Z-0470.2

HOUSE BILL 1771

ByRepresentatives 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

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; amending RCW 43.216.130 and 43.216.157; adding new sections to chapter 43.216 RCW; creating new sections; recodifying RCW 43.216.130, 43.216.152, 43.216.155, 43.216.157, and 43.216.159; providing an expiration date; and declaring an emergency.

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF WASHINGTON:

(2) Research shows that a properly designed home visiting program improves the parenting skills of parents with newborns through education about effective parenting and care, child development, health, safety, and nutrition. Home visiting also produces long-term benefits such as a reduction in infant emergency room visits, child abuse and neglect referrals, and maternal and infant mental health services referrals. The connection to services is often of equal value to the personal connection for a new parent to a person they know and trust so they do not feel alone and have a sounding board and someone to ask for help, when needed. The legislature further finds that cultural responsiveness in service delivery and community representation lead to more meaningful engagement with service providers and to greater community well-being overall.

(3) The legislature finds that in-home visitation can prove beneficial for each family, their infant, the postpartum mother, and for the community as a whole. While the primary goal of this act is to improve the lives of families and their newborns, the outcomes of these programs may result in a cost savings to the state of Washington and its taxpayers.

(4) The federal and Washington state governments have supported a limited number of families in Washington with modest investments in home visiting over the years. In 2010, the federal government established the maternal, infant, and early childhood home visiting program, which currently provides three hundred sixty-three million dollars to home visiting services nationwide. Also in 2010, the Washington state legislature created the home visiting services account, which is the state's portfolio account for home visiting services that includes state, federal, and private dollars. While these investments have allowed the state to serve more children and families, a recent home visiting needs assessment revealed that thousands of families in Washington would benefit from home visiting, but currently do not have access.

(5) Therefore, the legislature intends to create a universal home visiting program for all newborns and a statewide family linkage program that provides resources and referrals. The legislature further intends to welcome each family of a newborn with basic health, wellness, and stability services as well as information on important community resources to help build local community-based connections for new parents.

NEW SECTION.  Sec. 3. A new section is added to chapter 43.216 RCW to read as follows:

(1) Subject to the availability of amounts appropriated for this specific purpose, the department shall implement a universal home visiting program for newborns and their families residing in Washington state. The universal home visiting program must be available to all newborns, from birth to nine months old, and their families. Each family of any newborn must receive information about participation in the universal home visiting program. The program must be voluntary and any family must be able to disenroll from the program at any time.

(2) The department shall implement the universal home visiting program in a phased-in approach starting with at least two communities with the highest need, as determined by community risk factors such as rates of child welfare referrals, low birth weight rates, and percentage of low-income residents. The first communities selected must demonstrate interest in and capacity to host the program. In addition, the first communities selected must be clear on how they will ensure that the diversity of the community is reflected in its home visitors and ensure that the program is designed with the diversity in mind. By July 1, 2027, the universal home visiting program must be a statewide entitlement. The entitlement includes up to three home visits. Any additional referred services as described in subsection (3)(c) of this section are not part of the universal home visiting entitlement.

(3) The universal home visiting program must be administered as follows:

(a) An evidence-based or promising practice early childhood home visiting service delivery model must be adopted to provide the universal home visiting program, and the department shall comply with model fidelity. Enhancements or adaptations of the model must be made and evaluated with agreement of the model developer.

(b) The department shall attempt to meet the language needs of all families enrolled in the program. In implementing this act, the department shall also take steps to ensure culturally responsive service delivery.

(c) The home visitor must be a registered nurse licensed to practice registered nursing under chapter 18.79 RCW or an allied professional approved by the model.

(d) The department shall offer up to three home visits under the universal home visiting program. The first home visit must be for building trust and a strengths-based connection with the family, as well as assessing the health, safety, and immediate needs of the child and family. The first home visit must occur within the first thirty days after birth. If a family disenrolls in the program before the first visit but reenrolls at a later date, the first visit must occur within thirty days of reenrollment in the program. The first visit must also include resources to connect the family with various services if needed including, but not limited to, public benefits and services, transportation resources, and online tools and resources. The department may partner with private businesses to offer free resources in addition to public services and information. At the time of the first visit, the home visitor must provide the family with a document designed by the department to assist the family in tracking the progress, health, and education benchmarks for the newborn. The second and third home visits may be scheduled depending on the needs of the child and family. If additional services or needs are identified, the home visitor may refer, contingent upon the family's consent, the family or child for participation in long-term intensive home visiting services. Additional referrals for health care services, mental health services, public assistance programs, or other appropriate services may also be provided by the home visitor through local resources and the statewide family linkage program created in section 8 of this act.

(4) The department shall ensure that at least ten percent of the home visits, if needed, are provided outside of traditional work hours. For the purposes of this section, "traditional work hours" means Monday through Friday, 8 a.m. to 5 p.m.

(5) Between thirty days and forty-five days after the last home visit by the home visitor and prior to the case closure, the department shall ensure that the family is contacted to confirm whether the family received recommended services, and whether the family contacted, or was contacted by, the service provider offered to families through local community resources or the statewide family linkage program created in section 8 of this act. During this precase closure contact, the department shall also confirm whether the family has any additional needs not previously identified.

(6) The department shall work in collaboration with the department of health, the department of social and health services, and the health care authority to ensure effective service delivery.

