learners; 

(6) how the activities under this section will build on and promote coordination among existing programs of early childhood home visitation, if such programs exist in the community, in an effort to promote an array of home visitation that ensures more eligible families with English language learners are 

being served and are getting the most appropriate services to meet their needs; 

(7) how the program will ensure that—

(A) where appropriate to the program goals of the home visiting model, 

families participating in early childhood home visitation programs with 

English language learners will be introduced to and connected with their 

local schools to encourage ongoing parental involvement in their children’s 

education; and 

(B) the activities under this section will support the preparation of children for school; 

(8) how channels of communication will be established between staff of programs of early childhood home visitation and staff of other early childhood education programs, such as Head Start programs carried out under the Head 

Start Act (42 U.S.C. 9831 et seq.) and Early Head Start programs carried out 

under section 645A of such Act, preschool programs, and child care programs, 

to facilitate the coordination of services for eligible families with English language learners; 

(9) how eligible families with English language learners will be recruited and 

retained to receive services under this section; 

(10) how training and technical assistance will be provided to help the staff 

of programs of early childhood home visitation involved in activities under this 

section to more effectively serve eligible families with English language learners; 

(11) how the eligible applicant will evaluate the activities supported under 

this section in order to demonstrate outcomes related to the—

(A) number of eligible families with English language learners served by 

programs of early childhood home visitation; 

(B) parental knowledge of early learning and development; 

(C) positive parenting practices related to early learning and development; and 

(D) children’s cognitive, language, social-emotional, and physical development; 

(12) how the proposed program will conduct outreach activities to target both 

mothers and fathers and increase father involvement where safe and appropriate; and 

(13) such other information as the Secretary may require. 

(d) APPROVAL OF APPLICATIONS.—

(1) IN GENERAL.—The Secretary shall select applicants for funding under this 

section based on the quality of the applications and the recommendations of a 

peer review panel, as described in paragraph (2). 

(2) PEER REVIEW PANEL.—The peer review panel shall include not fewer 

than—

(A) 2 individuals who are experts in the field of home visitation; 


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(B) 2 individuals who are experts in early childhood development; 

(C) 2 individuals who are experts in serving eligible families with English 

language learners; 

(D) 1 individual who is a board certified pediatrician or a developmental 

pediatrician; and 

(E) 1 individual with expertise in administering public or private (including community-based) child maltreatment prevention programs. 

(e) AUTHORIZED ACTIVITIES.—Each eligible applicant that receives a grant under 

this section shall carry out the following activities: 

(1) Providing to as many eligible families with English language learners as 

practicable, voluntary early childhood home visitation, on not less frequently 

than a monthly basis, through the implementation of quality programs of early 

childhood home visitation that are research-based that provide parents with—

(A) knowledge of age-appropriate child development in cognitive, language, social-emotional, and motor domains; 

(B) knowledge of realistic expectations of age-appropriate child behaviors; 

(C) knowledge of health and wellness issues for children and parents; 

(D) modeling, consulting, and coaching on parenting practices; 

(E) skills to interact with their child to enhance age-appropriate development; 

(F) skills to recognize and seek help for issues related to health, developmental delays, and social, emotional, and behavioral skills; and 

(G) activities designed to help parents become full partners in the education of their children. 

(2) Ascertaining what health and developmental services the family receives 

and working with these providers to eliminate gaps in service by offering annual health, vision, hearing, and developmental screening for children from 

birth to entry into kindergarten, when not otherwise provided. 

(3) Providing referrals for participating eligible families with English language learners, as needed, to additional resources available in the community, 

such as center-based early education programs, child care services, health or 

mental health services, family literacy programs, employment agencies, social 

services, and child care resource and referral agencies. 

(4) Offering group meetings (at program discretion), on not less frequently 

than a monthly basis, for eligible families with English language learners 

that—

(A) further enhance the information, activities, and skill-building addressed during home visitation; 

(B) offer opportunities for parents to meet with and support each other; 

and 

(C) address challenges facing eligible families with English language 

learners. 

(5) Providing training and technical assistance to early childhood home visitation staff relating to—

(A) effective service to eligible families with English language learners, 

including skills to address challenges facing English language learners; 

(B) effective methods of implementing parent education, conducting home 

visiting, and promoting quality early childhood development, with sensitivity to cultural variations in parenting norms and attitudes toward formal 

support services; 

(C) the relationship of health and well-being of pregnant women to prenatal and early child development; 

(D) early childhood development with respect to children from birth until 

entry into kindergarten; 

(E) methods to help parents promote emergent literacy in their children 

from birth until entry into kindergarten; 

(F) implementing strategies for helping eligible families with English language learners coping with a crisis; 

(G) recruiting, supervising, and retaining qualified staff; 

(H) increasing services for underserved eligible families with English language learners; 

(I) methods to help parents effectively respond to their children’s needs 

and behaviors; 

(J) implementation of ongoing program quality improvement and evaluation of activities and outcomes; and 

(K) the relationship of father involvement to the health and well-being of 

pregnant women and to prenatal and early childhood development. 


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(6) Coordinating existing programs of early childhood home visitation in order 

to effectively and efficiently meet the needs of more eligible families with 

English language learners. 

(f) REPORTING REQUIREMENTS.—Each applicant that receives a grant under this 

section to carry out a program shall submit an annual report to the Secretary, and 

the lead State agency as described in section 4(c)(1), regarding the progress of such 

program in addressing the purposes of this Act. Such report shall include, at a minimum, a description of— (1) actual service delivery provided under the grant including— (A) program characteristics including descriptive information on the service model used and actual program performance; 

(B) provider characteristics including staff qualifications, work experience, and demographic characteristics; 

(C) recipient characteristics including number, demographic characteristics, and rates of family retention in programs; and 

(D) an estimate of annual program implementation costs; 

(2) recipient outcomes that are consistent with program goals including, 

where appropriate given the program being evaluated— (A) parental practices; 

(B) child health and development indicators; 

(C) child maltreatment indicators; 

(D) school readiness indicators; and 

(E) links to community services; 

(3) the research-based instruction, materials, and activities being used in the 

activities funded under the grant; and 

(4) the training and technical assistance, including ongoing professional development, provided to programs supported under the grant. 

(g) SUPPLEMENT NOT SUPPLANT.—Grant funds provided under this section shall 

be used to supplement, and not supplant, Federal and non-Federal funds available 

for carrying out the activities described in this section. 

(h) AUTHORIZATION OF APPROPRIATIONS.—There is authorized to be appropriated to carry out this section $20,000,000 for fiscal year 2009 and such sums for fiscal 

years 2010 through 2013. 

SEC. 6. TARGETED GRANTS FOR EARLY CHILDHOOD HOME VISITATION FOR MILITARY FAMILIES. 

(a) IN GENERAL.—The Secretary of Defense, in consultation with the Secretary of 

Education and the Secretary of Health and Human Services, shall make grants, on 

a competitive basis, to eligible applicants to enable such applicants to support and 

expand efforts to deliver services through high quality programs of early childhood 

home visitation to eligible families with a family member in the Armed Forces. 

(b) ELIGIBLE APPLICANT.—In this section, the term ‘‘eligible applicant’’ means any 

of the following: 

(1) A local educational agency that receives payments under title VIII of the 

Elementary and Secondary Education Act of 1965 (20 U.S.C. 7701 et seq.). 

(2) A school of the defense dependents’ education system under the Defense 

Dependents’ Education Act of 1978 (20 U.S.C. 921 et seq.). 

(3) A school established under section 2164 of title 10, United States Code. 

(4) A community-based organization serving families with a family member 

in the Armed Forces. 

(c) APPLICATIONS.—An eligible applicant that desires to receive a grant under this 

section shall submit an application to the Secretary of Defense at such time, in such 

manner, and containing such information as the Secretary of Defense may require. 

The application shall include a description of— (1) the results of a communitywide needs assessment that demonstrates the 

need for services to eligible families with a family member in the Armed Forces 

and describes— (A) community demographics; 

(B) the quality and capacity of existing programs of early childhood home 

visitation for eligible families with a family member in the Armed Forces; 

(C) the gaps in programs of early childhood home visitation for eligible 

families with a family member in the Armed Forces; and 

(D) the type of program of early childhood home visitation necessary to 

address the gaps identified; 

(2) the program of early childhood home visitation that will be supported by 

the grant under this section; 

(3) how the proposed program of early childhood home visitation will promote 

positive parenting skills and children’s early learning and development; 

(4) how the proposed program of early childhood home visitation will incorporate the authorized activities described in subsection (f); 


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(5) how services provided through a grant under this section will use materials that are appropriate toward eligible families with a family member in the 

Armed Forces; 

(6) how the activities under this section will build on and promote coordination with existing programs of early childhood home visitation, if such programs 

exist in the community, in an effort to promote an array of home visitation that 

ensures more eligible families with a family member in the Armed Forces are 

being served and are getting the most appropriate services to meet their needs; 

(7) how the program will ensure that— (A) where appropriate to the program goals of the home visiting model, 

families participating in early childhood home visitation programs with a 

family member in the Armed Forces will be introduced to and connected 

with their local schools to encourage ongoing parental involvement in their 

children’s education; and 

(B) the activities under this section will support the preparation of children for school; 

(8) how channels of communication will be established between staff of programs of early childhood home visitation and staff of other early childhood education programs, such as Head Start programs carried out under the Head 

Start Act (42 U.S.C. 9831 et seq.) and Early Head Start programs carried out 

under section 645A of such Act, preschool programs, family support programs, 

and child care programs, to facilitate the coordination of services for eligible 

families with a family member in the Armed Forces; 

(9) how eligible families with a family member in the Armed Forces will be 

recruited and retained to receive services under this section; 

(10) how training and technical assistance will be provided to help programs 

of early childhood home visitation involved in activities under this section to 

more effectively serve eligible families with a family member in the Armed 

Forces; 

(11) how the eligible applicant will evaluate the activities supported under 

this section in order to demonstrate outcomes related to the—

(A) number of eligible families with a family member in the Armed 

Forces served by programs of early childhood home visitation; 

(B) parental knowledge of early learning and development; 

(C) positive parenting practices related to early learning and development; and 

(D) children’s cognitive, language, social-emotional, and physical development; 

(12) how the proposed program will conduct outreach activities to target both 

mothers and fathers and increase father involvement where safe and appropriate; and 

(13) such other information as the Secretary of Defense may require. 

