Jackie Walorski Maternal and Child Home Visiting Reauthorization Act of 2022
Bill: H.R.8876 | Sponsor: Rep. Davis, Danny K. (D-IL)
Policy area: Health

Summary:
The Jackie Walorski Maternal and Child Home Visiting Reauthorization Act of 2022
This bill reauthorizes through FY2027, increases funding for, and modifies the Maternal, Infant, and Early Childhood Home Visiting Program. This program supports home visits for expectant and new parents who live in communities that are at-risk for poor maternal and child health outcomes.
Changes to the program include
The bill also reduces funding for the Medicare Improvement Fund.

To reauthorize the Maternal, Infant, and Early Childhood Home Visiting 
                    program, and for other purposes.

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

SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Jackie Walorski Maternal and Child 
Home Visiting Reauthorization Act of 2022''.

SEC. 2. OUTCOMES DASHBOARD.

    Section 511(d)(1) of the Social Security Act (42 U.S.C. 711(d)(1)) 
is amended--
            (1) in the paragraph heading, by striking ``benchmark 
        areas'' and inserting ``benchmark areas related to individual 
        family outcomes'';
            (2) in subparagraph (D)(i), by striking ``(B)'' and 
        inserting ``(C)''; and
            (3) by redesignating subparagraphs (B) through (D) as 
        subparagraphs (C) through (E), respectively, and inserting 
        after subparagraph (A) the following:
                    ``(B) Outcomes dashboards.--The Secretary shall, 
                directly or by grant or contract, establish and operate 
                a website accessible to the public that includes an 
                annually updated dashboard that--
                            ``(i) provides easy-to-understand 
                        information on the outcomes achieved by each 
                        eligible entity with respect to each of the 
                        benchmarks described in subparagraph (A) of 
                        this paragraph that apply to the eligible 
                        entity, which shall be based on only the data 
                        elements or types of data collected before the 
                        date of the enactment of this section unless 
                        administering agencies and the Secretary agree 
                        pursuant to subsection (h)(6) that additional 
                        data is required;
                            ``(ii) includes a template provided by the 
                        Secretary that will enable comparison among 
                        eligible entities not referred to in subsection 
                        (k)(2)(A) of--
                                    ``(I) a profile of each eligible 
                                entity showing outcome indicators and 
                                how the outcomes compare to benchmarks 
                                described in subclause (II);
                                    ``(II) information on the outcome 
                                indicators and requisite outcome levels 
                                established for each eligible entity;
                                    ``(III) information on each model 
                                employed in the program operated by 
                                each eligible entity, and regarding 
                                each benchmark area described in 
                                subsection (d)(1)(A) in which the model 
                                used by the eligible entity is expected 
                                to affect participant outcomes;
                                    ``(IV) the most recently available 
                                information from the report required by 
                                subparagraph (E) of this paragraph;
                                    ``(V) an electronic link to the 
                                State needs assessment under subsection 
                                (b)(1); and
                                    ``(VI) information regarding any 
                                penalty imposed, or other corrective 
                                action taken, by the Secretary against 
                                a State for failing to achieve a 
                                requisite outcome level or any other 
                                requirement imposed by or under this 
                                section, and an indication as to 
                                whether the eligible entity is 
                                operating under a corrective action 
                                plan under subparagraph (E)(ii) of this 
                                paragraph, and if so, a link to the 
                                plan, an explanation of the reason for 
                                the implementation of the plan, and a 
                                report on any progress made in 
                                operating under the plan;
                            ``(iii) includes information relating to 
                        those eligible entities for which funding is 
                        reserved under subsection (k)(2)(A), with 
                        modifications as necessary to reflect tribal 
                        sovereignty, data privacy, and participant 
                        confidentiality; and
                            ``(iv) protects data privacy and 
                        confidentiality of participant families.''.

SEC. 3. FUNDING.

