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115th Congress } { Rept. 115-315
HOUSE OF REPRESENTATIVES
1st Session } { Part 1
======================================================================
INCREASING OPPORTUNITY AND SUCCESS FOR CHILDREN AND PARENTS THROUGH
EVIDENCE-BASED HOME VISITING ACT
_______
September 21, 2017.--Committed to the Committee of the Whole House on
the State of the Union and ordered to be printed
_______
Mr. Brady of Texas, from the Committee on Ways and Means, submitted the
following
R E P O R T
together with
DISSENTING VIEWS
[To accompany H.R. 2824]
[Including cost estimate of the Congressional Budget Office]
The Committee on Ways and Means, to whom was referred the
bill (H.R. 2824) to amend title V of the Social Security Act to
extend the Maternal, Infant, and Early Childhood Home Visiting
Program, having considered the same, report favorably thereon
with an amendment and recommend that the bill as amended do
pass.
CONTENTS
Page
I. SUMMARY AND BACKGROUND...........................................5
A. Purpose and Summary................................. 5
B. Background and Need for Legislation................. 5
C. Legislative History................................. 6
II. EXPLANATION OF THE BILL..........................................7
Sections 1 and 2: Short Title and Table of Contents.... 7
Section 3: Continuing Evidence-Based Home Visiting
Program............................................ 7
Section 4: Continuing to Demonstrate Results to Help
Families........................................... 8
Section 5: Reviewing Statewide Needs to Target
Resources.......................................... 10
Section 6: Improving the Likelihood of Success in High
Risk Communities................................... 12
Section 7: Measuring Improvements in Family Economic
Self-Sufficiency................................... 13
Section 8: Option to Fund Evidence-Based Home Visiting
on a Pay for Outcome Basis......................... 14
Section 9: Strengthening Evidence-Based Home Visiting
Through State, Local, and Private Partnership...... 15
Section 10: Data Exchange Standards for Improved
Interoperability................................... 17
III. VOTES OF THE COMMITTEE..........................................19
IV. BUDGET EFFECTS OF THE BILL......................................22
A. Committee Estimate of Budgetary Effects............. 22
B. Statement Regarding New Budget Authority and Tax
Expenditures Budget Authority...................... 23
C. Cost Estimate Prepared by the Congressional Budget
Office............................................. 23
V. OTHER MATTERS TO BE DISCUSSED UNDER THE RULES OF THE HOUSE......25
A. Committee Oversight Findings and Recommendations.... 25
B. Statement of General Performance Goals and
Objectives......................................... 25
C. Information Relating to Unfunded Mandates........... 25
D. Congressional Earmarks, Limited Tax Benefits, and
Limited Tariff Benefits............................ 25
E. Duplication of Federal Programs..................... 25
F. Disclosure of Directed Rule Makings................. 26
VI. CHANGES IN EXISTING LAW MADE BY THE BILL, AS REPORTED...........26
VII. DISSENTING VIEWS................................................41
VIII.EXCHANGES OF LETTERS WITH ADDITIONAL COMMITTEES OF REFERRAL.....43
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 ``Increasing Opportunity and Success for
Children and Parents through Evidence-Based Home Visiting Act''.
SEC. 2. TABLE OF CONTENTS.
The table of contents of this Act is as follows:
Sec. 1. Short title.
Sec. 2. Table of contents.
Sec. 3. Continuing evidence-based home visiting program.
Sec. 4. Continuing to demonstrate results to help families.
Sec. 5. Reviewing statewide needs to target resources.
Sec. 6. Improving the likelihood of success in high-risk communities.
Sec. 7. Measuring improvements in family economic self-sufficiency.
Sec. 8. Option to fund evidence-based home visiting on a pay for
outcome basis.
Sec. 9. Strengthening evidence-based home visiting through state,
local, and private partnerships.
Sec. 10. Data exchange standards for improved interoperability.
SEC. 3. CONTINUING EVIDENCE-BASED HOME VISITING PROGRAM.
Section 511(j)(1)(H) of the Social Security Act (42 U.S.C.
711(j)(1)(H)) is amended by striking ``fiscal year 2017'' and inserting
``each of fiscal years 2017 through 2022''.
SEC. 4. CONTINUING TO DEMONSTRATE RESULTS TO HELP FAMILIES.
(a) Require Service Delivery Models to Demonstrate Improvement in
Applicable Benchmark Areas.--Section 511 of the Social Security Act (42
U.S.C. 711) is amended in each of subsections (d)(1)(A) and (h)(4)(A)
by striking ``each of''.
(b) Demonstration of Improvements in Subsequent Years.--Section
511(d)(1) of such Act (42 U.S.C. 711(d)(1)) is amended by adding at the
end the following:
``(D) Demonstration of improvements in subsequent
years.--
``(i) Continued measurement of improvement in
applicable benchmark areas.--The eligible
entity, after demonstrating improvements for
eligible families as specified in subparagraphs
(A) and (B), shall continue to track and report
not later than 30 days after the end of fiscal
year 2020 and every three years thereafter,
information demonstrating that the program
results in improvements for the eligible
families participating in the program in at
least 4 of the areas specified in subparagraph
(A) that the service delivery model or models,
selected by the entity, intend to improve.
``(ii) Corrective action plan.--If the
eligible entity fails to demonstrate
improvement in at least 4 of the areas
specified in subparagraph (A), the entity shall
develop and implement a plan to improve
outcomes in each of the areas specified in
subparagraph (A) that the service delivery
model or models, selected by the entity, intend
to improve, subject to approval by the
Secretary. The plan shall include provisions
for the Secretary to monitor implementation of
the plan and conduct continued oversight of the
program, including through submission by the
entity of regular reports to the Secretary.
``(iii) Technical assistance.--The Secretary
shall provide an eligible entity required to
develop and implement an improvement plan under
clause (ii) with technical assistance to
develop and implement the plan. The Secretary
may provide the technical assistance directly
or through grants, contracts, or cooperative
agreements.
``(iv) No improvement or failure to submit
report.--If the Secretary determines after a
period of time specified by the Secretary that
an eligible entity implementing an improvement
plan under clause (ii) has failed to
demonstrate any improvement in at least 4 of
the areas specified in subparagraph (A) that
the service delivery model or models intend to
improve, or if the Secretary determines that an
eligible entity has failed to submit the report
required by clause (i), the Secretary shall
terminate the grant made to the entity under
this section and may include any unexpended
grant funds in grants made to nonprofit
organizations under subsection (h)(2)(B).''.
(c) Including Information on Applicable Benchmarks in Application.--
Section 511(e)(5) of such Act (42 U.S.C. 711(e)(5)) is amended by
inserting ``that the service delivery model or models, selected by the
entity, intend to improve'' before the period at the end.
SEC. 5. REVIEWING STATEWIDE NEEDS TO TARGET RESOURCES.
Section 511(b)(1) of the Social Security Act (42 U.S.C. 711(b)(1)) is
amended by striking ``Not later than'' and all that follows through
``statewide'' the 2nd place it appears and inserting ``Each State
shall, as a condition of receiving payments from an allotment for the
State under section 502, review and update the statewide needs
assessment not later than October 1, 2020 (which may be separate from
but in coordination with the statewide''.
SEC. 6. IMPROVING THE LIKELIHOOD OF SUCCESS IN HIGH-RISK COMMUNITIES.
Section 511(d)(4)(A) of the Social Security Act (42 U.S.C.
711(d)(4)(A)) is amended by inserting ``, taking into account the
staffing, community resource, and other requirements of the service
delivery model or models that the eligible entity may need to develop
for the model to operate and demonstrate improvements for eligible
families'' before the period.
SEC. 7. MEASURING IMPROVEMENTS IN FAMILY ECONOMIC SELF-SUFFICIENCY.
Section 511(d)(1)(A)(v) of the Social Security Act (42 U.S.C.
711(d)(1)(A)(v)) is amended by inserting ``(which shall include
measures of employment and earnings)'' before the period.
SEC. 8. OPTION TO FUND EVIDENCE-BASED HOME VISITING ON A PAY FOR
OUTCOME BASIS.
(a) In General.--Section 511(c) of the Social Security Act (42 U.S.C.
711(c)) is amended by redesignating paragraphs (3) and (4) as
paragraphs (4) and (5), respectively, and by inserting after paragraph
(2) the following:
``(3) Authority to use grant for a pay for outcomes
initiative.--An eligible entity to which a grant is made under
paragraph (1) may use the grant to pay for the results of a pay
for outcomes initiative that satisfies the requirements of
subsection (d) and that will not result in a reduction of
funding for services delivered under this section while an
eligible entity develops or operates such an initiative.''.
(b) Definition of Pay for Outcomes Initiative.--Section 511(k) of
such Act (42 U.S.C. 711(k)) is amended by adding at the end the
following:
``(4) Pay for outcomes initiative.--The term `pay for
outcomes initiative' means a performance-based grant, contract,
cooperative agreement, or other agreement awarded by a public
entity in which a commitment is made to pay for improved
outcomes that result in social benefit and direct cost savings
or cost avoidance to the public sector. Such an initiative
shall include--
``(A) a feasibility study that describes how the
proposed intervention is based on evidence of
effectiveness;
``(B) a rigorous, third-party evaluation that uses
experimental or quasi-experimental design or other
research methodologies that allow for the strongest
possible causal inferences to determine whether the
initiative has met its proposed outcomes;
``(C) an annual, publicly available report on the
progress of the initiative; and
``(D) a requirement that payments are made to the
recipient of a grant, contract, or cooperative
agreement only when agreed upon outcomes are achieved,
except that this requirement shall not apply with
respect to payments to a third party conducting the
evaluation described in subparagraph (B).''.
(c) Extended Availability of Funds.--Section 511(j)(3) of such Act
(42 U.S.C. 711(j)(3)) is amended--
(1) by striking ``(3) Availability.--Funds'' and inserting
the following:
``(3) Availability.--
``(A) In general.--Except as provided in subparagraph
(B), funds''; and
(2) by adding at the end the following:
``(B) Funds for pay for outcomes initiatives.--Funds
made available to an eligible entity under this section
for a fiscal year (or portion of a fiscal year) for a
pay for outcomes initiative shall remain available for
expenditure by the eligible entity for not more than 10
years after the funds are so made available.''.
SEC. 9. STRENGTHENING EVIDENCE-BASED HOME VISITING THROUGH STATE,
LOCAL, AND PRIVATE PARTNERSHIPS.
(a) In General.--Section 511 of the Social Security Act (42 U.S.C.
711) is amended by adding at the end the following:
``(l) Matching Requirement.--
``(1) Program home visiting share.--
``(A) In general.--An eligible entity to which a
grant is made under this section for fiscal year 2020
or any succeeding fiscal year shall not use the grant
to cover more than the applicable percentage of the
costs of providing services or conducting activities
under this section during the fiscal year.
``(B) Applicable percentage.--In subparagraph (A),
the term `applicable percentage' means, with respect to
a fiscal year--
``(i) in the case of an eligible entity that
is a State or nonprofit organization--
``(I) 70 percent, in the case of
fiscal year 2020;
``(II) 60 percent, in the case of
fiscal year 2021; or
``(III) 50 percent, in the case of
fiscal year 2022 or any succeeding
fiscal year; or
``(ii) in the case of an eligible entity that
is an Indian Tribe (or a consortium of Indian
Tribes), a Tribal Organization, or an Urban
Indian Organization--
``(I) 100 percent, in the case of
fiscal year 2020 or 2021; or
``(II) 70 percent, in the case of
fiscal year 2022 or any succeeding
fiscal year.
``(2) Non-program home visiting share.--The share of the
costs of providing services or conducting activities under this
section not covered by grant funds may include--
``(A) State expenditures of Federal funds made
available other than under this section expended for
activities under this section;
``(B) State expenditures of State funds expended for
activities under this section as a condition of
receiving Federal funds other than under this section;
and
``(C) contributions made for activities under this
section from any other source, paid in cash or in kind,
valued at the fair market value of such
contribution.''.
(b) Conforming Amendment.--Section 511(h)(2)(A) of such Act (42
U.S.C. 711(h)(2)(A)) is amended in the 2nd sentence by striking
``Such'' and inserting ``Except as provided in subsection (l)(1),
such''.
SEC. 10. DATA EXCHANGE STANDARDS FOR IMPROVED INTEROPERABILITY.
(a) In General.--Section 511(h) of the Social Security Act (42 U.S.C.
711(h)) is amended by adding at the end the following:
``(5) Data exchange standards for improved
interoperability.--
``(A) Designation and use of data exchange
standards.--
``(i) Designation.--The head of the
department or agency responsible for
administering a program funded under this
section shall, in consultation with an
interagency work group established by the
Office of Management and Budget and considering
State government perspectives, designate data
exchange standards for necessary categories of
information that a State agency operating the
program is required to electronically exchange
with another State agency under applicable
Federal law.