(d) APPROVAL OF LOCAL APPLICATIONS.—

(1) IN GENERAL.—The Secretary of Defense shall select applicants for funding 

under this section based on the quality of the applications and the recommendations of a peer review panel, as described in paragraph (2). 

(2) PEER REVIEW PANEL.—The peer review panel shall include not fewer 

than—

(A) 2 individuals who are experts in the field of home visitation; 

(B) 2 individuals who are experts in early childhood development; 

(C) 2 individuals who are experts in family support for military families; 

(D) 1 individual who is a board certified pediatrician or developmental pediatrician; and 

(E) 1 individual with expertise in administering public or private (including community-based) child maltreatment prevention programs. 

(e) AUTHORIZED ACTIVITIES.—Each eligible applicant that receives a grant under 

this section shall carry out the following activities: 

(1) Providing to as many eligible families with a family member in the Armed 

Forces as practicable, voluntary early childhood home visitation, on not less frequently than a monthly basis, through the implementation of quality programs 

of early childhood home visitation that are research-based and that provide parents with—

(A) knowledge of age-appropriate child development in cognitive, language, social-emotional, and motor domains; 

(B) knowledge of realistic expectations of age-appropriate child behaviors; 

(C) knowledge of health and wellness issues for children and parents; 

(D) modeling, consulting, and coaching on parenting practices; 

(E) skills to interact with their child to enhance age-appropriate development; 


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(F) skills to recognize and seek help for issues related to health, developmental delays, and social, emotional, and behavioral skills; and 

(G) activities designed to help parents become full partners in the education of their children. 

(2) Ascertaining what health and developmental services the family receives 

and working with these providers to eliminate gaps in service by offering annual health, vision, hearing, and developmental screening for children from 

birth to entry into kindergarten, when not otherwise provided. 

(3) Providing referrals for participating eligible families with a family member 

in the Armed Forces, as needed, to additional resources available in the community, such as center-based early education programs, child care services, health 

or mental health services, family literacy programs, employment agencies, social 

services, and child care resource and referral agencies. 

(4) Offering group meetings (at program discretion), on not less frequently 

than a monthly basis, for eligible families with a family member in the Armed 

Forces that— (A) further enhance the information, activities, and skill-building addressed during home visitation; 

(B) offer opportunities for parents to meet with and support each other; 

and 

(C) address challenges facing eligible families with a family member in 

the Armed Forces. 

(5) Providing training and technical assistance to early childhood home visitation staff relating to—

(A) effective service to eligible families with a family member in the 

Armed Forces; 

(B) effective methods of implementing parent education, conducting home 

visiting, and promoting quality early childhood development, with sensitivity to cultural variations in parenting norms and attitudes toward formal 

support services; 

(C) the relationship of health and well-being of pregnant women to prenatal and early child development; 

(D) early childhood development with respect to children from birth until 

entry into kindergarten; 

(E) methods to help parents promote emergent literacy in their children 

from birth until entry into kindergarten; 

(F) implementing strategies for helping eligible families with a family 

member in the Armed Forces coping with crisis; 

(G) recruiting, supervising, and retaining qualified staff; 

(H) increasing services for underserved eligible families with a family 

member in the Armed Forces; 

(I) methods to help parents effectively respond to their children’s needs 

and behaviors; 

(J) implementation of ongoing program quality improvement and evaluation of activities and outcomes; and 

(K) the relationship of father involvement to the health and well-being of 

pregnant women and to prenatal and early childhood development. 

(6) Coordinating existing programs of early childhood home visitation in order 

to effectively and efficiently meet the needs of more eligible families with a family member in the Armed Forces. 

(f) REPORTING REQUIREMENTS.—Each applicant that receives a grant under this 

section to carry out a program shall submit an annual report to the Secretary, and 

the lead State agency as described in section 4(c)(1), regarding the progress of such 

program in addressing the purposes of this Act. Such report shall include, at a minimum, a description of—

(1) actual service delivery provided under the grant including—

(A) program characteristics including descriptive information on the service model used and actual program performance; 

(B) provider characteristics including staff qualifications, work experience, and demographic characteristics; 

(C) recipient characteristics including number, demographic characteristics, and family retention; and 

(D) an estimate of annual program implementation costs; 

(2) recipient outcomes that are consistent with program goals including, 

where appropriate given the program being evaluated—

(A) parental practices; 

(B) child health and development indicators; 

(C) child maltreatment indicators; 

(D) school readiness indicators; and 


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(E) links to community services; 

(3) the research-based instruction, materials, and activities being used in the 

activities funded under the grant; and 

(4) the training and technical assistance, including ongoing professional development, provided to programs supported under the grant. 

(g) SUPPLEMENT NOT SUPPLANT.—Grant funds provided under this section shall 

be used to supplement, and not supplant, Federal and non-Federal funds available 

for carrying out the activities described in this section. 

(h) AUTHORIZATION OF APPROPRIATIONS.—There are authorized to be appropriated to carry out this section $20,000,000 for fiscal year 2009 and such sums as may be 

necessary for fiscal years 2010 through 2013. 

SEC. 7. EVALUATION. 

(a) IN GENERAL.—From funds reserved under section 4(b)(1)(A), the Secretary 

shall conduct, through grant or contract, an independent evaluation of the effectiveness of home visitation programs carried out under this Act. 

(b) REPORTS.—

(1) INTERIM REPORT.—Not later than 2 years after the date of enactment of 

this Act, the Secretary shall submit an interim report on the evaluation conducted pursuant to subsection (a) to the Committee on Health, Education, 

Labor, and Pensions of the Senate and the Committee on Education and Labor 

of the House of Representatives. 

(2) FINAL REPORT.—Not later than 4 years after the date of enactment of this 

Act, the Secretary shall submit a final report on the evaluation conducted pursuant to subsection (a) to the committees described in paragraph (1). 

(c) STUDY.—The independent evaluation conducted under this section shall examine the following: 

(1) The effect of home visiting programs on child and parent outcomes, consistent with program goals, including, where appropriate given the program 

being evaluated, parental outcomes related to child health and development, 

parenting practices, child health and development, child maltreatment, school 

readiness, and links to community services. 

(2) The effectiveness of early childhood home visitation on different populations, including the extent to which variability exists in program ability to improve outcomes across programs and populations. 

SEC. 8. REPORTS TO CONGRESS. 

(a) IN GENERAL.—The Secretary shall annually provide a report to the Committee 

on Education and Labor in the House of Representatives and the Committee on 

Health, Education, Labor, and Pensions in the Senate, information on the activities 

carried out under this Act. 

(b) CONTENT.—The reports submitted under this section shall, at a minimum, include information about the programs carried out under this Act, including information on the following: 

(1) descriptions of the high need communities targeted by States for programs 

carried out under this Act; 

(2) the service delivery models funded under this Act; 

(3) program characteristics, including—

(A) staff qualifications and demographic characteristics; and 

(B) recipient characteristics including the number of families served, the 

demographic characteristics of the families served, and family retention and 

duration of services; 

(4) program-reported outcomes; 

(5) the findings from State evaluations; 

(6) the research-based instruction, materials, and activities being used in the 

activities funded under the grant; 

(7) the training and technical activities, including on-going professional development, provided to programs; and 

(8) the annual program implementation costs, including the cost per family 

served under the program. 

SEC. 9. SUPPORTING NEW PARENTS THROUGH HOSPITAL EDUCATION. 

(a) IN GENERAL.—The Secretary shall develop and implement a public information 

and educational campaign to inform the public and new parents about the importance of proper care for infants and children under 5 years of age, including healthy 

parent-child relationships, the demands and stress associated with caring for infants, positive responses to infants’ challenging behaviors including awareness of 

their social, emotional, and physical needs, awareness of the vulnerability of young 

children to abusive practices, and the signs and treatment of post-partum depression. 


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(b) ELEMENTS.—

(1) IN GENERAL.—The campaign developed under subsection (a) shall include 

the following elements: 

(A) The dissemination of educational and informational materials in 

print, audio, video, electronic, and other media. 

(B) The use of public service announcements and advertisements. 

(C) The dissemination of effective child abuse prevention practices and 

techniques, including information about research-based home visiting programs, respite care, crisis nurseries, and parent support networks, to parents, caregivers, maternity hospitals, children’s hospitals, pediatricians, 

child care centers, organizations providing prenatal and postnatal care, and 

organizations providing parenting education and support services. 

(D) Connection to existing parental involvement programs. 