    (a) Grant Amounts.--
            (1) In general.--Section 511(c)(4) of the Social Security 
        Act (42 U.S.C. 711(c)(4)) is amended to read as follows:
            ``(4) Grant amounts.--
                    ``(A) Base grants.--
                            ``(i) In general.--
                                    ``(I) General rule.--With respect 
                                to each of fiscal years 2023 through 
                                2027 for which an eligible entity not 
                                referred to in subsection (k)(2)(A) is 
                                awarded a base grant under this 
                                section, the amount of the grant 
                                payable to the eligible entity for the 
                                fiscal year is the amount described by 
                                clause (ii) of this subparagraph with 
                                respect to the eligible entity, except 
                                as provided in subclause (II) of this 
                                clause.
                                    ``(II) Substitution of successor 
                                eligible entity for predecessor.--If 
                                the 1st fiscal year for which an 
                                eligible entity is awarded a base grant 
                                under this section for a program 
                                operated in a State is among fiscal 
                                years 2024 through 2027, the amount 
                                described by clause (ii) with respect 
                                to the eligible entity is the amount of 
                                the base grant for which a program 
                                operated in the State was eligible 
                                under this subparagraph for fiscal year 
                                2023.
                            ``(ii) Amount described.--
                                    ``(I) General rule.--Subject to the 
                                succeeding provisions of this clause, 
                                the amount described by this clause 
                                with respect to an eligible entity is--
                                            ``(aa) the amount made 
                                        available under subsection (k) 
                                        for base grants for fiscal year 
                                        2023 that remains after making 
                                        the reservations required by 
                                        subsection (k)(2) or any other 
                                        reductions required by Federal 
                                        law for fiscal year 2023; 
                                        multiplied by
                                            ``(bb) the percentage of 
                                        children in all States who have 
                                        not attained 5 years of age (as 
                                        determined by the Secretary on 
                                        the basis of the data most 
                                        recently available before 
                                        fiscal year 2023) that is 
                                        represented by the number of 
                                        such children in the State in 
                                        which the eligible entity is 
                                        operating a program pursuant to 
                                        this section (as so 
                                        determined).
                                    ``(II) Adjustments to ensure stable 
                                funding.--If the amount otherwise 
                                payable to an eligible entity under 
                                subclause (I) for fiscal year 2023 is 
                                less than 90 percent, or greater than 
                                110 percent, of the amount payable 
                                under this section to the eligible 
                                entity for the program for fiscal year 
                                2021, the Secretary shall increase the 
                                amount otherwise so payable to 90 
                                percent, or decrease the amount 
                                otherwise so payable to 110 percent, as 
                                the case may be, of the amount 
                                otherwise so payable.
                                    ``(III) Adjustment to ensure all 
                                base grant funds are allocated.--If the 
                                amount described by subclause (I)(aa) 
                                is different than the total of the 
                                amounts otherwise described by 
                                subclause (I) after applying subclause 
                                (II), the Secretary shall increase or 
                                decrease the amounts otherwise so 
                                described after applying subclause (II) 
                                by such equal percentage as is 
                                necessary to reduce that difference to 
                                zero.
                                    ``(IV) Minimum base grant amount.--
                                Notwithstanding the preceding 
                                provisions of this clause, the amount 
                                described by this clause with respect 
                                to an eligible entity shall be not less 
                                than $1,000,000.
                    ``(B) Matching grants.--
                            ``(i) Amount of grant.--
                                    ``(I) General rule.--With respect 
                                to each of fiscal years 2024 through 
                                2027 for which an eligible entity not 
                                referred to in subsection (k)(2)(A) is 
                                awarded a grant under this section, the 
                                Secretary shall increase the amount of 
                                the grant payable to the eligible 
                                entity for the fiscal year under 
                                subparagraph (A) of this paragraph by 
                                the matching amount (if any) determined 
                                under subclause (II) of this clause 
                                with respect to the eligible entity for 
                                the fiscal year and the additional 
                                matching amount (if any) determined 
                                under clause (iii) of this subparagraph 
                                with respect to the eligible entity for 
                                the fiscal year.
                                    ``(II) Matching amount.--
                                            ``(aa) In general.--Subject 
                                        to item (bb) of this subclause, 
                                        the matching amount with 
                                        respect to an eligible entity 
                                        for a fiscal year is 75 percent 
                                        of the sum of--

