1.1                          A bill for an act 
  1.2             relating to health; establishing home visiting 
  1.3             programs for infant care; appropriating money; 
  1.4             proposing coding for new law in Minnesota Statutes, 
  1.5             chapter 145A. 
  1.6   BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA: 
  1.7      Section 1.  [145A.16] [HOME VISITING PROGRAMS FOR INFANT 
  1.8   CARE.] 
  1.9      Subdivision 1.  [ESTABLISHMENT.] The commissioner shall 
  1.10  establish a grant program to fund universal home visiting 
  1.11  programs designed to serve all live births in designated 
  1.12  geographic areas.  The commissioner shall designate the 
  1.13  geographic area to be served by each program.  At least one 
  1.14  program must provide home visiting services to families within 
  1.15  the seven-county metropolitan area, and at least one program 
  1.16  must provide home visiting services to families outside the 
  1.17  metropolitan area.  The purpose of the program is to strengthen 
  1.18  families and to promote positive parenting and healthy child 
  1.19  development.  
  1.20     Subd. 2.  [STEERING COMMITTEE.] The commissioner shall 
  1.21  establish an ad hoc steering committee to develop and implement 
  1.22  a comprehensive plan for the universal home visiting programs.  
  1.23  The members of the ad hoc steering committee shall include, at a 
  1.24  minimum, representatives of local public health departments, 
  1.25  public health nurses, other health care providers, 
  2.1   paraprofessionals, community-based family workers, 
  2.2   representatives of health insurance plans, and other individuals 
  2.3   with expertise in the field of home visiting, early childhood 
  2.4   health and development, and child abuse prevention.  
  2.5      Subd. 3.  [PROGRAM REQUIREMENTS.] The commissioner shall 
  2.6   award grants using a request for proposal system.  Existing home 
  2.7   visiting programs may apply for the grants.  Health information 
  2.8   and assessment, counseling, social support, educational 
  2.9   services, and referral to community resources must be offered to 
  2.10  all families, regardless of need or risk, beginning prenatally 
  2.11  or as soon after birth as possible, and continuing as needed.  
  2.12  Each program applying for a grant must have access to adequate 
  2.13  community resources to complement the home visiting services and 
  2.14  must be designed to: 
  2.15     (1) identify all newborn infants within the geographic area 
  2.16  served by the program.  Identification may be made prenatally or 
  2.17  at the time of birth; 
  2.18     (2) offer a home visit by a trained home visitor.  If home 
  2.19  visiting is accepted, the first visit must occur prenatally or 
  2.20  as soon after birth as possible and must include an assessment 
  2.21  by a public health nurse; 
  2.22     (3) offer, at a minimum, information on infant care, child 
  2.23  growth and development, positive parenting, the prevention of 
  2.24  disease and exposure to environmental hazards, and support 
  2.25  services available in the community; 
  2.26     (4) provide information about and referral to health care 
  2.27  services, if needed, including family planning, pediatric 
  2.28  preventive services, immunizations, and developmental 
  2.29  assessments, and provide information on the availability of 
  2.30  public assistance programs as appropriate; 
  2.31     (5) recruit home visit workers who will represent all the 
  2.32  races, cultures, and languages spoken by eligible families in 
  2.33  the designated geographic areas; and 
  2.34     (6) train and supervise home visitors in accordance with 
  2.35  the requirements established under subdivision 5.  
  2.36     Subd. 4.  [COORDINATION.] To minimize duplication, a 
  3.1   program receiving a grant must establish a coalition that 
  3.2   includes parents, health care providers that provide services to 
  3.3   families with young children in the service area, and 
  3.4   representatives of local schools, governmental and nonprofit 
  3.5   agencies, community-based organizations, health insurance plans, 
  3.6   and local hospitals.  The coalition must designate the roles of 
  3.7   all provider agencies, family identification methods, referral 
  3.8   mechanisms, and payment responsibilities appropriate for the 
  3.9   existing systems in the program's service area.  The coalition 
  3.10  must also coordinate with other programs offered by school 
  3.11  boards under section 121.882, subdivision 2b, and programs 
  3.12  offered under section 145A.15.  
  3.13     Subd. 5.  [TRAINING.] The commissioner shall establish 
  3.14  training requirements for home visitors and minimum requirements 
  3.15  for supervision by a public health nurse.  The requirements for 
  3.16  nurses must be consistent with chapter 148.  Training must 
  3.17  include child development, positive parenting techniques, and 
  3.18  diverse cultural practices in child rearing and family systems.  
  3.19  A program may use grant money to train home visitors. 
  3.20     Subd. 6.  [EVALUATION.] (a) The commissioner shall evaluate 
  3.21  the effectiveness of the home visiting programs, taking into 
  3.22  consideration the following goals:  
  3.23     (1) appropriate child growth, development, and access to 
  3.24  health care; 
  3.25     (2) appropriate utilization of preventive health care and 
  3.26  medical care for acute illnesses; 
  3.27     (3) lower rates of substantiated child abuse and neglect; 
  3.28     (4) up-to-date immunizations; 
  3.29     (5) a reduction in unintended pregnancies; 
  3.30     (6) increasing families' understanding of lead poisoning 
  3.31  prevention; 
  3.32     (7) lower rates of unintentional injuries; and 
  3.33     (8) fewer hospitalizations and emergency room visits.  
  3.34     (b) The commissioner shall report to the legislature by 
  3.35  February 15, 1998, on the comprehensive plan for the universal 
  3.36  home visiting programs and recommend any draft legislation 
  4.1   needed to implement the plan.  The commissioner shall report to 
  4.2   the legislature biennially beginning December 15, 2001, on the 
  4.3   effectiveness of the universal home visiting programs.  In the 
  4.4   report due December 15, 2001, the commissioner shall include 
  4.5   recommendations on the feasibility and cost of expanding the 
  4.6   program statewide.  
  4.7      Subd. 7.  [TECHNICAL ASSISTANCE.] The commissioner shall 
  4.8   provide administrative and technical assistance to each program, 
  4.9   including assistance conducting short- and long-term evaluations 
  4.10  of the home visiting program required under subdivision 6.  The 
  4.11  commissioner may request research and evaluation support from 
  4.12  the University of Minnesota.  
  4.13     Subd. 8.  [MATCHING FUNDS.] The commissioner and the grant 
  4.14  programs shall seek to supplement any state funding with private 
  4.15  and other nonstate funding sources, including other grants and 
  4.16  insurance coverage for services provided.  Program funding may 
  4.17  be used only to supplement, not to replace, existing funds being 
  4.18  used for home visiting.  
  4.19     Sec. 2.  [APPROPRIATIONS.] 
  4.20     (a) $....... is appropriated from the general fund to the 
  4.21  commissioner of health to be used for the universal home 
  4.22  visiting program described in section 1.  The appropriation is 
  4.23  available until June 30, 1999. 
  4.24     (b) $405,000 is appropriated from the general fund to the 
  4.25  commissioner of health to continue funding the home visiting 
  4.26  programs established under Minnesota Statutes, section 145A.15, 
  4.27  which received one-year funding for fiscal year 1997.  The sum 
  4.28  is available until expended.