Maternal, infant, and early childhood home visiting programs
Purposes
The purposes of this section are—
to strengthen and improve the programs and activities carried out under this subchapter;
to improve coordination of services for at risk communities; and
to identify and provide comprehensive services to improve outcomes for families who reside in at risk communities.
Requirement for all States to assess statewide needs and identify at risk communities
In general
Each State shall, as a condition of receiving payments from an allotment for the State under section 702 of this title, conduct a statewide needs assessment (which may be separate from but in coordination with the statewide needs assessment required under section 705(a) of this title and which shall be reviewed and updated by the State not later than
communities with concentrations of—
premature birth, low-birth weight infants, and infant mortality, including infant death due to neglect, or other indicators of at-risk prenatal, maternal, newborn, or child health;
poverty;
crime;
domestic violence;
high rates of high-school drop-outs;
substance abuse;
unemployment; or
child maltreatment;
the quality and capacity of existing programs or initiatives for early childhood home visitation in the State including—
the number and types of individuals and families who are receiving services under such programs or initiatives;
the gaps in early childhood home visitation in the State; and
the extent to which such programs or initiatives are meeting the needs of eligible families described in subsection (l)(2); and
the State’s capacity for providing substance abuse treatment and counseling services to individuals and families in need of such treatment or services.
Coordination with other assessments
Submission to the Secretary
Each State shall submit to the Secretary, in such form and manner as the Secretary shall require—
the results of the statewide needs assessment required under paragraph (1); and
a description of how the State intends to address needs identified by the assessment, particularly with respect to communities identified under paragraph (1)(A), which may include applying for a grant to conduct an early childhood home visitation program in accordance with the requirements of this section.
Grants for early childhood home visitation programs
Authority to make grants
Authority to use initial grant funds for planning or implementation
Authority to use grant for a pay for outcomes initiative
Grant amounts
Base grants
In general
General rule
Substitution of successor eligible entity for predecessor
Amount described
General rule
Subject to the succeeding provisions of this clause, the amount described by this clause with respect to an eligible entity is—
the amount made available under subsection (k) for base grants for fiscal year 2023 that remains after making the reservations required by subsection (k)(2) or any other reductions required by Federal law for fiscal year 2023; multiplied by
the percentage of children in all States who have not attained 5 years of age (as determined by the Secretary on the basis of the data most recently available before fiscal year 2023) that is represented by the number of such children in the State in which the eligible entity is operating a program pursuant to this section (as so determined).
Adjustments to ensure stable funding
Adjustment to ensure all base grant funds are allocated
Minimum base grant amount
Matching grants
Amount of grant
General rule
Matching amount
In general
Subject to item (bb) of this subclause, the matching amount with respect to an eligible entity for a fiscal year is 75 percent of the sum of—
the total amount obligated by the eligible entity for home visiting services in the State for the fiscal year, from Federal funds made available for the fiscal year under this subparagraph; and
the total amount so obligated by the eligible entity from non-Federal funds, determined under subclause (III).
Limitation
Determination of obligations from non-Federal funds
For purposes of this clause, the total amount obligated by an eligible entity from non-Federal funds is the total of the amounts that are obligated by the eligible entity from non-Federal sources, to the extent that—
the services are delivered in compliance with subsections (d)(2) and (d)(3);
the eligible entity has reported the obligations to the Secretary; and
the amount is not counted toward meeting the maintenance of effort requirement in subsection (f).
State allotments
The amount allotted under this subclause for a State in which an eligible entity is operating a program under this section for a fiscal year is—
the minimum matching grant allocation amount for the fiscal year; plus
the amount (if any) by which the amount made available under subsection (k) for matching grants for the fiscal year that remains after making the reservations required by subsection (k)(2) or any other reduction required by Federal law for the fiscal year exceeds the sum of the minimum matching grant allocation amounts for all eligible entities for the fiscal year; multiplied by
the percentage of children in all States who have not attained 5 years of age and are members of families with income not exceeding the poverty line (as determined by the Secretary on the basis of the most recently available data) that is represented by the number of such children in the State (as so determined).
