II 

111TH CONGRESS 

1ST SESSION S. 1267 

To amend title V of the Social Security Act to provide grants to establish 

or expand quality programs providing home visitation for low-income 

pregnant women and low-income families with young children, and for 

other purposes. 

IN THE SENATE OF THE UNITED STATES 

JUNE 16, 2009 

Mr. MENENDEZ (for himself and Mr. CASEY) introduced the following bill; 

which was read twice and referred to the Committee on Finance 

A BILL 

To amend title V of the Social Security Act to provide 

grants to establish or expand quality programs providing 

home visitation for low-income pregnant women and lowincome families with young children, and for other purposes. 

1 Be it enacted by the Senate and House of Representa2 tives of the United States of America in Congress assembled, 

3 SECTION 1. SHORT TITLE. 

4 This Act may be cited as the ‘‘Evidence-Based Home 

5 Visitation Act of 2009’’. 


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1 SEC. 2. GRANTS FOR QUALITY HOME VISITATION PRO2 GRAMS FOR LOW-INCOME PREGNANT WOMEN 

3 AND LOW-INCOME FAMILIES WITH YOUNG 

4 CHILDREN. 

5 Title V of the Social Security Act (42 U.S.C. 701 

6 et seq.) is amended by adding at the end the following: 

7 ‘‘SEC. 511. SEPARATE PROGRAM OF HOME VISITATION FOR 

8 LOW-INCOME PREGNANT WOMEN AND LOW9 INCOME FAMILIES WITH YOUNG CHILDREN. 

10 ‘‘(a) PURPOSE.—The purpose of this section is to im11 prove the well-being and development of children by ena12 bling the establishment and expansion of quality programs 

13 providing voluntary home visitation services to low-income 

14 pregnant women and low-income families with young chil15 dren. 

16 ‘‘(b) ACTIVITIES.—The Secretary shall take all nec17 essary steps to accomplish the purposes of this section, 

18 including the following: 

19 ‘‘(1) COMPETITIVE PLANNING GRANTS.—The 

20 Secretary shall award planning and start-up grants 

21 to local agencies to help them qualify for operating 

22 grants described in paragraph (2). 

23 ‘‘(2) COMPETITIVE OPERATING GRANTS.—The 

24 Secretary shall award operating grants to local agen25 cies to provide home visitation services to low-income 


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1 pregnant women or low-income families with young 

2 children, consistent with the following: 

3 ‘‘(A) ELIGIBILITY.—To receive an oper4 ating grant, a local agency must meet all re5 quirements established by the Secretary, includ6 ing the following: 

7 ‘‘(i) IMPLEMENTATION OF AN AP8 PROVED MODEL.—The local agency shall 

9 provide services consistent with a model of 

10 home visitation that the Secretary has ap11 proved as having demonstrated significant 

12 positive effects on important program-de13 termined child and parent outcomes, such 

14 as reducing abuse and neglect, improving 

15 prenatal health, improving child health and 

16 development, improving school readiness, 

17 reducing juvenile delinquency, and improv18 ing family economic self-sufficiency. 

19 ‘‘(ii) ACCREDITATION.—If the local 

20 agency proposes to implement an approved 

21 model of home visitation, the local agency 

22 must abide by the requirements, if any, of 

23 the national or regional home visitation 

24 program model identified by the Secretary, 


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1 to ensure the agency is capable of pro2 viding services consistent with the model. 

3 ‘‘(iii) STATE OR LOCAL MATCH.—The 

4 Secretary shall have the authority to estab5 lish State or local matching requirements 

6 as a condition for receiving a grant under 

7 this section, which may include in-kind 

8 contributions and payments made to the 

9 State under section 1903(a) for providing 

10 home visitation services (as defined in sec11 tion 1943(b)(2)) under the State plan 

12 under title XIX, and may include a waiver 

13 based on economic hardship. 

14 ‘‘(B) ALLOCATION.— 

15 ‘‘(i) PRIORITY FUNDING FOR PRO16 GRAMS WITH STRONGEST EVIDENCE.—In 

17 awarding operating grants during a fiscal 

18 year, the Secretary shall allot the largest 

19 feasible percentage of grant funding to 

20 local agencies that implement home visita21 tion models that are supported by the 

22 strongest evidence of effectiveness. 

23 ‘‘(ii) DISTRIBUTION.—In awarding 

24 operating grants, the Secretary shall take 


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1 into account the distribution of low-income 

2 families with young children by geography. 

