BILL ANALYSIS Ó
AB 50
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CONCURRENCE IN SENATE AMENDMENTS
AB
50 (Mullin)
As Amended September 4, 2015
Majority vote
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|ASSEMBLY: | 79-0 | (June 2, |SENATE: | 40-0 | (September 10, |
| | |2015) | | |2015) |
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Original Committee Reference: HEALTH
SUMMARY: Requires the Department of Health Care Services (DHCS)
to develop a plan, in consultation with stakeholders, on or
before January 1, 2017, to ensure that evidence-based home
visiting programs, as defined, are offered and provided to
Medi-Cal eligible pregnant and parenting women, as specified.
It also requires DHCS, in developing the plan, to prioritize the
identification of funding sources for home visiting services
other than state General Fund, including local, federal,
private, or other funds.
The Senate amendments clarify that this bill only requires DHCS
to develop a plan to determine the feasibility of offering home
visitation services.
EXISTING LAW:
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1)Establishes the Nurse Family Partnership (NFP) as a voluntary
nurse home visiting grant program for expectant first-time
mothers, their children, and their families, administered by
the Department of Public Health (DPH).
2)Requires DPH to develop a grant application and award grants
on a competitive basis to counties for the startup,
continuation, and expansion of NFP and requires a county, to
be eligible to receive an NFP grant, to agree to specific
staffing and service-related provisions.
3)Permits DPH to accept voluntary contributions, in cash or
in-kind, to pay for the costs in the implementation of the NFP
and requires private donations to be deposited into the
California Families and Children Account, which is created and
continuously appropriated to DHCS under this bill.
4)Prohibits state funds from being used to implement this bill.
5)Allows DPH to distribute grants if the Director of the
Department of Finance determines, in writing, that there are
sufficient funds from private donations available in the
account for expenditure for the purposes of the NFP.
Prohibits DPHs' administration costs from exceeding 5% of the
moneys in the account.
6)Permits DPH, in consultation with the NFP administrators, to
contract with one or more qualified organizations to assist
DPH in ensuring that grantees implement the program as
established under this bill and to conduct an annual
evaluation of the implementation of the grant program on a
statewide basis. Requires the first evaluation to be due 12
months after the award of grants.
FISCAL EFFECT: According to the Senate Appropriations
Committee, one-time costs, likely from $250,000 to $500,000 per
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year for one to two years, to consult with stakeholders, review
existing programs and program evaluations, and develop a plan
for the provision of home visitation services in Medi-Cal by
DHCS.
COMMENTS: According to the author, this bill is necessary to
increase accessibility for nurse led home visiting and help
improve efficiency on this piece of our system of care. This
bill helps to address the rising costs of Medi-Cal and potential
burdens of rising Medi-Cal enrollment. With increased Medi-Cal
enrollments come the societal savings, care coordination, case
management, and healthcare outcomes that NFP and other
evidence-based nurse home visiting programs, provide for the
consistent solutions resonating among stakeholders. These
measures will help improve Healthcare Effectiveness Data and
Information Set measures, access to services, and reduce costs
while further increasing savings. It is the responsibility of
the Legislature and in the best interest of all California
citizens to prioritize efficiency and effectiveness in the
consideration of fiscal expenditures.
The first California NFP implementing agencies were launched in
1996 in Fresno, Los Angeles, and Alameda Counties using Federal
Department of Justice funding. The successful implementation of
these initial NFP pilot sites demonstrated to other California
communities that it was possible to replicate a scientific-based
health strategy while also tailoring the program to meet the
needs of each community. NFP seeks to continue to build new
partnerships with medical managed care entities, school
districts, military bases, clinics and hospitals in order to
serve the thousands more eligible families in California that
could benefit from NFP's evidenced-based outcomes model.
The NFP sites in California have served approximately 9,000
families, of which the majority are Latino. The median age of
the mothers is 18 years. Seventy-two percent are enrolled in
Medi-Cal, and the median annual household income is $13,500.
The California NFP has documented outcomes for enrollees, and
demonstrated a 23% reduction in cigarette smoking during
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pregnancy. In addition, of those mothers who entered the
program without a high school diploma or General Educational
Development Test (GED), 42% had earned their diploma or GED, 25%
continued to work toward their diploma or GED, and 15% were
pursuing education beyond high school, by the time their infants
were 24 months old.
Children Now states in support that voluntary early childhood
home visiting programs strengthen the critical parent-child
relationship and connect families with information and resources
during the pivotal time from pregnancy to age five. Extensive
research has shown that voluntary home visiting programs
increase family self-sufficiency, positive parenting practices,
and maternal and child health. Children Now notes that
nationally, as well as in California, there is a diverse array
of home visiting program models in use, including both
nationally-known, intensive program models, as well as locally
designed programs intended to engage isolated populations or
address other specific local priorities.
This bill has no known opposition.
Analysis Prepared by: Paula Villescaz /
HEALTH / (916) 319-2097 FN: 0002301