``(ii) Data exchange standards must be
nonproprietary and interoperable.--The data
exchange standards designated under clause (i)
shall, to the extent practicable, be
nonproprietary and interoperable.
``(iii) Other requirements.--In designating
data exchange standards under this paragraph,
the Secretary shall, to the extent practicable,
incorporate--
``(I) interoperable standards
developed and maintained by an
international voluntary consensus
standards body, as defined by the
Office of Management and Budget;
``(II) interoperable standards
developed and maintained by
intergovernmental partnerships, such as
the National Information Exchange
Model; and
``(III) interoperable standards
developed and maintained by Federal
entities with authority over
contracting and financial assistance.
``(B) Data exchange standards for federal
reporting.--
``(i) Designation.--The head of the
department or agency responsible for
administering a program referred to in this
section shall, in consultation with an
interagency work group established by the
Office of Management and Budget, and
considering State government perspectives,
designate data exchange standards to govern
Federal reporting and exchange requirements
under applicable Federal law.
``(ii) Requirements.--The data exchange
reporting standards required by clause (i)
shall, to the extent practicable--
``(I) incorporate a widely accepted,
nonproprietary, searchable, computer-
readable format;
``(II) be consistent with and
implement applicable accounting
principles;
``(III) be implemented in a manner
that is cost-effective and improves
program efficiency and effectiveness;
and
``(IV) be capable of being
continually upgraded as necessary.
``(iii) Incorporation of nonproprietary
standards.--In designating data exchange
standards under this paragraph, the Secretary
shall, to the extent practicable, incorporate
existing nonproprietary standards, such as the
eXtensible Mark up Language.
``(iv) Rule of construction.--Nothing in this
paragraph shall be construed to require a
change to existing data exchange standards for
Federal reporting about a program referred to
in this section, if the head of the department
or agency responsible for administering the
program finds the standards to be effective and
efficient.''.
(b) Effective Date.--The amendments made by this section shall take
effect 2 years after the date of the enactment of this Act.
I. SUMMARY AND BACKGROUND
A. Purpose and Summary
H.R. 2824 as amended, the ``Increasing Opportunity and
Success for Children and Parents through Evidence-Based Home
Visiting Act,'' as ordered reported by the Committee on Ways
and Means on September 13, 2017, amends title V of the Social
Security Act to extend the Maternal, Infant, and Early
Childhood Home Visiting Program.
B. Background and Need for Legislation
Social services programs often are unable to demonstrate
they achieve better outcomes for poor families. According to
two former White House officials, ``based on our rough
calculations, less than $1 out of every $100 of government
spending is backed by even the most basic evidence that the
money is being spent wisely.''\1\ In contrast, the Maternal,
Infant, and Early Childhood Home Visiting program (MIECHV),
first funded as a pilot program in 2008 during the George W.
Bush Administration, only awards funds to states when they
operate one of 18 programs that meet a specified evidence
threshold (as confirmed by the U.S. Department of Health and
Human Services) demonstrating the model has been subject to a
high quality evaluation and yielded significant, positive
outcomes in areas such as reducing child abuse and neglect,
improving maternal and child health, and improving self-
sufficiency.
---------------------------------------------------------------------------
\1\The Atlantic, ``Can Government Play Moneyball?,'' John
Bridgeland and Peter Orszag, July/August 2013
---------------------------------------------------------------------------
Begun in 2010, the federal MIECHV program was designed to
strengthen existing maternal and child health programs, provide
services to improve outcomes for families in at-risk
communities, and better coordinate services. Under the MIECHV
program, states identify at-risk communities through statewide
assessments examining areas with concentrations of poor child
health outcomes and other difficulties such as high poverty,
crime, or unemployment. States then specify how they will serve
these communities using an evidence-based home visiting model.
While the bulk of program funding must be used to provide
services through home visiting models with evidence of
effectiveness as determined by HHS, up to 25 percent of total
funding can be used to fund promising, but still unproven,
approaches that will be evaluated ensuring continuous model
development. States receiving federal funding are not required
to match dollars with state or local money.
Set to expire September 30, 2017, MIECHV is currently the
only federal program for low-income families with children that
ties funding to evidence of effectiveness. MIECHV should be
extended so it can continue to deliver results for families in
need, and other programs should be modified to work more like
MIECHV, where funding is provided to develop and operate
evidence-based programs and states are held accountable for
delivering results.
C. Legislative History
BACKGROUND
H.R. 2824, the ``Increasing Opportunity through Evidence-
Based Home Visiting Act,'' was introduced on June 8, 2017, by
Representative Adrian Smith, Representative Michael C. Burgess,
Representative Patrick J. Tiberi, Representative Tom Reed,
Representative Patrick Meehan, Representative Kristi L. Noem,
and Representative Jackie Walorski and was referred to the
Committee on Ways and Means and Energy and Commerce.
COMMITTEE HEARINGS
The Ways and Means Subcommittee on Human Resources held a
hearing on March 15, 2017, titled ``Reauthorization of the
Maternal, Infant, and Early Childhood Home Visiting (MIECHV)
Program.'' The hearing examined the effectiveness of a range of
home visiting models, reviewed how states operate and fund
programs, and highlighted how an evidence-based home visiting
program can produce positive outcomes for children and
families.
As Subcommittee Chairman Adrian Smith (R-NE) remarked
during his opening statement:
``MIECHV is one of the only social programs where
funding is tied to proven evidence. For a home visiting
model to be funded, an evaluation must show the program
has demonstrated significant, positive outcomes in
areas such as reducing childhood abuse and neglect,
improving maternal and child health, and improving
economic self-sufficiency. Many of these approved
models are now being further studied through a rigorous
random assignment evaluation to better measure their
impacts so we know families are receiving real
help.''\2\
\2\Chairman of the Ways and Means Human Resources Subcommittee
Adrian Smith (R-NE), Opening Statement, Hearing on The Reauthorization
of the Maternal, Infant, and Early Childhood Home Visiting (MIECHV)
Program, March 15, 2017
---------------------------------------------------------------------------
COMMITTEE ACTION
The Committee on Ways and Means marked up H.R. 2824, the
``Increasing Opportunity and Success for Children and Parents
through Evidence-Based Home Visiting Act,'' on September 13,
2017. The bill was ordered favorably reported to the House of
Representatives, as amended, by a roll call vote of 22 yays to
15 nays.
II. EXPLANATION OF THE BILL
Sections 1 and 2: Short Title and Table of Contents
PRESENT LAW
No provision.
EXPLANATION OF PROVISION
This Act may be cited as ``Increasing Opportunity and
Success for Children and Parents through Evidence-Based Home
Visiting Act.''
REASON FOR CHANGE
The Committee believes that the short title and table of
contents accurately reflect the policy actions included in the
legislation.
EFFECTIVE DATE
These provisions are effective upon enactment.
Section 3: Continuing Evidence-Based Home Visiting Program
PRESENT LAW
The MIECHV law directly appropriated five years of
mandatory funding for the program in the MIECHV authorizing
statute: $100 million for FY2010; $250 million for FY2011; $350
million for FY2012; and $400 million for each of FY2013 through
FY2017. [Section 511(j)(1) of the Social Security Act]
EXPLANATION OF PROVISION
H.R. 2824, as amended, extends the appropriated, mandatory
funding of $400 million for the MIECHV program for FY 2018
through FY2022.
REASON FOR CHANGE
The Committee believes the extension of this evidence-based
program will help improve the lives of struggling families with
children, and that the program can serve as a model for how
other federal social programs can be reformed to focus on
outcomes.
EFFECTIVE DATE
This provision is effective upon enactment.
Section 4: Continuing To Demonstrate Results To Help Families
BENCHMARK AREAS
PRESENT LAW
Eligible entities must establish, subject to approval of
the HHS Secretary, quantifiable and measurable benchmarks for
demonstrating improvements for eligible families participating
in the program in each of six areas: (1) improved maternal and
newborn health; (2) prevention of child injuries, child abuse,
neglect, or maltreatment, and reduction of emergency department
visits; (3) improvements in school readiness and achievement;
(4) reduction in crime or domestic violence; (5) improvements
in family economic self-sufficiency; and (6) improvements in
the coordination and referrals for other community resources
and supports. Performance in the benchmark areas are to be
assessed at three and five years following the start of
program.
Each eligible entity is required to submit a report to the
HHS Secretary demonstrating that it has made improvements in at
least four of the six benchmark areas during the first three
years that it carries out the program.\3\ The report is to be
submitted within 30 days of the end of that three-year period.
[Section 511(d)(1) of the Social Security Act]
---------------------------------------------------------------------------
\3\Most eligible entities had to submit the report by October 30,
2014 to show that improvements were made between FY2012, when the
program was fully implemented, and FY2014, the third year of
implementation.
---------------------------------------------------------------------------
An eligible entity must submit, as part of its grant
application to HHS, the quantifiable and measurable benchmarks
it has established demonstrate that the program contributes to
improvements for eligible families in the six areas. [Section
511(e)(5)) of the Social Security Act]
EXPLANATION OF PROVISION
H.R. 2824, as amended, would require eligible entities to
track and report, subject to the approval of the HHS Secretary,
quantifiable and measurable benchmarks that are intended to
demonstrate continued improvements for eligible families. These
four or more benchmark areas would be subject to approval of
the HHS Secretary and would include only those that the service
delivery model, as selected by the eligible entity, are
intended to improve. The four or more benchmark areas would
continue to be included as part of the eligible entity's grant
application.
REASON FOR CHANGE
During the initial years of the program, states were
required to demonstrate improvements in specific areas for
families receiving services. However, these requirements have
now lapsed. This bill would renew the requirements for the
measurement and reporting of outcomes so Congress, the families
being served, and taxpayers funding these programs can be sure
these programs continue to deliver real results. Specifically,
the Committee intends that HHS continue to measure improvement
among eligible, enrolled families as a result of MIECHV grants
compared with families who do not receive these services. It is
the Committee's intent that each eligible entity shall continue
to identify at least four of the six possible benchmarks for
which it will track and report the progress of families
enrolled in the program. Eligible entities shall track and
report on family progress on the measures associated with the
selected benchmarks that the service delivery model in which
the family is participating is intended to improve. For
example, if reduction in child injury is not an intended
outcome of a particular home visiting model, families receiving
home visits through that model would not be required to be
included in measures tracking improvements in child injury,
although the eligible entity may choose to track this
information.
CORRECTIVE ACTION PLAN AND TECHNICAL ASSISTANCE
PRESENT LAW
If an eligible entity fails to demonstrate improvements in
four of the six benchmark areas within the first three years of
program implementation, it must develop and implement a plan to
make improvements in each of the applicable benchmark areas,
subject to approval by the HHS Secretary. The Secretary must
provide technical assistance (directly or through grants,
contracts, or cooperative agreements) to the eligible entity in
developing and implementing the plan. The HHS Secretary must
convene an advisory panel made up of staff from the Departments
of Health and Human Services and Education to make
recommendations about this technical assistance. [Section
511(d)(1) of the Social Security Act]
EXPLANATION OF PROVISION
If an eligible entity does not continue to demonstrate
ongoing improvements in at least four of the benchmark areas,
it must develop and implement a plan to make improvements in
each of the applicable benchmark areas (subject to approval by
the HHS Secretary) that are applicable to the service delivery
model selected by the entity. The improvement plan would
include provisions for the HHS Secretary to monitor the plan's
implementation and conduct continued oversight of the program,
including by regular reports submitted by the eligible entity.
The Secretary must provide technical assistance (directly or
through grants, contracts, or cooperative agreements) to the
eligible entity in developing and implementing the plan.
REASON FOR CHANGE
During the initial years of the program, if states did not
demonstrate improvements in specific areas for families
receiving services, they were required to develop an
improvement plan to address the problem. However, this
requirement has now lapsed. This bill would renew the
requirement that the state develop an improvement plan if they
don't achieve results, allowing Congress, the families being
served, and the taxpayers funding the program to have
confidence that efforts are being made to hold states
accountable and correct deficiencies if they arise.
Specifically, it is the Committee's intent that, if the
eligible entity fails to show participation in home visiting
improves family outcomes as compared to families who do not
receive home visiting services, the entity is required to
develop and implement an improvement plan. It is the
Committee's intent that eligible entities shall be held
accountable for demonstrating that families enrolled in home
visiting achieve improved outcomes. It is not the Committee's
intent to penalize eligible entities that have achieved
substantial outcomes and are unable to demonstrate further
progress among families enrolled in home visiting as compared
to families receiving these services in a prior year.
