1.1 	A bill for an act
1.2 	relating to modifying the home visiting program; appropriating money;amending 
1.3 	Minnesota Statutes 2006, section 145A.17.
1.4 	BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:

1.5 	Section 1. Minnesota Statutes 2006, section 145A.17, is amended to read:
1.6 	145A.17 FAMILY HOME VISITING PROGRAMS.
1.7 		Subdivision 1.Establishment; goals. The commissioner shall establish a program 
1.8 	to fund family home visiting programs designed to foster a healthy beginning for children 
1.9 	in families at or below 200 percent of the federal poverty guidelines beginnings, improve 
1.10 	pregnancy outcomes, promote school readiness, prevent child abuse and neglect, reduce 
1.11 	juvenile delinquency, promote positive parenting and resiliency in children, and promote 
1.12 	family health and economic self-sufficiency for children and families. The commissioner 
1.13 	shall promote partnerships, collaboration, and multidisciplinary visiting done by teams of 
1.14 	professionals and paraprofessionals from the fields of public health nursing, social work, 
1.15 	and early childhood education. A program funded under this section must serve families 
1.16 	at or below 200 percent of the federal poverty guidelines, and other families determined 
1.17 	to be at risk, including but not limited to being at risk for child abuse, child neglect, or 
1.18 	juvenile delinquency. Programs must give priority for services to families considered to 
1.19 	be in need of services, including but not limited tobegin prenatally whenever possible and 
1.20 	must be targeted to families with:
1.21 	(1) adolescent parents;
1.22 	(2) a history of alcohol or other drug abuse;
1.23 	(3) a history of child abuse, domestic abuse, or other types of violence;
1.24 	(4) a history of domestic abuse, rape, or other forms of victimization;
2.1 	(5) reduced cognitive functioning;
2.2 	(6) a lack of knowledge of child growth and development stages;
2.3 	(7) low resiliency to adversities and environmental stresses; or
2.4 	(8) insufficient financial resources to meet family needs;
2.5 	(9) a history of homelessness;
2.6 	(10) a risk of long-term welfare dependence or family instability due to employment 
2.7 	barriers; or
2.8 	(11) other risk factors as determined by the commissioner.
2.9 		Subd. 3.Requirements for programs; process. (a) Before a community health 
2.10 	board or tribal government may receive an allocation under subdivision 2, a community 
2.11 	health board or tribal government must submit a proposal to the commissioner that 
2.12 	includes identification, based on a community assessment, of the populations at or below 
2.13 	200 percent of the federal poverty guidelines that will be served and the other populations 
2.14 	that will be served. Each program that receives funds must Community health boards 
2.15 	and tribal governments that receive funding under this section must submit a plan to 
2.16 	the commissioner describing a multidisciplinary approach to targeted home visiting for 
2.17 	families. The plan must be submitted on forms provided by the commissioner. At a 
2.18 	minimum, the plan must include the following:
2.19 	(1) a description of outreach strategies to families prenatally or at birth;
2.20 	(2) provisions for the seamless delivery of health, safety, and early learning services; 
2.21 	(3) methods to promote continuity of services when families move within the state;
2.22 	(4) a description of the community demographics;
2.23 	(5) a plan for meeting outcome measures; and
2.24 	(6) a proposed work plan that includes:
2.25 	(i) coordination to ensure nonduplication of services for children and families;
2.26 	(ii) a description of the strategies to ensure that children and families at greatest risk 
2.27 	receive appropriate services; and
2.28 	(iii) collaboration with multidisciplinary partners including public health, 
2.29 	ECFE, Head Start, community health workers, social workers, community home 
2.30 	visiting programs, school districts, and other relevant partners. Letters of intent from 
2.31 	multidisciplinary partners must be submitted with the plan.
2.32 	(b) Each program that receives funds must accomplish the following program 
2.33 	requirements:
2.34 	(1) use either a broad community-based or selective community-based strategy to 
2.35 	provide preventive and early intervention home visiting services;
3.1 	(2) offer a home visit by a trained home visitor. If a home visit is accepted, the first 
3.2 	home visit must occur prenatally or as soon after birth as possible and must include a 
3.3 	public health nursing assessment by a public health nurse;
3.4 	(3) offer, at a minimum, information on infant care, child growth and development, 
3.5 	positive parenting, preventing diseases, preventing exposure to environmental hazards, 
3.6 	and support services available in the community;
3.7 	(4) provide information on and referrals to health care services, if needed, including 
3.8 	information on and assistance in applying for health care coverage for which the child or 
3.9 	family may be eligible; and provide information on preventive services, developmental 
3.10 	assessments, and the availability of public assistance programs as appropriate;
3.11 	(5) provide youth development programs when appropriate;
3.12 	(6) recruit home visitors who will represent, to the extent possible, the races, 
3.13 	cultures, and languages spoken by families that may be served;
3.14 	(7) train and supervise home visitors in accordance with the requirements established 
3.15 	under subdivision 4;
3.16 	(8) maximize resources and minimize duplication by coordinating activitiesor 
3.17 	contracting with local social and human services organizations, education organizations, 
3.18 	and other appropriate governmental entities and community-based organizations and 
3.19 	agencies; and
3.20 	(9) utilize appropriate racial and ethnic approaches to providing home visiting 
3.21 	services; and
3.22 	(10) connect eligible families, as needed, to additional resources available in the 
3.23 	community, including, but not limited to, early care and education programs, health or 
3.24 	mental health services, family literacy programs, employment agencies, social services, 
3.25 	and child care resources and referral agencies.