Minimum matching grant allocation amount
Subject to subclause (VI), for purposes of subclause (IV), the minimum matching grant allocation amount for a fiscal year is—
in the case of fiscal year 2024, $776,000;
in the case of fiscal year 2025, $1,000,000;
in the case of fiscal year 2026, $1,500,000; and
in the case of fiscal year 2027, $2,000,000.
Special rule
Submission of statement expressing interest in additional matching funds if available
Carryover and reallocation of unobligated funds
In general
State allotments
The Secretary shall allot to each eligible entity that has made such a submission for a fiscal year—
the total amount (if any) made available under subclause (I) for the fiscal year; multiplied by
the percentage of children who have not attained 5 years of age and are members of families with income not exceeding the poverty line (as determined by the Secretary on the basis of the most recently available data) in all of the States in which any eligible entity that has made such a submission is so operating a program, that is represented by the number of such children in the State (as so determined) in which the eligible entity is operating such a program.
Additional matching amount
In general
Subject to item (bb) of this subclause, the additional matching amount with respect to an eligible entity for a fiscal year is 75 percent of the sum of—
the total amount obligated by the eligible entity for home visiting services in the State for the fiscal year, from Federal funds made available for the fiscal year under this subparagraph; and
the total amount so obligated by the eligible entity from non-Federal funds, determined under clause (i)(III),
that are not taken into account in determining the matching amount with respect to the eligible entity under clause (i).
Limitation
Technical assistance
Requirements
The requirements of this subsection for an early childhood home visitation program conducted with a grant made under this section are as follows:
Quantifiable, measurable improvement in benchmark areas related to individual family outcomes
In general
The eligible entity establishes, subject to the approval of the Secretary, quantifiable, measurable 3- and 5-year benchmarks for demonstrating that the program results in improvements for the eligible families participating in the program in the following areas:
Improved maternal and newborn health.
Prevention of child injuries, child abuse, neglect, or maltreatment, and reduction of emergency department visits.
Improvement in school readiness and achievement.
Reduction in crime or domestic violence.
Improvements in family economic self-sufficiency.
Improvements in the coordination and referrals for other community resources and supports.
Outcomes dashboards
The Secretary shall, directly or by grant or contract, establish and operate a website accessible to the public that includes an annually updated dashboard that—
provides easy-to-understand information on the outcomes achieved by each eligible entity with respect to each of the benchmarks described in subparagraph (A) of this paragraph that apply to the eligible entity, which shall be based on only the data elements or types of data collected before
includes a template provided by the Secretary that will enable comparison among eligible entities not referred to in subsection (k)(2)(A) of—
a profile of each eligible entity showing outcome indicators and how the outcomes compare to benchmarks described in subclause (II);
information on the outcome indicators and requisite outcome levels established for each eligible entity;
information on each model employed in the program operated by each eligible entity, and regarding each benchmark area described in subsection (d)(1)(A) in which the model used by the eligible entity is expected to affect participant outcomes;
the most recently available information from the report required by subparagraph (E) of this paragraph;
an electronic link to the State needs assessment under subsection (b)(1); and
information regarding any penalty imposed, or other corrective action taken, by the Secretary against a State for failing to achieve a requisite outcome level or any other requirement imposed by or under this section, and an indication as to whether the eligible entity is operating under a corrective action plan under subparagraph (E)(ii) of this paragraph, and if so, a link to the plan, an explanation of the reason for the implementation of the plan, and a report on any progress made in operating under the plan;
includes information relating to those eligible entities for which funding is reserved under subsection (k)(2)(A), with modifications as necessary to reflect tribal sovereignty, data privacy, and participant confidentiality; and
protects data privacy and confidentiality of participant families.
Demonstration of improvements after 3 years
Report to the Secretary
Corrective action plan
Technical assistance
In general
Advisory panel
No improvement or failure to submit report
Final report
Demonstration of improvements in subsequent years
Continued measurement of improvement in applicable benchmark areas
Corrective action plan
Technical assistance
No improvement or failure to submit report
Improvements in outcomes for individual families
In general
Participant outcomes
The participant outcomes described in this subparagraph are the following:
Improvements in prenatal, maternal, and newborn health, including improved pregnancy outcomes 1
Improvements in child health and development, including the prevention of child injuries and maltreatment and improvements in cognitive, language, social-emotional, and physical developmental indicators.
Improvements in parenting skills.