TERMINATION OF FUNDING
PRESENT LAW
The HHS Secretary must terminate a jurisdiction's MIECHV
funding if, after a period of time specified by the Secretary,
the jurisdiction has failed to demonstrate any improvements in
outcomes following the first three years of the program's
implementation, or if the Secretary determines that the
jurisdiction has failed to submit the required report on
performance in the benchmark areas after the initial three
years that the program is implemented. The Secretary may
include any unexpended grant funds in grants made to nonprofit
organizations that operate home visiting programs in states
that had not (as of the beginning of FY2012), applied or been
approved for a MIECHV grant. [Section 511(d)(1) of the Social
Security Act]
EXPLANATION OF PROVISION
H.R. 2824, as amended, would extend these same requirements
for an eligible entity that does not continue to demonstrate
ongoing improvements in at least four of the benchmark areas in
subsequent years, or if the eligible entity has failed to
submit the required annual report to the HHS Secretary on
improvements made in the benchmark areas.
REASON FOR CHANGE
The Committee believes renewing the requirement that HHS
terminate MIECHV funding to a jurisdiction that has failed to
demonstrate results will ensure federal funds are spent on
programs that truly help those in need, instead of continuing
to support programs that are ineffective. Renewing this
requirement is consistent with the other efforts in this
section to revive the set of policies that helped to establish
MIECHV as a leading program to provide real results to
families.
EFFECTIVE DATE
These provisions in this section are effective upon
enactment.
Section 5: Reviewing Statewide Needs To Target Resources
PRESENT LAW
As a condition of receiving funds under the Maternal and
Child Health Services Block Grant for FY2011, states were
required to conduct a statewide needs assessment for the MIECHV
program.\4\ The statewide needs assessment has three purposes,
as outlined in the law:
---------------------------------------------------------------------------
\4\The Maternal and Child Health Block Grant, authorized under
Title V of the Social Security Act, is a flexible source of funds that
states use to support maternal and child health programs.
---------------------------------------------------------------------------
Identify communities with concentrations of
premature birth, low-birth weight infants, and infant
mortality, including infant death due to neglect or other
indicators of at-risk prenatal, maternal, newborn, or child
health; poverty; crime; domestic violence; high school
dropouts; substance abuse; unemployment; or child maltreatment.
Determine the quality and capacity of existing
programs or initiatives for early childhood home visitation in
the jurisdiction, including the number and types of individuals
and families who are receiving services under such programs or
initiatives; gaps in early childhood home visitation in the
jurisdiction; and the extent to which such programs and
initiatives are meeting the needs of eligible families.
Determine the state's capacity for providing
substance abuse treatment and counseling services to
individuals and families in need of such treatment or services.
The needs assessment was to be separate from the statewide
needs assessment required under the Maternal and Child Health
Services Block Grant. [Section 511(b)(1) of the Social Security
Act]
EXPLANATION OF PROVISION
H.R. 2824, as amended, would require eligible entities to
review and update their statewide needs assessment by October
1, 2020 as a condition of receiving funds under the Maternal
and Child Health Services Block Grant. The assessment must be
coordinated with statewide needs assessment required under the
Maternal and Child Health Services Block Grant, but may be
conducted separately.
REASON FOR CHANGE
In order to guide placement of home visiting programs
funded by MIECHV in high-risk communities with the greatest
need, states conducted needs assessments in FY 2010 before
receiving funding for the next fiscal year. The Committee
recognizes that those initial assessments are nearly a decade
old and should be reviewed and updated. It is the Committee's
intent that state needs assessments be updated no later than
October 1, 2020 (allowing states to select the schedules as
they see fit), and that states may exercise the option to
coordinate with other related data collection and analysis
efforts as they choose. States shall retain the authority to
use the information gathered at their discretion. The
Committee's intent in requiring the review and updating of the
needs assessment is for states to gather more recent
information on community needs and reaffirm that MIECHV
programs are being operated in areas of high need. Nothing in
this section shall be construed to require moving MIECHV-funded
home visiting programs, defunding of programs for the sole
purpose of moving services to other communities, or otherwise
disrupting existing home visiting programs, their relationships
in the community, and their services to eligible families.
EFFECTIVE DATE
This provision is effective upon enactment.
Section 6: Improving the Likelihood of Success in High Risk Communities
PRESENT LAW
Eligible entities must give priority for providing home
visiting services to specified high-risk populations, including
eligible families who (1) reside in communities in need of home
visiting services, as identified in the statewide needs
assessment; (2) are low income; (3) are pregnant women under
age 21; (4) have a history of child abuse or neglect or have
had interactions with child welfare services; (5) have a
history of substance abuse or need substance abuse treatment;
(6) have users of tobacco products in the home; (7) are or have
children with low student achievement; (8) have children with
developmental delays or disabilities; or (9) include
individuals who are, or were, serving in the Armed Forces,
including families with members who have multiple deployments
outside of the United States. [Section 511(d)(4) of the Social
Security Act]
EXPLANATION OF PROVISION
H.R. 2824, as amended, would continue to give priority for
services to those high risk families identified in the needs
assessment, while allowing eligible entities to take into
account additional factors--staffing, community resource, and
other requirements of the service delivery model(s)--that the
eligible entity may need to develop for the model to operate
and demonstrate improvements for these eligible families.
REASON FOR CHANGE
The Committee recognizes that, as states conduct updated
needs assessments and consider the placement of home visiting
programs in the highest need communities, they may determine a
particular community needs additional technical assistance or
other resources prior to launch of a home visiting program to
increase the likelihood that the program will succeed and that
families will benefit from home visiting. States are encouraged
to offer such assistance to help communities prepare to
implement a MIECHV home visiting model. States are also
encouraged to consider the full range of MIECHV-approved models
when determining how best to support successful home visiting
in any given community. Nothing in this section shall be
construed to give States the option not to support the success
of home visiting in communities of highest risk and need.
EFFECTIVE DATE
This provision is effective upon enactment.
Section 7: Measuring Improvements in Family Economic Self-Sufficiency
PRESENT LAW
One of the six benchmark areas in which program performance
may be measured pertains to improvements in family economic
self-sufficiency. [Section 511(d)(1)(v) of the Social Security
Act]
EXPLANATION OF PROVISION
H.R. 2824, as amended, would specify that improvements in
family economic self-sufficiency must include measures of
employment and earnings.
REASON FOR CHANGE
Under current law, each eligible entity must establish
quantifiable, measureable benchmarks to demonstrate that their
MIECHV programs are resulting in improvements in at least four
of six benchmarks, with one of these benchmarks being
``improvements in family economic self-sufficiency.'' While the
Committee believes the plain language in the statute is clear
and that measuring economic self-sufficiency means measurement
of employment and earnings, recent administrative changes have
modified the way states track their performance relative to
this benchmark so that employment and earnings are no longer
considered as part of this metric.\5\ As a result, the
Committee believes it is necessary to specify that employment
and earnings measures be part of this benchmark area, so that
an eligible entity who indicates they plan to improve family
economic self-sufficiency will report this information.
---------------------------------------------------------------------------
\5\MIECHV Form 2 Performance Indicators and Systems Outcomes Data
Collection and Reporting Manual and Grantee Plan, updated October 2016
describes the new indicators used to measure family economic self-
sufficiency, which are primary caregiver education and continuity of
insurance coverage.
---------------------------------------------------------------------------
At the same time, the Committee does not believe the home
visitor must necessarily be the person tasked with collecting
detailed data on employment and earnings for those they visit,
although visitors from models intending to improve family
economic self-sufficiency will likely be asking about and
gathering some information on these topics. Instead, the
Committee expects eligible entities to work with state and
federal partners to utilize employment and earnings information
the family already provides (such as information collected and
used to determine eligibility for other benefits and services
the family may be receiving) or that is available from other
sources.
The Committee recognizes this provision will require
coordination between states, MIECHV models, the Administration
for Children and Families (ACF), and the Health Resources and
Services Administration (HRSA). The Committee further
recognizes that the data collected under this provision may be
incomplete until data is shared between all applicable
departments of government, and encourages states, MIECV models,
and HHS to provide Congress with information on how to improve
this data sharing through legislative changes if necessary.
EFFECTIVE DATE
This provision is effective upon enactment.
Section 8: Option to Fund Evidence-Based Home Visiting on a Pay for
Outcome Basis
PRESENT LAW
No provision.
EXPLANATION OF PROVISION
H.R. 2824, as amended, would add new language to enable an
eligible entity to use MIECHV grants for a pay-for-outcomes
initiative that satisfy the requirements for providing
evidence-based home visiting services.
H.R. 2824, as amended, would separately define ``pay for
outcome initiative'' as a performance-based grant, contract,
cooperative agreement or other agreement awarded by a public
entity inwhich a commitment is made to pay for improved
outcomes that result in social benefit and direct cost savings or cost
avoidance to the public sector. Such an initiative would include--
a feasibility study that describes how the
proposed intervention is based on evidence of
effectiveness;
a rigorous, third-party evaluation that uses
experimental or quasi-experimental design, or other
research methodologies, that allow for the strongest
possible causal inferences to determine whether the
initiative has met its proposed outcomes;
an annual, publicly available report on the
progress of the initiative; and
a requirement that payments are made to the
recipient of a grant, contract, or cooperative
agreement only when agreed upon outcomes are achieved,
except that this requirement would not apply to
payments for the third-party evaluation.
Funding for pay-for-outcomes initiatives could be expended
by the eligible entity for up to 10 years after the funds are
made available, and funds could be reused to fund other MIECHV
projects if outcomes are not met and therefore payment is not
made.
REASON FOR CHANGE
The Committee recognizes that there is bipartisan support
to use federal funds to pay for programs that produce real
results. Groups ranging from conservative think tanks to
liberal advocacy organizations have recommended funding
programs on a ``pay-for-outcomes'' basis. States and local
governments are testing this strategy now--including in
MIEHCV--but unless Congress allows federal funds to be used to
pay for outcomes, their opportunities are limited as a
substantial amount of funding for evidence-based home visiting
programs is provided by the federal government. By allowing
MIECHV grantees to pay for outcomes, more approaches can be
tested and evaluated to determine whether they deliver real
results for families with children.
A key feature of ``pay for outcomes'' financing is that the
entity funding the project works with the service provider to
jointly identify objective, quantifiable outcomes that must be
met for payment to be made and an independent evaluator
determines if the goals are met. By selecting an objective
outcome goal instead of some other metric for payment, the
government is less likely to pay for things that don't produce
the outcome they are seeking (such as clients served, classes
taught, or costs incurred). In addition, the outcome for
individuals served will be compared with the outcomes for a
control group to confirm the services provided are responsible
for producing the outcome.
``Pay for outcomes'' financing also aligns the interests of
the government, other funders, and service providers. In a
traditional contract, the government agrees to pay for various
inputs, processes, or services, which may encourage providers
to increase those factors--regardless of whether they improve
the outcome or not. In a ``pay for outcomes'' financing
structure, the funder only pays if the project achieves the
desired outcomes. As a result, service providers have a strong
incentive to produce the positive social outcome and manage the
project to ensure it succeeds.
The Committee believes allowing MIECHV grantees to use
funding to pay for outcomes will help focus more federal
spending on programs that deliver results. The Committee heard
about an effort currently underway in South Carolina using non-
federal funds during a March 15, 2017 hearing on
reauthorization testing this ``pay for outcomes'' structure,
and this provision will allow other states to test this
approach as well. Paying for outcomes can reduce bureaucracy
and increase local flexibility, as payment is tied to achieving
an agreed-upon result instead of the performance of specific
intermediate actions intended to be a proxy for outcomes. And
because payment is tied to results, programs that are not
successful no longer continue--meaning federal funds are
focused on what works.
EFFECTIVE DATE
This provision is effective upon enactment.
Section 9: Strengthening Evidence-Based Home Visiting Through State,
Local, and Private Partnership
PRESENT LAW
MIECHV funds provided to an eligible entity must be used to
supplement and not supplant funds from other sources for early
childhood home visiting. [Section 511(c) of the Social Security
Act.]
EXPLANATION OF PROVISION
H.R. 2824, as amended, would require an eligible entity to
support its MIECHV home visiting services with funds other than
those provided under the MIECHV program. Beginning with FY2020,
state or nonprofit organizations must support the MIECHV
program with no less than 30% of non-MIECHV funds. This
percentage would rise to 40% for FY2021 and to 50% for FY2022
and succeeding years. For an Indian Tribe (or a consortium of
that Indian Tribes), a Tribal Organization, or an Urban Indian
Organization, there would be an additional two-year delay with
no less than 30% of funds coming from non-MIECHV sources
beginning in FY2022.
These non-MIECHV funds (which could be other federal funds,
or non-federal dollars) could be paid in cash or in kind. The
HHS Secretary could attribute fair market value to goods,
services, and facilities provided from non-federal sources.