                                                    ``(AA) the total 
                                                amount obligated by the 
                                                eligible entity for 
                                                home visiting services 
                                                in the State for the 
                                                fiscal year, from 
                                                Federal funds made 
                                                available for the 
                                                fiscal year under this 
                                                subparagraph; and

                                                    ``(BB) the total 
                                                amount so obligated by 
                                                the eligible entity 
                                                from non-Federal funds, 
                                                determined under 
                                                subclause (III).

                                            ``(bb) Limitation.--The 
                                        matching amount with respect to 
                                        an eligible entity for a fiscal 
                                        year shall not exceed the 
                                        allotment under subclause (IV) 
                                        for the State in which the 
                                        eligible entity is operating a 
                                        program under this section for 
                                        the fiscal year.
                                    ``(III) Determination of 
                                obligations from non-federal funds.--
                                For purposes of this clause, the total 
                                amount obligated by an eligible entity 
                                from non-Federal funds is the total of 
                                the amounts that are obligated by the 
                                eligible entity from non-Federal 
                                sources, to the extent that--
                                            ``(aa) the services are 
                                        delivered in compliance with 
                                        subsections (d)(2) and (d)(3);
                                            ``(bb) the eligible entity 
                                        has reported the obligations to 
                                        the Secretary; and
                                            ``(cc) the amount is not 
                                        counted toward meeting the 
                                        maintenance of effort 
                                        requirement in subsection (f).
                                    ``(IV) State allotments.--The 
                                amount allotted under this subclause 
                                for a State in which an eligible entity 
                                is operating a program under this 
                                section for a fiscal year is--
                                            ``(aa) the minimum matching 
                                        grant allocation amount for the 
                                        fiscal year; plus
                                            ``(bb)(AA) the amount (if 
                                        any) by which the amount made 
                                        available under subsection (k) 
                                        for matching grants for the 
                                        fiscal year that remains after 
                                        making the reservations 
                                        required by subsection (k)(2) 
                                        or any other reduction required 
                                        by Federal law for the fiscal 
                                        year exceeds the sum of the 
                                        minimum matching grant 
                                        allocation amounts for all 
                                        eligible entities for the 
                                        fiscal year; multiplied by
                                            ``(BB) the percentage of 
                                        children in all States who have 
                                        not attained 5 years of age and 
                                        are members of families with 
                                        income not exceeding the 
                                        poverty line (as determined by 
                                        the Secretary on the basis of 
                                        the most recently available 
                                        data) that is represented by 
                                        the number of such children in 
                                        the State (as so determined).
                                    ``(V) Minimum matching grant 
                                allocation amount.--Subject to 
                                subclause (VI), for purposes of 
                                subclause (IV), the minimum matching 
                                grant allocation amount for a fiscal 
                                year is--
