Rhode Island 2023 Regular Session

Rhode Island Senate Bill S0207 Compare Versions

Only one version of the bill is available at this time.

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5	5	2023 -- S 0207
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7	7	LC001628
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9	9	S TATE OF RHODE IS LAND
10	10	IN GENERAL ASSEMBLY
11	11	JANUARY SESSION, A.D. 2023
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14	14	A N A C T
15	15	RELATING TO HEALTH AND SAFETY -- THE RHODE ISLAND FAMILY HOME-
16	16	VISITING ACT
17	17	Introduced By: Senators Valverde, Gu, Lawson, Murray, Lauria, DiMario, Miller,
18	18	DiPalma, Pearson, and Quezada
19	19	Date Introduced: February 16, 2023
20	20	Referred To: Senate Finance
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23	23	It is enacted by the General Assembly as follows:
24	24	SECTION 1. Legislative findings. 1
25	25	The general assembly hereby finds that: 2
26	26	(1) A child's first experiences and relationships set the foundation for development and 3
27	27	learning that leads to success in school and in life. 4
28	28	(2) Voluntary, high-quality home-visiting programs help families learn about and connect 5
29	29	to essential resources, adjust to parenthood, build parenting skills, and address challenges 6
30	30	commonly faced by young families. 7
31	31	(3) For at least four (4) decades, Rhode Island’s first connections program, overseen by the 8
32	32	department of health, has been providing free, voluntary, statewide home-visiting to pregnant 9
33	33	women and to families with newborns, infants, and toddlers, reaching about thirty-five (35%) of 10
34	34	families with new babies. Families typically receive one to four (4) home visits. The program is 11
35	35	staffed with nurses, social workers, and community health workers and is funded with federal 12
36	36	Individuals with Disabilities Education Act Part C resources, Medicaid billing, and other federal 13
37	37	grants. 14
38	38	Prior to a temporary, one-year increase in state fiscal year 2023, the Medicaid rates for first 15
39	39	connections services have not increased since 2000. Inadequate funding had resulted in significant 16
40	40	program staffing challenges and an average operating loss for first connections programs of one 17
41	41	hundred thirty-six dollars and seventy cents ($136.70) per visit. The temporary, one-year Medicaid 18
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45	45	rate increase will expire on June 30, 2023. In 2022, South County Home Health terminated their 1
46	46	contract with the state to deliver first connections services, citing lack of sufficient resources to 2
47	47	adequately staff the program. 3
48	48	(4) Following the establishment of the federal Maternal, Infant, and Early Childhood Home 4
49	49	Visiting program in 2010, Rhode Island expanded home-visiting services to include several longer-5
50	50	term, comprehensive, and evidence-based program models with strong evidence they improve 6
51	51	short-term and long-term outcomes for children and families. In 2022, the federal funding was 7
52	52	reauthorized and now includes a twenty-five percent (25%) state match requirement to receive base 8
53	53	federal funding to sustain existing programs and new expansion funds. The state match requirement 9
54	54	will go into effect in federal fiscal year 2024. 10
55	55	(5) By enacting this law, the general assembly recognizes the short-term and long-term 11
56	56	benefits of voluntary, high quality, culturally responsive home-visiting services to pregnant and 12
57	57	parenting families with newborns, infants, and toddlers. 13
58	58	SECTION 2. Section 23-13.7-2 of the General Laws in Chapter 23-13.7 entitled "The 14
59	59	Rhode Island Family Home-Visiting Act" is hereby amended to read as follows: 15
60	60	23-13.7-2. Home-visiting system components. 16
61	61	(a) The Rhode Island department of health shall coordinate the system of early childhood 17
62	62	home-visiting services in Rhode Island and shall work with the department of human services and 18
63	63	department of children, youth and families to identify effective, evidence-based, home-visiting 19
64	64	models that meet the needs of vulnerable families with young children, including the most 20
65	65	vulnerable families. 21
66	66	(b) The Rhode Island department of health shall implement a statewide home-visiting 22
67	67	system that uses evidence-based models proven to improve child and family outcomes. Evidence-23
68	68	based, home-visiting programs must follow with fidelity a program model with comprehensive 24
69	69	standards that ensure high-quality service delivery, use research-based curricula, and have 25
70	70	demonstrated significant positive outcomes in at least two (2) of the following areas: 26
71	71	(1) Improved prenatal, maternal, infant, or child health outcomes; 27
72	72	(2) Improved safety and reduced child maltreatment and injury; 28
73	73	(3) Improved family economic security and self-sufficiency; 29
74	74	(4) Enhanced early childhood development (social-emotional, language, cognitive, 30
75	75	physical) to improve children’s readiness to succeed in school. 31
