California Legislature—2015–16 Regular Session

Assembly BillNo. 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:

P1    1

SECTION 1.  

The Legislature finds and declares all of the
2following:

P2    1(a) In 2014, the Legislature passed Assembly Concurrent
2Resolution No. 155 by Assembly Member Raul Bocanegra,
3recognizing that research over the last two decades in the evolving
4fields of neuroscience, molecular biology, public health, genomics,
5and epigenetics reveals that experiences in the first few years of
6life build changes into the biology of the human body which, in
7turn, influence the person’s physical and mental health over his or
8her lifetime.

9(b) On May 3, 2012, Governor Edmund G, Brown Jr. issued
10Executive Order B-19-12, establishing the “Let’s Get Healthy
11California Task Force” to develop a 10-year plan for improving
12the health of Californians, controlling health care costs, promoting
13personal responsibility for individual health, and advancing health
14equity.”

15(c) The task force identified several priorities, including a subset
16for “Healthy Beginnings,” which include reducing infant deaths,
17increasing vaccination rates, reducing childhood trauma, and
18reducing adolescent tobacco use.

19(d) The final report of the task force states “the challenge going
20forward is to identify evidence-based interventions and quicken
21the pace of uptake across the state,” in order to meet the ambitious
22goals in the Governor’s directive.

23(e) In addition to reducing healthcare costs, the Nurse-Family
24Partnership has demonstrated proven outcomes addressing factors
25that contribute to toxic stress and made measurable progress
26towards many of the goals identified by the task force.

27(f) The Nurse-Family Partnership is an evidence-based,
28community health program that improves pregnancy outcomes,
29improves child health and development, and improves economic
30self-sufficiency.

31(g) Multiple peer-reviewed, randomized, controlled trials and
32longitudinal followup studies have clearly demonstrated the
33efficacy of the Nurse-Family Partnership programs, through
34significant sustained results, in achieving these goals.

35(h) The Nurse-Family Partnership provides lifelong health and
36economic benefits to both mothers and children served by the
37program.

38(i) These lifelong benefits have the potential to achieve
39substantial savings to federal, state, and local governments with
40respect to programs and services, including Medicaid, Child
P3    1Protective Services, law enforcement, special education, the
2Supplemental Nutrition Assistance Program (SNAP), and
3Temporary Assistance for Needy Families (TANF) program,
4among others. These savings far exceed the costs of implementing
5the Nurse-Family Partnership program.

6(j) Twenty-one California counties currently operate a
7Nurse-Family Partnership program. Only a fraction of potentially
8eligible recipients are receiving these highly beneficial and
9cost-effective services.

10(k) However, if California were to provide these services to
11significantly more eligible first-time mothers, the state could see
12population-wide health and economic benefits that would carry
13over to future generations.

14(l) Therefore, it is the intent of the Legislature to develop a
15means to leverage public and private dollars to substantially expand
16the scale of the Nurse-Family Partnership in California, beginning
17with regions and populations with the greatest need.

18

SEC. 2.  

Section 123492 of the Health and Safety Code is
19amended to read:

20

123492.  

The department shall develop a grant application and
21award grants on a competitive basis to counties for the startup,
22continuation, and expansion of the program established pursuant
23to Section 123491. To be eligible to receive a grant for purposes
24of that section, a county shall agree tobegin insert doend insert all of the following:

25(a) Serve through the program only pregnant, low-income
26women who have had no previous live births. Notwithstanding
27subdivision (b) of Section 123485, women who are juvenile
28offenders or who are clients of the juvenile systembegin insert, with no history
29of prior live births,end insert
shall be deemed eligible for services under the
30program.

31(b) Enroll women in the program while they are still pregnant,
32before the 28th week of gestation, and preferably before the 16th
33week of gestation, and continue those women in the program
34through the first two years of the child’s life.

35(c) Use as home visitors only registered nurses who have been
36licensed in the state.

37(d) Have nurse home visitors undergo training according to the
38program and follow the home visit guidelines developed by the
39Nurse-Family Partnership program.

P4    1(e) Have nurse home visitors specially trained inbegin insert the
2Nurse-Family Partnership guidelines forend insert
prenatal care and early
3child development.

4(f) Have nurse home visitors follow a visit schedule keyed to
5the developmental stages of pregnancy and early childhood.

6(g) Ensure that, to the extent possible, services shall be rendered
7in a culturally and linguistically competent manner.

8(h) Limit a nurse home visitor’s caseload to no more than 25
9active families at any given time.

10(i) begin deleteProvide for end deletebegin insertFor end insertevery eight nurse home visitorsbegin insert, provideend insert a
11full-time nurse supervisor who holds at least a bachelor’s degree
12in nursing and has substantial experience in community health
13nursing.

begin delete

14(j) Have nurse home visitors and nurse supervisors trained in
15effective home visitation techniques by qualified trainers.

end delete
begin delete

16(k)

end delete

17begin insert(j)end insert Have nurse home visitors and nurse supervisors trained in
18the method of assessing early infant development and parent-child
19interaction in a manner consistent with the program.

begin delete

20(l)

end delete

21begin insert(k)end insert Provide data on operations, results, and expenditures in the
22formats and with the frequencies specified by the department.

begin delete

23(m)

end delete

24begin insert(l)end insert Collaborate with other home visiting and family support
25programs in the community to avoid duplication of services and
26complement and integrate with existing services to the extent
27practicable.

begin delete

28(n)

end delete

29begin insert(m)end insert Demonstrate that adoption of the Nurse-Family Partnership
30program is supported by a local governmental or
31government-affiliated community planning board, decisionmaking
32board, or advisory body responsible for assuring the availability
33of effective, coordinated services for families and children in the
34community.

begin delete

35(o)

end delete

36begin insert(n)end insert Provide cash or in-kind matching funds in the amount of
37100 percent of the grant award.

begin delete

38(p)

end delete

P5    1begin insert(o)end insert Prohibit the use of moneys received for the program as a
2match for grants currently administered by the department.



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