3.26 	(c) When available, programs that receive funds under this section must offer or 
3.27 	provide the family with a referral to center-based or group meetings that meet at least 
3.28 	once per month for those families identified with additional needs. The meetings must 
3.29 	focus on further enhancing the information, activities, and skill-building addressed during 
3.30 	home visitation; offering opportunities for parents to meet with and support each other; 
3.31 	and offering infants and toddlers a safe, nurturing, and stimulating environment for 
3.32 	socialization and supervised play with qualified teachers.
3.33 	(b)(d) Funds available under this section shall not be used for medical services. The 
3.34 	commissioner shall establish an administrative cost limit for recipients of funds. The 
3.35 	outcome measures established under subdivision 6 must be specified to recipients of 
3.36 	funds at the time the funds are distributed.
4.1 	(c)(e) Data collected on individuals served by the home visiting programs must 
4.2 	remain confidential and must not be disclosed by providers of home visiting services 
4.3 	without a specific informed written consent that identifies disclosures to be made. 
4.4 	Upon request, agencies providing home visiting services must provide recipients with 
4.5 	information on disclosures, including the names of entities and individuals receiving the 
4.6 	information and the general purpose of the disclosure. Prospective and current recipients 
4.7 	of home visiting services must be told and informed in writing that written consent for 
4.8 	disclosure of data is not required for access to home visiting services.
4.9 		Subd. 4.Training. The commissioner shall establish training requirements for 
4.10 	home visitors and minimum requirements for supervision by a public health nurse. The 
4.11 	requirements for nurses must be consistent with chapter 148. The commissioner must 
4.12 	provide training for home visitors. Training must include child development, positive 
4.13 	parenting techniques, screening and referrals for child abuse and neglect, and diverse 
4.14 	cultural practices in child rearing and family systems the following:
4.15 	(1) effective relationships for engaging and retaining families and ensuring family 
4.16 	health, safety, and early learning;
4.17 	(2) effective methods of implementing parent education, conducting home visiting, 
4.18 	and promoting quality early childhood development;
4.19 	(3) early childhood development from birth to age five;
4.20 	(4) diverse cultural practices in child rearing and family systems;
4.21 	(5) recruiting, supervising, and retaining qualified staff;
4.22 	(6) increasing services for underserved populations; and 
4.23 	(7) relevant issues related to child welfare and protective services, with information 
4.24 	provided being consistent with state child welfare agency training.
4.25 		Subd. 5.Technical assistance. The commissioner shall provide administrative 
4.26 	and technical assistance to each program, including assistance in data collection and 
4.27 	other activities related to conducting short- and long-term evaluations of the programs 
4.28 	as required under subdivision 7. The commissioner may request research and evaluation 
4.29 	support from the University of Minnesota.
4.30 		Subd. 6.Outcome and performance measures. The commissioner shall establish 
4.31 	outcomesmeasures to determine the impact of family home visiting programs funded 
4.32 	under this section on the following areas:
4.33 	(1) appropriate utilization of preventive health care;
4.34 	(2) rates of substantiated child abuse and neglect;
4.35 	(3) rates of unintentional child injuries;
4.36 	(4) rates of children who are screened and who pass early childhood screening; and
5.1 	(5) rates of children accessing early care and educational services;
5.2 	(6) program retention rates;
5.3 	(7) number of home visits provided compared to the number of home visits planned;
5.4 	(8) participant satisfaction;
5.5 	(9) rates of at-risk populations reached; and
5.6 	(10) any additional qualitative goals and quantitative measures established by the 
5.7 	commissioner.
5.8 		Subd. 7.Evaluation. Using the qualitative goals and quantitative outcome and 
5.9 	performance measures established under subdivisions 1 and 6, the commissioner shall 
5.10 	conduct ongoing evaluations of the programs funded under this section. Community 
5.11 	health boards and tribal governments shall cooperate with the commissioner in the 
5.12 	evaluations and shall provide the commissioner with the information necessary to conduct 
5.13 	the evaluations. As part of the ongoing evaluations, the commissioner shall rate the impact 
5.14 	of the programs on the outcome measures listed in subdivision 6, and shall periodically 
5.15 	determine whether home visiting programs are the best way to achieve the qualitative 
5.16 	goals established under subdivisions 1 and 6. If the commissioner determines that home 
5.17 	visiting programs are not the best way to achieve these goals, the commissioner shall 
5.18 	provide the legislature with alternative methods for achieving them.
5.19 		Subd. 8.Report. By January 15, 2002, and January 15 of each even-numbered 
5.20 	year thereafter, the commissioner shall submit a report to the legislature on the family 
5.21 	home visiting programs funded under this section and on the results of the evaluations 
5.22 	conducted under subdivision 7.
5.23 		Subd. 9.No supplanting of existing funds. Funding available under this section 
5.24 	may be used only to supplement, not to replace, nonstate funds being used for home 
5.25 	visiting services as of July 1, 2001.

5.26 	Sec. 2. APPROPRIATION.
 5.27 	$...... is appropriated for the biennium beginning July 1, 2007, from the general 
5.28 	fund to the commissioner of health for the family home visiting grant program. The 
5.29 	commissioner shall distribute funds to community health boards and tribal governments 
5.30 	using a formula developed, in conjunction with the State Community Health Services 
5.31 	Advisory Committee and tribal governments. The commissioner may use five percent 
5.32 	of the funds appropriated in each fiscal year to conduct the ongoing evaluations required 
5.33 	under Minnesota Statutes, section 145A.17, subdivision 7, and may use ten percent of the 
5.34 	funds appropriated each fiscal year to provide training and technical assistance as required 
5.35 	under Minnesota Statutes, section 145A.17, subdivisions 4 and 5.