I 

111TH CONGRESS 

1ST SESSION H. R. 2667 

To amend part B of title IV of the Social Security Act to provide grants 

to States to establish or expand quality programs providing home visitation for families with young children and families expecting children. 

IN THE HOUSE OF REPRESENTATIVES 

JUNE 2, 2009 

Mr. MCDERMOTT (for himself, Mr. DAVIS of Illinois, and Mr. PLATTS) introduced the following bill; which was referred to the Committee on Ways 

and Means 

A BILL 

To amend part B of title IV of the Social Security Act 

to provide grants to States to establish or expand quality 

programs providing home visitation for families with 

young children and families expecting children. 

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 ‘‘Early Support for 

5 Families Act’’. 

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1 SEC. 2. GRANTS TO STATES FOR QUALITY HOME VISITA2 TION PROGRAMS FOR FAMILIES WITH YOUNG 

3 CHILDREN AND FAMILIES EXPECTING CHIL4 DREN. 

5 Part B of title IV of the Social Security Act (42 

6 U.S.C. 621–629i) is amended by adding at the end the 

7 following: 

8 ‘‘Subpart 3—Support for Quality Home Visitation 

9 Programs 

10 ‘‘SEC. 440. HOME VISITATION PROGRAMS FOR FAMILIES 

11 WITH YOUNG CHILDREN AND FAMILIES EX12 PECTING CHILDREN. 

13 ‘‘(a) PURPOSE.—The purpose of this section is to im14 prove the well-being and development of children by ena15 bling the establishment and expansion of quality programs 

16 providing voluntary home visitation for families with 

17 young children and families expecting children. 

18 ‘‘(b) GRANT APPLICATION.—A State that desires to 

19 receive a grant under this section shall submit to the Sec20 retary, at such time and in such manner as the Secretary 

21 may require, an application for the grant that includes the 

22 following: 

23 ‘‘(1) DESCRIPTION OF HOME VISITATION PRO24 GRAMS.—A description of the high quality programs 

25 of home visitation for families with young children 

26 and families expecting children that will be supmstockstill on PROD1PC66 with BILLS

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1 ported by a grant made to the State under this sec2 tion, the outcomes the programs are intended to 

3 achieve, and the evidence supporting the effective4 ness of the programs. 

5 ‘‘(2) RESULTS OF NEEDS ASSESSMENT.—The 

6 results of a statewide needs assessment that de7 scribes— 

8 ‘‘(A) the number, quality, and capacity of 

9 home visitation programs for families with 

10 young children and families expecting children 

11 in the State; 

12 ‘‘(B) the number and types of eligible fam13 ilies who are receiving services under the pro14 grams; 

15 ‘‘(C) the sources and amount of funding 

16 provided to the programs; 

17 ‘‘(D) the gaps in early childhood home visi18 tation in the State, including identification of 

19 communities that are in high need of the serv20 ices; and 

21 ‘‘(E) training and technical assistance ac22 tivities designed to achieve or support the goals 

23 of the programs. 

24 ‘‘(3) ASSURANCES.—Assurances from the State 

25 that— 

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1 ‘‘(A) in supporting home visitation pro2 grams using funds provided under this section, 

3 the State shall identify and prioritize serving 

4 communities that are in high need of such serv5 ices, especially communities with a high propor6 tion of low-income families or a high incidence 

7 of child maltreatment; 

8 ‘‘(B) the State will reserve 5 percent of the 

9 grant funds for training and technical assist10 ance to the home visitation programs using 

11 such funds; 

12 ‘‘(C) in supporting home visitation pro13 grams using funds provided under this section, 

14 the State will promote coordination and collabo15 ration with other child and family services, 

16 health services, income supports, and other re17 lated assistance; 

18 ‘‘(D) home visitation programs supported 

19 using such funds will, when appropriate, pro20 vide referrals to other programs serving chil21 dren and families; and 

22 ‘‘(E) the State will comply with subsection 

23 (i), and cooperate with any evaluation con24 ducted under subsection (j). 