Improvements in school readiness and child academic achievement.
Reductions in crime or domestic violence.
Improvements in family economic self-sufficiency.
Improvements in the coordination of referrals for, and the provision of, other community resources and supports for eligible families, consistent with State child welfare agency training.
Core components
The program includes the following core components:
Service delivery model or models
In general
Subject to clause (ii), the program is conducted using 1 or more of the service delivery models described in item (aa) or (bb) of subclause (I) or in subclause (II) selected by the eligible entity:
The model conforms to a clear consistent home visitation model that has been in existence for at least 3 years and is research-based, grounded in relevant empirically-based knowledge, linked to program determined outcomes, associated with a national organization or institution of higher education that has comprehensive home visitation program standards that ensure high quality service delivery and continuous program quality improvement, and has demonstrated significant,2
randomized controlled research designs, and the evaluation results have been published in a peer-reviewed journal; or
quasi-experimental research designs.
The model conforms to a promising and new approach to achieving the benchmark areas specified in paragraph (1)(A) and the participant outcomes described in paragraph (2)(B), has been developed or identified by a national organization or institution of higher education, and will be evaluated through well-designed and rigorous process.
Majority of grant funds used for evidence-based models
Criteria for evidence of effectiveness of models
Use of grant to provide or support targeted, intensive home visiting services
Additional requirements
The program adheres to a clear, consistent model that satisfies the requirements of being grounded in empirically-based knowledge related to home visiting and linked to the benchmark areas specified in paragraph (1)(A) and the participant outcomes described in paragraph (2)(B) related to the purposes of the program.
The program employs well-trained and competent staff, as demonstrated by education or training, such as nurses, social workers, educators, child development specialists, or other well-trained and competent staff, and provides ongoing and specific training on the model being delivered.
The program maintains high quality supervision to establish home visitor competencies.
The program demonstrates strong organizational capacity to implement the activities involved.
The program establishes appropriate linkages and referral networks to other community resources and supports for eligible families.
The program monitors the fidelity of program implementation to ensure that services are delivered pursuant to the specified model.
If the application submitted by the eligible entity includes the assurance described in subsection (e)(10)(C) with respect to the program, the program provides in-person service consistent with the assurances.
Virtual home visits
In general
Standards for training applicable to virtual service delivery
Reporting requirement
Virtual home visit defined
Technical assistance
Priority for serving high-risk populations
The eligible entity gives priority to providing services under the program to the following:
Eligible families who reside in communities in need of such services, as identified in the statewide needs assessment required under subsection (b)(1)(A), taking into account the staffing, community resource, and other requirements to operate at least one approved model of home visiting and demonstrate improvements for eligible families.
Low-income eligible families.
Eligible families who are pregnant women who have not attained age 21.
Eligible families that have a history of child abuse or neglect or have had interactions with child welfare services.
Eligible families that have a history of substance abuse or need substance abuse treatment.
Eligible families that have users of tobacco products in the home.
Eligible families that are or have children with low student achievement.
Eligible families with children with developmental delays or disabilities.
Eligible families who, or that include individuals who, are serving or formerly served in the Armed Forces, including such families that have members of the Armed Forces who have had multiple deployments outside of the United States.
Limitation on use of funds for administrative costs
In general
Authority to grant exceptions
In general
Conditions
An eligible entity meets a condition of this clause if the eligible entity—
conducts the program by directly providing home visits to eligible families and without a sub-recipient;
in the fiscal year for which the grant for the program is made under this section, proposes to expand services in 1 or more communities identified in the statewide needs assessment under subsection (b) and in which home visiting services are not provided; or
has conducted the program for fewer than 3 years.
Application requirements
An eligible entity desiring a grant under this section shall submit an application to the Secretary for approval, in such manner as the Secretary may require, that includes the following:
A description of the populations to be served by the entity, including specific information regarding how the entity will serve high risk populations described in subsection (d)(4).
An assurance that the entity will give priority to serving low-income eligible families and eligible families who reside in at risk communities identified in the statewide needs assessment required under subsection (b)(1)(A).
The service delivery model or models described in subsection (d)(3)(A) that the entity will use under the program and the basis for the selection of the model or models.
A statement identifying how the selection of the populations to be served and the service delivery model or models that the entity will use under the program for such populations is consistent with the results of the statewide needs assessment conducted under subsection (b).