                                            ``(aa) in the case of 
                                        fiscal year 2024, $776,000;
                                            ``(bb) in the case of 
                                        fiscal year 2025, $1,000,000;
                                            ``(cc) in the case of 
                                        fiscal year 2026, $1,500,000; 
                                        and
                                            ``(dd) in the case of 
                                        fiscal year 2027, $2,000,000.
                                    ``(VI) Special rule.--If, after 
                                making any reductions otherwise 
                                required by law for a fiscal year, the 
                                amount made available for matching 
                                grants under this clause for the fiscal 
                                year is insufficient to provide the 
                                minimum matching grant allocation 
                                amount to each eligible entity 
                                operating a program under this section 
                                for the fiscal year, the Secretary may 
                                make a proportionate adjustment to the 
                                minimum matching grant allocation 
                                amount for the fiscal year to 
                                accommodate the reductions.
                            ``(ii) Submission of statement expressing 
                        interest in additional matching funds if 
                        available.--Before the beginning of a fiscal 
                        year for which an eligible entity desires a 
                        matching grant under this subparagraph for a 
                        program operated under this section, the 
                        eligible entity shall submit to the Secretary a 
                        statement as to whether the eligible entity 
                        desires additional matching grant funds that 
                        may be made available under clause (iii) for 
                        the fiscal year.
                            ``(iii) Carryover and reallocation of 
                        unobligated funds.--
                                    ``(I) In general.--If the Secretary 
                                determines that an amount allotted 
                                under clause (i)(IV) of this 
                                subparagraph for a fiscal year will not 
                                be awarded during the fiscal year, or 
                                that an amount made available under 
                                subsection (k)(1) for a fiscal year for 
                                matching grants will not be obligated 
                                by an eligible entity for the fiscal 
                                year, the amount shall be available for 
                                matching grants under this subparagraph 
                                for the succeeding fiscal year for 
                                eligible entities that have made 
                                submissions under clause (ii) of this 
                                subparagraph for additional matching 
                                grant funds from the amount.
                                    ``(II) State allotments.--The 
                                Secretary shall allot to each eligible 
                                entity that has made such a submission 
                                for a fiscal year--
                                            ``(aa) the total amount (if 
                                        any) made available under 
                                        subclause (I) for the fiscal 
                                        year; multiplied by
                                            ``(bb) the percentage of 
                                        children who have not attained 
                                        5 years of age and are members 
                                        of families with income not 
                                        exceeding the poverty line (as 
                                        determined by the Secretary on 
                                        the basis of the most recently 
                                        available data) in all of the 
                                        States in which any eligible 
                                        entity that has made such a 
                                        submission is so operating a 
                                        program, that is represented by 
                                        the number of such children in 
                                        the State (as so determined) in 
                                        which the eligible entity is 
                                        operating such a program.
                                    ``(III) Additional matching 
                                amount.--
                                            ``(aa) In general.--Subject 
                                        to item (bb) of this subclause, 
                                        the additional matching amount 
                                        with respect to an eligible 
                                        entity for a fiscal year is 75 
                                        percent of the sum of--