3 ‘‘(3) MODEL APPROACH.—The Secretary, acting 

4 through the Director of the Centers for Disease 

5 Control and Prevention, shall determine whether to 

6 approve a model of home visitation services as quali7 fying in either or both of the following categories: 

8 ‘‘(A) Meeting the requirements for Secre9 tarial approval described in paragraph 

10 (2)(A)(i). 

11 ‘‘(B) Being supported by the strongest evi12 dence of effectiveness. 

13 ‘‘(4) RESEARCH.— 

14 ‘‘(A) IN GENERAL.—The Secretary shall 

15 fund an ongoing program of research to accom16 plish the following goals: 

17 ‘‘(i) Establishing the strongest evi18 dence of effectiveness for a home visitation 

19 model that has not yet been found to have 

20 such evidence. 

21 ‘‘(ii) In the case of an approved home 

22 visitation model, furthering improvements 

23 of such model, facilitating effective and ef24 ficient replication of the model, and facili25 tating adaptations of the model. 


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1 ‘‘(B) REQUIREMENT.—Evaluations funded 

2 under clauses (i) and (ii) of subparagraph (A) 

3 shall be specific to each approved model of 

4 home visitation and shall include evaluations of 

5 program outcomes for each home visitation pro6 gram model separately. 

7 ‘‘(5) ADMINISTRATION.—The Secretary shall 

8 perform, either directly or through a private con9 tractor, the following administrative functions de10 scribed in subparagraph (A): 

11 ‘‘(A) ADMINISTRATIVE FUNCTIONS.—The 

12 administrative functions described in this sub13 paragraph shall include— 

14 ‘‘(i) helping a local agency that re15 ceives a planning grant qualify for an oper16 ating grant; 

17 ‘‘(ii) providing training and technical 

18 assistance to local agencies that receive 

19 planning or operating grants; and 

20 ‘‘(iii) conducting quality assurance 

21 and quality improvement activities with re22 spect to local agencies that receive plan23 ning or operating grants. 


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1 ‘‘(B) CONTRACTING REQUIREMENTS.—In 

2 electing whether to employ a contractor and in 

3 selecting a contractor— 

4 ‘‘(i) the Secretary shall make such 

5 election and selection separately with re6 spect to each approved model of home visi7 tation; and 

8 ‘‘(ii) the Secretary shall contract with 

9 a private organization to perform the func10 tion if, for a fixed amount of administra11 tive dollars, greater fidelity to the approved 

12 model of home visitation is likely to result 

13 than if the responsibilities are carried out 

14 by the Secretary directly. 

15 ‘‘(c) OTHER PROVISIONS.— 

16 ‘‘(1) REGULATIONS.—The Secretary shall pro17 mulgate such regulations or guidance as the Sec18 retary determines necessary for the effective imple19 mentation of this section not later than 1 year fol20 lowing the date of enactment of this Act. 

21 ‘‘(2) NATIONAL ADVISORY BOARD.—The Sec22 retary shall establish and meet periodically with a 

23 national advisory board to seek advice about major 

24 policy issues involved in implementing this section. 


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1 ‘‘(3) TREATMENT OF ASSISTANCE.—No funding 

2 or services provided to low-income families under 

3 this section shall be considered— 

4 ‘‘(A) taxable income to the families who re5 ceive services; or 

6 ‘‘(B) income or resources countable in de7 termining eligibility for, or the amount of, any 

8 public benefit provided under Federal law or 

9 the law of any State or political subdivision 

10 thereof. 

11 ‘‘(4) EVALUATION.—The Secretary shall con12 duct, by grant, contract, or interagency agreement, 

13 a comprehensive, independent evaluation of the serv14 ices provided with grants awarded under this sec15 tion, including the cost and effectiveness of such 

16 services. The independent evaluation conducted 

17 under this section shall be specific to each approved 

18 program model of home visitation and shall include 

19 program outcomes for each home visitation model 

20 separately. By not later than 3 years after the date 

21 of enactment of this section, the Secretary shall sub22 mit to Congress a report on such evaluation. 

23 ‘‘(d) DEFINITIONS.—In this section: 

24 ‘‘(1) LOCAL AGENCY.—The term ‘local agency’ 

25 may include a unit of State, local, county, or city 


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1 government, an Indian tribe or tribal organization, 

2 or a non-governmental organization. 

3 ‘‘(2) LOW-INCOME.—The term ‘low-income’ 

4 means individuals whose family income does not ex5 ceed 200 percent of the poverty line for a family of 

6 the size involved. Low-income shall also include chil7 dren and families whose income did not exceed 200 

8 percent of the Federal poverty level for a family of 

9 the size involved when they began receiving a course 

10 of home visitation services but whose income exceed11 ed the allowable amount during the course of receiv12 ing home visitation services. 