REASON FOR CHANGE
MIECHV programs have been shown to reduce child abuse and
neglect, improve maternal and child health, and increase self-
sufficiency among other impacts, and these benefits--both
social and fiscal--will accrue to the state and the federal
government. As a result, the Committee believes states should
be expected to contribute other resources to support MIECHV. In
addition, the Committee believes programs are operated more
effectively and efficiently when states are investing their own
funds. Requiring matching funds also increases resources to the
program, allowing it to reach at least $800 million a year in
spending by FY2022.
Most social programs funded by this Committee, and many
funded by other committees, already require states to match
federal dollars, including Medicaid (where states spent $212
billion in state matching funds in FY 2016), foster care and
adoption (where states spent $6 billion in state matching funds
in FY 2015) along with other programs such as child support,
child care, and child welfare.\6\ The requirement that states
invest funds beyond those provided by the federal government
should be no different for this program.
---------------------------------------------------------------------------
\6\Medicaid and CHIP Payment and Access Commission, Exhibit 16:
Medicaid Spending by State, Category, and Source of Funds.
Committee on Ways and Means Green Book, 2016. Table 11-8: Title IV-
E Foster Care, Adoption Assistance, and Kinship Guardianship Assistance
Spending by State, FY2015.
---------------------------------------------------------------------------
In addition to making this program more consistent with
other federal social programs requiring outside investment,
many of the savings that result from the success of this
program--such as decreased hospital admissions, increased
school readiness, reduced child abuse and neglect--are savings
realized at the state and local level. These benefits reinforce
the idea that it is already in the best financial interest of
states to invest in this program.
The Congressional Budget Office projects the federal
government will spend almost $700 billion more than it takes in
this year, and that the U.S. now has $20 trillion in debt.
Because of this, the Committee believes the most responsible
way to continue this program and expand its reach is to provide
funding for it by improving the integrity of another program to
offset the cost [as was done in H.R. 2972, the Control of
Unlawful Fugitive Felons (CUFF) Act, which was marked up and
passed in conjunction with this bill], as well as create a
strong federal-state financial partnership going forward.
This bill gives states substantial flexibility in meeting
the matching requirement, allowing contributions to be made in
cash or in kind from many different sources. For example, a
state or local government could spend their own funds or accept
contributions from a nonprofit organization or foundation. A
state could also support MIECHV with other federal funds
intended for a similar purpose (such as funds from the
Temporary Assistance for Needy Families or Social Services
Block Grant programs). This requirement will encourage states
to shift spending towards evidence-based approaches that
deliver real results for families, magnifying the impact of the
program and yielding positive outcomes for more parents and
their children across the country.
Taking into account the feedback from stakeholders, an
Indian Tribe (or a consortium of that Indian Tribes), a Tribal
Organization, or an Urban Indian Organization operating a home
visiting program with MIECHV funds will have an additional two
years to implement the match requirement. The Committee intends
to continue to phase in this match requirement in a future
reauthorization until it also reaches a 50 percent match
requirement. The Committee found several other examples within
its jurisdiction where tribes are expected to provide the same
level of match as states, and believes tribes should have the
same expectations.
The Committee has also determined many states are likely to
already meet or exceed a 50 percent match requirement, even
though this level of matching will not be fully phased in until
FY 2022. Based on preliminary and incomplete data reviewed by
the Committee, at least $340 million is already being spent
each year on evidence-based home visiting programs. Based on
this information, more than a dozen states appear to exceed the
FY 2022 match requirement today, and other states are likely to
already meet or exceed this requirement. The Committee sees
this as an opportunity to support and strengthen state and
local investment dedicated to home visiting by focusing
spending on evidence-based models that are shown to deliver
results.
The Committee also believes this provision should work in
conjunction with, not in addition to, the requirement in 511(f)
of the Social Security Act that requires eligible entities to
maintain previous efforts with MIECHV funds used to
``supplement, and not supplant, funds from other sources for
early childhood home visitation programs or initiatives.''
EFFECTIVE DATE
This provision is effective upon enactment.
Section 10: Data Exchange Standards for Improved Interoperability
PRESENT LAW
No provision.
EXPLANATION OF PROVISION
This provision requires the head of the department or
agency responsible for the MIECHV program (i.e., the Health
Resources and Services Administration (HRSA) and the
Administration for Children and Families (ACF)), per Section
511(h) of the Social Security Act, to designate data exchange
standards for necessary categories of information that a state
agency operating a home visiting program is required to
exchange with another state agency under federal law. These
standards are to be developed in consultation with an
interagency workgroup established by the Office of Management
and Budget (OMB) and considering the perspectives of states. To
the extent practicable, the data exchange standards would be
required to be nonproprietary and interoperable and incorporate
standards developed and maintained by three groups of
stakeholders: (1) an international voluntary consensus
standards body, as defined by OMB; (2) intergovernmental
partnerships, such as the National Information Exchange Model;
and (3) federal entities with authority over contracting and
financial assistance.
Also in consultation with OMB, and considering the
perspectives of state governments, the provision directs HRSA
and ACF to designate data exchange standards to govern federal
reporting and data exchanges required under federal law. To the
extent practicable, the data exchange standards would be
required to (1) incorporate features that are widely accepted,
nonproprietary, and searchable, and are in computer-readable
format (such as the eXtensible Markup Language); (2) be
consistent with and implement applicable accounting principles;
(3) be implemented in a manner that is cost-effective and
improves program efficiency and effectiveness; and (4) be
capable of being continually upgraded as necessary.
This provision includes a rule of construction to specify
that changes in existing data standards for federal reporting
would not require a change to standards found to be effective
and efficient.
REASON FOR CHANGE
The Committee believes the programs within its jurisdiction
should, from an information technology standpoint, operate
consistently within and across programs. By beginning the
process of data standardization and the use of common reporting
mechanisms in this section, the Committee is achieving three
goals: better preventing and identifying fraud and abuse;
increasing the efficiency of administrative resources; and
producing program savings for U.S. taxpayers. The private
sector is decades ahead in its ability to use data efficiently
to seamlessly provide better service as well as detect patterns
of fraud, such as when credit cards are lost or stolen, and
streamlining backend data processing. The public sector needs
to review those best practices to better improve the operation
of social service programs, prevent and identify fraud and
abuse, and improve recovery of misspent taxpayer funds. The
first step is organizing the data, as this section directs the
Secretary to do with the MIECHV program.
The Subcommittee on Human Resources has previously received
testimony confirming cooperation and collaboration between
social services programs is not only hindered by the programs
themselves operating in different silos, but also because the
accompanying data is not easily shared or used to better
understand the services individuals are receiving. The
Committee supports consistent data standards that are non-
proprietary and that promote the interoperability of data
across various information technology platforms, including
state legacy systems. Improved data standards will help
increase the efficiency of data exchanges to use and reuse data
within and across programs, and consistent data standards will
allow states to automate the exchange of participant data,
reducing delays and improving the availability of information
on outcomes. It will also help to automate application forms by
pre-populating them with reliable and verified data, which can
reduce the burden on staff and allow them more time to engage
individuals in services, all while reducing error.
Programs already covered by this language include other
systems that home visiting families are likely to be engaged
with, increasing the overall effectiveness of this provision,
including: child welfare, Temporary Assistance for Needy
Families, Child Support Enforcement, Unemployment Insurance,
and Supplemental Nutrition Assistance.
EFFECTIVE DATE
This provision is effective 2 years following the date of
enactment.
III. VOTES OF THE COMMITTEE
In compliance with the Rules of the House of
Representatives, the following statement is made concerning the
vote of the Committee on Ways and Means during the markup
consideration of H.R. 2824, ``Increasing Opportunity and
Success for Children and Parents through Evidence-Based Home
Visiting Act'' on September 13, 2017.
An amendment in the nature of a substitute was offered by
Chairman Brady and adopted by voice vote (with a quorum being
present).
The amendment offered by Mr. Pascrell to the amendment in
the nature of a substitute to H.R. 2824, which would strike
Section 9, which strengthens state, local, and private
investments in home visiting, was not agreed to by a roll call
vote of 21 nays to 13 yeas (with a quorum being present). The
vote was as follows:
----------------------------------------------------------------------------------------------------------------
Representative Yea Nay Present Representative Yea Nay Present
----------------------------------------------------------------------------------------------------------------
Mr. Brady........................ ....... X ......... Mr. Neal........... X ....... .........
Mr. Johnson...................... ....... X ......... Mr. Levin.......... X ....... .........
Mr. Nunes........................ ....... X ......... Mr. Lewis.......... X ....... .........
Mr. Tiberi....................... ....... ....... ......... Mr. Doggett........ X ....... .........
Mr. Reichert..................... ....... X ......... Mr. Thompson....... X ....... .........
Mr. Roskam....................... ....... X ......... Mr. Larson......... X ....... .........
Mr. Buchanan..................... ....... ....... ......... Mr. Blumenauer..... ....... ....... .........
Mr. Smith (NE)................... ....... X ......... Mr. Kind........... X ....... .........
Ms. Jenkins...................... ....... X ......... Mr. Pascrell....... X ....... .........
Mr. Paulsen...................... ....... X ......... Mr. Crowley........ X ....... .........
Mr. Marchant..................... ....... X ......... Mr. Davis.......... X ....... .........
Ms. Black........................ ....... X ......... Ms. Sanchez........ ....... ....... .........
Mr. Reed......................... ....... X ......... Mr. Higgins........ X ....... .........
Mr. Kelly........................ ....... X ......... Ms. Sewell......... X ....... .........
Mr. Renacci...................... ....... X ......... Ms. DelBene........ X ....... .........
Mr. Meehan....................... ....... X ......... Ms. Chu............ ....... ....... .........
Ms. Noem......................... ....... X .........
Mr. Holding...................... ....... X .........
Mr. Smith (MO)................... ....... X .........
Mr. Rice......................... ....... X .........
Mr. Schweikert................... ....... X .........
Ms. Walorski..................... ....... X .........
Mr. Curbelo...................... ....... ....... .........
Mr. Bishop....................... ....... X .........
----------------------------------------------------------------------------------------------------------------
The vote on Mr. Roskam's motion to table Mr. Doggett's
appeal of the ruling of the Chair was agreed to by a roll call
vote of 21 yeas to 15 nays (with a quorum being present). The
vote was as follows:
----------------------------------------------------------------------------------------------------------------
Representative Yea Nay Present Representative Yea Nay Present
----------------------------------------------------------------------------------------------------------------
Mr. Brady........................ ....... X ......... Mr. Neal........... X ....... .........
Mr. Johnson...................... ....... X ......... Mr. Levin.......... X ....... .........
Mr. Nunes........................ ....... X ......... Mr. Lewis.......... X ....... .........
Mr. Tiberi....................... ....... ....... ......... Mr. Doggett........ X ....... .........
Mr. Reichert..................... ....... X ......... Mr. Thompson....... X ....... .........
Mr. Roskam....................... ....... X ......... Mr. Larson......... ....... ....... .........
Mr. Buchanan..................... ....... X ......... Mr. Blumenauer..... X ....... .........
Mr. Smith (NE)................... ....... X ......... Mr. Kind........... X ....... .........
Ms. Jenkins...................... ....... X ......... Mr. Pascrell....... X ....... .........
Mr. Paulsen...................... ....... X ......... Mr. Crowley........ X ....... .........
Mr. Marchant..................... ....... X ......... Mr. Davis.......... X ....... .........
Ms. Black........................ ....... ....... ......... Ms. Sanchez........ X ....... .........
Mr. Reed......................... ....... X ......... Mr. Higgins........ X ....... .........
Mr. Kelly........................ ....... X ......... Ms. Sewell......... X ....... .........
Mr. Renacci...................... ....... X ......... Ms. DelBene........ X ....... .........
Mr. Meehan....................... ....... X ......... Ms. Chu............ X ....... .........
Ms. Noem......................... ....... X .........
Mr. Holding...................... ....... X .........
Mr. Smith (MO)................... ....... ....... .........
Mr. Rice......................... ....... X .........
Mr. Schweikert................... ....... X .........
Ms. Walorski..................... ....... X .........
Mr. Curbelo...................... ....... X .........
Mr. Bishop....................... ....... X .........
----------------------------------------------------------------------------------------------------------------
The vote on Mr. Reichert's motion to table Mr. Davis'
appeal of the ruling of the Chair was agreed to by a roll call
vote of 21 yeas to 15 nays (with a quorum being present). The
vote was as follows:
----------------------------------------------------------------------------------------------------------------
Representative Yea Nay Present Representative Yea Nay Present
----------------------------------------------------------------------------------------------------------------
Mr. Brady........................ ....... X ......... Mr. Neal........... X ....... .........
Mr. Johnson...................... ....... X ......... Mr. Levin.......... X ....... .........
Mr. Nunes........................ ....... X ......... Mr. Lewis.......... X ....... .........
Mr. Tiberi....................... ....... ....... ......... Mr. Doggett........ X ....... .........