The quantifiable, measurable benchmarks established by the State to demonstrate that the program contributes to improvements in the areas specified in subsection (d)(1)(A) that the service delivery model or models selected by the entity are intended to improve.
An assurance that the entity will obtain and submit documentation or other appropriate evidence from the organization or entity that developed the service delivery model or models used under the program to verify that the program is implemented and services are delivered according to the model specifications.
Assurances that the entity will establish procedures to ensure that—
the participation of each eligible family in the program is voluntary; and
services are provided to an eligible family in accordance with the individual assessment for that family.
Assurances that the entity will—
submit annual reports to the Secretary regarding the program and activities carried out under the program that include such information and data as the Secretary shall require, including the number of virtual home visits conducted under the program in the year covered by the report, disaggregated with respect to each home visiting model under which the virtual home visits are conducted; and
participate in, and cooperate with, data and information collection necessary for the evaluation required under subsection (g)(2) and other research and evaluation activities carried out under subsection (h)(3).
A description of other State programs that include home visitation services, including, if applicable to the State, other programs carried out under this subchapter with funds made available from allotments under section 702(c) of this title, programs funded under subchapter IV, title II of the Child Abuse Prevention and Treatment Act [42 U.S.C. 5116 et seq.] (relating to community-based grants for the prevention of child abuse and neglect), and section 9840a of this title (relating to Early Head Start programs).
At the option of the eligible entity—
a description of any limitations or constraints on virtual home visits under the program, including—
a description of the plan of the eligible entity to encourage in-person home visits; and
a description of the considerations to be used in determining when a virtual home visit is appropriate, including client consent, client preference, geographic limitations, model fidelity, and hazardous conditions including public health emergencies, weather events, health concerns for home visitors and client families, and other local issues;
an assurance that—
the virtual home visit is implemented as a model enhancement; or
the Secretary has identified the home visit as part of an effective model or model adaptation, based on an evidence of effectiveness review conducted using the criteria established under subsection (d)(3)(A)(iii); and
an assurance to the Secretary that at least 1 in-person home visit shall be conducted for each client family under the program during the 12-month period that begins with the entry of the client family into the program, and during each succeeding 12-month period, except that any such period in which a public health emergency declared under Federal law, or under the law of the State in which the program is conducted, is in effect shall be extended by the length of time in which the declaration is in effect.
Other information as required by the Secretary.
Maintenance of effort
In general
Publication of amounts
Grace period
Evaluation
Independent, expert advisory panel
The Secretary, in accordance with subsection (h)(1)(A), shall appoint an independent advisory panel consisting of experts in program evaluation and research, education, and early childhood development—
to review, and make recommendations on, the design and plan for the evaluation required under paragraph (2) within 1 year after
to maintain and advise the Secretary regarding the progress of the evaluation; and
to comment, if the panel so desires, on the report submitted under paragraph (3).
Authority to conduct evaluation
On the basis of the recommendations of the advisory panel under paragraph (1), the Secretary shall, by grant, contract, or interagency agreement, conduct an evaluation of the statewide needs assessments submitted under subsection (b) and the grants made under subsections (c) and (h)(3)(B). The evaluation shall include—
an analysis, on a State-by-State basis, of the results of such assessments, including indicators of maternal and prenatal health and infant health and mortality, and State actions in response to the assessments; and
an assessment of—
the effect of early childhood home visitation programs on child and parent outcomes, including with respect to each of the benchmark areas specified in subsection (d)(1)(A) and the participant outcomes described in subsection (d)(2)(B);
the effectiveness of such programs on different populations, including the extent to which the ability of programs to improve participant outcomes varies across programs and populations; and
the potential for the activities conducted under such programs, if scaled broadly, to improve health care practices, eliminate health disparities, and improve health care system quality, efficiencies, and reduce costs.
