II 

110TH CONGRESS 

1ST SESSION S. 1052 

To amend titles XIX and XXI of the Social Security Act to provide States 

with the option to provide nurse home visitation services under Medicaid 

and the State Children’s Health Insurance Program. 

IN THE SENATE OF THE UNITED STATES 

MARCH 29, 2007 

Mr. SALAZAR (for himself and Mr. SPECTER) introduced the following bill; 

which was read twice and referred to the Committee on Finance 

A BILL 

To amend titles XIX and XXI of the Social Security Act 

to provide States with the option to provide nurse home 

visitation services under Medicaid and the State Children’s Health Insurance Program. 

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 ‘‘Healthy Children and 

5 Families Act of 2007’’. 

6 SEC. 2. FINDINGS AND PURPOSE. 

7 (a) FINDINGS.—Congress makes the following find8 ings: 


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1 (1) Medicaid and the State Children’s Health 

2 Insurance Program have collectively provided health 

3 insurance coverage to over 38,000,000 low-income 

4 pregnant women and children. 

5 (2) Evidence-based nurse home visitation pro6 grams can improve the health status of low-income 

7 pregnant women and children enrolled in Medicaid 

8 and the State Children’s Health Insurance Program 

9 by promoting access to prenatal and well-baby care, 

10 reducing pre-term births, reducing high-risk preg11 nancies, increasing time intervals between first and 

12 subsequent births, and improving child cognitive, so13 cial and behavioral skills, and development. 

14 (3) In addition to health benefits, evidence15 based nurse home visitation programs have been 

16 proven to increase maternal employment and eco17 nomic self-sufficiency and significantly reduce child 

18 abuse and neglect, child arrests, maternal arrests, 

19 and involvement in the criminal justice system. 

20 (4) Evidence-based nurse home visitation pro21 grams are cost effective, yielding a 5-to-1 return on 

22 investment for every dollar spent on services, and 

23 producing a net benefit to society of $34,000 per 

24 high risk family served. 


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1 (b) PURPOSE.—The purpose of this Act is to encour2 age States to utilize evidence-based nurse home visitation 

3 services for low-income pregnant mothers and children 

4 to— 

5 (1) improve the prenatal health of children; 

6 (2) improve pregnancy outcomes; 

7 (3) improve child health and development; 

8 (4) improve child development and mental 

9 health related to elementary school readiness; 

10 (5) improve family stability and economic self11 sufficiency; 

12 (6) reduce the incidence of child abuse and ne13 glect; 

14 (7) reduce maternal and child involvement in 

15 the criminal justice system; and 

16 (8) increase birth intervals between preg17 nancies. 

18 SEC. 3. ADDITIONAL OPTIONS FOR STATES TO PROVIDE 

19 NURSE HOME VISITATION SERVICES. 

20 (a) SCHIP.—Section 2110(a)(15) of the Social Secu21 rity Act (42 U.S.C. 1397jj(a)(15)) is amended— 

22 (1) by inserting ‘‘(A)’’ after ‘‘(15)’’; and 

23 (2) by adding at the end the following: 

24 ‘‘(B)(i) Evidence-based nurse home visitation 

25 services (such as services related to improving preVerDate Aug 31 2005 00:25 Apr 04, 2007 Jkt 059200 PO 00000 Frm 00003 Fmt 6652 Sfmt 6201 E:\BILLS\S1052.IS S1052

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1 natal health, pregnancy outcomes, child health and 

2 development, school readiness, family stability and 

3 economic self-sufficiency, reducing child abuse, ne4 glect, and injury, reducing maternal and child in5 volvement in the criminal justice system, and in6 creasing birth intervals between pregnancies) on be7 half of a targeted low-income child who has not at8 tained age 2 and is the first live birth to a biological 

9 mother, but only if such services are provided in ac10 cordance with outcome standards that have been 

11 replicated in multiple, rigorous, randomized con12 trolled trials in multiple sites, with outcomes that 

13 improve prenatal health of children, pregnancy out14 comes, child health, child development, academic 

15 achievement, and mental health, reduce child abuse, 

16 neglect, and injury, reduce maternal and child in17 volvement in the criminal justice system, increase 

18 birth intervals between pregnancies, and improve 

19 maternal employment.’’. 

20 (b) MEDICAID.—Section 1905(a) of the Social Secu21 rity Act (42 U.S.C. 1396d(a)) is amended— 

22 (1) in paragraph (27), by striking ‘‘and’’ at the 

23 end; 

24 (2) by redesignating paragraph (28) as para25 graph (29); and 


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1 (3) by inserting after paragraph (27) the fol2 lowing: 

3 ‘‘(28) evidence-based nurse home visitation 

4 services (such as services related to improving pre5 natal health, pregnancy outcomes, child health and 

6 development, school readiness, family stability and 

7 economic self-sufficiency, reducing child abuse, ne8 glect, and injury, reducing maternal and child in9 volvement in the criminal justice system, and in10 creasing birth intervals between pregnancies) for a 

11 first-time pregnant woman or on behalf of a child 

12 who has not attained age 2 and is the first live birth 

13 to a biological mother, but only if such services are 

14 provided in accordance with outcome standards that 

15 have been replicated in multiple, rigorous, random16 ized controlled trials in multiple sites, with outcomes 

17 that improve prenatal health of children, pregnancy 

18 outcomes, child health, child development, academic 

19 achievement, and mental health, reduce child abuse, 

20 neglect, and injury, reduce maternal and child in21 volvement in the criminal justice system, increase 

22 birth intervals between pregnancies, and improve 

23 maternal employment; and’’. 

24 (c) RULE OF CONSTRUCTION.—Nothing in the 

25 amendments made by this Act shall be construed as affectVerDate Aug 31 2005 00:25 Apr 04, 2007 Jkt 059200 PO 00000 Frm 00005 Fmt 6652 Sfmt 6201 E:\BILLS\S1052.IS S1052

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1 ing the ability of a State under the Medicaid program 

2 under title XIX of the Social Security Act or the State 

3 Children’s Health Insurance Program under title XXI of 

4 such Act to provide nurse home visitation services as part 

5 of another class of items and services falling within the 

6 definition of medical assistance or child health assistance 

7 under such titles, or as an administrative expenditure for 

8 which payment is made under section 1903(a) or 2105(a) 

9 of such Act, on or after the date of enactment of this Act. 

10 (d) TIMELY APPROVAL OF AMENDMENTS OR PRO11 POSALS.—The Secretary of Health and Human Services 

12 shall, in a timely manner, review and notify a State of 

13 the Secretary’s approval or disapproval of— 

14 (1) any proposed amendment to a State Med15 icaid plan under title XIX of the Social Security Act 

16 to provide nurse home visitation services as medical 

17 assistance described in section 1905(a)(28) of such 

18 Act; 

19 (2) any proposed amendment to a State child 

20 health plan under title XXI of such Act to provide 

21 such services as child health assistance described in 

22 section 2110(a)(15)(B) of such Act; or 

23 (3) any proposal submitted under section 1115 

24 of such Act to provide nurse home visitation services 

25 described in sections 1905(a)(28) and 


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1 2110(a)(15)(B) of such Act under a waiver approved 

2 under such section 1115. 

3 (e) EFFECTIVE DATE.—The amendments made by 

4 this section take effect on October 1, 2007, and apply to 

5 child health assistance provided under title XXI of the So6 cial Security Act and medical assistance provided under 

7 title XIX of such Act on or after that date. 

Æ 


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