NEW SECTION.  Sec. 4. A new section is added to chapter 43.216 RCW to read as follows:

(1) After the first two communities have implemented universal home visiting to scale as described in section 3 of this act, the department shall conduct an independent evaluation to measure family and child outcomes for at least those two communities with a focus on child health, maternal health, referrals to child welfare, availability of health care, dependency hearings, access to healthy food, return on investment, and family satisfaction with the program. The department shall also examine the overall community health and the associated outcomes regarding community health as a result of the program. The department must submit this report, in compliance with RCW 43.01.036, to the appropriate committees of the legislature and the governor by November 1, 2026.

(2) This section expires December 1, 2026.

NEW SECTION.  Sec. 5. A new section is added to chapter 43.216 RCW to read as follows:

(1) The department shall develop an implementation plan for the universal home visiting program created in section 3 of this act, which must include, but not be limited to, the following:

(a) A description of the evidence-based early childhood home visiting services delivery model selected by the department, in conjunction with the first communities selected to host the program, why it was selected, and a description of other models that were considered;

(b) A description of the department's regional phased-in approach, with priority given to communities demonstrating the highest need, and a timeline for implementation, which must be done in consultation with local health jurisdictions, cities, counties, community-based organizations, and early learning regional coalitions;

(c) A recruitment and outreach strategy for families and communities;

(d) A workforce plan for training, recruitment, hiring, and retention of diverse, multilingual, and culturally responsive home visitors throughout the state; and

(e) A plan to promote the universal home visiting program to gain the broadest use and understanding of the opportunities provided by the program and to increase community participation.

(2) The department must submit the implementation plan, in compliance with RCW 43.01.036, to the appropriate committees of the legislature and the governor by October 1, 2020. The department, or its contracted home visitors, may begin service delivery for the universal home visiting program prior to submission of the implementation plan.

Sec. 6. RCW 43.216.130 and 2017 c 171 s 2 are each amended to read as follows:

(1)(a) The home visiting services account is created in the state treasury. Revenues to the account shall consist of appropriations by the legislature and all other sources deposited in the account. All federal funds received by the department for home visiting activities must be deposited into the account.

(b)(i) Expenditures from the account shall be used for state matching funds for the purposes of the program established in this section and federally funded activities for the home visiting program, including administrative expenses.

(ii) The department oversees the account and is the lead state agency for home visiting system development. The nongovernmental private-public partnership supports the home visiting service delivery system and provides support functions to funded programs.

(iii) It is the intent of the legislature that state funds invested in the account be matched by the private-public partnership each fiscal year.

(iv) Amounts used for program administration by the department may not exceed an average of ten percent in any two consecutive fiscal years.

(v) Authorizations for expenditures may be given only after private funds are committed. The nongovernmental private-public partnership must report to the department quarterly to demonstrate investment of private match funds.

(c) Expenditures from the account are subject to appropriation and the allotment provisions of chapter 43.88 RCW.

(2) The department must expend moneys from the account to provide state matching funds for partnership activities to implement home visiting services and administer the infrastructure necessary to develop, support, and evaluate evidence-based, research-based, and promising home visiting programs.

(3) Activities eligible for funding through the account include, but are not limited to:

(a) Home visiting services that achieve one or more of the following: (i) Enhancing child development and well-being by alleviating the effects on child development of poverty and other known risk factors; (ii) reducing the incidence of child abuse and neglect; or (iii) promoting school readiness for young children and their families; ((and))

(b) Development and maintenance of the infrastructure for home visiting programs, including training, quality improvement, and evaluation; and

(c) The universal home visiting program created in section 3 of this act, which may be funded with a budget proviso. The private-public partnership match described in subsection (1)(b)(iii) of this section does not apply to the universal home visiting program.

(4) ((Beginning July 1, 2010,))The department shall contract with the nongovernmental private-public partnership designated in RCW ((43.215.070))43.216.065 to support programs funded through the home visiting services account. The department shall monitor performance and provide periodic reports on the uses and outcomes of the home visiting services account.

(5) The department shall, in the administration of the programs:

(a) Fund programs through a competitive bid process or in compliance with the regulations of the funding source; and

(b) Convene an advisory committee of diverse early learning and home visiting experts, including ((one)) representatives from the department, to advise the partnership regarding research and the distribution of funds from the account to eligible programs.

Sec. 7. RCW 43.216.157 and 2011 1st sp.s. c 32 s 6 are each amended to read as follows:

The definitions in this section apply throughout this section and RCW ((43.215.145, 43.215.147, and 43.121.185))43.216.130, 43.216.152, 43.216.155, 43.216.159 (as recodified by this act), and sections 3, 5, 8, and 9 of this act unless the context clearly requires otherwise.

(1) "Evidence-based" means a program or practice that has had multiple site random controlled trials across heterogeneous populations demonstrating that the program or practice is effective for the population.

(2) "Home visitation" means providing services in the permanent or temporary residence, or in other familiar surroundings, of the family receiving such services.

(3) "Research-based" means a program or practice that has some research demonstrating effectiveness, but that does not yet meet the standard of evidence-based practices.

NEW SECTION.  Sec. 8. A new section is added to chapter 43.216 RCW to read as follows:

(1)

(2) In developing the statewide family linkage program, the department shall create an implementation plan to be delivered, in compliance with RCW 43.01.036, to the appropriate committees of the legislature and the governor by October 1, 2020.

(3) The statewide family linkage program must be operational statewide by July 1, 2027.

NEW SECTION.  Sec. 9. A new section is added to chapter 43.216 RCW to read as follows:

The department may adopt rules under chapter 34.05 RCW for the administration of the universal home visiting program created in section 3 of this act and the statewide family linkage program created in section 8 of this act.

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