                                                    ``(AA) the total 
                                                amount obligated by the 
                                                eligible entity for 
                                                home visiting services 
                                                in the State for the 
                                                fiscal year, from 
                                                Federal funds made 
                                                available for the 
                                                fiscal year under this 
                                                subparagraph; and

                                                    ``(BB) the total 
                                                amount so obligated by 
                                                the eligible entity 
                                                from non-Federal funds, 
                                                determined under clause 
                                                (i)(III),

                                        that are not taken into account 
                                        in determining the matching 
                                        amount with respect to the 
                                        eligible entity under clause 
                                        (i).
                                            ``(bb) Limitation.--The 
                                        additional matching amount with 
                                        respect to an eligible entity 
                                        for a fiscal year shall not 
                                        exceed the allotment under 
                                        subclause (II) for the State in 
                                        which the eligible entity is 
                                        operating a program under this 
                                        section for the fiscal year.''.
            (2) Maintenance of effort.--Section 511(f) of such Act (42 
        U.S.C. 711) is amended to read as follows:
    ``(f) Maintenance of Effort.--
            ``(1) In general.--Notwithstanding any other provision of 
        this section, the Secretary may not make a grant to an eligible 
        entity under this section for a fiscal year if the total amount 
        of non-Federal funds obligated by the eligible entity in the 
        State in the fiscal year for a program operated pursuant to 
        this section is less than the total amount of non-Federal funds 
        reported to have been expended by any eligible entity for such 
        a program in the State in fiscal year 2019 or 2021, whichever 
        is the lesser.
            ``(2) Publication of amounts.--Not later than June 30, 
        2023, the Secretary shall cause to have published in the 
        Federal Register the amount of non-Federal funds expended as 
        described in this section that has been reported by each 
        eligible entity not referred to in subsection (k)(2)(A) for 
        each of fiscal years 2019 and 2021.
            ``(3) Grace period.--The Secretary may, in exceptional 
        circumstances, allow an eligible entity a period to come into 
        compliance with this subsection. The Secretary shall provide 
        technical assistance to any eligible entity to assist the 
        entity in doing so.''.
    (b) Reservations of Funds for Certain Purposes.--Section 511(j)(2) 
of such Act (42 U.S.C. 711(j)(2)) is amended--
            (1) in the matter preceding subparagraph (A), by striking 
        ``the amount'' and inserting ``each amount made available for 
        base grants and each amount made available for matching 
        grants'';
            (2) in subparagraph (A)--
                    (A) by striking ``3'' and inserting ``6''; and
                    (B) by striking ``and'' at the end; and
            (3) by striking subparagraph (B) and inserting the 
        following:
                    ``(B) 2 percent of such amount for purposes of 
                providing technical assistance, directly or through 
                grants or contracts, for purposes as otherwise 
                described in subsections (c)(5), (d)(1)(C)(iii), 
                (d)(1)(E)(iii), and (d)(4)(E);
                    ``(C) 2 percent of such amount for purposes of 
                workforce support, retention, and case management, 
                including workforce-related technical assistance, 
                research and evaluation, and program administration, 
                directly or through grants or contracts, of which the 
                Secretary shall use not more than $1,500,000 to 
                establish and operate the Jackie Walorski Center for 
                Evidence-Based Case Management; and
                    ``(D) 3 percent of such amount for purposes of 
                research and evaluation (directly or through grants or 
                contracts), and for administering this section 
                (directly, through contracts, or otherwise).''.
    (c) Appropriations.--Section 511(j)(1) of such Act (42 U.S.C. 
711(j)(1)) is amended by striking subparagraphs (A) through (H) and 
inserting the following:
                    ``(A) for fiscal year 2023, $500,000,000 for base 
                grants;
                    ``(B) for fiscal year 2024, $550,000,000, of which 
                $500,000,000 shall be for base grants and $50,000,000 
                shall be for matching grants;
                    ``(C) for fiscal year 2025, $600,000,000, of which 
                $500,000,000 shall be for base grants and $100,000,000 
                shall be for matching grants;
                    ``(D) for fiscal year 2026, $650,000,000, of which 
                $500,000,000 shall be for base grants and $150,000,000 
                shall be for matching grants; and
                    ``(E) for fiscal year 2027, $800,000,000, of which 
                $500,000,000 shall be for base grants and $300,000,000 
                shall be for matching grants.''.
    (d) Disposition of Excess Funds Reserved for Research, Evaluation, 
and Administration.--Section 511(j) of such Act (42 U.S.C. 711(j)) is 
amended by adding at the end the following:
            ``(5) Disposition of excess funds reserved for research, 
        evaluation, and administration.--To the extent that the amounts 
        reserved under paragraph (2)(D) for a fiscal year are not 
        obligated in the fiscal year, the Secretary may use the funds 
        for any purpose described in this section or to offset any 
        reduction with respect to this section that is required by 
        Federal law.''.

SEC. 4. REQUIREMENT THAT HOME VISITING PROGRAMS BE TARGETED AND 
              INTENSIVE.

    Section 511(d)(3) of the Social Security Act (42 U.S.C. 711(d)(3)) 
is amended by redesignating subparagraph (B) as subparagraph (C) and 
inserting after subparagraph (A) the following:
                    ``(B) Use of grant to provide or support targeted, 
                intensive home visiting services.--The program uses the 
                grant to provide or support targeted, intensive home 
                visiting services for the populations described in 
                paragraph (5).''.

SEC. 5. LIMITATION ON USE OF FUNDS FOR ADMINISTRATION.