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1 ‘‘(4) OTHER INFORMATION.—Such other infor2 mation as the Secretary may require. 

3 ‘‘(c) ALLOTMENTS.— 

4 ‘‘(1) INDIAN TRIBES.—From the amount re5 served under subsection (m)(2) for a fiscal year, the 

6 Secretary shall allot to each Indian tribe that meets 

7 the requirement of subsection (d), if applicable, for 

8 the fiscal year the amount that bears the same ratio 

9 to the amount so reserved as the number of children 

10 in the Indian tribe whose families have income that 

11 does not exceed 200 percent of the poverty line bears 

12 to the total number of children in such Indian tribes 

13 whose families have income that does not exceed 200 

14 percent of the poverty line. 

15 ‘‘(2) STATES AND TERRITORIES.—From the 

16 amount appropriated under subsection (n) for a fis17 cal year that remains after making the reservations 

18 required by subsection (m), the Secretary shall allot 

19 to each State that is not an Indian tribe and that 

20 meets the requirement of subsection (d), if applica21 ble, for the fiscal year the amount that bears the 

22 same ratio to the remainder of the amount so appro23 priated as the number of children in the State whose 

24 families have income that does not exceed 200 per25 cent of the poverty line bears to the total number of 

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1 children in such States whose families have income 

2 that does not exceed 200 percent of the poverty line. 

3 ‘‘(3) REALLOTMENTS.—The amount of any al4 lotment to a State under a paragraph of this sub5 section for any fiscal year that the State certifies to 

6 the Secretary will not be expended by the State pur7 suant to this section shall be available for reallot8 ment using the allotment methodology specified in 

9 that paragraph. Any amount so reallotted to a State 

10 is deemed part of the allotment of the State under 

11 this subsection. 

12 ‘‘(d) MAINTENANCE OF EFFORT.—Beginning with 

13 fiscal year 2011, a State meets the requirement of this 

14 subsection for a fiscal year if the Secretary finds that the 

15 aggregate expenditures by the State for quality programs 

16 of home visitation for families with young children and 

17 families expecting children for the then preceding fiscal 

18 year was not less than 100 percent of such aggregate ex19 penditures for the then 2nd preceding fiscal year. 

20 ‘‘(e) PAYMENT OF GRANT.— 

21 ‘‘(1) IN GENERAL.—The Secretary shall make a 

22 grant to each State that meets the requirements of 

23 subsections (b) and (d), if applicable, for a fiscal 

24 year for which funds are appropriated under sub25 section (n), in an amount equal to the lesser of— 

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1 ‘‘(A) the reimbursable percentage of the el2 igible expenditures of the State for the fiscal 

3 year; or 

4 ‘‘(B) the amount allotted to the State 

5 under subsection (c) for the fiscal year. 

6 ‘‘(2) REIMBURSABLE PERCENTAGE DEFINED.— 

7 In paragraph (1), the term ‘reimbursable percent8 age’ means, with respect to a fiscal year— 

9 ‘‘(A) 85 percent, in the case of fiscal year 

10 2010; 

11 ‘‘(B) 80 percent, in the case of fiscal year 

12 2011; or 

13 ‘‘(C) 75 percent, in the case of fiscal year 

14 2012 and any succeeding fiscal year. 

15 ‘‘(f) ELIGIBLE EXPENDITURES.— 

16 ‘‘(1) IN GENERAL.—In this section, the term 

17 ‘eligible expenditures’— 

18 ‘‘(A) means expenditures to provide vol19 untary home visitation for as many families 

20 with young children and families expecting chil21 dren as practicable, through the implementation 

22 or expansion of high quality programs that— 

23 ‘‘(i) adhere to clear evidence-based 

24 models of home visitation that have dem25 onstrated significant positive effects on immstockstill on PROD1PC66 with BILLS

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1 portant program-determined child and par2 enting outcomes, such as reducing abuse 

3 and neglect and improving child health and 

4 development; 

5 ‘‘(ii) employ well-trained and com6 petent staff, maintain high quality super7 vision, and show strong organizational ca8 pacity to implement such a program; and 

9 ‘‘(iii) establish appropriate linkages 

10 and referrals to other community resources 

11 and supports; and 

12 ‘‘(B) includes expenditures for training, 

13 technical assistance, and evaluations related to 

14 the programs. 