(2) EXISTING PROGRAMS.—The Secretary, in implementing and executing the 

public information and educational campaign under this section, should seek 

collaboration with and referrals to existing parental involvement programs that 

specialize in strengthening children’s cognitive skills, early literacy skills, social 

or emotional and physical development and existing prenatal and early childhood home visitation programs. 

(3) EXISTING STATE REQUIREMENTS.—The Secretary, in implementing and executing the public information and educational campaign under this section, 

shall consider with pre-existing State requirements to ensure that no unnecessary burdens are placed on hospitals, military hospitals, and birth centers receiving educational materials. 

(c) AUTHORIZATION OF APPROPRIATIONS.—There are authorized to be appropriated 

to carry out this section such sums as may be necessary for fiscal years 2009 

through 2013. 

I. PURPOSE

The purpose of H.R. 2343, the ‘‘Education Begins at Home Act 

of 2008,’’ is to enable states, Indian tribes, tribal organizations, territories and possessions to deliver high quality programs of early 

childhood home visitation in order to promote positive outcomes for 

children and families by improving readiness for school, child 

health and development and positive parenting practices, and by 

reducing child maltreatment. 

II. COMMITTEE ACTION

110TH CONGRESS

Full Committee hearing on ‘‘H.R. 2343—Education Begins At Home 

Act’’ 

On Wednesday June 11, 2008, the Committee on Education and 

Labor held a hearing in Washington, D.C. entitled ‘‘H.R. 2343—

Education Begins At Home Act.’’ The hearing reviewed the research on home visitation programs, the components necessary for 

implementing high quality programs, and the prevention benefits 

of home visitation programs. Witnesses spoke in favor of H.R. 2343 

and highlighted how the legislation supports high quality programs. Testifying before the Full Committee were Heather Weiss, 

Ed.D., Founder and Director of the Harvard Family Research 

Project and Senior Research Associate and Lecturer at the Harvard 

Graduate School of Education; Laura A. Ditka, Esq., Allegheny 

County Deputy District Attorney and Chief of the Child Abuse 

Unit; Julie Fenley, mother of two children and military spouse and 

a participant in a home visiting program for military families; 

Makeda London, Program Manager, Healthy Families Program in 

Chicago, IL; William A. Estrada, Esq., Director of Federal Relations for Home School Legal Defense Association; and, Jeanne 


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Smart, R.N., M.S.N., Director, Nurse-Family Partnership, Los Angeles County. 

Legislative action 

On May 16, 2007, Representatives Danny Davis (D–IL) and Todd 

Platts (R–PA) introduced H.R. 2343, the ‘‘Education Begins at 

Home Act.’’ The bill authorizes $400 million over three years for 

the Secretary of Health and Human Services (HHS) to allot grants 

for programs of early childhood home visitation on a formula basis 

to states, Indian tribes, tribal organizations, territories, and possessions. To receive funds, states and other eligible entities must demonstrate how they will support activities that will improve parental 

practices, child health and development, school readiness, and links 

to community services, and how they will lessen child mistreatment. States also must demonstrate that funds are used for programs with strong organizational capacities that employ welltrained staff. H.R. 2343 identifies the critical elements of quality 

home visitation programs, while allowing states to select specific 

service models that reflect the quality elements. The Secretary of 

HHS and states must each set-aside specified funds for evaluations 

of programs. In addition, the bill authorizes $50 million over three 

years for competitive grants for early childhood home visitation 

programs for limited-English proficient families and another $50 

million over three years for such services for military families. 

Full Committee Markup of H.R. 2343 

On Wednesday, June 18, 2008 and Thursday, June 19, 2008, the 

Committee on Education and Labor considered H.R. 2343 in legislative session and reported the bill favorably, as amended, to the 

House of Representatives by voice vote. The Committee adopted the 

following amendments: 

1. An amendment in the nature of a substitute offered by Chairman Miller (D–CA) was adopted by voice vote. The amendment in 

the nature of a substitute contained minor technical changes and 

the following modifications to H.R. 2343: 

• Changes a $400 million authorization for fiscal years 2008–

2010 to a five-year authorization period with $150 million allotted 

for fiscal year 2009 and such sums thereafter. 

• Changes a $50 million authorization for fiscal years 2008–2010 

for military families to a five-year authorization period with $20 

million allotted for fiscal year 2009 and such sums thereafter. 

• Changes a $50 million authorization for fiscal years 2008–2010 

for English language learners to a five-year authorization period 

with $20 million allotted for fiscal year 2009 and such sums thereafter. 

• Requires states and other eligible entities to identify and 

prioritize serving communities in high need of home visitation services, such as communities with low student achievement, high 

rates of teen pregnancy, high proportions of low income families, 

high incidences of child abuse, high volumes of children with developmental delays or disabilities, large concentrations of individuals 

currently serving in the Armed Forces, and large concentrations of 

individuals who formerly served in the Armed Forces. 


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• Changes the formula to states from the proportion of children 

under age five to the proportion of children under age five from 

families with incomes below the poverty line. 

• Requires that programs funded under the Act adopt a home 

visiting model that is (1) research-based and grounded in knowledge related to home visiting and child health or child development, (2) linked to program-determined outcomes, (3) associated 

with an organization or institution that has comprehensive standards, including standardized training and on-going professional development, that has been evaluated and had results published in 

a peer-reviewed journal, and that has been in existence at least 

three years prior to being funded under the Act. 

• Adds a state match of ten percent in fiscal year 2011, twenty 

percent in fiscal year 2012, and thirty percent in fiscal year 2013. 

• Strikes changes to the Early Head Start program. 

• Strikes the requirement that hospitals offer parenting classes 

to new parents. 

2. An amendment offered by Representative Hinojosa (D–TX), 

was adopted by voice vote. The amendment improves the coordination of services to children and families with English language 

learners. 

The Committee rejected two amendments by rollcall vote. An 

amendment offered by Representative Souder (R–IN) was defeated 

by rollcall vote of 17–24, and an amendment offered by Representative Kuhl (R–NY) was defeated by rollcall vote of 17–25. 

III. SUMMARY OF THE BILL

Purpose 

The purpose of H.R. 2343, the Education Begins at Home Act of 

2008, is to expand access to high quality home visitation programs 

for young children and their families in order to help support and 

strengthen families, increase school readiness and improve academic achievement, and decrease the incidence of child abuse and 

neglect. 

Grants for Early Childhood Home Visitation 

H.R. 2343 authorizes $150 million in fiscal year 2009 and such 

sums as necessary for fiscal year 2010 through fiscal year 2013 for 

the Secretary of Health and Human Services (HHS), in consultation with the Secretary of Education, to allot grants to states, Indian tribes, tribal organizations, territories, and possessions for 

funding early childhood home visitation programs. State plans are 

approved through a peer review process and funds are distributed 

based upon the proportion of children under age five from families 

residing in the state whose incomes are below the poverty line. 

Three percent of funds may be used for federal administrative 

costs, two percent of funds are reserved for payments to Indian 

tribes or tribal organizations, and no more than .5 percent are reserved for payments to territories and possessions. Additionally, 

funds are reserved for an independent evaluation and training and 

technical assistance for states. 

To be eligible to receive funds under this bill, a state must submit an application that includes the results of a statewide needs 

assessment regarding home visitation services in the state; provide 


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an assurance that the state will reserve ten percent of funds to provide training and technical assistance to home visitation programs 

and three percent of funds for evaluations of home visitation programs; submit a state plan with information on the home visitation 

programs to be funded under the Act; submit information on how 

the lead state agency will promote collaboration among a broad 

range of child- and family-serving programs and other information. 

The state must also provide an assurance that the state will identify and prioritize serving communities that are in high need of 

home visitation services, such as communities with low student 

achievement, high rates of teen pregnancy, high proportions of low 

income families, high incidences of child abuse, high volumes of 

children with developmental delays or disabilities, large concentrations of individuals currently serving in the Armed Forces, and 

large concentrations of individuals who formerly served in the 

Armed Forces. 

In addition to using specified funds for evaluation and training 

and technical assistance, states shall use the funds provided under 

this Act to offer voluntary early childhood home visitation services 

to eligible families not less frequently than on a monthly basis. An 

eligible family includes a woman who is pregnant and the father 

of the child, and a parent or primary caregiver of a child under the 

age of entry into kindergarten. Primary caregivers may include foster parents, grandparents or other relatives of the child. 

H.R. 2343 also authorizes twenty million dollars in fiscal year 

2009 and such sums as may be necessary for fiscal year 2010 

through fiscal year 2013 for the Secretary of HHS, in consultation 

with the Secretary of Education, to fund through a competitive 

process, programs serving eligible families with English language 

learners. Applications are approved through a peer review process. 

Twenty million dollars are additionally authorized in fiscal year 

2009 and such sums as may be necessary for fiscal year 2010 

through fiscal year 2013 for the Secretary of Defense, in consultation with the Secretary of Education and the Secretary of HHS, to 

fund through a competitive process, programs serving eligible families with a family member in the Armed Forces. Applications are 

approved through a peer review process. 

Evaluation 

H.R. 2343 requires program evaluation by the Secretary of HHS 

and by states receiving funds. The bill requires three percent of 

funds be reserved for the Secretary to conduct an independent evaluation of the effectiveness of the home visitation programs carried 

out under the Act. No later than two years after the date of enactment of H.R. 2343, the Secretary of HHS must submit to the Committee on Education and Labor of the House of Representatives 

and the Committee on Health, Education, Labor, and Pensions of 

the Senate, an interim report on the evaluation. A final report on 

the evaluation must be submitted to these Committees no later 

than four years after the date of enactment of H.R. 2343. In addition, states must reserve three percent of funds for evaluations of 

the programs funded under this Act. Finally, local programs are required to use home visiting models linked to program-determined 

outcomes. 