Report
Other provisions
Intra-agency collaboration
The Secretary shall ensure that the Maternal and Child Health Bureau and the Administration for Children and Families collaborate with respect to carrying out this section, including with respect to—
reviewing and analyzing the statewide needs assessments required under subsection (b), the awarding and oversight of grants awarded under this section, the establishment of the advisory panels required under subsections (d)(1)(B)(iii)(II) and (g)(1), and the evaluation and report required under subsection (g); and
consulting with other Federal agencies with responsibility for administering or evaluating programs that serve eligible families to coordinate and collaborate with respect to research related to such programs and families, including the Office of the Assistant Secretary for Planning and Evaluation of the Department of Health and Human Services, the Centers for Disease Control and Prevention, the National Institute of Child Health and Human Development of the National Institutes of Health, the Office of Juvenile Justice and Delinquency Prevention of the Department of Justice, and the Institute of Education Sciences of the Department of Education.
Grants to eligible entities that are not States
Indian Tribes, Tribal Organizations, or Urban Indian Organizations
The Secretary shall specify requirements for eligible entities that are Indian Tribes (or a consortium of Indian Tribes), Tribal Organizations, or Urban Indian Organizations to apply for and conduct an early childhood home visitation program with a grant under this section. Such requirements shall, to the greatest extent practicable, be consistent with the requirements applicable to eligible entities that are States and shall require an Indian Tribe (or consortium), Tribal Organization, or Urban Indian Organization to—
conduct a needs assessment similar to the assessment required for all States under subsection (b); and
establish quantifiable, measurable 3- and 5-year benchmarks consistent with subsection (d)(1)(A).
Nonprofit organizations
If, as of the beginning of fiscal year 2012, a State has not applied or been approved for a grant under this section, the Secretary may use amounts appropriated under paragraph (1) of subsection (k) that are available for expenditure under paragraph (3) of that subsection to make a grant to an eligible entity that is a nonprofit organization described in subsection (l)(1)(B) to conduct an early childhood home visitation program in the State. The Secretary shall specify the requirements for such an organization to apply for and conduct the program which shall, to the greatest extent practicable, be consistent with the requirements applicable to eligible entities that are States and shall require the organization to—
carry out the program based on the needs assessment conducted by the State under subsection (b); and
establish quantifiable, measurable 3- and 5-year benchmarks consistent with subsection (d)(1)(A).
Research and other evaluation activities
In general
Requirements
The Secretary shall ensure that—
evaluation of a specific program or project is conducted by persons or individuals not directly involved in the operation of such program or project; and
the conduct of research and evaluation activities includes consultation with independent researchers, State officials, and developers and providers of home visiting programs on topics including research design and administrative data matching.
Report and recommendation
Not later than
information regarding the extent to which eligible entities receiving grants under this section demonstrated improvements in the areas specified in subsection (d)(1)(A);
information regarding any technical assistance provided under subsection (d)(1)(B)(iii)(I), including the type of any such assistance provided; and
recommendations for such legislative or administrative action as the Secretary determines appropriate.
Data exchange standards for improved interoperability
Designation and use of data exchange standards
Designation
Data exchange standards must be nonproprietary and interoperable
Other requirements
In designating data exchange standards under this paragraph, the Secretary shall, to the extent practicable, incorporate—
interoperable standards developed and maintained by an international voluntary consensus standards body, as defined by the Office of Management and Budget;
interoperable standards developed and maintained by intergovernmental partnerships, such as the National Information Exchange Model; and
interoperable standards developed and maintained by Federal entities with authority over contracting and financial assistance.
Data exchange standards for Federal reporting
Designation
Requirements
The data exchange reporting standards required by clause (i) shall, to the extent practicable—
incorporate a widely accepted, nonproprietary, searchable, computer-readable format;
be consistent with and implement applicable accounting principles;
be implemented in a manner that is cost-effective and improves program efficiency and effectiveness; and
be capable of being continually upgraded as necessary.
Incorporation of nonproprietary standards
Rule of construction
Reduction of administrative burden
In general
The Secretary shall reduce the burden, on States and public and private implementing agencies at the local level, of administering this section, by—
reviewing and revising administrative data collection instruments and forms to eliminate duplication and streamline reporting requirements for States, eligible entities referred to in subsection (k)(2)(A), and nonprofit organizations referred to in subsection (l)(1)(B), including timelines for submitting reports;
conducting an analysis of the total number of hours reported by administering agencies on complying with paperwork requirements, and exploring, in consultation with administering agencies, ways to reduce the number of hours spent by at least 15 percent;
conducting a review of paperwork and data collection requirements for tribal grantees, and exploring, in consultation with tribes and tribal organizations, ways to reduce administrative burden, respect sovereignty, and acknowledge the different focus points for tribal grantees;
collecting input from relevant State fiscal officials to align fiscal requirements and oversight for States and eligible entities to ensure consistency with standards and guidelines for other Federal formula grant programs; and
consulting with administering agencies and service delivery model representatives on needed and unneeded data elements regarding the dashboards provided for in subsection (d)(1)(B), consistent with the data requirements of such subsection.