Mr. Reichert..................... ....... X ......... Mr. Thompson....... X ....... .........
Mr. Roskam....................... ....... X ......... Mr. Larson......... ....... ....... .........
Mr. Buchanan..................... ....... X ......... Mr. Blumenauer..... X ....... .........
Mr. Smith (NE)................... ....... X ......... Mr. Kind........... X ....... .........
Ms. Jenkins...................... ....... X ......... Mr. Pascrell....... X ....... .........
Mr. Paulsen...................... ....... X ......... Mr. Crowley........ X ....... .........
Mr. Marchant..................... ....... X ......... Mr. Davis.......... X ....... .........
Ms. Black........................ ....... ....... ......... Ms. Sanchez........ X ....... .........
Mr. Reed......................... ....... X ......... Mr. Higgins........ X ....... .........
Mr. Kelly........................ ....... X ......... Ms. Sewell......... X ....... .........
Mr. Renacci...................... ....... X ......... Ms. DelBene........ X ....... .........
Mr. Meehan....................... ....... X ......... Ms. Chu............ X ....... .........
Ms. Noem......................... ....... X .........
Mr. Holding...................... ....... X .........
Mr. Smith (MO)................... ....... ....... .........
Mr. Rice......................... ....... X .........
Mr. Schweikert................... ....... X .........
Ms. Walorski..................... ....... X .........
Mr. Curbelo...................... ....... X .........
Mr. Bishop....................... ....... X .........
----------------------------------------------------------------------------------------------------------------
The amendment offered by Mr. Davis to the amendment in the
nature of a substitute to H.R. 2824, which would increase
spending on MIECHV without offsetting the increase with
reductions in other spending, was not agreed to by a roll call
vote of 21 nays to 15 yeas (with a quorum being present). The
vote was as follows:
----------------------------------------------------------------------------------------------------------------
Representative Yea Nay Present Representative Yea Nay Present
----------------------------------------------------------------------------------------------------------------
Mr. Brady........................ ....... X ......... Mr. Neal........... X ....... .........
Mr. Johnson...................... ....... X ......... Mr. Levin.......... X ....... .........
Mr. Nunes........................ ....... X ......... Mr. Lewis.......... X ....... .........
Mr. Tiberi....................... ....... ....... ......... Mr. Doggett........ X ....... .........
Mr. Reichert..................... ....... X ......... Mr. Thompson....... X ....... .........
Mr. Roskam....................... ....... X ......... Mr. Larson......... ....... ....... .........
Mr. Buchanan..................... ....... X ......... Mr. Blumenauer..... X ....... .........
Mr. Smith (NE)................... ....... X ......... Mr. Kind........... X ....... .........
Ms. Jenkins...................... ....... X ......... Mr. Pascrell....... X ....... .........
Mr. Paulsen...................... ....... X ......... Mr. Crowley........ X ....... .........
Mr. Marchant..................... ....... X ......... Mr. Davis.......... X ....... .........
Ms. Black........................ ....... ....... ......... Ms. Sanchez........ X ....... .........
Mr. Reed......................... ....... X ......... Mr. Higgins........ X ....... .........
Mr. Kelly........................ ....... X ......... Ms. Sewell......... X ....... .........
Mr. Renacci...................... ....... X ......... Ms. DelBene........ X ....... .........
Mr. Meehan....................... ....... X ......... Ms. Chu............ X ....... .........
Ms. Noem......................... ....... X .........
Mr. Holding...................... ....... X .........
Mr. Smith (MO)................... ....... ....... .........
Mr. Rice......................... ....... X .........
Mr. Schweikert................... ....... X .........
Ms. Walorski..................... ....... X .........
Mr. Curbelo...................... ....... X .........
Mr. Bishop....................... ....... X .........
----------------------------------------------------------------------------------------------------------------
The amendment offered by Mr. Pascrell to the amendment in
the nature of a substitute to H.R. 2824, which would eliminate
the requirement that states measure employment and earnings
when they choose to achieve improvements in family and economic
self-sufficiency, was not agreed to by a roll call vote of 22
nays to 15 yeas (with a quorum being present). The vote was as
follows:
----------------------------------------------------------------------------------------------------------------
Representative Yea Nay Present Representative Yea Nay Present
----------------------------------------------------------------------------------------------------------------
Mr. Brady........................ ....... X ......... Mr. Neal........... X ....... .........
Mr. Johnson...................... ....... X ......... Mr. Levin.......... X ....... .........
Mr. Nunes........................ ....... X ......... Mr. Lewis.......... X ....... .........
Mr. Tiberi....................... ....... ....... ......... Mr. Doggett........ X ....... .........
Mr. Reichert..................... ....... X ......... Mr. Thompson....... X ....... .........
Mr. Roskam....................... ....... X ......... Mr. Larson......... ....... ....... .........
Mr. Buchanan..................... ....... X ......... Mr. Blumenauer..... X ....... .........
Mr. Smith (NE)................... ....... X ......... Mr. Kind........... X ....... .........
Ms. Jenkins...................... ....... X ......... Mr. Pascrell....... X ....... .........
Mr. Paulsen...................... ....... X ......... Mr. Crowley........ X ....... .........
Mr. Marchant..................... ....... X ......... Mr. Davis.......... X ....... .........
Ms. Black........................ ....... ....... ......... Ms. Sanchez........ X ....... .........
Mr. Reed......................... ....... X ......... Mr. Higgins........ X ....... .........
Mr. Kelly........................ ....... X ......... Ms. Sewell......... X ....... .........
Mr. Renacci...................... ....... X ......... Ms. DelBene........ X ....... .........
Mr. Meehan....................... ....... X ......... Ms. Chu............ X ....... .........
Ms. Noem......................... ....... X .........
Mr. Holding...................... ....... X .........
Mr. Smith (MO)................... ....... X .........
Mr. Rice......................... ....... X .........
Mr. Schweikert................... ....... X .........
Ms. Walorski..................... ....... X .........
Mr. Curbelo...................... ....... X .........
Mr. Bishop....................... ....... X .........
----------------------------------------------------------------------------------------------------------------
The amendment offered by Ms. DelBene to the amendment in
the nature of a substitute to H.R. 2824, which would eliminate
the requirement that states direct additional resources to
MIECHV beginning in FY 2020 and increase funding for tribes
without offsetting the increase with reductions in other
spending, was not agreed to by a roll call vote of 22 nays to
15 yeas (with a quorum being present). The vote was as follows:
----------------------------------------------------------------------------------------------------------------
Representative Yea Nay Present Representative Yea Nay Present
----------------------------------------------------------------------------------------------------------------
Mr. Brady........................ ....... X ......... Mr. Neal........... X ....... .........
Mr. Johnson...................... ....... X ......... Mr. Levin.......... X ....... .........
Mr. Nunes........................ ....... X ......... Mr. Lewis.......... X ....... .........
Mr. Tiberi....................... ....... ....... ......... Mr. Doggett........ X ....... .........
Mr. Reichert..................... ....... X ......... Mr. Thompson....... X ....... .........
Mr. Roskam....................... ....... X ......... Mr. Larson......... ....... ....... .........
Mr. Buchanan..................... ....... X ......... Mr. Blumenauer..... X ....... .........
Mr. Smith (NE)................... ....... X ......... Mr. Kind........... X ....... .........
Ms. Jenkins...................... ....... X ......... Mr. Pascrell....... X ....... .........
Mr. Paulsen...................... ....... X ......... Mr. Crowley........ X ....... .........
Mr. Marchant..................... ....... X ......... Mr. Davis.......... X ....... .........
Ms. Black........................ ....... ....... ......... Ms. Sanchez........ X ....... .........
Mr. Reed......................... ....... X ......... Mr. Higgins........ X ....... .........
Mr. Kelly........................ ....... X ......... Ms. Sewell......... X ....... .........
Mr. Renacci...................... ....... X ......... Ms. DelBene........ X ....... .........
Mr. Meehan....................... ....... X ......... Ms. Chu............ X ....... .........
Ms. Noem......................... ....... X .........
Mr. Holding...................... ....... X .........
Mr. Smith (MO)................... ....... X .........
Mr. Rice......................... ....... X .........
Mr. Schweikert................... ....... X .........
Ms. Walorski..................... ....... X .........
Mr. Curbelo...................... ....... X .........
Mr. Bishop....................... ....... X .........
----------------------------------------------------------------------------------------------------------------
H.R. 2842 as ordered favorably reported to the House of
Representatives as amended by a roll call vote of 22 yeas to 15
nays (with a quorum being present). The vote was as follows:
----------------------------------------------------------------------------------------------------------------
Representative Yea Nay Present Representative Yea Nay Present
----------------------------------------------------------------------------------------------------------------
Mr. Brady........................ ....... X ......... Mr. Neal........... X ....... .........
Mr. Johnson...................... ....... X ......... Mr. Levin.......... X ....... .........
Mr. Nunes........................ ....... X ......... Mr. Lewis.......... X ....... .........
Mr. Tiberi....................... ....... ....... ......... Mr. Doggett........ X ....... .........
Mr. Reichert..................... ....... X ......... Mr. Thompson....... X ....... .........
Mr. Roskam....................... ....... X ......... Mr. Larson......... ....... ....... .........
Mr. Buchanan..................... ....... X ......... Mr. Blumenauer..... X ....... .........
Mr. Smith (NE)................... ....... X ......... Mr. Kind........... X ....... .........
Ms. Jenkins...................... ....... X ......... Mr. Pascrell....... X ....... .........
Mr. Paulsen...................... ....... X ......... Mr. Crowley........ X ....... .........
Mr. Marchant..................... ....... X ......... Mr. Davis.......... X ....... .........
Ms. Black........................ ....... ....... ......... Ms. Sanchez........ X ....... .........
Mr. Reed......................... ....... X ......... Mr. Higgins........ X ....... .........
Mr. Kelly........................ ....... X ......... Ms. Sewell......... X ....... .........
Mr. Renacci...................... ....... X ......... Ms. DelBene........ X ....... .........
Mr. Meehan....................... ....... X ......... Ms. Chu............ X ....... .........
Ms. Noem......................... ....... X .........
Mr. Holding...................... ....... X .........
Mr. Smith (MO)................... ....... X .........
Mr. Rice......................... ....... X .........
Mr. Schweikert................... ....... X .........
Ms. Walorski..................... ....... X .........
Mr. Curbelo...................... ....... X .........
Mr. Bishop....................... ....... X .........
----------------------------------------------------------------------------------------------------------------
IV. BUDGET EFFECTS OF THE BILL
A. Committee Estimate of Budgetary Effects
In compliance with clause 3(d) of rule XIII of the Rules of
the House of Representatives, the following statement is made
concerning the effects on the budget of the bill, H.R. 2824, as
reported. The Committee agrees with the estimate prepared by
the Congressional Budget Office (CBO), which is included below.
B. Statement Regarding New Budget Authority and Tax Expenditures Budget
Authority
In compliance with clause 3(c)(2) of rule XIII of the Rules
of the House of Representatives, the Committee states that the
bill would create new budget authority to fund the MIECHV
program through FY 2022, but is intended to be accompanied by
H.R. 2972, the Control of Unlawful Fugitive Felons (CUFF) Act,
which will more than offset increase in budget authority in
this bill. The Committee states further that the bill involves
no new or increased tax expenditures.
C. Cost Estimate Prepared by the Congressional Budget Office
In compliance with clause 3(c)(3) of rule XIII of the Rules
of the House of Representatives, requiring a cost estimate
prepared by the CBO, the following statement by CBO is
provided.
U.S. Congress,
Congressional Budget Office,
Washington, DC, September 20, 2017.
Hon. Kevin Brady,
Chairman, Committee on Ways and Means,
House of Representatives, Washington, DC.
Dear Mr. Chairman: The Congressional Budget Office has
prepared the enclosed cost estimate for H.R. 2824, the
Increasing Opportunity and Success for Children and Parents
through Evidence-Based Home Visiting Act.
If you wish further details on this estimate, we will be
pleased to provide them. The CBO staff contact is Lisa Ramirez-
Branum.
Sincerely,
Keith Hall, Director.
Enclosure.
H.R. 2824--Increasing Opportunity and Success for Children and Parents
Through Evidence-Based Home Visiting Act
Summary: H.R. 2824 would reauthorize the Maternal, Infant,
and Early Childhood Home Visiting (MIECHV) program through
fiscal year 2022 and would directly appropriate $400 million
for each fiscal year 2018 through 2022 for the program. CBO
estimates that enacting the bill would cost about $2 billion
over the 2017-2027 period.
Pay-as-you-go procedures apply because enacting the bill
would affect direct spending. H.R. 2824 would not affect
revenues.
CBO estimates that enacting the bill would not increase net
direct spending or on-budget deficits in any of the four
consecutive 10-year periods beginning in 2028.