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Public Awareness Campaign 

The bill authorizes such sums as may be necessary for the Secretary of HHS to implement a public information and educational 

campaign to inform the public and new parents about the importance of the first five years of life. 

IV. COMMITTEE VIEWS

The Committee believes investing in our nation’s children during 

their first years of life is critical to helping them arrive at school 

healthy and ready to succeed. H.R. 2343 reflects an important investment that will not only serve to strengthen families but will ultimately save taxpayer money by reducing the need for child welfare services and special education services and by decreasing the 

rate of school failure. Parents are children’s first and most important teachers and helping parents support their children’s development is essential. 

Research on brain and child development demonstrates that children’s experiences in the first five years of life have a lasting impact on their health, learning, and behavior. Approximately eightyfive percent of brain growth occurs in the first three years of life. 

In these early years of life, infant and toddler brains create 700 

new synapses per second. Synapses determine which neurons are 

activated in the brain, essentially affecting what the brain knows 

and what it can do. Neurons that are frequently activated by experiences and interactions are strengthened and those that do not get 

activated actually die or are ‘‘pruned.’’ 1 So, in fact, children’s experiences both positive and negative actually change brain architecture and brain chemistry.2 For example, one study found that infants whose mothers spoke to them more frequently knew almost 

300 more words by age two than children who were not spoken to 

as frequently.3 Conversely, exposure to chronic stress stimulates 

chemicals in the brain that limit the health and growth of synapses 

and negatively affect child health and behavior.4 For example, children who are abused and neglected develop physical and mental 

health problems.5 The Committee concludes that supporting 

healthy childhood experiences and reducing detrimental experiences are the best way to support early childhood development and 

provide children with the building blocks they need to succeed in 

school and in life. The relationship that forms between a parent 

and a child in these early years is vital to a child’s learning and 

behavior. 

Early Childhood Home Visitation Programs 

The Committee believes the high quality early childhood home 

visitation programs authorized under H.R. 2343 provide a proven 

and cost-effective method for supporting parents’ helping children, 

and strengthening families. Investment in these types of programs 

supports brain and child development and fosters healthy parentchild relationships. These voluntary programs provide parents and 

pregnant women with education and supportive services to help 

them better understand the learning and developmental needs of 

their children, build long-lasting positive parent-child bonds, and 

reduce family and parenting stress. The Committee understands 

that quality home visiting programs often link families to a variety 


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of community services, including adult and family literacy programs, child care services, early education programs, child care resource and referral agencies, early intervention programs, child 

abuse prevention and treatment programs, health and mental 

health services, nutrition services, substance abuse treatment services, domestic and family violence prevention programs, employment agencies, fatherhood programs, income support programs, 

English as a Second Language services, and schools. Home visitation program activities are designed to promote positive outcomes 

for children and families in the areas of school-readiness, improved 

child health and development, positive parenting practices, reductions in child mistreatment, and parents’ ability to support their 

children’s social-emotional, cognitive, language, and physical development. Different program models target different types of families, ranging from first-time teen mothers to families, regardless of 

income, with children in a specific age group. These programs typically provide services anywhere from a two- to a five-year period. 

At least thirty-seven states support home visiting programs. Yet, 

because of inadequate funding, only a small fraction of families 

who would benefit from such services are able to receive them.6

There is currently no dedicated federal funding stream for early 

childhood home visitation programs. Local programs are funded 

through a combination of state, local, private, and federal funds, 

such as the Child Abuse and Prevention Treatment Act (CAPTA), 

Early Head Start, Elementary and Secondary Education Act 

(ESEA), and Temporary Assistance for Needy Families (TANF). 

The Committee believes that a dedicated federal funding stream for 

home visitation programs would allow more families to receive 

these important services, reduce child abuse, and improve children’s achievement in school. 

Child Maltreatment 

Child abuse and neglect is a significant problem that can represent a toxic stress to brain and human development and have 

long-term consequences for children who suffer from abuse. According to the Department of Health and Human Services, an estimated 905,000 children were victims of maltreatment in fiscal year 

2006.7 The youngest children have the highest rate of victimization. For children age birth to one year, the rate of child victimization was 24.4 per 1,000 children. The victimization rate was 14.2 

per 1,000 children for children between age one and three, and the 

victimization rate was 13.5 per 1,000 children for children between 

four and seven years of age.8

The long-term effects of child abuse are far reaching and may include a higher risk for health and social problems as adults, for example, alcoholism, depression, drug abuse, eating disorders, obesity, sexual promiscuity, smoking, suicide, and certain chronic diseases.9 Furthermore, child abuse and neglect can have long-term 

economic and societal costs through increased use of the juvenile 

and adult criminal justice systems, the increased health care costs 

resulting from mental illness, substance abuse, and domestic violence, and the loss of economic productivity due to unemployment 

and underemployment. A 2007 report by Prevent Child Abuse 

America, estimated the annual cost to the United States of child 

abuse and neglect at approximately 104 billion dollars.10


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In 2006, approximately 83 percent of victims were abused by a 

parent acting alone or in concert with another.11 Some of the factors associated with parents who abuse or neglect their children, 

include physical and mental health problems, low cognitive functioning, lack of knowledge of child development and parenting 

skills, parental history of child abuse as a child, socio-economic status, job and marital situation, low self-esteem and feeling isolated, 

parent-child interaction, characteristics of the child, and one’s attitude toward children and violence.12

The Committee believes funding effective programs proven to reduce child abuse and neglect is a moral imperative. Early childhood 

home visitation programs provide a method for doing just that. 

This view of home visitation programs is shared by Joan E. Ohl, 

Commissioner for Children, Youth and Families at the Department 

of Health and Human Services.13 By working closely with families 

at risk for child abuse, home visitation programs reduce parent 

stress, improve parenting techniques, and ultimately decrease incidents of child abuse. 

School Readiness 

Children’s experiences prior to school entry have a lasting effect 

on learning and school success. Children who enter school behind 

their peers have great difficulty catching up and, on average, tend 

to stay behind their peers.14 The achievement gap in elementary 

and secondary school between low income students and their more 

advantaged peers begins before kindergarten.15 With nearly 12 million children under the age of five spending significant time in 

child care settings, efforts to improve the quality of child care and 

other early learning settings are critical to closing the achievement 

gap. Efforts to support the home environment so that families have 

the tools they need to help their children reach kindergarten 

healthy and ready to succeed are just as essential. Research demonstrates that home visitation programs are an effective method for 

supporting parents in their desire to educate their children. 

Research on Models of Home Visitation 

The Committee is keenly aware of the significant body of research surrounding high quality home visitation models. Such models are built upon extensive research on child development that 

demonstrates how influential parents and the home environment 

are to children’s school achievement, mental health, and behavior. 

Children’s early school achievement and literacy development are 

rooted in early adult-child communication and patterns of interaction.16 Family risk factors and family stress have short and long 

term effects on youth and adolescents.17 Home visitation programs 

aim to increase positive parenting practices, reduce harmful ones, 

and decrease family stress. 

Empirical evaluations of early childhood home visiting conclusively demonstrate its positive effect on children and families. 

Though some home visitation models target different populations 

and may aim to influence distinct child and family outcomes, there 

is research demonstrating the effectiveness of each of the major national home visitation program models: Early Head Start, Healthy 

Families America, Home Instruction for Parents of Preschool 

Youngsters, Parent-Child Home Program, Parents as Teachers, and 


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Nurse-Family Partnership. A meta-analysis of sixty studies on 

home visiting programs found such programs had a positive effect 

on children’s cognitive and socio-emotional development, improved 

parenting practices and maternal education, and aided in the prevention of child abuse.18 Another meta-analysis that included more 

recent studies also found a decrease in reports of abuse to child 

protective services and on child injuries.19 For example, children 

whose families participate in home visitation programs show improved school performance and behavior at kindergarten entry and 

through the sixth grade, lower high school dropout rates and higher graduation rates.20 Participation in home visitation programs 

decreases emergency room visits, and programs targeted to highrisk pregnant teenagers can cut incidences of child abuse nearly in 

half.21 Home visiting programs also lead to more positive health 

outcomes for mothers, increased intervals between births, less use 

of welfare and food stamps, and increased father involvement.22

Cost Benefits 

Investing in effective intervention programs in early childhood 

yields high economic benefits.23 Money invested in high quality 

home visitation programs reduces later costs to society. For example, community-based services to overburdened families are far less 

costly than the costs of child protective services, law enforcement, 

courts, foster care, health care, and the treatment of adults recovering from abuse.24 A report by Washington State found a return of a minimum of $2.88 for every dollar invested in the Nurse-Family Partnership program, with a return of $5.70 for higher risk populations. The government achieves saving by lowering costs for 

health care, child protection, education, criminal justice, mental 

health, and government assistance.25 A study by the RAND Corporation found cost benefits to a number of home visitation models.26 Therefore, the Committee views investment in high quality 

home visitation programs to be not only good education, welfare, 

and health policy, but strong fiscal policy as well. 

Targeting Services 

Home visiting programs may target specific at-risk populations 

and can sometimes provide a universal approach to service delivery. Local communities make different decisions about which type 

of model to use, with some localities choosing to provide a universal 

approach in order to decrease potential stigmatization or to screen 

families to determine the need for more intensive services. Universal approaches have clear benefits. In a 1995 report, the U.S. 