Findings on paperwork reduction
Inclusion in report
Implementation
Application of other provisions of subchapter
In general
Exceptions
The following provisions of this subchapter shall apply to a grant made under this section to the same extent and in the same manner as such provisions apply to allotments made under section 702(c) of this title:
Section 704(b)(6) of this title (relating to prohibition on payments to excluded individuals and entities).
Section 704(c) of this title (relating to the use of funds for the purchase of technical assistance).
Section 706 of this title (relating to reports and audits), but only to the extent determined by the Secretary to be appropriate for grants made under this section.
Section 707 of this title (relating to penalties for false statements).
Section 708 of this title (relating to nondiscrimination).
Section 709(a) of this title (relating to the administration of the grant program).
Annual report to Congress
By
an eligible entity-by-eligible entity summary of the outcomes measured by the entity with respect to each benchmark described in subsection (e)(5) that apply to the entity;
information regarding any technical assistance funded under subparagraph (B) or (C) of subsection (k)(2), including the type of any such assistance provided;
information on the demographic makeup of families served by each such entity to the extent possible while respecting participant confidentiality, including race, ethnicity, educational attainment at enrollment, household income, and other demographic markers as determined by the Secretary;
the information described in subsection (d)(1)(E);
the estimated share of the eligible population served using grants made under this section;
a description of each service delivery model funded under this section by the eligible entities in each State, and the share (if any) of the grants expended on each model;
a description of non-Federal expenditures by eligible entities to qualify for matching funds under subsection (c)(4);
information on the uses of funds reserved under subsection (k)(2)(C);
information relating to those eligible entities for which funding is reserved under subsection (k)(2)(A), with modifications as necessary to reflect tribal data sovereignty, data privacy, and participant confidentiality; and
a list of data elements collected from eligible entities, and the purpose of each data element in measuring performance or enforcing requirements under this section.
Appropriations
In general
Out of any funds in the Treasury not otherwise appropriated, there are appropriated to the Secretary to carry out this section—
for fiscal year 2023, $500,000,000 for base grants;
for fiscal year 2024, $550,000,000, of which $500,000,000 shall be for base grants and $50,000,000 shall be for matching grants;
for fiscal year 2025, $600,000,000, of which $500,000,000 shall be for base grants and $100,000,000 shall be for matching grants;
for fiscal year 2026, $650,000,000, of which $500,000,000 shall be for base grants and $150,000,000 shall be for matching grants; and
for fiscal year 2027, $800,000,000, of which $500,000,000 shall be for base grants and $300,000,000 shall be for matching grants.
Reservations
Of each amount made available for base grants and each amount made available for matching grants appropriated under this subsection for a fiscal year (or portion of a fiscal year), the Secretary shall reserve—
6 percent of such amount for purposes of making and administering grants to eligible entities that are Indian Tribes (or a consortium of Indian Tribes), Tribal Organizations, or Urban Indian Organizations;
2 percent of such amount for purposes of providing technical assistance, directly or through grants or contracts—
for purposes as otherwise described in subsections (c)(5), (d)(1)(C)(iii), (d)(1)(E)(iii), and (d)(4)(E); and
to entities referred to in subparagraph (A) of this paragraph;
2 percent of such amount for purposes of the provision of workforce support, retention, and case management, including workforce-related technical assistance, to eligible entities, research and evaluation, and program administration, directly or through grants or contracts, of which the Secretary shall use not more than $1,500,000 to establish and operate the Jackie Walorski Center for Evidence-Based Case Management; and
3 percent of such amount for purposes of research and evaluation (directly or through grants or contracts), and for administering this section (directly, through contracts, or otherwise).