13 ‘‘(3) POVERTY LINE.—The term ‘poverty line’ 

14 has the meaning given such term in section 673(2) 

15 of the Community Services Block Grant Act (42 

16 U.S.C. 9902(2)), including any revision required by 

17 such section. 

18 ‘‘(4) STRONGEST EVIDENCE OF EFFECTIVE19 NESS.—The term ‘strongest evidence of effective20 ness’ means, with respect to a model of home visita21 tion, that rigorous, scientific evaluations dem22 onstrate sizable, sustained effects on important out23 comes in at least 3 of the following 5 areas: 

24 ‘‘(A) Prenatal, maternal, and newborn 

25 health. 


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1 ‘‘(B) Child health and development (in2 cluding prevention of injuries and maltreat3 ment). 

4 ‘‘(C) School readiness and academic 

5 achievement. 

6 ‘‘(D) Juvenile delinquency. 

7 ‘‘(E) Family economic self-sufficiency. 

8 ‘‘(5) INDIAN TRIBE; TRIBAL ORGANIZATION.— 

9 The terms ‘Indian tribe’ and ‘tribal organization’ 

10 have the meanings given such terms in section 4 of 

11 the Indian Self-Determination and Education Assist12 ance Act (25 U.S.C. 450b). 

13 ‘‘(e) APPROPRIATIONS.—Out of any money in the 

14 Treasury not otherwise appropriated, there is appro15 priated to the Secretary to carry out this section— 

16 ‘‘(1) $100,000,000 for fiscal year 2010; 

17 ‘‘(2) $250,000,000 for fiscal year 2011; 

18 ‘‘(3) $400,000,000 for fiscal year 2012; 

19 ‘‘(4) $550,000,000 for fiscal year 2013; and 

20 ‘‘(5) $700,000,000 for fiscal year 2014.’’. 

21 SEC. 3. MEDICAID OPTION FOR SIMPLIFIED BILLING BY AP22 PROVED HOME VISITATION AGENCIES. 

23 (a) STATE PLAN AMENDMENT.—Section 1902(a) of 

24 the Social Security Act (42 U.S.C. 1396a(a)) is amend25 ed— 


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1 (1) in paragraph (72), by striking ‘‘and’’ at the 

2 end; 

3 (2) in paragraph (73), by striking the period at 

4 the end and inserting ‘‘; and’’; and 

5 (3) by inserting after paragraph (73) the fol6 lowing: 

7 ‘‘(74) at the option of the State, provide for 

8 simplified billing by approved home visitation agen9 cies under section 1943.’’. 

10 (b) SIMPLIFIED BILLING BY APPROVED HOME VISI11 TATION AGENCIES.—Title XIX of such Act is amended 

12 by adding at the end the following: 

13 ‘‘SEC. 1943. SIMPLIFIED BILLING BY APPROVED

14 HOME VISITATION AGENCIES.— 

15 ‘‘(a) IN GENERAL.—A State electing the option de16 scribed in this Section may permit an approved home visi17 tation agency to use a simplified method to submit claims 

18 for payment for home visitation services, but only to the 

19 extent that such services are covered under the State plan. 

20 ‘‘(b) DEFINITIONS.—In this section: 

21 ‘‘(1) APPROVED HOME VISITATION AGENCY.— 

22 The term ‘approved home visitation agency’ means 

23 a local agency with an operating grant under section 

24 511(b)(2). 


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1 ‘‘(2) HOME VISITATION SERVICES.—The term 

2 ‘home visitation services’ means services provided 

3 consistently with the approved model of home visita4 tion services that is being implemented by the local 

5 agency described in paragraph (1) and that are cov6 ered under the State plan. 

7 ‘‘(3) SIMPLIFIED METHOD TO SUBMIT CLAIMS

8 FOR PAYMENT.—The term ‘simplified method to 

9 submit claims for payment’ means a billing method 

10 through which an approved home visitation agency 

11 submits claims based on the weighted average cost 

12 per visit of providing, through the approved model of 

13 home visitation services being implemented by such 

14 agency, home visitation services. 

15 ‘‘(c) NO EXPANSION OF COVERED SERVICES.—Noth16 ing in this section shall be construed to authorize the pro17 vision of, or payment for, home visitation or other services 

18 under this title that are not covered under the State 

19 plan.’’. 

Æ 


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