15 ‘‘(2) PRIORITY FUNDING FOR PROGRAMS WITH

16 STRONGEST EVIDENCE.— 

17 ‘‘(A) IN GENERAL.—The expenditures, de18 scribed in paragraph (1), of a State for a fiscal 

19 year that are attributable to the cost of pro20 grams that do not adhere to a model of home 

21 visitation with the strongest evidence of effec22 tiveness shall not be considered eligible expendi23 tures for the fiscal year to the extent that the 

24 total of the expenditures exceeds the applicable 

25 percentage for the fiscal year of the allotment 

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1 of the State under subsection (c) for the fiscal 

2 year. 

3 ‘‘(B) APPLICABLE PERCENTAGE DE4 FINED.—In subparagraph (A), the term ‘appli5 cable percentage’ means, with respect to a fiscal 

6 year— 

7 ‘‘(i) 60 percent for fiscal year 2010; 

8 ‘‘(ii) 55 percent for fiscal year 2011; 

9 ‘‘(iii) 50 percent for fiscal year 2012; 

10 ‘‘(iv) 45 percent for fiscal year 2013; 

11 or 

12 ‘‘(v) 40 percent for fiscal year 2014. 

13 ‘‘(g) NO USE OF OTHER FEDERAL FUNDS FOR

14 STATE MATCH.—A State to which a grant is made under 

15 this section may not expend any Federal funds to meet 

16 the State share of the cost of an eligible expenditure for 

17 which the State receives a payment under this section. 

18 ‘‘(h) WAIVER AUTHORITY.— 

19 ‘‘(1) IN GENERAL.—The Secretary may waive 

20 or modify the application of any provision of this 

21 section, other than subsection (b) or (f), to an In22 dian tribe if the failure to do so would impose an 

23 undue burden on the Indian tribe. 

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1 ‘‘(2) SPECIAL RULE.—An Indian tribe is 

2 deemed to meet the requirement of subsection (d) 

3 for purposes of subsections (c) and (e) if— 

4 ‘‘(A) the Secretary waives the requirement; 

5 or 

6 ‘‘(B) the Secretary modifies the require7 ment, and the Indian tribe meets the modified 

8 requirement. 

9 ‘‘(i) STATE REPORTS.—Each State to which a grant 

10 is made under this section shall submit to the Secretary 

11 an annual report on the progress made by the State in 

12 addressing the purposes of this section. Each such report 

13 shall include a description of— 

14 ‘‘(1) the services delivered by the programs that 

15 received funds from the grant; 

16 ‘‘(2) the characteristics of each such program, 

17 including information on the service model used by 

18 the program and the performance of the program; 

19 ‘‘(3) the characteristics of the providers of serv20 ices through the program, including staff qualifica21 tions, work experience, and demographic characteris22 tics; 

23 ‘‘(4) the characteristics of the recipients of serv24 ices provided through the program, including the 

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1 number of the recipients, the demographic charac2 teristics of the recipients, and family retention; 

3 ‘‘(5) the annual cost of implementing the pro4 gram, including the cost per family served under the 

5 program; 

6 ‘‘(6) the outcomes experienced by recipients of 

7 services through the program; 

8 ‘‘(7) the training and technical assistance pro9 vided to aid implementation of the program, and 

10 how the training and technical assistance contrib11 uted to the outcomes achieved through the program; 

12 and 

13 ‘‘(8) the indicators and methods used to mon14 itor whether the program is being implemented as 

15 designed. 