    (a) In General.--Section 511(d) of the Social Security Act (42 
U.S.C. 711(d)) is amended by adding at the end the following:
            ``(5) Limitation on use of funds for administrative 
        costs.--
                    ``(A) In general.--Except as provided in 
                subparagraph (B) of this paragraph, an eligible entity 
                to which funds are provided under subsection (c) or 
                (h)(2)(B) shall not use more than 10 percent of the 
                funds to cover the costs of administration.
                    ``(B) Authority to grant exceptions.--
                            ``(i) In general.--The Secretary may 
                        authorize an eligible entity that meets a 
                        condition of clause (ii) of this subparagraph 
                        to exceed the percentage limitation in 
                        subparagraph (A) with respect to a program 
                        conducted under this subsection by not more 
                        than 5 percentage points, subject to such terms 
                        and conditions as the Secretary deems 
                        appropriate.
                            ``(ii) Conditions.--An eligible entity 
                        meets a condition of this clause if the 
                        eligible entity--
                                    ``(I) conducts the program by 
                                directly providing home visits to 
                                eligible families and without a sub-
                                recipient;
                                    ``(II) in the fiscal year for which 
                                the grant for the program is made under 
                                this section, proposes to expand 
                                services in 1 or more communities 
                                identified in the statewide needs 
                                assessment under subsection (b) and in 
                                which home visiting services are not 
                                provided; or
                                    ``(III) has conducted the program 
                                for fewer than 3 years.''.
    (b) Conforming Amendments.--Section 511(i)(2) of such Act (42 
U.S.C. 711(i)(2)) is amended by striking subparagraph (C) and 
redesignating subparagraphs (D) through (G) as subparagraphs (C) 
through (F), respectively.

SEC. 6. ANNUAL REPORT TO CONGRESS.

    (a) In General.--Section 511 of the Social Security Act (42 U.S.C. 
711) is amended by redesignating subsections (j) and (k) as subsections 
(k) and (l), respectively, and inserting after subsection (i) the 
following:
    ``(j) Annual Report to Congress.--By December 31, 2023, and 
annually thereafter, the Secretary shall submit to the Congress a 
written report on the grants made under this section for the then 
preceding fiscal year, which shall include--
            ``(1) an eligible entity-by-eligible entity summary of the 
        outcomes measured by the entity with respect to each benchmark 
        described in subsection (e)(5) that apply to the entity;
            ``(2) information regarding any technical assistance funded 
        under subparagraph (B) or (C) of subsection (k)(2), including 
        the type of any such assistance provided;
            ``(3) information on the demographic makeup of families 
        served by each such entity to the extent possible while 
        respecting participant confidentiality, including race, 
        ethnicity, educational attainment at enrollment, household 
        income, and other demographic markers as determined by the 
        Secretary;
            ``(4) the information described in subsection (d)(1)(E);
            ``(5) the estimated share of the eligible population served 
        using grants made under this section;
            ``(6) a description of each service delivery model funded 
        under this section by the eligible entities in each State, and 
        the share (if any) of the grants expended on each model;
            ``(7) a description of non-Federal expenditures by eligible 
        entities to qualify for matching funds under subsection (c)(4);
            ``(8) information on the uses of funds reserved under 
        subsection (k)(2)(C);
            ``(9) information relating to those eligible entities for 
        which funding is reserved under subsection (k)(2)(A), with 
        modifications as necessary to reflect tribal data sovereignty, 
        data privacy, and participant confidentiality; and
            ``(10) a list of data elements collected from eligible 
        entities, and the purpose of each data element in measuring 
        performance or enforcing requirements under this section.''.
    (b) Conforming Amendments.--
            (1) Section 511 of such Act (42 U.S.C. 711) is amended--
                    (A) in subsection (b)(1)(B)(iii), by striking 
                ``(k)(2)'' and inserting ``(l)(2)''; and
                    (B) in subsection (h)(2)(B)--
                            (i) by striking ``(j)'' and inserting 
                        ``(k)''; and
                            (ii) by striking ``(k)(1)(B)'' and 
                        inserting ``(l)(1)(B)''.
            (2) Section 511A(c) of such Act (42 U.S.C. 711a(c)) is 
        amended in each of paragraphs (5) and (7) by striking 
        ``511(k)(2)'' and inserting ``511(l)(2)''.

