2024 -- S 2360 | |
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LC004315 | |
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STATE OF RHODE ISLAND | |
IN GENERAL ASSEMBLY | |
JANUARY SESSION, A.D. 2024 | |
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A N A C T | |
RELATING TO HEALTH AND SAFETY -- THE RHODE ISLAND FAMILY HOME- | |
VISITING ACT | |
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Introduced By: Senators Valverde, Murray, DiPalma, Pearson, Lawson, Lauria, DiMario, | |
Date Introduced: February 12, 2024 | |
Referred To: Senate Finance | |
It is enacted by the General Assembly as follows: | |
1 | SECTION 1. Legislative findings. |
2 | The general assembly hereby finds that: |
3 | (1) A child's first experiences and relationships set the foundation for development and |
4 | learning that leads to success in school and in life. |
5 | (2) Voluntary, high-quality home-visiting programs help families learn about and connect |
6 | to essential resources, adjust to parenthood, build parenting skills, and address challenges |
7 | commonly faced by young families. |
8 | (3) For at least four (4) decades, Rhode Island’s first connections program, overseen by the |
9 | department of health, has been providing free, voluntary, statewide home-visiting to pregnant |
10 | women and to families with newborns, infants, and toddlers, reaching about thirty-five (35%) of |
11 | families with new babies. Families typically receive one to four (4) home visits. The program is |
12 | staffed with nurses, social workers, and community health workers and is funded with federal |
13 | Individuals with Disabilities Education Act Part C resources, Medicaid billing, and other federal |
14 | grants. |
15 | Prior to a temporary increase in state fiscal year 2023 that was continued into 2024, the |
16 | Medicaid rates for first connections services had not increased since 2000. Inadequate funding had |
17 | resulted in significant program staffing challenges and an average operating loss for first |
18 | connections programs of one hundred thirty-six dollars and seventy cents ($136.70) per visit. The |
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1 | temporary, two (2) year Medicaid rate increase will expire on June 30, 2024. In 2022, South County |
2 | Home Health terminated their contract with the state to deliver first connections services, citing |
3 | lack of sufficient resources to adequately staff the program. |
4 | (4) Following the establishment of the federal Maternal, Infant, and Early Childhood Home |
5 | Visiting program in 2010, Rhode Island expanded home-visiting services to include several longer- |
6 | term, comprehensive, and evidence-based program models with strong evidence they improve |
7 | short-term and long-term outcomes for children and families. In 2022, the federal funding was |
8 | reauthorized and now includes a twenty-five percent (25%) state match requirement to receive base |
9 | federal funding to sustain existing programs and new expansion funds. The state match requirement |
10 | will go into effect in federal fiscal year 2024. |
11 | (5) By enacting this law, the general assembly recognizes the short-term and long-term |
12 | benefits of voluntary, high quality, culturally responsive home-visiting services to pregnant and |
13 | parenting families with newborns, infants, and toddlers. |
14 | SECTION 2. Section 23-13.7-2 of the General Laws in Chapter 23-13.7 entitled "The |
15 | Rhode Island Family Home-Visiting Act" is hereby amended to read as follows: |
16 | 23-13.7-2. Home-visiting system components. |
17 | (a) The Rhode Island department of health shall coordinate the system of early childhood |
18 | home-visiting services in Rhode Island and shall work with the department of human services and |
19 | department of children, youth and families to identify effective, evidence-based, home-visiting |
20 | models that meet the needs of vulnerable families with young children, including the most |
21 | vulnerable families. |
22 | (b) The Rhode Island department of health shall implement a statewide home-visiting |
23 | system that uses evidence-based models proven to improve child and family outcomes. Evidence- |
24 | based, home-visiting programs must follow with fidelity a program model with comprehensive |
25 | standards that ensure high-quality service delivery, use research-based curricula, and have |
26 | demonstrated significant positive outcomes in at least two (2) of the following areas: |
27 | (1) Improved prenatal, maternal, infant, or child health outcomes; |
28 | (2) Improved safety and reduced child maltreatment and injury; |
29 | (3) Improved family economic security and self-sufficiency; |
30 | (4) Enhanced early childhood development (social-emotional, language, cognitive, |
31 | physical) to improve children’s readiness to succeed in school. |
32 | (c) The Rhode Island department of health shall implement a system to identify and refer |
33 | families prenatally, or as early after the birth of a child as possible, to voluntary, evidence-based, |
34 | home-visiting programs. The referral system shall prioritize families for services based on risk |