16 ‘‘(j) EVALUATION.— 

17 ‘‘(1) IN GENERAL.—The Secretary shall, by 

18 grant or contract, provide for the conduct of an 

19 independent evaluation of the effectiveness of home 

20 visitation programs receiving funds provided under 

21 this section, which shall examine the following: 

22 ‘‘(A) The effect of home visitation pro23 grams on child and parent outcomes, including 

24 child maltreatment, child health and developmstockstill on PROD1PC66 with BILLS

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1 ment, school readiness, and links to community 

2 services. 

3 ‘‘(B) The effectiveness of home visitation 

4 programs on different populations, including 

5 the extent to which the ability of programs to 

6 improve outcomes varies across programs and 

7 populations. 

8 ‘‘(2) REPORTS TO THE CONGRESS.— 

9 ‘‘(A) INTERIM REPORT.—Within 2 years 

10 after the date of the enactment of this section, 

11 the Secretary shall submit to the Congress an 

12 interim report on the evaluation conducted pur13 suant to paragraph (1). 

14 ‘‘(B) FINAL REPORT.—Within 4 years 

15 after the date of the enactment of this section, 

16 the Secretary shall submit to the Congress a 

17 final report on the evaluation conducted pursu18 ant to paragraph (1). 

19 ‘‘(k) ANNUAL REPORTS TO THE CONGRESS.—The 

20 Secretary shall submit annually to the Congress a report 

21 on the activities carried out using funds made available 

22 under this section, which shall include a description of the 

23 following: 

24 ‘‘(1) The high need communities targeted by 

25 States for programs carried out under this section. 

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1 ‘‘(2) The service delivery models used in the 

2 programs receiving funds provided under this sec3 tion. 

4 ‘‘(3) The characteristics of the programs, in5 cluding— 

6 ‘‘(A) the qualifications and demographic 

7 characteristics of program staff; and 

8 ‘‘(B) recipient characteristics including the 

9 number of families served, the demographic 

10 characteristics of the families served, and fam11 ily retention and duration of services. 

12 ‘‘(4) The outcomes reported by the programs. 

13 ‘‘(5) The research-based instruction, materials, 

14 and activities being used in the activities funded 

15 under the grant. 

16 ‘‘(6) The training and technical activities, in17 cluding on-going professional development, provided 

18 to the programs. 

19 ‘‘(7) The annual costs of implementing the pro20 grams, including the cost per family served under 

21 the programs. 

22 ‘‘(8) The indicators and methods used by States 

23 to monitor whether the programs are being been im24 plemented as designed. 

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1 ‘‘(l) RESERVATIONS OF FUNDS.—From the amounts 

2 appropriated for a fiscal year under subsection (m), the 

3 Secretary shall reserve— 

4 ‘‘(1) $10,000,000 to pay the cost of the evalua5 tion provided for in subsection (k), and the provision 

6 to States of training and technical assistance, in7 cluding the dissemination of best practices in early 

8 childhood home visitation; and 

9 ‘‘(2) after making the reservation required by 

10 paragraph (1), an amount equal to 3 percent of the 

11 amount so appropriated, to pay for grants to Indian 

12 tribes under this section. 

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

14 Treasury of the United States not otherwise appropriated, 

15 there is appropriated to the Secretary to carry out this 

16 section— 

17 ‘‘(1) $100,000,000 for fiscal year 2010; 

18 ‘‘(2) $250,000,000 for fiscal year 2011; 

19 ‘‘(3) $400,000,000 for fiscal year 2012; 

20 ‘‘(4) $550,000,000 for fiscal year 2013; and 

21 ‘‘(5) $700,000,000 for fiscal year 2014. 

22 ‘‘(n) INDIAN TRIBES TREATED AS STATES.—In this 

23 section, paragraphs (4), (5), and (6) of section 431(a) 

24 shall apply.’’. 

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