SEC. 7. REDUCTION OF ADMINISTRATIVE BURDEN.

    Section 511(h) of the Social Security Act (42 U.S.C. 711(h)) is 
amended by adding at the end the following:
            ``(6) Reduction of administrative burden.--
                    ``(A) In general.--The Secretary shall reduce the 
                burden, on States and public and private implementing 
                agencies at the local level, of administering this 
                section, by--
                            ``(i) reviewing and revising administrative 
                        data collection instruments and forms to 
                        eliminate duplication and streamline reporting 
                        requirements for States, eligible entities 
                        referred to in subsection (k)(2)(A), and 
                        nonprofit organizations referred to in 
                        subsection (l)(1)(B), including timelines for 
                        submitting reports;
                            ``(ii) conducting an analysis of the total 
                        number of hours reported by administering 
                        agencies on complying with paperwork 
                        requirements, and exploring, in consultation 
                        with administering agencies, ways to reduce the 
                        number of hours spent by at least 15 percent;
                            ``(iii) conducting a review of paperwork 
                        and data collection requirements for tribal 
                        grantees, and exploring, in consultation with 
                        tribes and tribal organizations, ways to reduce 
                        administrative burden, respect sovereignty, and 
                        acknowledge the different focus points for 
                        tribal grantees;
                            ``(iv) collecting input from relevant State 
                        fiscal officials to align fiscal requirements 
                        and oversight for States and eligible entities 
                        to ensure consistency with standards and 
                        guidelines for other Federal formula grant 
                        programs; and
                            ``(v) consulting with administering 
                        agencies and service delivery model 
                        representatives on needed and unneeded data 
                        elements regarding the dashboards provided for 
                        in subsection (d)(1)(B), consistent with the 
                        data requirements of such subsection.
                    ``(B) Findings on paperwork reduction.--
                            ``(i) Inclusion in report.--In the 1st 
                        report submitted pursuant to subsection (j) 
                        more than 18 months after the date of the 
                        enactment of this Act, the Secretary shall 
                        include the findings of the Secretary with 
                        respect to the matters described in 
                        subparagraph (A).
                            ``(ii) Implementation.--Within 2 years 
                        after complying with clause (i), the Secretary 
                        shall implement the findings referred to in 
                        clause (i).''.

SEC. 8. VIRTUAL HOME VISITING AUTHORIZATION AND RESTRICTIONS.

