BILL NUMBER: AB 50	INTRODUCED
	BILL TEXT


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  do  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  , with no history of prior  
live births,  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  the
Nurse-Family Partnership guidelines for  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)  Provide for   For  every eight
nurse home visitors  , provide a full-time nurse supervisor
who holds at least a bachelor's degree in nursing and has substantial
experience in community health nursing. 
   (j) Have nurse home visitors and nurse supervisors trained in
effective home visitation techniques by qualified trainers. 

   (k) 
    (j)  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.

   (l) 
    (k)  Provide data on operations, results, and
expenditures in the formats and with the frequencies specified by the
department. 
   (m) 
    (l)  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. 
   (n) 
    (m)  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. 
   (o) 
    (n)  Provide cash or in-kind matching funds in the
amount of 100 percent of the grant award. 
   (p) 
    (o)  Prohibit the use of moneys received for the program
as a match for grants currently administered by the department.