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1 | factors known to impair child development, including: |
2 | (1) Adolescent parent(s); |
3 | (2) History of prenatal drug or alcohol abuse; |
4 | (3) History of child maltreatment, domestic abuse, or other types of violence; |
5 | (4) Incarcerated parent(s); |
6 | (5) Reduced parental cognitive functioning or significant disability; |
7 | (6) Insufficient financial resources to meet family needs; |
8 | (7) History of homelessness; or |
9 | (8) Other risk factors as determined by the department. |
10 | (d) The Medicaid rate increase authorized for the first connections program in state fiscal |
11 | year 2023 and continued in state fiscal year 2024, shall be made permanent. |
12 | (e) Annually, on or before July 1, of each year, beginning July 1, 2025, the Medicaid |
13 | payment rates for first connections services shall be adjusted to reflect increases in program |
14 | operating costs, based on the consumer price index calculated by the U.S. Bureau of Labor Statics. |
15 | (f) Beginning on or before October 1, 2016, and annually thereafter, the Rhode Island |
16 | department of health shall issue a state home-visiting report that outlines the components of the |
17 | state’s family home-visiting system that shall be shared with the governor, speaker of the house, |
18 | and senate president, made publicly available on the department’s website, and sent to members of |
19 | the children's cabinet, the RI early learning council, and the RI family home visiting council. The |
20 | report shall include: |
21 | (1) The number of families served by first connections and each evidence-based family |
22 | home-visiting model; and |
23 | (2) Demographic data on families served; and |
24 | (3) Duration of participation of families; and |
25 | (4) Cross-departmental coordination; and |
26 | (5) Outcomes related to prenatal, maternal, infant and child health, child maltreatment, |
27 | family economic security, and child development and school readiness; and |
28 | (6) Implementation challenges, including challenges related to funding and program |
29 | operations, and problems recruiting and retaining qualified and effective home-visiting program |
30 | staff; and |
31 | (7) An annual estimate of the number of children born to Rhode Island families who would |
32 | benefit from a universal, voluntary, short-term home visiting program and the number who face |
33 | significant risk factors known to impair child development and who would benefit from the |
34 | comprehensive, long-term, evidence-based home visiting services; and, and a plan including the |
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1 | fiscal costs and benefits |
2 | (8) An annual estimate of the available federal family home visiting funding, the state |
3 | match required to maximize federal funding, and the state general revenue needed to sustain high- |
4 | quality home-visiting services statewide and to gradually expand access to the existing voluntary, |
5 | evidence-based, family home-visiting programs in Rhode Island to all vulnerable families who |
6 | would benefit. |
7 | (g) The October 1, 2025 family home-visiting report shall include a plan with cost estimates |
8 | to expand home-visiting services over five (5) years to offer universal, voluntary family home- |
9 | visiting services statewide. The department shall review the progress made in other states and |
10 | municipalities that are making family home-visiting universally available, including Connecticut, |
11 | New Jersey, and Oregon. This report shall also include recommendations from the department |
12 | about the feasibility, advantages, and disadvantages of adopting and integrating the evidence-based |
13 | family connects universal newborn home-visiting model into the state's service array. |
14 | (e)(h) State appropriations for this purpose shall be combined with federal dollars to fund |
15 | the expansion of voluntary, evidence-based, home-visiting programs, to all families who would |
16 | benefit with the goal of offering the program to all the state’s pregnant and parenting teens; families |
17 | with a history of involvement with the child welfare system; and other vulnerable families. |
18 | SECTION 3. This act shall take effect upon passage. |
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EXPLANATION | |
BY THE LEGISLATIVE COUNCIL | |
OF | |
A N A C T | |
RELATING TO HEALTH AND SAFETY -- THE RHODE ISLAND FAMILY HOME- | |
VISITING ACT | |
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1 | This act would make the Medicaid rate increase permanent for the first connections family |
2 | home-visiting program, require additional information to be added to the annual family home- |
3 | visiting report, and direct the department of health to develop a plan with federal and state cost |
4 | estimates to phase-in expansion of voluntary home-visiting services to reach all families who would |
5 | benefit. |
6 | This act would take effect upon passage. |
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