Advisory Board on Child Abuse and Neglect recommended a voluntary universal home visiting approach that reaches all families 

as an effective fatality prevention strategy.27 Research on universal 

models of home visiting finds that the school readiness of children 

from non-poor families is improved by participation in home visitation programs.28 Parent involvement in children’s education is also 

increased by universal home visitation programs.29 Moreover, home 

visitation programs promote early identification of developmental 

disabilities that occur in children regardless of socioeconomic level. 

However, given limited resources available for these programs, the 

Committee also recognizes the need to target resources to high 

need communities. 


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The Committee believes that H.R. 2343 strikes the right balance 

by targeting funds to high need communities while allowing states 

and local programs the flexibility to determine what type of model 

and approach best meets the needs of families within those communities. H.R. 2343 defines eligible families as those with a woman 

who is pregnant and the father of the child, if available, or a parent or primary caregiver of a child under the age of entry into kindergarten, including grandparents, foster parents, or other relatives of the child who serves as the primary caregiver of the child. 

H.R. 2343 requires states to identify and prioritize communities in 

high need of home visiting services, such as those with low student 

achievement, high rates of teen pregnancy, high proportions of low 

income families, high incidences of child abuse, high rates of children with developmental delays or disabilities, large concentrations 

of individuals who are English language learners, large concentrations of individuals currently serving in the Armed Forces, and 

large concentrations of individuals who formerly served in the 

Armed Forces. The bill also trusts the states and local programs to 

determine how to best serve the families in targeted communities. 

The Committee believes this flexibility is critical as it will allow 

local programs to evaluate an individual family’s needs and make 

a determination based on those needs. For example, a local program could use a family needs assessment to determine that the 

risk of child abuse within a specific family was greater for a different family who had slightly less income. Similarly, the bill will 

provide programs with the discretion to determine that the family 

with income over the poverty line and struggling to raise a child 

with autism was in greater need of services than the family with 

income under the poverty line who is still doing well. This approach allows rural areas, which often find service delivery a challenge because of the stigma perceived by potential clients, to use 

a combined universal and targeted approach. In the end, this combined approach will lead to families in high need communities 

being more engaged in programs and programs being more successful. Again, given the limited resources available for such programs, 

the Committee believes these funds should be appropriately targeted. However, the Committee finds that an approach that specifically limits services to families under the federal poverty line may 

undermine the ability of states and local programs to best target 

these funds to children at-risk. 

Program Quality and Accountability 

The Committee believes strong accountability is critical when 

funding a new federal program. H.R. 2343 includes numerous provisions to ensure funds will be spent appropriately and effectively. 

For example, the Committee intends that only programs using 

proven research-based home visitation models should receive funds 

under this Act. Research indicates that high quality and effective 

programs share key characteristics. These include having evaluation components that connect specific program elements to specific 

outcomes; providing services long enough that a positive relationship between parents and the service provider can be established; 

employing well-trained and competent staff who follow a standardized curriculum; implementing high quality supervision and ongoing professional development; having strong organizational caVerDate Aug 31 2005 07:17 Aug 05, 2008 Jkt 069006 PO 00000 Frm 00022 Fmt 6659 Sfmt 6602 E:\HR\OC\HR818P1.XXX HR818P1

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pacity; and, providing linkages to other community resources and 

supports.30 The bill requires states to fund only programs that 

meet these specific criteria and programs that adopt a clear and 

consistent model of home visitation that is research-based, grounded in empirically-based knowledge related to home visiting and 

child health or development; linked to program-determined outcomes; associated with a national organization or institution of 

higher education that has comprehensive home visitation standards; and has been in existence at least three years and has been 

evaluated, with the results of the evaluation published in a peerreviewed journal. This approach allows states to choose the specific 

home visiting programs that meet the needs of their communities, 

and will ensure that funds will go only to programs using a model 

proven to be effective and designed to ensure standardized training 

and on-going professional development that will ensure high quality service delivery and continuous program improvement. The 

Committee intends that the training of all home visitors draws on 

practices based in evidence and theory to the maximum extent 

practicable. For example, there are a variety of programs that train 

home visitors using research-based strategies to develop caregivers’

child-rearing skills in order to lower the likelihood of abuse or neglect and prepare children for school success. 

Moreover, H.R. 2343 requires state applications to be reviewed 

by a qualified panel of experts. Because the funds authorized in 

this bill represent a large investment, it is important that states 

demonstrate the capacity to use the funds wisely and effectively. 

The Committee recognizes that multiple professionals could serve 

as experts on childhood development, including psychologists or social workers with expertise in early child development and early 

childhood educators. The Committee believes the peer review panel 

will help ensure that objective and thorough consideration is given 

to each application. 

H.R. 2343 prioritizes program evaluation to ensure funds are 

spent effectively and that Congress, the Department of Health and 

Human Services, states, and local programs have the information 

they need to make wise funding decisions and program improvements. In addition to requiring local programs to use models that 

track program-determined outcomes, the bill requires the Department of Health and Human Services to set-aside funds to conduct 

an independent evaluation of the activities carried out by the bill. 

The bill also requires states to set aside funding to conduct evaluations of the programs they fund under the bill. The Committee believes evaluation of these programs will enhance program accountability and ensure that high quality programs receive funding. 

The Committee supports the focus on training and technical assistance in H.R. 2343 as it will improve program quality. The established national models of home visitation provide on-going training and technical assistance to local programs. Training and technical assistance activities support professional development, program improvement, and adherence to program standards and curriculum. By requiring set-asides for training and technical assistance, H.R. 2343 promotes program quality and integrity. 


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English Language Learners 

English language learners (ELL) are a growing subgroup of children in America and are at substantial risk for academic problems. 

The number of ELL children enrolled in schools in the United 

States has increased substantially in the past decade. During the 

2004–2005 academic year, there were an estimated 5.1 million ELL 

students enrolled in public pre-kindergarten, elementary, and secondary schools—a fifty-six percent increase since the 1994–1995 

school year.31 However, there is a larger share of ELL students in 

the lower grades, with approximately 52.6 percent enrolled in 

grades preK-five and 47.4 percent enrolled in grades six to 

twelve.32 Based on the 2005 National Assessment for Educational 

Progress, only twenty-nine percent of ELL eighth-grade students 

scored at or above the basic achievement level for mathematics. 

Only twenty-nine percent of ELL eighth graders scored at or above 

the basic achievement level for reading. Furthermore, Hispanic 

ELL students are less likely to complete high school than Hispanics who are fluent in English.33 Given these risks and the 

unique language development needs of ELL children and families, 

the Committee believes a competitive grant program targeted toward serving these children and their families is warranted. The 

Committee maintains that this will help ELL children arrive at 

school with better developed English language and literacy skills 

that will better prepare them to succeed in school. 

During Committee consideration of H.R. 2343, the minority offered an amendment to prohibit services to undocumented immigrant families. This amendment would have actually denied services to children who are United States citizens. The amendment 

was soundly defeated. Unfortunately, the proponents of this 

amendment rely upon the false impression that large numbers of 

ELL children are undocumented. To the contrary, research indicates that over ninety percent of children under age five of immigrants are United States citizens.34 It has also been shown that 

children of immigrants are at risk for slower cognitive and language development, as well as poor academic performance.35 The 

Committee is greatly concerned about any amendment that would 

deny services to children who are United States citizens. 

Military families 

Military families are experiencing many new and significant 

challenges, including multiple and extended deployments and the 

return of injured and disabled parents. These challenges, characterized by uncertainty, separation, and sometimes the loss of a parent or spouse, can create high levels of stress for children and their 

parents.36 Common conditions experienced by military families, 

such as geographic isolation and frequent and long separations, can 

be difficult for children. In pre-deployment periods, infants have 

been found to be fussy and change their eating habits. Preschoolers 

sometimes react by displaying tantrums, sadness, changes in eating patterns, and anxiety. Post- deployment concerns include the 

possibility of an increased risk of child abuse, especially for families 

with services members experiencing combat-related stress, posttraumatic stress disorder, or both. Recognizing the unique demands 

of military service and the need to support military families, the 

Congress provided appropriations for the Department of Defense to 


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fund early childhood home visitation programs for military families. This has provided support to families on twelve military bases 

but has not been sufficient funding to provide services to all families who may seek these services. 

The Committee greatly appreciates the effort and sacrifice of our 

Armed Forces and their families and strongly believes every effort 

should be made to support these families. Providing premiere 

health and mental health care to our active servicemen and women 

and our veterans is paramount. In addition, providing services such 

as home visitation programs, that can decrease family stress, assist 

with separations and reunions, and support parents and children, 

represent a key method of supporting military families and ensuring those parents have the tools they need to support healthy child 

development. 

H.R. 2343 addresses this need by authorizing $20 million for fiscal year 2009 and such sums thereafter through fiscal year 2013 

for home visiting programs for military families. 

V. SECTION-BY-SECTION ANALYSIS

Section 1. Short title 

Cites the short title as the ‘‘Education Begins at Home Act of 

2008.’’

Section 2. Findings and purposes 

Sets forth findings and the purpose of the bill. 

Section 3. Definitions 

Sets forth definitions for the terms ‘‘eligible family,’’ ‘‘English language learner,’’ ‘‘home visitation,’’ ‘‘Indian tribe,’’ ‘‘Secretary,’’

‘‘State,’’ ‘‘Territories and possessions,’’ and ‘‘tribal organization.’’

