California Legislature—2015–16 Regular Session

Assembly Bill No. 50

Introduced by Assembly Member Mullin

December 1, 2014

An act to amend Section 123492 of the Health and Safety Code, relating to perinatal care.

LEGISLATIVE COUNSEL’S DIGEST

AB 50, as introduced, Mullin. Nurse-Family Partnership.

Existing law establishes the Nurse-Family Partnership program, which is administered by the State Department of Public Health, to provide grants for voluntary nurse home visiting programs for expectant first-time mothers, their children, and their families. Under existing law, a county is required to satisfy specified requirements in order to be eligible to receive a grant.

This bill would declare the intent of the Legislature to develop a means to leverage public and private dollars to substantially expand the scale of the Nurse-Family Partnership in California, in accordance with specified findings. The bill would revise the requirements relating to the award and use of Nurse-Family Partnership grants, including eliminating a requirement for nurse home visitors and supervisors to receive certain training in effective home visitation techniques.

Vote: majority. Appropriation: no. Fiscal committee: yes. State-mandated local program: no.

The people of the State of California do enact as follows:

SECTION 1.  

The Legislature finds and declares all of the
following:

(a) In 2014, the Legislature passed Assembly Concurrent
Resolution No. 155 by Assembly Member Raul Bocanegra,
recognizing that research over the last two decades in the evolving
fields of neuroscience, molecular biology, public health, genomics,
and epigenetics reveals that experiences in the first few years of
life build changes into the biology of the human body which, in
turn, influence the person’s physical and mental health over his or
her lifetime.

(b) On May 3, 2012, Governor Edmund G, Brown Jr. issued
Executive Order B-19-12, establishing the “Let’s Get Healthy
California Task Force” to develop a 10-year plan for improving
the health of Californians, controlling health care costs, promoting
personal responsibility for individual health, and advancing health
equity.”

(c) The task force identified several priorities, including a subset
for “Healthy Beginnings,” which include reducing infant deaths,
increasing vaccination rates, reducing childhood trauma, and
reducing adolescent tobacco use.

(d) The final report of the task force states “the challenge going
forward is to identify evidence-based interventions and quicken
the pace of uptake across the state,” in order to meet the ambitious
goals in the Governor’s directive.

(e) In addition to reducing healthcare costs, the Nurse-Family
Partnership has demonstrated proven outcomes addressing factors
that contribute to toxic stress and made measurable progress
towards many of the goals identified by the task force.

(f) The Nurse-Family Partnership is an evidence-based,
community health program that improves pregnancy outcomes,
improves child health and development, and improves economic
self-sufficiency.

(g) Multiple peer-reviewed, randomized, controlled trials and
longitudinal followup studies have clearly demonstrated the
efficacy of the Nurse-Family Partnership programs, through
significant sustained results, in achieving these goals.

(h) The Nurse-Family Partnership provides lifelong health and
economic benefits to both mothers and children served by the
program.

(i) These lifelong benefits have the potential to achieve
substantial savings to federal, state, and local governments with
respect to programs and services, including Medicaid, Child
Protective Services, law enforcement, special education, the
Supplemental Nutrition Assistance Program (SNAP), and
Temporary Assistance for Needy Families (TANF) program,
among others. These savings far exceed the costs of implementing
the Nurse-Family Partnership program.

(j) Twenty-one California counties currently operate a
Nurse-Family Partnership program. Only a fraction of potentially
eligible recipients are receiving these highly beneficial and
cost-effective services.

(k) However, if California were to provide these services to
significantly more eligible first-time mothers, the state could see
population-wide health and economic benefits that would carry
over to future generations.

(l) Therefore, it is the intent of the Legislature to develop a
means to leverage public and private dollars to substantially expand
the scale of the Nurse-Family Partnership in California, beginning
with regions and populations with the greatest need.

SEC. 2.  

Section 123492 of the Health and Safety Code is
amended to read:

123492.  

The department shall develop a grant application and
award grants on a competitive basis to counties for the startup,
continuation, and expansion of the program established pursuant
to Section 123491. To be eligible to receive a grant for purposes
of that section, a county shall agree to begin insert do end insert all of the following:

(a) Serve through the program only pregnant, low-income
women who have had no previous live births. Notwithstanding
subdivision (b) of Section 123485, women who are juvenile
offenders or who are clients of the juvenile system begin insert , with no history
of prior live births, end insert shall be deemed eligible for services under the
program.

(b) Enroll women in the program while they are still pregnant,
before the 28th week of gestation, and preferably before the 16th
week of gestation, and continue those women in the program
through the first two years of the child’s life.

(c) Use as home visitors only registered nurses who have been
licensed in the state.

(d) Have nurse home visitors undergo training according to the
program and follow the home visit guidelines developed by the
Nurse-Family Partnership program.

(e) Have nurse home visitors specially trained in begin insert the
Nurse-Family Partnership guidelines for end insert prenatal care and early
child development.

(f) Have nurse home visitors follow a visit schedule keyed to
the developmental stages of pregnancy and early childhood.

(g) Ensure that, to the extent possible, services shall be rendered
in a culturally and linguistically competent manner.

(h) Limit a nurse home visitor’s caseload to no more than 25
active families at any given time.

(i)  begin delete Provide for end delete begin insert For end insert every eight nurse home visitors begin insert , provide end insert a
full-time nurse supervisor who holds at least a bachelor’s degree
in nursing and has substantial experience in community health
nursing.

begin delete

(j) Have nurse home visitors and nurse supervisors trained in
effective home visitation techniques by qualified trainers.

end delete begin delete

(k)

end delete

begin insert (j) end insert  Have nurse home visitors and nurse supervisors trained in
the method of assessing early infant development and parent-child
interaction in a manner consistent with the program.

begin delete

(l)

end delete

begin insert (k) end insert  Provide data on operations, results, and expenditures in the
formats and with the frequencies specified by the department.

begin delete

(m)

end delete

begin insert (l) end insert  Collaborate with other home visiting and family support
programs in the community to avoid duplication of services and
complement and integrate with existing services to the extent
practicable.

begin delete

(n)

end delete

begin insert (m) end insert  Demonstrate that adoption of the Nurse-Family Partnership
program is supported by a local governmental or
government-affiliated community planning board, decisionmaking
board, or advisory body responsible for assuring the availability
of effective, coordinated services for families and children in the
community.

begin delete

(o)

end delete

begin insert (n) end insert  Provide cash or in-kind matching funds in the amount of
100 percent of the grant award.

begin delete

(p)

end delete

begin insert (o) end insert  Prohibit the use of moneys received for the program as a
match for grants currently administered by the department.