76	76	(c) The Rhode Island department of health shall implement a system to identify and refer 32
77	77	families prenatally, or as early after the birth of a child as possible, to voluntary, evidence-based, 33
78	78	home-visiting programs. The referral system shall prioritize families for services based on risk 34
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82	82	factors known to impair child development, including: 1
83	83	(1) Adolescent parent(s); 2
84	84	(2) History of prenatal drug or alcohol abuse; 3
85	85	(3) History of child maltreatment, domestic abuse, or other types of violence; 4
86	86	(4) Incarcerated parent(s); 5
87	87	(5) Reduced parental cognitive functioning or significant disability; 6
88	88	(6) Insufficient financial resources to meet family needs; 7
89	89	(7) History of homelessness; or 8
90	90	(8) Other risk factors as determined by the department. 9
91	91	(d) The Medicaid rate increase authorized for the first connections program in state fiscal 10
92	92	year 2023 shall be made permanent. 11
93	93	(e) Beginning on or before October 1, 2016, and annually thereafter, the Rhode Island 12
94	94	department of health shall issue a state home-visiting report that outlines the components of the 13
95	95	state’s family home-visiting system that shall be shared with the governor, speaker of the house, 14
96	96	and senate president, made publicly available on the department’s website, and sent to members of 15
97	97	the children’s cabinet, the RI early learning council, and the RI family home visiting council. The 16
98	98	report shall include: 17
99	99	(1) The number of families served by first connections and each evidence-based family 18
100	100	home-visiting model; and 19
101	101	(2) Demographic data on families served; and 20
102	102	(3) Duration of participation of families; and 21
103	103	(4) Cross-departmental coordination; and 22
104	104	(5) Outcomes related to prenatal, maternal, infant and child health, child maltreatment, 23
105	105	family economic security, and child development and school readiness; and 24
106	106	(6) Implementation challenges, including challenges related to funding and program 25
107	107	operations, and problems recruiting and retaining qualified and effective home-visiting program 26
108	108	staff; and 27
109	109	(7) An annual estimate of the number of children born to Rhode Island families who would 28
110	110	benefit from a universal, voluntary, short-term home visiting program and the number who face 29
111	111	significant risk factors known to impair child development and who would benefit from the 30
112	112	comprehensive, long-term, evidence-based home visiting services; and, and a plan including the 31
113	113	fiscal costs and benefits 32
114	114	(8) An annual estimate of the available federal funding and the state general revenue needed 33
115	115	to sustain high-quality home-visiting services statewide and to gradually expand access to the 34
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119	119	existing voluntary, evidence-based, family home-visiting programs in Rhode Island to all 1
120	120	vulnerable families who would benefit. 2
121	121	(e)(f) The October 1, 2024 family home-visiting report shall include a plan with cost 3
122	122	estimates to expand home-visiting services over five (5) years to offer universal, voluntary family 4
123	123	home-visiting services statewide. The department shall review the progress made in other states 5
124	124	and municipalities that are making family home-visiting universally available, including 6
125	125	Connecticut, New Jersey, and Oregon. This report shall also include recommendations from the 7
126	126	department about the feasibility, advantages, and disadvantages of adopting and integrating the 8
127	127	evidence-based family connects universal newborn home-visiting model into the state’s service 9
128	128	array. 10
129	129	(f)(g) State appropriations for this purpose shall be combined with federal dollars to fund 11
130	130	the expansion of voluntary, evidence-based, home-visiting programs, to all families who would 12
131	131	benefit with the goal of offering the program to all the state’s pregnant and parenting teens; families 13
132	132	with a history of involvement with the child welfare system; and other vulnerable families. 14
133	133	SECTION 3. This act shall take effect upon passage. 15
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140	140	EXPLANATION
141	141	BY THE LEGISLATIVE COUNCIL
142	142	OF
143	143	A N A C T
144	144	RELATING TO HEALTH AND SAFETY -- THE RHODE ISLAND FAM ILY HOME-
145	145	VISITING ACT
146	146	***
147	147	This act would make the Medicaid rate increase permanent for the first connections family 1
148	148	home-visiting program, require additional information to be added to the annual family home-2
149	149	visiting report, and direct the department of health to develop a plan with federal and state cost 3
150	150	estimates to phase-in expansion of voluntary home-visiting services to reach all families who would 4
151	151	benefit. 5
152	152	This act would take effect upon passage. 6
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