Section 4. Grants for Early Childhood Home Visitation 

Authorizes $150,000,000 for fiscal year 2009 and such sums as 

may be necessary for fiscal years 2010 through 2013 for the Secretary of Health and Human Services (HHS), in consultation with 

the Secretary of Education, to make grants to States, Indian tribes, 

tribal organizations, territories and possessions to establish or expand high quality programs of early childhood home visitation. Includes specific reservations for an independent evaluation, Federal 

administrative costs, payments to Indian tribes or tribal organizations, payments to territories and possessions, and training and 

technical assistance for States. State allotments are determined by 

formula. 

Includes requirements regarding the contents of state grant applications. Specifies the composition of a peer review panel to be 

convened to make recommendations to the Secretary regarding the 

approval of applications and the criteria which the panel shall consider when reviewing applicants. Includes the allow use of funds 

for states, including a reservation of 10 percent for providing training and technical assistance to early childhood home visitation programs and a cap of 5 percent for administrative purposes. 

Requires that states receiving funds under the Act maintain 

their aggregate expenditures within the State for early childhood 

home visitation, and additionally requires a state match of 10 perVerDate Aug 31 2005 07:17 Aug 05, 2008 Jkt 069006 PO 00000 Frm 00025 Fmt 6659 Sfmt 6602 E:\HR\OC\HR818P1.XXX HR818P1

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cent in fiscal year 2011, 20 percent in fiscal year 2012, and 30 percent in fiscal year 2013. Includes annual State reporting requirements to the Secretary. 

Section 5. Targeted grants for Early Childhood Home Visitation for 

Families with English Language Learners 

Authorizes $20,000,000 for fiscal year 2009 and such sums as 

may be necessary for fiscal years 2010 through 2013 for the Secretary of Health and Human Services, in consultation with the Secretary of Education, to make grants on a competitive basis to support and expand delivery of high quality early childhood home visitation programs to eligible families with English language learners. 

Defines eligible applicants and the requirements for applications by 

such entities. Specifies the process for peer review of grant applications. Includes an allowable use of funds and reporting requirements for grant recipients. Requires that grant funds supplement 

and not supplant Federal and non-Federal funds. 

Section 6. Targeted grants for Early Childhood Home Visitation for 

Military Families 

Authorizes $20,000,000 for fiscal year 2009 and such sums as 

may be necessary for fiscal years 2010 through 2013 for the Secretary of Defense, in consultation with the Secretary of HHS and 

the Secretary of Education, to make grants on a competitive basis 

to support and expand delivery of high quality early childhood 

home visitation programs to eligible families with a family member 

in the Armed Forces. Defines eligible applicants and the requirements for applications by such entities. Specifies the process for 

peer review of grant applications. Includes an allowable use of 

funds and reporting requirements for grant recipients. Requires 

that grant funds supplement and not supplant Federal and nonFederal funds. 

Section 7. Evaluation 

Requires the Secretary to conduct, through grant or contract, an 

independent evaluation of the effectiveness of home visitation programs carried out under the Act. Specifies a timeline for the Secretary to submit to Congress an interim report and a final report 

on the evaluation. 

Section 8. Reports to Congress 

Requires the Secretary to annually report to Congress on the activities carried out under the Act and specifies what information 

must be included in such reports. 

Section 9. Supporting New Parents Through Hospital Education 

Authorizes such sums as may be necessary for fiscal years 2009 

through 2013 for the Secretary to carry out a public information 

and educational campaign to inform the public and new parents 

about the importance of proper care for infants and children under 

5 years of age. 

VI. EXPLANATION OF AMENDMENTS

The Amendment in the Nature of a Substitute, as amended, is 

explained in the body of this report. 


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VII. APPLICATION OF LAW TO THE LEGISLATIVE BRANCH

Section 102(b)(3) of Public Law 104–1, the Congressional Accountability Act, requires a description of the application of this bill 

to the legislative branch. H.R. 2343 authorizes early childhood 

home visitation programs. The bill has no direct impact on legislative branch employees. 

VIII. UNFUNDED MANDATE STATEMENT

Section 423 of the Congressional Budget and Impoundment Control Act (as amended by Section 101(a)(2) of the Unfunded Mandates Reform Act, P.L. 104–4) requires a statement of whether the 

provisions of the reported bill include unfunded mandates. H.R. 

2343 contains no intergovernmental or private-sector mandates as 

defined by the Unfunded Mandates Reform Act (UMRA). 

IX. EARMARK STATEMENT

H.R. 2343 does not contain any congressional earmarks, limited 

tax benefits, or limited tariff benefits as defined in clauses 9(d), 

9(e) or 9(f) of rule XXI of the Rules of the House of Representatives. 

X. ROLL CALL


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XI. STATEMENT OF OVERSIGHT FINDINGS AND RECOMMENDATIONS OF

THE COMMITTEE

In compliance with clause 3(c)(1) of rule XIII and clause 2(b)(1) 

of rule X of the Rules of the House of Representatives, the Committee advises that the Committee’s oversight findings and recommendations are reflected in the body of this report. 

XII. NEW BUDGET AUTHORITY AND CBO COST ESTIMATE

With respect to the requirements of clause 3(c)(2) of rule XIII of 

the Rules of the House of Representatives and section 308(a) of the 

Congressional Budget Act of 1974 and with respect to requirements 

of 3(c)(3) of rule XIII of the Rules of the House of Representatives 

and section 402 of the Congressional Budget Act of 1974, the Committee has received the following estimate for H.R. 2343 from the 

Director of the Congressional Budget Office: 

U.S. CONGRESS, 

CONGRESSIONAL BUDGET OFFICE, 

Washington, DC, July 8, 2008. 

Hon. GEORGE MILLER, 

Chairman, Committee on Education and Labor, 

House of Representatives, Washington, DC. 

DEAR MR. CHAIRMAN: The Congressional Budget Office has prepared the enclosed cost estimate for H.R. 2343, the Education Begins at Home Act of 2008. 

If you wish further details on this estimate, we will be pleased 

to provide them. The CBO staff contact is Jonathan Morancy. 

Sincerely, 

ROBERT A. SUNSHINE

(For Peter R. Orszag, Director). 

Enclosure. 

H.R. 2343. Education Begins at Home Act of 2008 

Summary: H.R. 2343 would authorize the appropriation of $190 

million for 2009 and such sums as may be necessary for each year 

from 2010 through 2013 for grants to provide home visitation services during early childhood. In addition, the bill would authorize 

the appropriation of such sums as may be necessary for fiscal years 

2009 through 2013 to provide a public information and educational 

campaign regarding proper care for children under five years of 

age. 

CBO estimates that implementing the bill would cost $57 million 

in 2009 and $767 million over the 2009–2013 period, assuming the 

appropriation of the necessary amounts. Enacting H.R. 2343 would 

not affect direct spending or revenues. 

H.R. 2343 contains no intergovernmental or private-sector mandates as defined in the Unfunded Mandates Reform Act (UMRA); 

any costs to state, local, or tribal governments would be incurred 

voluntarily. 

Estimated cost to the Federal Government: The estimated budgetary impact of H.R. 2343 is shown in the following table. The costs 

of this legislation fall within budget functions 050 (national defense) and 500 (education, training, employment, and social services). 


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By fiscal year, in millions of dollars— 

2009 2010 2011 2012 2013 2009– 

2013 

CHANGES IN SPENDING SUBJECT TO APPROPRIATION 

Early Childhood Home Visitation: 

Estimated Authorization Level ............................................. 150 153 156 159 162 780 

Estimated Outlays ............................................................... 45 90 153 156 159 603 

Early Childhood Home Visitation—English Language Learners: 

Estimated Authorization Level ............................................. 20 20 21 21 22 104 

Estimated Outlays ............................................................... 6 12 20 21 21 80 

Early Childhood Home Visitation—Military Families: 

Estimated Authorization Level ............................................. 20 20 21 21 22 104 

Estimated Outlays ............................................................... 6 12 20 21 21 80 

Public Information and Education Campaign: 

Estimated Authorization Level ............................................. 1 1 1 1 1 5 

Estimated Outlays ............................................................... * 1 1 1 1 4 

Total Changes 

Estimated Authorization Level .................................... 191 194 199 202 207 993 

Estimated Outlays ...................................................... 57 115 194 199 202 767 

Note.—* = less than $500,000. 

Basis of estimate: For this estimate, CBO assumes that H.R. 

2343 will be enacted near the end of fiscal year 2008, the authorized amounts will be appropriated by the beginning of each fiscal 

year, and outlays will follow historical spending patterns. 

The bill would authorize appropriations for three programs to 

provide home visitation services during early childhood and would 

increase spending by $763 million over the 2009–2013 period, assuming appropriation of the estimated amounts. For each of those 

programs, the bill would authorize a specific amount for 2009 and 

such sums as may be necessary for the years 2010–2013. CBO assumes that the amount authorized for 2009 would be adjusted for 

inflation for each year through 2013. Specifically H.R. 2343 would: 

• Authorize the appropriation of $150 million for 2009 for grants 

to provide visitation services to all families. CBO estimates that 

implementing this program would increase discretionary costs by 

$603 million over the 2009–2013 period. 

• Authorize the appropriation of $20 million for 2009 for grants 

to provide visitation services targeted to families with individuals 

learning English. CBO estimates that implementing this program 

would increase discretionary costs by $80 million over the 2009–

2013 period. 

