HOUSE BILL REPORT

HB 1771

This analysis was prepared by non-partisan legislative staff for the use of legislative members in their deliberations. This analysis is not a part of the legislation nor does it constitute a statement of legislative intent.

As Reported by House Committee On:

Human Services & Early Learning

Title: An act relating to establishing the welcome to Washington baby act to create family supports through universal home visiting programs and a statewide family linkage program for resources and referrals.

Brief Description: Establishing the welcome to Washington baby act to create family supports through universal home visiting programs and a statewide family linkage program for resources and referrals.

Sponsors: Representatives Senn, Jinkins, Davis, Macri, Mead, Ortiz-Self, Shewmake, Goodman, Lekanoff, Chapman, Entenman, Appleton, Fey, Lovick, Bergquist, Doglio, Ormsby, Pollet and Frame; by request of Office of the Governor.

Brief History:

Committee Activity:

Human Services & Early Learning: 2/5/19, 2/19/19 [DPS].

Brief Summary of Substitute Bill

  • Requires the Department of Children, Youth, and Families to select up to four demonstration sites in which to implement short-term, universal, voluntary, community-based home visiting during an infant's first year.

HOUSE COMMITTEE ON HUMAN SERVICES & EARLY LEARNING

Majority Report: The substitute bill be substituted therefor and the substitute bill do pass. Signed by 7 members: Representatives Senn, Chair; Callan, Vice Chair; Frame, Vice Chair; Goodman, Kilduff, Lovick and Ortiz-Self.

Minority Report: Do not pass. Signed by 6 members: Representatives Dent, Ranking Minority Member; Eslick, Assistant Ranking Minority Member; McCaslin, Assistant Ranking Minority Member; Corry, Griffey and Klippert.

Staff: Dawn Eychaner (786-7135).

Background:

Home visiting programs deliver voluntary services to pregnant women, young children, and families at home and are designed to alleviate the effects of poverty and other risk factors on child development. The Department of Children, Youth, and Families (DCYF) administers the state Home Visiting Services Account (HVSA). The HVSA receives state, federal, and private funding for the provision of home visiting services, including grant funds from the federal Maternal Infant and Early Childhood Home Visiting (MIECHV) program. An advisory committee gives advice regarding research and the distribution of funds from the HVSA. The stated intent of the Legislature is that state funds invested in the HVSA be matched by public-private partnership funds each fiscal year.

In addition to home visiting models funded through the HVSA, local and community-based agencies deliver a number of other home visiting services that are supported with federal, private, or local funding. Each model has its own requirements for provider qualifications, program goals, and the duration or frequency of services for various target populations that can include pregnant women and children up to age 5. A Home Visiting Scan published in 2017 by the DCYF reported 8,852 funded slots were available to families statewide though nine different home visiting program models. In 2017 the Department of Health (DOH) published a home visiting needs assessment estimating the potential need for home visiting services based on certain risk factors and low-income births by county and school locale, as well as by race and ethnicity.

Evidence-Based Home Visiting.

The MIECHV grant funds evidence-based home visiting and requires that grantees demonstrate measurable improvement in at least four of six benchmark domains. The six domains are improvement in maternal and newborn health; reduction in child injuries, abuse, and neglect; improved school readiness and achievement; reduction in crime or domestic violence; improved economic self-sufficiency; and improved coordination and referral for other community resources and supports.

In Washington, the MIECHV grant funds the Nurse-Family Partnership, and Parents as Teachers home visiting services. For federal fiscal year 2018, Washington's MIECHV grant was $10.46 million.

State statute defines evidence-based home visiting as a program or practice that had multiple site random controlled trials across heterogeneous populations demonstrating that the program or practice is effective for the population.

–––––––––––––––––––––––––––––––––

Summary of Substitute Bill:

Short-Term Universal, Voluntary, Community-Based Home Visiting Program.

Subject to funds appropriated, the DCYF must implement a short-term universal, voluntary, community-based home visiting program (community-based HVP) to be available to all families in up to four demonstration sites. The DCYF must select demonstration sites by October 1, 2019, based on communities with the highest needs and community interest and capacity. The DCYF must begin implementation of services in the demonstration sites by January 1, 2021.

To be eligible for funding, a community-based HVP must:

The initial home visit must focus on the immediate health and safety needs of the child, mother, and family, and if appropriate, provide the family with information and referrals to local community-based resources matched to the family's needs. As appropriate, the community-based HVP must include a process for following up with families to facilitate the family's connection to local service providers.

The DCYF must offer technical assistance to assist communities in the demonstration sites with engagement, planning, and implementation activities including:

All personally identifiable data collected under a community-based HVP is confidential. A community-based HVP may only disclose:

The DCYF may adopt rules to implement the community-based HVP.

The DCYF must report to the Governor and the Legislature by:

Funding for the community-based HVP may be deposited into the HVSA. State funds are not required to be matched by public-private partnership funds. The DCYF representation on the advisory committee advising on the distribution of HVSA funds is increased to more than one representative.

Definitions are added for various home visiting services and outdated statutory references are updated.

Substitute Bill Compared to Original Bill:

The substitute bill:

–––––––––––––––––––––––––––––––––

Appropriation: None.

Fiscal Note: New fiscal note requested on February 19, 2019.

Effective Date of Substitute Bill: The bill takes effect 90 days after adjournment of the session in which the bill is passed.

Staff Summary of Public Testimony:

(In support) Not all parents have access to resources through a primary care doctor and extended family to give extra support when they bring home a new baby. These services will help identify maternal depression, ensure bonding, healthy eating and breastfeeding at the beginning of life, and will help babies and moms to thrive while targeting the needs of specific communities. Home visitors help parents build confidence in their parenting skills. The guidance of a home visitor can result in long-term better physical health outcomes for children and identify adverse childhood experiences. Families of all incomes can benefit from this voluntary service. Universal services are important to remove any stigma associated with home visiting and to promote equity. The public saves $3 for every $1 invested in home visiting programs. This program is not government surveillance and is voluntary. Allowing adequate time to address nurse workforce issues can be addressed, and the community-based planning processes have already begun. Family linkage programs like Help Me Grow have been used successfully at a limited scale. Perfectly healthy newborns wind up in the emergency room for things that normal newborns do but that parents are afraid of, which is costly and exposes newborns to illnesses in the hospital environment. A contracted provider, not child protective services and not the government, would be the one going into the home.

(Opposed) The language in the bill is concerning for those who value parental rights, including the descriptions applying to all newborns and the statewide entitlement. The terms "voluntary" and "dis-enroll" only appear once. Data collection and privacy is a concern. Home visiting nurses sometimes provide incorrect information that is not culturally representative. Communities should provide services, and this should not be coming from a government mandate. There is no assurance that data collected is kept private and that questionnaires are being stored securely. The state does not know better than parents what children need. A parent's own experience and desires should take precedence.

Persons Testifying: (In support) Representative Senn, prime sponsor; Trudi Inslee; RaShelle Davis, Office of the Governor; Susan Barbeau and Kate Ginn, First 5 FUNdamentals; Emilia Santiago; Carrie Glover, WithinReach; Julian Ayer, Washington Chapter of American Academy of Pediatrics; Laurie Lippold, Partners for Our Children; and Erica Hallock, Fight Crime: Invest in Kids and Home Visiting Coalition.

(Opposed) Karen Larsen; Sharon Hanek; and Ken Springer.

Persons Signed In To Testify But Not Testifying: None.