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AB-1046 Nurse-Family Partnership program.(2021-2022)

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Date Published: 02/18/2021 09:00 PM
AB1046:v99#DOCUMENT


CALIFORNIA LEGISLATURE— 2021–2022 REGULAR SESSION

Assembly Bill
No. 1046

Introduced by Assembly Member Blanca Rubio

February 18, 2021

An act to amend Section 123491 of the Health and Safety Code, relating to perinatal services.


LEGISLATIVE COUNSEL'S DIGEST


AB 1046, as introduced, Blanca Rubio. Nurse-Family Partnership program.
Existing law establishes the Nurse-Family Partnership program, administered and implemented by the State Department of Health Care Services, for purposes of making grants to eligible participating counties for the provision of voluntary registered nurse home visiting services for expectant first-time low-income mothers, their children, and their families.
This bill would require the California Health and Human Services Agency to consult with specified stakeholders from diverse geographical regions of the state to identify mechanisms to improve the state and counties’ ability to effectively draw down Medi-Cal funding for evidence-based maternal-infant and early childhood home visiting encounters. The bill would require the agency to consider specified factors in identifying benefit authorities and scope of coverage for activities and services delivered by covered providers in fidelity with model requirements for evidence-based maternal, infant, and early childhood home visiting programs.
Vote: MAJORITY   Appropriation: NO   Fiscal Committee: YES   Local Program: NO  

The people of the State of California do enact as follows:


SECTION 1.

 The Legislature finds and declares all of the following:
(a) According to 2019 statistics, California has a poverty rate of 18.2 percent, among the highest of any state in the country.
(b) Children born into poverty are at higher risk of health and developmental disparities, including, but not limited to, premature birth, infant mortality, crime, domestic violence, developmental delays, dropping out of high school, substance abuse, unemployment, and child abuse and neglect.
(c) Extensive research has shown that evidence-based maternal-infant and early childhood home visiting programs serving pregnant and parenting mothers, prenatally through children turning five years of age, improve maternal and child health, family self-sufficiency, positive parenting practices, child development, and school readiness, and reduce child maltreatment and neglect.
(d) California has recognized the benefits of voluntary, evidence-based maternal-infant and early childhood home visiting programs with the allocation of General Funds to be administered through the California Home Visiting Program and CalWORKs Home Visiting Program. Thousands more families around the state stand to benefit from home visiting, and mechanisms to enhance funding through federal matching dollars.
(e) Of the programs offered, multiple randomized controlled trials of the Nurse-Family Partnership maternal-infant and early childhood home visiting program, which uses highly skilled nurses and begins prenatally, have demonstrated reductions in preterm births, all-cause maternal mortality, smoking during pregnancy, complications of pregnancy, closely spaced subsequent births, childhood injuries resulting in costly emergency department use and hospitalizations, improved childhood immunization rates, compliance with well-child visit schedules, lower body mass index rates, and improved family wellbeing, including increased family self-sufficiency.
(f) Nurse-Family Partnership and other voluntary, evidence-based maternal-infant and early childhood home visiting programs offered in California were recognized in 2020 by the Office of the Surgeon General as primary and secondary prevention strategies to reduce adverse health and child development effects of toxic stress attributable to adverse childhood experiences and to prevent intergenerational transmission of ACEs. Further, research cited by the Surgeon General affirms “prenatal initiation of home visiting most successfully prevented child abuse, especially when mothers enrolled at or before a gestational age of 24 weeks.”
(g) Data collected by Nurse-Family Partnership indicates over 90 percent of expectant participants who give birth in the program are enrolled in Medi-Cal for pregnancy, delivery, and postpartum coverage.
(h) More than 20 other states have identified Medicaid benefits through which the activities and services delivered by nonphysician medical professionals in the home in the course of evidence-based maternal-infant and early childhood home visits can be consistently and adequately reimbursed.
(i) Lack of inclusion of evidence-based maternal-infant and early childhood home visiting services as covered services for pregnant people, parents, infants, and children within the State Plan disincentivizes Medi-Cal managed care plans from consistently contracting with evidence-based maternal-infant and early childhood home visiting providers for these services.
(j) Inconsistent ability for evidence-based maternal-infant and early childhood home visiting providers to leverage Medi-Cal reimbursement for activities and services delivered through the course of home visit encounters has perpetuated inequitable access of these critical services in ways that are exacerbated in rural and other communities with fewer resources than more densely populated communities.

SEC. 2.

 Section 123491 of the Health and Safety Code is amended to read:

123491.
 (a) There is hereby established a voluntary nurse home visiting grant program for expectant first-time mothers, their children, and their families, to be administered by the department pursuant to Section 123492. The program may be cited as the Nurse-Family Partnership program.
(b) The goals and objectives of the program shall be the same as, but shall not be limited to, those in the community-based comprehensive perinatal health care system as set forth in Section 123505.
(c) The department shall adopt regulations for the implementation of this section in accordance with Section 123516.
(d) (1) The California Health and Human Services Agency shall consult with stakeholders from diverse geographical regions of the state to identify mechanisms to improve the state and counties’ ability to effectively draw down Medi-Cal funding for evidence-based maternal-infant and early childhood home visiting encounters. The agency shall consider all of the following in identifying benefit authorities and scope of coverage for activities and services delivered by covered providers in fidelity with model requirements for evidence-based maternal, infant, and early childhood home visiting programs:
(A) Extent of current use of federal and nonfederal reimbursement under existing Medi-Cal benefits to be sustained.
(B) Variety of screening, assessment, health education, care coordination, and case management activities provided in the home by nonphysician health care providers within the prenatal year following pregnancy, and early childhood phases of maternal-infant and early childhood home visiting programs.
(C) Identification of any eligible funds to serve as sources of nonfederal match.
(2) Consulted stakeholders shall include, but not be limited to, representatives of any of the following:
(A) Developers of evidence-based home visiting models authorized through the California Home Visiting and CalWORKS Home Visiting programs.
(B) Local health jurisdictions’ divisions, including maternal, child, and adolescent health, human services, and behavioral health divisions.
(C) The California Children and Families Commission.
(D) Medi-Cal managed care organizations.
(E) Others with expertise in perinatal, maternal, and infant health.