Availability
In general
Funds for pay for outcomes initiatives
Allocation of funds
Disposition of excess funds reserved for research, evaluation, and administration
Definitions
In this section:
Eligible entity
In general
Nonprofit organizations
Eligible family
The term “eligible family” means—
a woman who is pregnant, and the father of the child if the father is available; or
a parent or primary caregiver of a child, including grandparents or other relatives of the child, and foster parents, who are serving as the child’s primary caregiver from birth to kindergarten entry, and including a noncustodial parent who has an ongoing relationship with, and at times provides physical care for, the child.
Indian Tribe; Tribal Organization
Pay for outcomes initiative
The term “pay for outcomes initiative” means a performance-based grant, contract, cooperative agreement, or other agreement awarded by a public entity in which a commitment is made to pay for improved outcomes achieved as a result of the intervention that result in social benefit and direct cost savings or cost avoidance to the public sector. Such an initiative shall include—
a feasibility study that describes how the proposed intervention is based on evidence of effectiveness;
a rigorous, third-party evaluation that uses experimental or quasi-experimental design or other research methodologies that allow for the strongest possible causal inferences to determine whether the initiative has met its proposed outcomes as a result of the intervention;
an annual, publicly available report on the progress of the initiative; and
a requirement that payments are made to the recipient of a grant, contract, or cooperative agreement only when agreed upon outcomes are achieved, except that this requirement shall not apply with respect to payments to a third party conducting the evaluation described in subparagraph (B).
Source
(Aug. 14, 1935, ch. 531, title V, § 511, as added Pub. L. 111–148, title II, § 2951,Notes
Editorial Notes
References in Text
Codification
Prior Provisions
Amendments
Statutory Notes and Related Subsidiaries
Effective Date of 2022 Amendment
In general.—
Except as provided in paragraph (2), this section [amending this section and section 711a of this title and enacting provisions set out as notes under this section and section 1305 of this title] and the amendments made by this section shall take effect on
Virtual home visiting provisions.—
The amendments made by subsection (h) [amending this section] shall take effect on
Effective Date of 2018 Amendment
Transition Rule
In general.—
A virtual home visit conducted before the effective date of the amendments made by this subsection [
Virtual home visit defined.—
In subparagraph (A), the term ‘virtual home visit’ means a visit conducted solely by use of electronic information and telecommunications technologies.”
Allowing Home Visiting Programs To Continue Serving Families Safely
In General.—
For purposes of section 511 of the Social Security Act [42 U.S.C. 711], during the COVID–19 public health emergency period—
a virtual home visit shall be considered a home visit;
funding for, and staffing levels of, a program conducted pursuant to such section shall not be reduced on account of reduced enrollment in the program; and
funds provided for such a program may be used—
to train home visitors in conducting a virtual home visit and in emergency preparedness and response planning for families served, and may include training on how to safely conduct intimate partner violence screenings remotely, training on safety and planning for families served;
for the acquisition by families enrolled in the program of such technological means as are needed to conduct and support a virtual home visit; and
to provide emergency supplies to families served, regardless of whether the provision of such supplies is within the scope of the approved program, such as diapers, formula, non-perishable food, water, hand soap, and hand sanitizer.
Virtual Home Visit Defined.—
In subsection (a), the term ‘virtual home visit’ means a home visit, as described in an applicable service delivery model, that is conducted solely by the use of electronic information and telecommunications technologies.
Authority to Delay Deadlines.—
In general.—
The Secretary may extend the deadline by which a requirement of section 511 of the Social Security Act must be met, by such period of time as the Secretary deems appropriate, taking into consideration the impact of the COVID–19 public health emergency on eligible entity home visiting programs and the impact of families enrolled in home visiting programs. The Secretary may delay the deadline for submission, waive performance measures, or allow for alternative data sources to be used to show improvement in performance in the manner provided in section 511(d)(1) of such Act.
Delay of deadline for statewide needs assessment.—
The Secretary may delay the
Guidance.—
The Secretary shall provide to eligible entities funded under section 511 of the Social Security Act information on the parameters used in extending a deadline under paragraph (1) or (2) of this subsection.
Timely Release of Title V Funds.—
The authorities provided in this section shall not be interpreted to authorize or require any delay in the timely release of funds under title V of the Social Security Act [42 U.S.C. 701 et seq.].”