1.1                          A bill for an act
  1.2             relating to health; expanding the home health visiting 
  1.3             program; appropriating money; amending Minnesota 
  1.4             Statutes 1994, section 145A.15. 
  1.5   BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA: 
  1.6      Section 1.  Minnesota Statutes 1994, section 145A.15, is 
  1.7   amended to read: 
  1.8      145A.15 [HOME VISITING PROGRAM.] 
  1.9      Subdivision 1.  [ESTABLISHMENT.] The commissioner of health 
  1.10  shall establish a expand the current grant program designed to 
  1.11  prevent child abuse and neglect and reduce juvenile delinquency 
  1.12  and crime by promoting positive parenting and a healthy 
  1.13  beginning for children by providing early intervention services 
  1.14  for families at risk of child abuse and neglect.  The grant 
  1.15  program shall provide early intervention services for families 
  1.16  at risk of child abuse and neglect and will include: 
  1.17     (1) expansion of current public health nurse and family 
  1.18  aide home visiting programs which prevent child abuse and 
  1.19  neglect; 
  1.20     (2) early intervention to promote a healthy and nurturing 
  1.21  beginning; 
  1.22     (3) distribution of educational and public information 
  1.23  programs and materials in hospital maternity divisions, 
  1.24  well-baby clinics, obstetrical clinics, and community clinics; 
  1.25  and 
  2.1      (3) (4) training of home visitors in skills necessary for 
  2.2   comprehensive home visiting which promotes a healthy and 
  2.3   nurturing beginning for the child. 
  2.4      Subd. 2.  [GRANT RECIPIENTS.] The commissioner is 
  2.5   authorized to award grants to programs that meet the 
  2.6   requirements of subdivision 3 and that are targeted to include a 
  2.7   strong prevention focus for at-risk families.  Families 
  2.8   considered to be at-risk for child abuse and neglect include, 
  2.9   but are not limited to, families with: 
  2.10     (1) adolescent parents; 
  2.11     (2) a history of alcohol and other drug abuse; 
  2.12     (3) a history of child abuse, domestic abuse, or other 
  2.13  dysfunction in the family of origin; 
  2.14     (4) a history of domestic abuse, rape, or other forms of 
  2.15  victimization; 
  2.16     (5) reduced cognitive functioning; 
  2.17     (6) a lack of knowledge of child growth and development 
  2.18  stages; or 
  2.19     (7) difficulty dealing with stress, including stress caused 
  2.20  by discrimination, mental illness, a high incidence of crime or 
  2.21  poverty in the neighborhood, unemployment, divorce, and lack of 
  2.22  basic needs, often found in conjunction with a pattern of family 
  2.23  isolation. 
  2.24     Subd. 3.  [PROGRAM REQUIREMENTS.] (a) The commissioner 
  2.25  shall award grants, using a request for proposal system, to 
  2.26  programs designed to: 
  2.27     (1) develop a risk assessment tool and offer direct contact 
  2.28  families at the birth of the child through a public health nurse 
  2.29  or trained program representative who will meet the family, 
  2.30  provide information, describe the benefits of the program, and 
  2.31  offer a home visit to the family to occur during the first weeks 
  2.32  of the newborn's life in the home setting; 
  2.33     (2) visit the family and newborn in the home setting at 
  2.34  which time the public health nurse or trained individual will 
  2.35  answer parents' questions, give information, including 
  2.36  information on breast feeding, and make referrals to any other 
  3.1   appropriate services; 
  3.2      (3) conduct a screening process to determine if families 
  3.3   need additional support or are at risk for child abuse and 
  3.4   neglect and provide additional home visiting services to at-risk 
  3.5   families including, but not limited to, education on:  parenting 
  3.6   skills, child development and stages of growth, communication 
  3.7   skills, stress management, problem-solving skills, positive 
  3.8   child discipline practices, methods to improve parent-child 
  3.9   interactions and enhance self-esteem, community support services 
  3.10  and other resources, and how to enjoy and have fun with your 
  3.11  children; 
  3.12     (2) (4) establish clear objectives and protocols for the 
  3.13  home visits; 
  3.14     (3) (5) determine the frequency and duration of home visits 
  3.15  based on a risk-need assessment of the client; except that home 
  3.16  visits shall may begin in the second as early as the first 
  3.17  trimester of pregnancy and continue based on the need of the 
  3.18  client until the child reaches age six; 
  3.19     (6) refer and actively assist the family in accessing new 
  3.20  parent and family education, self-help and support services 
  3.21  available in the community; 
  3.22     (4) (7) develop and distribute educational resource 
  3.23  materials and offer presentations on the prevention of child 
  3.24  abuse and neglect for use in hospital maternity divisions, 
  3.25  well-baby clinics, obstetrical clinics, and community clinics; 
  3.26  and 
  3.27     (5) (8) coordinate with other local home visitation 
  3.28  programs, particularly those offered by school boards under 
  3.29  section 121.882, subdivision 2b, so as to avoid duplication. 
  3.30     (b) Programs must provide at least 40 hours of training for 
  3.31  public health nurses, family aides, and other home visitors.  
  3.32  Training must include information on the following: 
  3.33     (1) the dynamics of child abuse and neglect, domestic 
  3.34  violence, and victimization within family systems; 
  3.35     (2) signs of abuse or other indications that a child may be 
  3.36  at risk of abuse or neglect; 
  4.1      (3) what is child abuse and neglect; 
  4.2      (4) how to properly report cases of child abuse and 
  4.3   neglect; 
  4.4      (5) sensitivity and respect for diverse cultural 
  4.5   preferences practices in child rearing; 
  4.6      (6) community resources, social service agencies, and 
  4.7   family support activities or programs; 
  4.8      (7) healthy child development and growth; 
  4.9      (8) parenting skills; 
  4.10     (9) positive child discipline practices; 
  4.11     (10) identification of stress factors and stress reduction 
  4.12  techniques; 
  4.13     (11) home visiting techniques; and 
  4.14     (12) risk assessment measures; and 
  4.15     (13) caring for the special needs of newborns and mothers 
  4.16  before and after the birth of the infant. 
  4.17     Program services must be community-based, accessible, and 
  4.18  culturally relevant and must be designed to foster collaboration 
  4.19  among existing agencies and community-based organizations. 
  4.20     Subd. 4.  [EVALUATION.] Each program that receives a grant 
  4.21  under this section must include a plan for program evaluation 
  4.22  designed to measure the effectiveness of the program in 
  4.23  preventing child abuse and neglect.  On January 1, 1994, and 
  4.24  annually thereafter, the commissioner of health shall submit a 
  4.25  report to the legislature on all activities initiated in the 
  4.26  prior biennium under this section.  The report shall include 
  4.27  information on the outcomes reported by all programs that 
  4.28  received grant funds under this section in that biennium. 
  4.29     Sec. 2.  [DELAYED IMPLEMENTATION FOR EXISTING PROGRAMS.] 
  4.30     The amendments to Minnesota Statutes, section 145A.15, 
  4.31  subdivisions 1 and 3, do not become effective until July 1, 
  4.32  1996, for home health visiting programs that received a grant 
  4.33  under Minnesota Statutes, section 145A.15, and that were in 
  4.34  existence on December 31, 1994. 
  4.35     Sec. 3.  [APPROPRIATION.] 
  4.36     $....... is appropriated from the general fund to the 
  5.1   commissioner of health for the purpose of administering the 
  5.2   program in section 1 to be made available until June 30, 1997.