• Authorize the appropriation of $20 million for 2009 for grants 

to provide visitation services targeted to military families. CBO estimates that implementing this program would increase discretionary costs by $80 million over the 2009–2013 period. 

Finally, the bill would authorize such sums as may be necessary 

for fiscal years 2009 through 2013 to provide a public education 

campaign designed to teach new parents about the importance of 

proper care for children under five years of age. CBO estimates 

that this provision would cost $4 million over the 2009–2013 period, assuming the availability of appropriated funds. 

Estimated impact on state, local, and tribal governments: H.R. 

2343 contains no intergovernmental or private-sector mandates as 

defined in UMRA. Grant funds authorized in the bill would benefit 

state, local, and tribal governments that provide home visitation 

services to families with young children. Any costs those governments incur to comply with grant requirements, including proVerDate Aug 31 2005 07:17 Aug 05, 2008 Jkt 069006 PO 00000 Frm 00031 Fmt 6659 Sfmt 6602 E:\HR\OC\HR818P1.XXX HR818P1

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viding matching funds or submitting reports, would be incurred 

voluntarily. 

Estimate prepared by: Federal Costs: Jonathan Morancy. Impact 

on State, Local, and Tribal Governments: Lisa Ramirez-Branum. 

Impact on the Private Sector: Patrick Bernhardt. 

Estimate approved by: Keith Fontenot, Deputy Assistant Director 

for Health and Human Resources, Budget Analysis Division. 

XIII. STATEMENT OF GENERAL PERFORMANCE GOALS AND OBJECTIVES

In accordance with clause 3(c) of rule XIII of the House of Representatives, the goal of H.R. 2343 is to provide states, Indian 

tribes, tribal organizations, territories and possessions authority 

and funding, through the Secretary of Health and Human Services, 

to deliver high quality programs of early childhood home visitation. 

The Committee expects the Department of Health and Human 

Services to comply with H.R. 2343 and implement the changes to 

the law in accordance with these stated goals. 

XIV. CONSTITUTIONAL AUTHORITY STATEMENT

Under clause 3(d)(1) of rule XIII of the House of Representatives, 

the Committee must include a statement citing the specific powers 

granted to Congress in the Constitution to enact the law proposed 

by H.R. 2343. The Committee believes that the amendments made 

by this bill are within Congress’ authority under Article I, section 

8, clause 18 of the U.S. Constitution. 

XV. COMMITTEE ESTIMATE

Clause 3(d)(2) of rule XIII of the House of Representatives requires an estimate and a comparison of the costs that would be incurred in carrying out H.R. 2343. However, clause 3(d)(3)(B) of that 

rule provides that this requirement does not apply when the Committee has included in its report a timely submitted cost estimate 

of the bill prepared by the Director of the Congressional Budget Office under section 402 of the Congressional Budget Act. 

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

None. 

XVII. COMMITTEE CORRESPONENCE

None. 

ENDNOTES

1Testimony of Deborah Philips, Hearing, U.S. House of Representatives, Committee on Education and Labor, Investing in Early Education: Paths to Improving Children’s Success, January 

23, 2008. 2Presentation by Pat Levitt, Ph.D, Director, Vanderbilt Kennedy Center for Research on 

Human Development, U.S. House of Representatives, National Summit on America’s Children 

(‘‘National Summit’’), Washington D.C., May 22, 2007. 3 Huttenlocher, J., Haight, W., Bryk, A., Seltzer, M., & Lyons, T. (1991). Early vocabulary 

growth: Relation to language input and gender. Developmental Psychology, 27, 236–248. 4See Presentation by Megan Gunnar, Ph.D., Regents Professor and Distinguished McKnight 

University Professor, Institute of Child Development, University of Minnesota, U.S. House of 

Representatives, National Summit; see also Friedman, R.J & Chase-Lansdale, P.L. (2001), 

Chronic adversities, in M. Rutter and E. Taylor (Eds.), Child and Adolescent Psychiatry: Modern 

Approaches, 4th Edition. Blackwell Scientific Publications. 5Felitti, V., Anda, R., Nordenberg, D., Williamson, D., Spitz, A., Edwards, V., et al. (1998). 

Relationship of childhood abuse and household dysfunction to many of the leading causes of 

death in adults. American Journal of Preventive Medicine 1998;14(4):245–58; see also Presentation by Megan Gunnar, Ph.D., U.S. House of Representatives, National Summit. 


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6Gomby, D.S., ‘‘Home Visitation in 2005: Outcomes for Children and Parents’’, Working Paper 

No 7, Invest in Kids Working Group, July 2005. Available at www.ced.org/projects/kids.shtml 7 U.S. Department of Health and Human Services, Administration on Children, Youth and 

Families, Children.s Bureau, Child Maltreatment: 2006 (Washington, D.C.: U.S. Government 

Printing Office, 2008). 8 U.S. Department of Health and Human Services, Administration on Children, Youth and 

Families, Children’s Bureau, Child Maltreatment: 2006. Table 3–9. (Washington, D.C.: U.S. Government Printing Office, 2008). 9D. Cicchetti, S. Toth and F. Rogosch, (2000). The development of psychological wellness in 

maltreated children, in D. Cicchetti, J. Rappaport, I. Sandler and R.P. Weissberg, Editors, The 

promotion of wellness in children and adolescents, Child Welfare League of America Inc, Washington, pp. 395–426; Corso, P.S., Edwards, V.J., Fang, X.M., Mercey, J.A (2008). Health-related 

quality of life among adults who experienced maltreatment during childhood. American Journal 

of Public Health 98 (6): 1094–1100; Pelcovitz, D., Kaplan, S.J., DeRosa, R.R., Mandel, F.S., and 

Salzinger, S. (2000). Psychiatric disorder in adolescents exposed to violence and physical abuse, 

American Journal of Orthopsychiatry 70, pp. 360–369. 10Wang, C.T. & Holton, J. September 2007. Total Estimated Cost of Child Abuse and Neglect 

in the United States. Economic Impact Study. Prevent Child Abuse America. Chicago, IL. 11 U.S. Department of Health and Human Services, Administration on Children, Youth and 

Families, Children’s Bureau, Child Maltreatment: 2006 (Washington, D.C.: U.S. Government 

Printing Office, 2008). 12Felitti V, Anda R, Nordenberg D, Williamson D, Spitz A, Edwards V, et al. (1998). Relationship of childhood abuse and household dysfunction to many of the leading causes of death in 

adults. American Journal of Preventive Medicine, 14(4):245–58; Runyan D, Wattam C, Ikeda R, 

Hassan F, Ramiro L. Child abuse and neglect by parents and other caregivers, in Krug E, 

Dahlberg LL, Mercy JA, Zwi AB, Lozano R, editors. World Report on Violence and Health. Geneva, Switzerland: World Health Organization; 2002. p. 59–86. Available from URL: www.who.int/ 

violencelinjurylprevention/violence/globallcampaign/en/chap3.pdf 13 Centers for Disease Control and Prevention. Transcript, April 3, 2008. http://www.cdc.gov/ 

media/transcripts/2008/t080403.htm 14 Ramey, C.T., & Ramey, S.L. (2004). Early learning and school readiness: Can early intervention make a difference? Merrill-Palmer Quarterly, 50 (4), 471–491; Entwisle, D.R. (1995). 

The role of schools in sustaining benefits of early childhood programs. The Future of Children, 

5, 133–144. 15 U.S. Department of Education, National Center for Education Statistics. Early Childhood 

Longitudinal Study, Kindergarten Class of 1998–1999. 16Presentation by Dolores Norton, Ph.D, Samuel Deutsch Professor, School of Social Services 

Administration, University of Chicago, U.S. House of Representatives, National Summit. 17Forehand, R., Biggar, H., & Kotchik, B.A. (1998). Cumulative risk across family stressors: 

Short- and long-term effects for adolescents. Journal of Abnormal Child Psychology, 26(2), 119– 128. 18Sweet, M.A. & Appelbaum, M.I. (2004), Is home visiting an effective strategy? A meta-analytic review of home visiting programs for families with young children, Child Development, 

75(5):1435–1456. 19Geeraert, L., Van den Noorgate, W., Grietens, H., and Onghena, P. (2004). The effects of 

early prevention programs for families with young children at risk for physical child abuse and 

neglect: A meta-analysis. Child Maltreatment, 9(3), 277–291. 20 Bradley, R. & Gilkey, B. (2002). The impacts of the Home Instructional Program for Preschool Youngsters on school performance in 3rd and 6th grade. Early Education and Development, 13(3), 302–311; Levenstein, P., Levenstein, S., Shiminski, J. & Stolzberg, J. (1998). Longterm impact of a verbal interaction program for at-risk toddlers: An exploratory study of high 

school outcomes in a replication of the Mother-Child Home Program. Journal of Applied Developmental Psychology, 19, 267–285. 21Olds, D.L., Kitzman, H., Hanks, C., Cole, R., Anson, E., Sidora, K., Luckey, D.W., Henderson, C., Holmberg, J., Tutt, R.A., et al. (2007). Effects of nurse home visiting on maternal and 

child functioning: age-nine follow-up of randomized trial. Pediatrics, 120(4): 832–45. Olds, D.L., 

Robinson, J., Pettitt, L., Luckey D.W., Holmbery J., Ng, R.K., Isacks, K., Sheff, K. (2004). Effects 

of home visits by paraprofessionals and by nurses: age-four follow-up of a randomized trial. Pediatrics, 114(6): 560–8. 22Olds, D.L., Kitzman, H., Cole, R., Robinson, J., Sidora, K., Luckey, D., Henderson, C., 