H.R. 2824 contains no intergovernmental or private-sector
mandates as defined in the Unfunded Mandates Reform Act (UMRA).
Estimated cost to the Federal Government: The estimated
budgetary effect of H.R. 2824 is shown in the following table.
The costs of this legislation fall within budget function 550
(health).
--------------------------------------------------------------------------------------------------------------------------------------------------------
By fiscal year, in millions of dollars--
-------------------------------------------------------------------------------------------------------------
2017 2018 2019 2020 2021 2022 2023 2024 2025 2026 2027 2017-2022 2017-2027
--------------------------------------------------------------------------------------------------------------------------------------------------------
INCREASES IN DIRECT SPENDING
Budget Authority.......................... 0 400 400 400 400 400 0 0 0 0 0 2,000 2,000
Estimated Outlays......................... 0 12 140 300 396 396 384 256 96 0 0 1,244 1,980
--------------------------------------------------------------------------------------------------------------------------------------------------------
Basis of estimate: The Health Resources and Services
Administration (HRSA) administers the MIECHV grant program. The
funds are distributed to states, territories, and tribal
entities to develop and implement evidence-based, voluntary
programs that aim to improve maternal and child health, prevent
child abuse and neglect, encourage positive parenting, and
promote child development and school readiness. In fiscal year
2017, the MIECHV program received $372 million, after
accounting for sequestration. The program expires at the end of
fiscal year 2017.
H.R. 2824 would appropriate $400 million for each fiscal
year 2018 through 2022 for the MIECHV program and would make
several other programmatic changes. The bill would:
Require states to review and update
assessments on statewide needs and identify at-risk
communities by October 1, 2020;
Set standards for data exchange with state
agencies;
Authorize a grantee to use funds for pay-
for-outcomes initiatives;
Alter several reporting and benchmark
requirements; and
Require grantees, starting in 2020, to
provide matching funds. Grantees could count spending
on relevant activities from other federal funds or by
third parties toward the matching requirement.
Based on historical spending patterns, CBO estimates
enacting H.R. 2824 would cost about $2 billion over the 2018-
2027 period.
Pay-As-You-Go considerations: The Statutory Pay-As-You-Go
Act of 2010 establishes budget-reporting and enforcement
procedures for legislation affecting direct spending or
revenues. The net changes in outlays that are subject to those
pay-as-you-go procedures are shown in the following table.
CBO ESTIMATE OF PAY-AS-YOU-GO EFFECTS FOR H.R. 2824, AS ORDERED REPORTED BY THE HOUSE COMMITTEE ON WAYS AND MEANS ON SEPTEMBER 13, 2017
--------------------------------------------------------------------------------------------------------------------------------------------------------
By fiscal year, in millions of dollars--
--------------------------------------------------------------------------------------------------
2017 2018 2019 2020 2021 2022 2023 2024 2025 2026 2027 2017-2022 2017-2027
--------------------------------------------------------------------------------------------------------------------------------------------------
NET INCREASE IN THE DEFICIT
Statutory Pay-As-You-Go Impact................. 0 12 140 300 396 396 384 256 96 0 0 1,244 1,980
--------------------------------------------------------------------------------------------------------------------------------------------------------
Increase in long-term direct spending and deficits: CBO
estimates that enacting the legislation would not increase net
direct spending or on-budget deficits in any of the four
consecutive 10-year periods beginning in 2028.
Intergovernmental and private-sector impact: H.R. 2824
contains no intergovernmental or private-sector mandates as
defined in UMRA.
Estimate prepared by: Federal costs: Lisa Ramirez-Branum,
Ellen Werble, and Emily King; Impact on state, local, and
tribal governments; Zachary Byrum; Impact on the Private
Sector: Amy Petz.
Estimate approved by: H. Samuel Papenfuss, Deputy Assistant
Director for Budget Analysis.
V. OTHER MATTERS TO BE DISCUSSED UNDER THE RULES OF THE HOUSE
A. Committee Oversight Findings and Recommendations
With respect to clause 3(c)(1) of rule XIII of the Rules of
the House of Representatives, the Committee made findings and
recommendations that are reflected in this report.
B. Statement of General Performance Goals and Objectives
With respect to clause 3(c)(4) of rule XIII of the Rules of
the House of Representatives, Committee establishes the
following performance related goals and objectives for this
legislation: To fund evidence-based programs that improve the
lives of families in at-risk communities by reducing child
abuse and neglect, improving maternal and child health, and
improving self-sufficiency.
C. Information Relating to Unfunded Mandates
This information is provided in accordance with section 423
of the Unfunded Mandates Reform Act of 1995 (Pub. L. No. 104-
4). The Committee has determined that the bill does not contain
Federal mandates on the private sector. The Committee has
determined that the bill does not impose a Federal
intergovernmental mandate on State, local, or tribal
governments.
D. Congressional Earmarks, Limited Tax Benefits, and Limited Tariff
Benefits
With respect to clause 9 of rule XXI of the Rules of the
House of Representatives, the Committee has carefully reviewed
the provisions of the bill, and states that the provisions of
the bill do not contain any congressional earmarks, limited tax
benefits, or limited tariff benefits within the meaning of the
rule.
E. Duplication of Federal Programs
In compliance with clause 3(c)(5) of rule XIII of the Rules
of the House of Representatives, the Committee states that no
provision of the bill establishes or reauthorizes: (1) a
program of the Federal Government known to be duplicative of
another Federal program; (2) a program included in any report
from the Government Accountability Office to Congress pursuant
to section 21 of Public Law 111-139; or (3) a program related
to a program identified in the most recent Catalog of Federal
Domestic Assistance, published pursuant to the Federal Program
Information Act (Pub. L. No. 95-220, as amended by Pub. L. No.
98-169).
F. Disclosure of Directed Rule Makings
In compliance with Sec. 3(i) of H. Res. 5 (115th Congress),
the following statement is made concerning directed rule
makings: The Committee advises that the bill requires no
directed rulemakings within the meaning of such section.
VI. CHANGES IN EXISTING LAW MADE BY THE BILL, AS REPORTED
In compliance with clause 3(e) of rule XIII of the Rules of
the House of Representatives, changes in existing law made by
the bill, as reported, are shown as follows (new matter in
printed in italic and existing law in which no change is
proposed is shown in roman):
Changes in Existing Law Made by the Bill, as Reported
In compliance with clause 3(e) of rule XIII of the Rules of
the House of Representatives, changes in existing law made by
the bill, as reported, are shown as follows (existing law
proposed to be omitted is enclosed in black brackets, new
matter is printed in italic, and existing law in which no
change is proposed is shown in roman):
SOCIAL SECURITY ACT
* * * * * * *
TITLE V--MATERNAL AND CHILD HEALTH SERVICES BLOCK GRANT
* * * * * * *
SEC. 511. MATERNAL, INFANT, AND EARLY CHILDHOOD HOME VISITING PROGRAMS.
(a) Purposes.--The purposes of this section are--
(1) to strengthen and improve the programs and
activities carried out under this title;
(2) to improve coordination of services for at risk
communities; and
(3) to identify and provide comprehensive services to
improve outcomes for families who reside in at risk
communities.
(b) Requirement for All States To Assess Statewide Needs and
Identify at Risk Communities.--
(1) In general.--[Not later than 6 months after the
date of enactment of this section, each State shall, as
a condition of receiving payments from an allotment for
the State under section 502 for fiscal year 2011,
conduct a statewide needs assessment (which shall be
separate from the statewide] Each State shall, as a
condition of receiving payments from an allotment for
the State under section 502, review and update the
statewide needs assessment not later than October 1,
2020 (which may be separate from but in coordination
with the statewide needs assessment required under
section 505(a)) that identifies--
(A) communities with concentrations of--
(i) premature birth, low-birth weight
infants, and infant mortality,
including infant death due to neglect,
or other indicators of at-risk
prenatal, maternal, newborn, or child
health;
(ii) poverty;
(iii) crime;
(iv) domestic violence;
(v) high rates of high-school drop-
outs;
(vi) substance abuse;
(vii) unemployment; or
(viii) child maltreatment;
(B) the quality and capacity of existing
programs or initiatives for early childhood
home visitation in the State including--
(i) the number and types of
individuals and families who are
receiving services under such programs
or initiatives;
(ii) the gaps in early childhood home
visitation in the State; and
(iii) the extent to which such
programs or initiatives are meeting the
needs of eligible families described in
subsection (k)(2); and
(C) the State's capacity for providing
substance abuse treatment and counseling
services to individuals and families in need of
such treatment or services.
(2) Coordination with other assessments.--In
conducting the statewide needs assessment required
under paragraph (1), the State shall coordinate with,
and take into account, other appropriate needs
assessments conducted by the State, as determined by
the Secretary, including the needs assessment required
under section 505(a) (both the most recently completed
assessment and any such assessment in progress), the
communitywide strategic planning and needs assessments
conducted in accordance with section 640(g)(1)(C) of
the Head Start Act, and the inventory of current unmet
needs and current community-based and prevention-
focused programs and activities to prevent child abuse
and neglect, and other family resource services
operating in the State required under section 205(3) of
the Child Abuse Prevention and Treatment Act.
(3) Submission to the secretary.--Each State shall
submit to the Secretary, in such form and manner as the
Secretary shall require--
(A) the results of the statewide needs
assessment required under paragraph (1); and
(B) a description of how the State intends to
address needs identified by the assessment,
particularly with respect to communities
identified under paragraph (1)(A), which may
include applying for a grant to conduct an
early childhood home visitation program in
accordance with the requirements of this
section.
(c) Grants for Early Childhood Home Visitation Programs.--
(1) Authority to make grants.--In addition to any
other payments made under this title to a State, the
Secretary shall make grants to eligible entities to
enable the entities to deliver services under early
childhood home visitation programs that satisfy the
requirements of subsection (d) to eligible families in
order to promote improvements in maternal and prenatal
health, infant health, child health and development,
parenting related to child development outcomes, school
readiness, and the socioeconomic status of such
families, and reductions in child abuse, neglect, and
injuries.
(2) Authority to use initial grant funds for planning
or implementation.--An eligible entity that receives a
grant under paragraph (1) may use a portion of the
funds made available to the entity during the first 6
months of the period for which the grant is made for
planning or implementation activities to assist with
the establishment of early childhood home visitation
programs that satisfy the requirements of subsection
(d).
(3) Authority to use grant for a pay for outcomes
initiative.--An eligible entity to which a grant is
made under paragraph (1) may use the grant to pay for
the results of a pay for outcomes initiative that
satisfies the requirements of subsection (d) and that
will not result in a reduction of funding for services
delivered under this section while an eligible entity
develops or operates such an initiative.
[(3)] (4) Grant duration.--The Secretary shall
determine the period of years for which a grant is made
to an eligible entity under paragraph (1).
[(4)] (5) Technical assistance.--The Secretary shall
provide an eligible entity that receives a grant under
paragraph (1) with technical assistance in
administering programs or activities conducted in whole
or in part with grant funds.
(d) Requirements.--The requirements of this subsection for an
early childhood home visitation program conducted with a grant
made under this section are as follows:
(1) Quantifiable, measurable improvement in benchmark
areas.--
(A) In general.--The eligible entity
establishes, subject to the approval of the
Secretary, quantifiable, measurable 3- and 5-
year benchmarks for demonstrating that the
program results in improvements for the
eligible families participating in the program
in [each of] the following areas:
(i) Improved maternal and newborn
health.
(ii) Prevention of child injuries,
child abuse, neglect, or maltreatment,
and reduction of emergency department
visits.
(iii) Improvement in school readiness
and achievement.
(iv) Reduction in crime or domestic
violence.
(v) Improvements in family economic
self-sufficiency (which shall include
measures of employment and earnings).
(vi) Improvements in the coordination
and referrals for other community
resources and supports.
(B) Demonstration of improvements after 3
years.--
(i) Report to the secretary.--Not
later than 30 days after the end of the
3rd year in which the eligible entity
conducts the program, the entity
submits to the Secretary a report
demonstrating improvement in at least 4
of the areas specified in subparagraph
(A).
(ii) Corrective action plan.--If the
report submitted by the eligible entity
under clause (i) fails to demonstrate
improvement in at least 4 of the areas
specified in subparagraph (A), the
entity shall develop and implement a
plan to improve outcomes in each of the
areas specified in subparagraph (A),
subject to approval by the Secretary.
The plan shall include provisions for
the Secretary to monitor implementation
of the plan and conduct continued
oversight of the program, including
through submission by the entity of
regular reports to the Secretary.
(iii) Technical assistance.--
(I) In general.--The
Secretary shall provide an
eligible entity required to
develop and implement an
improvement plan under clause
(ii) with technical assistance
to develop and implement the
plan. The Secretary may provide
the technical assistance
directly or through grants,
contracts, or cooperative
agreements.