    (a) Virtual Home Visits.--
            (1) Application requirements.--Section 511(e) of the Social 
        Security Act (42 U.S.C. 711(e)) is amended by redesignating 
        paragraph (10) as paragraph (11) and inserting after paragraph 
        (9) the following:
            ``(10) At the option of the eligible entity--
                    ``(A) a description of any limitations or 
                constraints on virtual home visits under the program, 
                including--
                            ``(i) a description of the plan of the 
                        eligible entity to encourage in-person home 
                        visits; and
                            ``(ii) a description of the considerations 
                        to be used in determining when a virtual home 
                        visit is appropriate, including client consent, 
                        client preference, geographic limitations, 
                        model fidelity, and hazardous conditions 
                        including public health emergencies, weather 
                        events, health concerns for home visitors and 
                        client families, and other local issues;
                    ``(B) an assurance that--
                            ``(i) the virtual home visit is implemented 
                        as a model enhancement; or
                            ``(ii) the Secretary has identified the 
                        home visit as part of an effective model or 
                        model adaptation, based on an evidence of 
                        effectiveness review conducted using the 
                        criteria established under subsection 
                        (d)(3)(A)(iii); and
                    ``(C) an assurance to the Secretary that at least 1 
                in-person home visit shall be conducted for each client 
                family under the program during the 12-month period 
                that begins with the entry of the client family into 
                the program, and during each succeeding 12-month 
                period, except that any such period in which a public 
                health emergency declared under Federal law, or under 
                the law of the State in which the program is conducted, 
                is in effect shall be extended by the length of time in 
                which the declaration is in effect.''.
            (2) Applicable rules.--Section 511(d) of such Act (42 
        U.S.C. 711(d)) is amended by redesignating paragraph (4) and 
        paragraph (5) (as added by section 5(a) of this Act) as 
        paragraphs (5) and (6), respectively, and inserting after 
        paragraph (3) the following:
            ``(4) Virtual home visits.--
                    ``(A) In general.--A virtual home visit conducted 
                under the program shall be considered a home visit for 
                purposes of this section if the application for funding 
                of the program submitted pursuant to this section most 
                recently after the effective date of this paragraph 
                includes the material described in subsection (e)(10).
                    ``(B) Standards for training applicable to virtual 
                service delivery.--The standards for training 
                requirements applicable to virtual service delivery 
                under a home visiting model shall be equivalent to 
                those that apply to in-person service delivery under 
                the model.
                    ``(C) Reporting requirement.--A grant made under 
                this section for the program may not be used for any 
                virtual home visit during a year, unless the eligible 
                entity to which the grant is made submits the report 
                described in subsection (e)(8)(A) for the year.
                    ``(D) Virtual home visit defined.--In this section, 
                the term `virtual home visit' means a visit conducted 
                solely by use of electronic information and 
                telecommunications technologies.
                    ``(E) Technical assistance.--If the Secretary finds 
                that an eligible entity has not complied with the 
                assurance described in subsection (e)(10)(C), the 
                Secretary shall, directly or through grants, contracts, 
                or cooperative agreements, provide the eligible entity 
                with such technical assistance as is necessary to 
                assist the eligible entity in doing so.''.
            (3) Program requirement.--Section 511(d)(3)(C) of such Act 
        (42 U.S.C. 711(d)(3)(C)), as so redesignated by section 4 of 
        this Act, is amended by adding at the end the following:
                            ``(vii) If the application submitted by the 
                        eligible entity includes the assurance 
                        described in subsection (e)(10)(C) with respect 
                        to the program, the program provides in-person 
                        service consistent with the assurances.''.
            (4) Reports.--Section 511(e)(8)(A) of such Act (42 U.S.C. 
        711(e)(8)(A)) is amended by inserting ``, including the number 
        of virtual home visits conducted under the program in the year 
        covered by the report, disaggregated with respect to each home 
        visiting model under which the virtual home visits are 
        conducted'' before the semicolon.
    (b) Transition Rule.--
            (1) In general.--A virtual home visit conducted before the 
        effective date of the amendments made by this section under an 
        early childhood home visitation program funded under section 
        511 of the Social Security Act shall be considered a home visit 
        for purposes of such section.
            (2) Virtual home visit defined.--In paragraph (1), the term 
        ``virtual home visit'' means a visit conducted solely by use of 
        electronic information and telecommunications technologies.

SEC. 9. BUDGET OFFSET.

    Section 1898(b)(1) of the Social Security Act (42 U.S.C. 
1395iii(b)(1)) is amended by striking ``$7,308,000,000'' and inserting 
``$4,418,000,000''.

SEC. 10. EFFECTIVE DATE.

    (a) In General.--Except as provided in subsections (b) and (c), 
this Act and the amendments made by this Act shall take effect on 
October 1, 2022.
    (b) Virtual Home Visiting Provisions.--The amendments made by 
section 8 shall take effect on October 1, 2023.
    (c) Budget Offset.--The amendment made by section 9 shall take 
effect on the date of the enactment of this Act.

            Passed the House of Representatives December 2, 2022.

            Attest:

                                             CHERYL L. JOHNSON,

                                                                 Clerk.