Hanks, C., Bondy, J., Homberg, J. Effects of nurse home visiting on maternal life-course and 

child development: age-six follow-up of randomized trial. Pediatrics, 114(6): 1550–9. 23Keynote Address by James Heckman, Professor of Economics, Director of the Center for Social Program Evaluation, Harris School of Public Policy, University of Chicago, U.S. House of 

Representatives, National Summit. 24 U.S. General Accounting Office (1992). Child Abuse: Prevention Programs Need Greater 

Emphasis. GAO/HRS–92–99. 25Testimony of Michelle Ridge, Hearing, U.S. House of Representatives Subcommittee on 

Education Reform, September 27, 2006. 26Karoly, L., Kilburn, M.R., and Cannon, J.S. (2005). Early Childhood Interventions: Proven 

Results, Future Promise. 27 U.S. Advisory Board on Child Abuse and Neglect (1995) A Nation’s Shame: Fatal Child 

Abuse and Neglect in the United States. 28Zigler, E., Pfannenstiel, J.C., & Seitz, V. (2008). The Parents as Teachers program and 

school success: A replication and extension. Journal of Primary Prevention, 29, 103–120. 29Pfannenstiel, J. (1998). New Parents as Teachers project: A follow-up investigation. Overland Park, KS: Research & Training Associates. 30Testimony of Deborah Daro, Hearing, U.S. House of Representatives Subcommittee on Education Reform, Perspectives on Early Childhood Home Visitation Programs, September 27, 2006; 


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see also Testimony of Heather B. Weiss, Hearing, U.S. House of Representatives Committee on 

Education and Labor, H.R. 2343, The Education Begins at Home Act, June 11, 2008. 31Pearson, G. (2006). Ask NCELA No. 1: How many school-aged English language learners 

(ELLs) are there in the U.S.?’’ Washington, DC: National Clearinghouse for English Language 

Acquisition and Language Instruction Education Programs, http://www.ncela.gwu.edu/expert/ 

faq/011eps.htm. 32Fix, M. & Passel, J. (January 2003). U.S. Immigration Trends and Implications for Schools. 

Washington DC: Immigration Studies Program, Urban Institute. 33Fry, R. (2003). Hispanic Youth Dropping Out of U.S. Schools: Measuring the Challenge. 

Washington, DC: Pew Hispanic Center. 34 Calderon, M. (2007). Buenos Principios: Latino Children in the Earliest Years of Life (Washington, DC: National Council of La Raza), iv, available at http://www.nclr.org/content/publications/download/45609 35See, e.g., Fry, R. (2003). Hispanic Youth Dropping Out of U.S. Schools: Measuring the Challenge. Washington, DC: Pew Hispanic Center; Calderon, M. (2007). Buenos Principios: Latino 

Children in the Earliest Years of Life (Washington, DC: National Council of La Raza), iv, available at http://www.nclr.org/content/publications/download/45609 36 Johnson, SJ.J., Sherman, M.D., Hoffman, J.S., Johnson, P.L. et al. (February 2007). The 

Psychological Needs of the U.S. Military Service Members and Their Families: A Preliminary 

Report. American Psychological Association. Presidential Task Force on Military Deployment 

Services for Youth, Families, and Service Members. Washington DC. 


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MINORITY VIEWS 

Republican Members of the Committee on Education and Labor 

believe that parents play an essential role in a child’s development. 

Committee Republicans understand that home visitation programs 

can increase school readiness and promote positive parenting practices. Further, home visitation assists in child abuse and neglect 

prevention and in the early identification of developmental and 

health delays. While Committee Democrats worked to come to a 

compromise on the bill’s language for markup, Committee Republicans believe there is still work to be done to strengthen the language. We are concerned that the only two amendments offered by 

Republicans were rejected, even though they would have strengthened the bill. 

CHANGES FROM THE INTRODUCED BILL TO THE MARKUP SUBSTITUTE

During the Committee markup of H.R. 2343, Chairman George 

Miller (D–CA) offered an Amendment in the Nature of a Substitute 

that made several essential changes to the introduced bill. Most 

importantly, in order to ensure that the most disadvantaged families are taken into consideration, the amendment included changes 

to the funding formula to be based on the number of children aged 

birth to 5 years from families whose income is below the poverty 

line. Additionally, a provision that required States to provide an assurance that they will prioritize serving communities that are in 

high need of services was included. 

The Substitute also made a handful of other changes to the introduced bill that Republicans believe will help make the legislation 

stronger. This includes changing the structure of the authorization 

of appropriations to span 5 years; authorizing $150 million for the 

first year of the State grant program and $20 million each for the 

first year of the English language learner and military family targeted programs; and requiring programs receiving funding to adopt 

a clear, consistent model that is research based, linked to program 

determined outcomes, and has been in existence at least 3 years. 

The Substitute also ensured that representatives from home visitation programs are included in an existing State level early childhood coordinating body such as the State Advisory Council on 

Early Childhood Care and Education as defined in Head Start 

(striking the original requirement for the coordinating body to include a variety of representatives from child welfare programs, 

child health insurance programs, food stamp programs, etc.). The 

Substitute included a State match requirement beginning in Fiscal 

Year 2011 at 10 percent growing to a match of 30 percent in Fiscal 

Year 2013. Finally, the Substitute removed language requiring parents to sign a written waiver if they do not wish to participate in 

a parent training class. 


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36 

TARGETING PROGRAMS TO THOSE MOST IN NEED AND ENSURING

ONLY LEGAL U.S. RESIDENTS AND CITIZENS CAN PARTICIPATE IN

THE FEDERALLY FUNDED PROGRAM

Unfortunately, the two Republican amendments offered during 

the Committee markup were not accepted. Committee Republicans 

believe that these amendments would have made the bill a great 

deal stronger. 

Congressman Mark Souder (R–IN) offered an amendment to 

prioritize services for low-income participants at or below the poverty level. As introduced, the bill does not contain a requirement 

that States and other eligible entities ensure program participants 

are the most economically disadvantaged citizens. The Souder 

amendment simply asked States applying for home visitation 

grants from the Federal government to provide assurances that 

low-income families would be given priority for participation as 

well as those communities in high need of home visitation services, 

to the extent feasible. Committee Republicans agree that local communities are the best judge of those in need of services within the 

community, and that’s why the Souder amendment was crafted deliberately as a priority for the funding, while still maintaining 

flexibility at the local level. However, we believe that Federal funds 

must be used to serve those in greatest need first; without a priority for serving those who are most disadvantaged, Republicans 

believe there is a danger that funds could be siphoned away by 

higher income communities who may be more savvy and able to access services without Federal assistance. This amendment provided 

flexibility for programs to serve other participants in need of services, as long as priority was first given to those low-income families 

in need of services. This amendment was defeated on a party line 

vote. 

Congressman Randy Kuhl (R–NY) offered an amendment to ensure that only legal residents are allowed to receive the benefit of 

Federally-funded home visitation programs. The bill as currently 

drafted defines an eligible family as a woman who is pregnant and 

the father of the child, or a parent or primary caregiver of a child 

prior to entry into kindergarten. While Committee Democrats 

argue that this amendment would deny services to children who 

are United States citizens, it is clear to Committee Republicans 

that services provided for in this legislation are to and for parents. 

These services may in some way benefit children but the services 

are not education services provided directly to children but rather 

social services offered to parents and, therefore, this amendment 

would not have denied any services to U.S. citizens. There is no restriction or requirement in that definition that program participants be legal residents or U.S. citizens. The Kuhl amendment 

would have ensured that only individuals who are legal residents 

or citizens of the United States could take part in this program as 

defined by the term ‘‘eligible family’’ in the bill. Committee Republicans do not believe that individuals who enter the United States 

illegally should be able to participate in supplemental programs 

funded with Federal tax dollars. We believe that this bill must be 

clarified to ensure that this country’s limited Federal funds are 

used to serve only those who are in this country legally. UnfortuVerDate Aug 31 2005 07:17 Aug 05, 2008 Jkt 069006 PO 00000 Frm 00036 Fmt 6604 Sfmt 6604 E:\HR\OC\HR818P1.XXX HR818P1

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37 

nately, this amendment was not accepted by the Committee; it 

failed by a vote of 17 to 25. 

CONCLUSION

Committee Republicans appreciate that Committee Democrats 

were willing to work in a bipartisan fashion on this legislation. 

While the Substitute was an improvement, it was not perfect. And 

so, Committee Republicans look forward to a continued dialogue as 

this bill moves through the legislative process. It is always dangerous when the Federal government seeks to take on the role of 

the parent; thus, we must guard closely against Federal overreaching. The emphasis of this legislation should not be on replacing parental responsibility or involvement, but on supporting those 

parents in need and encouraging positive family development. This 

legislation will benefit from more stringent targeting for our most 

disadvantaged citizens and assurances that only legal residents 

and citizens of the United States can partake in these new Federally-funded programs. 

BUCK MCKEON. 

CATHY MCMORRIS RODGERS. 

KENNY MARCHANT. 

MARK SOUDER. 

C. W. BOUSTANY, Jr. 

RANDY KUHL. 

TODD R. PLATTS. 

RIC KELLER. 

DAVID DAVIS. 

JOE WILSON. 

TIM WALBERG. 

JOHN KLINE. 

Æ 


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