(II) Advisory panel.--The
Secretary shall establish an
advisory panel for purposes of
obtaining recommendations
regarding the technical
assistance provided to entities
in accordance with subclause
(I).
(iv) No improvement or failure to
submit report.--If the Secretary
determines after a period of time
specified by the Secretary that an
eligible entity implementing an
improvement plan under clause (ii) has
failed to demonstrate any improvement
in the areas specified in subparagraph
(A), or if the Secretary determines
that an eligible entity has failed to
submit the report required under clause
(i), the Secretary shall terminate the
entity's grant and may include any
unexpended grant funds in grants made
to nonprofit organizations under
subsection (h)(2)(B).
(C) Final report.--Not later than December
31, 2015, the eligible entity shall submit a
report to the Secretary demonstrating
improvements (if any) in each of the areas
specified in subparagraph (A).
(D) Demonstration of improvements in
subsequent years.--
(i) Continued measurement of
improvement in applicable benchmark
areas.--The eligible entity, after
demonstrating improvements for eligible
families as specified in subparagraphs
(A) and (B), shall continue to track
and report not later than 30 days after
the end of fiscal year 2020 and every
three years thereafter, information
demonstrating that the program results
in improvements for the eligible
families participating in the program
in at least 4 of the areas specified in
subparagraph (A) that the service
delivery model or models, selected by
the entity, intend to improve.
(ii) Corrective action plan.--If the
eligible entity fails to demonstrate
improvement in at least 4 of the areas
specified in subparagraph (A), the
entity shall develop and implement a
plan to improve outcomes in each of the
areas specified in subparagraph (A)
that the service delivery model or
models, selected by the entity, intend
to improve, subject to approval by the
Secretary. The plan shall include
provisions for the Secretary to monitor
implementation of the plan and conduct
continued oversight of the program,
including through submission by the
entity of regular reports to the
Secretary.
(iii) Technical assistance.--The
Secretary shall provide an eligible
entity required to develop and
implement an improvement plan under
clause (ii) with technical assistance
to develop and implement the plan. The
Secretary may provide the technical
assistance directly or through grants,
contracts, or cooperative agreements.
(iv) No improvement or failure to
submit report.--If the Secretary
determines after a period of time
specified by the Secretary that an
eligible entity implementing an
improvement plan under clause (ii) has
failed to demonstrate any improvement
in at least 4 of the areas specified in
subparagraph (A) that the service
delivery model or models intend to
improve, or if the Secretary determines
that an eligible entity has failed to
submit the report required by clause
(i), the Secretary shall terminate the
grant made to the entity under this
section and may include any unexpended
grant funds in grants made to nonprofit
organizations under subsection
(h)(2)(B).
(2) Improvements in outcomes for individual
families.--
(A) In general.--The program is designed,
with respect to an eligible family
participating in the program, to result in the
participant outcomes described in subparagraph
(B) that the eligible entity identifies on the
basis of an individualized assessment of the
family, are relevant for that family.
(B) Participant outcomes.--The participant
outcomes described in this subparagraph are the
following:
(i) Improvements in prenatal,
maternal, and newborn health, including
improved pregnancy outcomes
(ii) Improvements in child health and
development, including the prevention
of child injuries and maltreatment and
improvements in cognitive, language,
social-emotional, and physical
developmental indicators.
(iii) Improvements in parenting
skills.
(iv) Improvements in school readiness
and child academic achievement.
(v) Reductions in crime or domestic
violence.
(vi) Improvements in family economic
self-sufficiency.
(vii) Improvements in the
coordination of referrals for, and the
provision of, other community resources
and supports for eligible families,
consistent with State child welfare
agency training.
(3) Core components.--The program includes the
following core components:
(A) Service delivery model or models.--
(i) In general.--Subject to clause
(ii), the program is conducted using 1
or more of the service delivery models
described in item (aa) or (bb) of
subclause (I) or in subclause (II)
selected by the eligible entity:
(I) The model conforms to a
clear consistent home
visitation model that has been
in existence for at least 3
years and is research-based,
grounded in relevant
empirically-based knowledge,
linked to program determined
outcomes, associated with a
national organization or
institution of higher education
that has comprehensive home
visitation program standards
that ensure high quality
service delivery and continuous
program quality improvement,
and has demonstrated
significant, (and in the case
of the service delivery model
described in item (aa),
sustained) positive outcomes,
as described in the benchmark
areas specified in paragraph
(1)(A) and the participant
outcomes described in paragraph
(2)(B), when evaluated using
well-designed and rigorous--
(aa) randomized
controlled research
designs, and the
evaluation results have
been published in a
peer-reviewed journal;
or
(bb) quasi-
experimental research
designs.
(II) The model conforms to a
promising and new approach to
achieving the benchmark areas
specified in paragraph (1)(A)
and the participant outcomes
described in paragraph (2)(B),
has been developed or
identified by a national
organization or institution of
higher education, and will be
evaluated through well-designed
and rigorous process.
(ii) Majority of grant funds used for
evidence-based models.--An eligible
entity shall use not more than 25
percent of the amount of the grant paid
to the entity for a fiscal year for
purposes of conducting a program using
the service delivery model described in
clause (i)(II).
(iii) Criteria for evidence of
effectiveness of models.--The Secretary
shall establish criteria for evidence
of effectiveness of the service
delivery models and shall ensure that
the process for establishing the
criteria is transparent and provides
the opportunity for public comment.
(B) Additional requirements.--
(i) The program adheres to a clear,
consistent model that satisfies the
requirements of being grounded in
empirically-based knowledge related to
home visiting and linked to the
benchmark areas specified in paragraph
(1)(A) and the participant outcomes
described in paragraph (2)(B) related
to the purposes of the program.
(ii) The program employs well-trained
and competent staff, as demonstrated by
education or training, such as nurses,
social workers, educators, child
development specialists, or other well-
trained and competent staff, and
provides ongoing and specific training
on the model being delivered.
(iii) The program maintains high
quality supervision to establish home
visitor competencies.
(iv) The program demonstrates strong
organizational capacity to implement
the activities involved.
(v) The program establishes
appropriate linkages and referral
networks to other community resources
and supports for eligible families.
(vi) The program monitors the
fidelity of program implementation to
ensure that services are delivered
pursuant to the specified model.
(4) Priority for serving high-risk populations.--The
eligible entity gives priority to providing services
under the program to the following:
(A) Eligible families who reside in
communities in need of such services, as
identified in the statewide needs assessment
required under subsection (b)(1)(A), taking
into account the staffing, community resource,
and other requirements of the service delivery
model or models that the eligible entity may
need to develop for the model to operate and
demonstrate improvements for eligible families.
(B) Low-income eligible families.
(C) Eligible families who are pregnant women
who have not attained age 21.
(D) Eligible families that have a history of
child abuse or neglect or have had interactions
with child welfare services.
(E) Eligible families that have a history of
substance abuse or need substance abuse
treatment.
(F) Eligible families that have users of
tobacco products in the home.
(G) Eligible families that are or have
children with low student achievement.
(H) Eligible families with children with
developmental delays or disabilities.
(I) Eligible families who, or that include
individuals who, are serving or formerly served
in the Armed Forces, including such families
that have members of the Armed Forces who have
had multiple deployments outside of the United
States.
(e) Application Requirements.--An eligible entity desiring a
grant under this section shall submit an application to the
Secretary for approval, in such manner as the Secretary may
require, that includes the following:
(1) A description of the populations to be served by
the entity, including specific information regarding
how the entity will serve high risk populations
described in subsection (d)(4).
(2) An assurance that the entity will give priority
to serving low-income eligible families and eligible
families who reside in at risk communities identified
in the statewide needs assessment required under
subsection (b)(1)(A).
(3) The service delivery model or models described in
subsection (d)(3)(A) that the entity will use under the
program and the basis for the selection of the model or
models.
(4) A statement identifying how the selection of the
populations to be served and the service delivery model
or models that the entity will use under the program
for such populations is consistent with the results of
the statewide needs assessment conducted under
subsection (b).
(5) The quantifiable, measurable benchmarks
established by the State to demonstrate that the
program contributes to improvements in the areas
specified in subsection (d)(1)(A) that the service
delivery model or models, selected by the entity,
intend to improve.
(6) An assurance that the entity will obtain and
submit documentation or other appropriate evidence from
the organization or entity that developed the service
delivery model or models used under the program to
verify that the program is implemented and services are
delivered according to the model specifications.
(7) Assurances that the entity will establish
procedures to ensure that--
(A) the participation of each eligible family
in the program is voluntary; and
(B) services are provided to an eligible
family in accordance with the individual
assessment for that family.
(8) Assurances that the entity will--
(A) submit annual reports to the Secretary
regarding the program and activities carried
out under the program that include such
information and data as the Secretary shall
require; and
(B) participate in, and cooperate with, data
and information collection necessary for the
evaluation required under subsection (g)(2) and
other research and evaluation activities
carried out under subsection (h)(3).
(9) A description of other State programs that
include home visitation services, including, if
applicable to the State, other programs carried out
under this title with funds made available from
allotments under section 502(c), programs funded under
title IV, title II of the Child Abuse Prevention and
Treatment Act (relating to community-based grants for
the prevention of child abuse and neglect), and section
645A of the Head Start Act (relating to Early Head
Start programs).
(10) Other information as required by the Secretary.
(f) Maintenance of Effort.--Funds provided to an eligible
entity receiving a grant under this section shall supplement,
and not supplant, funds from other sources for early childhood
home visitation programs or initiatives.
(g) Evaluation.--
(1) Independent, expert advisory panel.--The
Secretary, in accordance with subsection (h)(1)(A),
shall appoint an independent advisory panel consisting
of experts in program evaluation and research,
education, and early childhood development--
(A) to review, and make recommendations on,
the design and plan for the evaluation required
under paragraph (2) within 1 year after the
date of enactment of this section;
(B) to maintain and advise the Secretary
regarding the progress of the evaluation; and
(C) to comment, if the panel so desires, on
the report submitted under paragraph (3).
(2) Authority to conduct evaluation.--On the basis of
the recommendations of the advisory panel under
paragraph (1), the Secretary shall, by grant, contract,
or interagency agreement, conduct an evaluation of the
statewide needs assessments submitted under subsection
(b) and the grants made under subsections (c) and
(h)(3)(B). The evaluation shall include--
(A) an analysis, on a State-by-State basis,
of the results of such assessments, including
indicators of maternal and prenatal health and
infant health and mortality, and State actions
in response to the assessments; and
(B) an assessment of--
(i) the effect of early childhood
home visitation programs on child and
parent outcomes, including with respect
to each of the benchmark areas
specified in subsection (d)(1)(A) and
the participant outcomes described in
subsection (d)(2)(B);
(ii) the effectiveness of such
programs on different populations,
including the extent to which the
ability of programs to improve
participant outcomes varies across
programs and populations; and
(iii) the potential for the
activities conducted under such
programs, if scaled broadly, to improve
health care practices, eliminate health
disparities, and improve health care
system quality, efficiencies, and
reduce costs.
(3) Report.--Not later than March 31, 2015, the
Secretary shall submit a report to Congress on the
results of the evaluation conducted under paragraph (2)
and shall make the report publicly available.
(h) Other Provisions.--
(1) Intra-agency collaboration.--The Secretary shall
ensure that the Maternal and Child Health Bureau and
the Administration for Children and Families
collaborate with respect to carrying out this section,
including with respect to--
(A) reviewing and analyzing the statewide
needs assessments required under subsection
(b), the awarding and oversight of grants
awarded under this section, the establishment
of the advisory panels required under
subsections (d)(1)(B)(iii)(II) and (g)(1), and
the evaluation and report required under
subsection (g); and
(B) consulting with other Federal agencies
with responsibility for administering or
evaluating programs that serve eligible
families to coordinate and collaborate with
respect to research related to such programs
and families, including the Office of the
Assistant Secretary for Planning and Evaluation
of the Department of Health and Human Services,
the Centers for Disease Control and Prevention,
the National Institute of Child Health and
Human Development of the National Institutes of
Health, the Office of Juvenile Justice and
Delinquency Prevention of the Department of
Justice, and the Institute of Education
Sciences of the Department of Education.
(2) Grants to eligible entities that are not
states.--
(A) Indian tribes, tribal organizations, or
urban indian organizations.--The Secretary
shall specify requirements for eligible
entities that are Indian Tribes (or a
consortium of Indian Tribes), Tribal
Organizations, or Urban Indian Organizations to
apply for and conduct an early childhood home
visitation program with a grant under this
section. [Such] Except as provided in
subsection (l)(1), such requirements shall, to
the greatest extent practicable, be consistent
with the requirements applicable to eligible
entities that are States and shall require an
Indian Tribe (or consortium), Tribal
Organization, or Urban Indian Organization to--
(i) conduct a needs assessment
similar to the assessment required for
all States under subsection (b); and
(ii) establish quantifiable,
measurable 3- and 5-year benchmarks
consistent with subsection (d)(1)(A).
(B) Nonprofit organizations.--If, as of the
beginning of fiscal year 2012, a State has not
applied or been approved for a grant under this
section, the Secretary may use amounts
appropriated under paragraph (1) of subsection
(j) that are available for expenditure under
paragraph (3) of that subsection to make a
grant to an eligible entity that is a nonprofit
organization described in subsection (k)(1)(B)
to conduct an early childhood home visitation
program in the State. The Secretary shall
specify the requirements for such an
organization to apply for and conduct the
program which shall, to the greatest extent
practicable, be consistent with the
requirements applicable to eligible entities
that are States and shall require the
organization to--
(i) carry out the program based on
the needs assessment conducted by the
State under subsection (b); and
(ii) establish quantifiable,
measurable 3- and 5-year benchmarks
consistent with subsection (d)(1)(A).
(3) Research and other evaluation activities.--
(A) In general.--The Secretary shall carry
out a continuous program of research and
evaluation activities in order to increase
knowledge about the implementation and
effectiveness of home visiting programs, using
random assignment designs to the maximum extent
feasible. The Secretary may carry out such
activities directly, or through grants,
cooperative agreements, or contracts.
(B) Requirements.--The Secretary shall ensure
that--
(i) evaluation of a specific program
or project is conducted by persons or
individuals not directly involved in
the operation of such program or
project; and
(ii) the conduct of research and
evaluation activities includes
consultation with independent
researchers, State officials, and
developers and providers of home
visiting programs on topics including
research design and administrative data
matching.
(4) Report and recommendation.--Not later than
December 31, 2015, the Secretary shall submit a report
to Congress regarding the programs conducted with
grants under this section. The report required under
this paragraph shall include--
(A) information regarding the extent to which
eligible entities receiving grants under this
section demonstrated improvements in [each of]
the areas specified in subsection (d)(1)(A);
(B) information regarding any technical
assistance provided under subsection
(d)(1)(B)(iii)(I), including the type of any
such assistance provided; and
(C) recommendations for such legislative or
administrative action as the Secretary
determines appropriate.
(5) Data exchange standards for improved
interoperability.--
(A) Designation and use of data exchange
standards.--
(i) Designation.--The head of the
department or agency responsible for
administering a program funded under
this section shall, in consultation
with an interagency work group
established by the Office of Management
and Budget and considering State
government perspectives, designate data
exchange standards for necessary
categories of information that a State
agency operating the program is
required to electronically exchange
with another State agency under
applicable Federal law.
(ii) Data exchange standards must be
nonproprietary and interoperable.--The
data exchange standards designated
under clause (i) shall, to the extent
practicable, be nonproprietary and
interoperable.
(iii) Other requirements.--In
designating data exchange standards
under this paragraph, the Secretary
shall, to the extent practicable,
incorporate--
(I) interoperable standards
developed and maintained by an
international voluntary
consensus standards body, as
defined by the Office of
Management and Budget;
(II) interoperable standards
developed and maintained by
intergovernmental partnerships,
such as the National
Information Exchange Model; and
(III) interoperable standards
developed and maintained by
Federal entities with authority
over contracting and financial
assistance.
(B) Data exchange standards for federal
reporting.--
(i) Designation.--The head of the
department or agency responsible for
administering a program referred to in
this section shall, in consultation
with an interagency work group
established by the Office of Management
and Budget, and considering State
government perspectives, designate data
exchange standards to govern Federal
reporting and exchange requirements
under applicable Federal law.
(ii) Requirements.--The data exchange
reporting standards required by clause
(i) shall, to the extent practicable--
(I) incorporate a widely
accepted, nonproprietary,
searchable, computer-readable
format;
(II) be consistent with and
implement applicable accounting
principles;
(III) be implemented in a
manner that is cost-effective
and improves program efficiency
and effectiveness; and
(IV) be capable of being
continually upgraded as
necessary.
(iii) Incorporation of nonproprietary
standards.--In designating data
exchange standards under this
paragraph, the Secretary shall, to the
extent practicable, incorporate
existing nonproprietary standards, such
as the eXtensible Mark up Language.
(iv) Rule of construction.--Nothing
in this paragraph shall be construed to
require a change to existing data
exchange standards for Federal
reporting about a program referred to
in this section, if the head of the
department or agency responsible for
administering the program finds the
standards to be effective and
efficient.
(i) Application of Other Provisions of Title.--
(1) In general.--Except as provided in paragraph (2),
the other provisions of this title shall not apply to a
grant made under this section.
(2) Exceptions.--The following provisions of this
title shall apply to a grant made under this section to
the same extent and in the same manner as such
provisions apply to allotments made under section
502(c):
(A) Section 504(b)(6) (relating to
prohibition on payments to excluded individuals
and entities).
(B) Section 504(c) (relating to the use of
funds for the purchase of technical
assistance).
(C) Section 504(d) (relating to a limitation
on administrative expenditures).
(D) Section 506 (relating to reports and
audits), but only to the extent determined by
the Secretary to be appropriate for grants made
under this section.
(E) Section 507 (relating to penalties for
false statements).
(F) Section 508 (relating to
nondiscrimination).
(G) Section 509(a) (relating to the
administration of the grant program).
(j) Appropriations.--
(1) In general.--Out of any funds in the Treasury not
otherwise appropriated, there are appropriated to the
Secretary to carry out this section--
(A) $100,000,000 for fiscal year 2010;
(B) $250,000,000 for fiscal year 2011;
(C) $350,000,000 for fiscal year 2012;
(D) $400,000,000 for fiscal year 2013;
(E) $400,000,000 for fiscal year 2014;
(F) for fiscal year 2015, $400,000,000;
(G) for fiscal year 2016, $400,000,000; and
(H) for [fiscal year 2017] each of fiscal
years 2017 through 2022, $400,000,000.
(2) Reservations.--Of the amount appropriated under
this subsection for a fiscal year (or portion of a
fiscal year), the Secretary shall reserve--
(A) 3 percent of such amount for purposes of
making grants to eligible entities that are
Indian Tribes (or a consortium of Indian
Tribes), Tribal Organizations, or Urban Indian
Organizations; and
(B) 3 percent of such amount for purposes of
carrying out subsections (d)(1)(B)(iii), (g),
and (h)(3).
[(3) Availability.--Funds]
(3) Availability._
(A) In general._Except as provided in
subparagraph (B), funds made available to an
eligible entity under this section for a fiscal
year (or portion of a fiscal year) shall remain
available for expenditure by the eligible
entity through the end of the second succeeding
fiscal year after award. Any funds that are not
expended by the eligible entity during the
period in which the funds are available under
the preceding sentence may be used for grants
to nonprofit organizations under subsection
(h)(2)(B).
(B) Funds for pay for outcomes initiatives.--
Funds made available to an eligible entity
under this section for a fiscal year (or
portion of a fiscal year) for a pay for
outcomes initiative shall remain available for
expenditure by the eligible entity for not more
than 10 years after the funds are so made
available.
(k) Definitions.--In this section:
(1) Eligible entity.--
(A) In general.--The term ``eligible entity''
means a State, an Indian Tribe, Tribal
Organization, or Urban Indian Organization,
Puerto Rico, Guam, the Virgin Islands, the
Northern Mariana Islands, and American Samoa.
(B) Nonprofit organizations.--Only for
purposes of awarding grants under subsection
(h)(2)(B), such term shall include a nonprofit
organization with an established record of
providing early childhood home visitation
programs or initiatives in a State or several
States.
(2) 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,
including grandparents or other relatives of
the child, and foster parents, who are serving
as the child's primary caregiver from birth to
kindergarten entry, and including a
noncustodial parent who has an ongoing
relationship with, and at times provides
physical care for, the child.
(3) Indian tribe; tribal organization.--The terms
``Indian Tribe'' and ``Tribal Organization'', and
``Urban Indian Organization'' have the meanings given
such terms in section 4 of the Indian Health Care
Improvement Act.
(4) Pay for outcomes initiative.--The term ``pay for
outcomes initiative'' means a performance-based grant,
contract, cooperative agreement, or other agreement
awarded by a public entity in which a commitment is
made to pay for improved outcomes that result in social
benefit and direct cost savings or cost avoidance to
the public sector. Such an initiative shall include--
(A) a feasibility study that describes how
the proposed intervention is based on evidence
of effectiveness;
(B) a rigorous, third-party evaluation that
uses experimental or quasi-experimental design
or other research methodologies that allow for
the strongest possible causal inferences to
determine whether the initiative has met its
proposed outcomes;
(C) an annual, publicly available report on
the progress of the initiative; and
(D) a requirement that payments are made to
the recipient of a grant, contract, or
cooperative agreement only when agreed upon
outcomes are achieved, except that this
requirement shall not apply with respect to
payments to a third party conducting the
evaluation described in subparagraph (B).
(l) Matching Requirement.--
(1) Program home visiting share.--
(A) In general.--An eligible entity to which
a grant is made under this section for fiscal
year 2020 or any succeeding fiscal year shall
not use the grant to cover more than the
applicable percentage of the costs of providing
services or conducting activities under this
section during the fiscal year.
(B) Applicable percentage.--In subparagraph
(A), the term ``applicable percentage'' means,
with respect to a fiscal year--
(i) in the case of an eligible entity
that is a State or nonprofit
organization--
(I) 70 percent, in the case
of fiscal year 2020;
(II) 60 percent, in the case
of fiscal year 2021; or
(III) 50 percent, in the case
of fiscal year 2022 or any
succeeding fiscal year; or
(ii) in the case of an eligible
entity that is an Indian Tribe (or a
consortium of Indian Tribes), a Tribal
Organization, or an Urban Indian
Organization--
(I) 100 percent, in the case
of fiscal year 2020 or 2021; or
(II) 70 percent, in the case
of fiscal year 2022 or any
succeeding fiscal year.
(2) Non-program home visiting share.--The share of
the costs of providing services or conducting
activities under this section not covered by grant
funds may include--
(A) State expenditures of Federal funds made
available other than under this section
expended for activities under this section;
(B) State expenditures of State funds
expended for activities under this section as a
condition of receiving Federal funds other than
under this section; and
(C) contributions made for activities under
this section from any other source, paid in
cash or in kind, valued at the fair market
value of such contribution.
* * * * * * *
VII. DISSENTING VIEWS
Democrats strongly support moving quickly to reauthorize
the Maternal, Infant, and Early Childhood Home Visiting Program
(MIECHV) before it expires on September 30, 2017. We are
concerned that by advancing a partisan bill with policy changes
not supported by home visiting experts, the Majority has made a
timely reauthorization more difficult. A delay in
reauthorization could disrupt successful and effective programs
in our districts and across the country.
H.R. 2824 does not provide a single penny of new funding,
despite abundant evidence that MIECHV makes a real, measurable
difference in the lives of children and families served by home
visiting. At the current funding levels, only six percent of
eligible families are getting this life-changing help, and less
than one-third of our counties have MIECHV home visiting. We
offered an amendment to double funding over the next five
years, which was unfortunately rejected by the Majority.
Our understanding, both from our Committee hearings and
from our own experience at home, is that MIECHV is working.
However, H.R. 2824 makes policy changes to MIECHV that were not
requested by any home visiting program or expert. We offered a
number of amendments to remove or revise policies that we, and
home visiting experts and advocates, believe would reduce the
number of states and communities operating successful home
visiting programs or undermine the programs that are currently
helping families. We were disappointed that none of these
amendments were accepted.
We also are concerned that the Majority plans to offset the
budget impact of reauthorizing MIECHV by combining this bill
with H.R. 2792, a bill to cut Supplemental Security Income
(SSI). We unequivocally reject the idea that the only way to
continue home visiting is to cut benefits for vulnerable
seniors and Americans with severe disabilities. During our
markup, we offered several amendments providing better ways to
pay for the bill, which the Chairman ruled were not in order.
We continue to hope the Majority will reconsider their
approach, and return to our long policy of bipartisan action to
expand and strengthen home visiting for the families and
communities that need it.
Richrd E. Neal.
John Lewis.
Mike Thompson.
Ron Kind.
Joseph Crowley.
Linda T. Sanchez.
Suzan DelBene.
Sander M. Levin.
Lloyd Doggett.
Earl Blumenauer.
Bill Pascrell, Jr.
Danny K. Davis.
Terri Sewell.
Judy Chu.
Brian Higgins.
----------
Mr. Chairman: On H.R. 2824, I am in full agreement with the
dissenting views of my Democratic colleagues. Had I been
present for the votes on the amendments submitted by my
Democratic colleagues, I would have supported them.
Had I been present for the vote on reporting H.R. 2824 out
of the Committee, I would have voted No.
John B. Larson,
Member of Congress.
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