,i #aae? ,,congress #a/ ,session ,h4 ,r4 #cbia ,,9 ,,! ,,h\se ,,( ,,repres5tatives ,july #ah1 #bjag,mr4 ,ryan ( ,ohio 7= himself & ,mr4 ,b5 ,ray ,lujn ( ,new ,mexico7 introduc$ ! foll[+ bill2 :i* 0 ref]r$ to ! ,committee on ,en]gy & ,comm]ce ,a ,,bill ,to am5d title ,,xix ( ! ,social ,security ,act to provide = a ,/ate option to provide = mat]nal1 infant1 & e>ly *ildhood home visit+ programs1 & = o!r purposes4 #a4 ,%ort title ,?is ,act may be cit$ z ! ,alleviat+ ,adv]se ,*ildhood ,exp]i5ces ,act4 #b4 ,f9d+s ,congress f9ds ! foll[+3 7#a7 ,adv]se *ildhood exp]i5ces include emotional & physical neglect & abuse1 sexual abuse1 intimate p>tn] viol5ce1 h\sehold sub/ance abuse1 h\sehold m5tal illness1 p>5tal sep>ation or divorce1 & hav+ an inc>c]at$ h\sehold memb]4 7#b7 ,f9d+s f ! adv]se *ildhood exp]i5ces /udy conduct$ by ! ,c5t]s = ,disease ,control & ,prev5tion h %[n t adv]se *ildhood exp]i5ces pr$ispose *ildr5 t[>d negative trajectories f infancy into adul?ood4 7#c7 ,z ! numb] ( adv]se *ildhood exp]i5ces increases s does ! risk = myoc>dial inf>ction1 a/hma1 m5tal di/ress1 depression1 smok+1 disability1 unemploym5t1 l[]$ educational atta9m5t1 opioid abuse1 coron>y he>t disease1 /roke1 & diabetes4 7#d7 ,accord+ to ! ,c5t]s = ,disease ,control & ,prev5tion1 adults :o _h be5 expos$ to m ?an "o adv]se *ildhood exp]i5ce 7 significantly m likely to be unemploy$1 to be liv+ 9 pov]ty1 & n to h graduat$ high s*ool ?an adults :o _h n exp]i5c$ an adv]se *ildhood exp]i5ce4 7#e7 ,! ,c5t]s = ,disease ,control & ,prev5tion also f\nd t j "o ye> ( confirm$ cases ( *ild maltreatm5t co/s #abd1jjj1jjj1jjj ov] ! lifetime ( ! traumatiz$ *ildr54 ,^! include increases 9 *ildhood heal? c>e co/s1 adult m$ical co/s1 productivity losses1 *ild welf>e co/s1 crim9al ju/ice co/s1 & special education co/s4 7#f7 ,home visit+ programs1 p$iatric-bas$ s]vices & in=m$1 evid5ce-bas$ approa*es h be5 prov5 to prev5t & mitigate ! negative effects ( adv]se *ildhood exp]i5ces on *ildr5 & families4 7#g7 ,p>ticipants 9 ! ,nurse-,family ,p>tn]%ip's home visit+ program h %[n a #dh p]c5t r$uction 9 ,/ate-v]ifi$ reports ( *ild abuse & neglect by age #ae1 a #fg p]c5t r$uction 9 behavioral & emotional problems by age #f1 & a #ei p]c5t r$uction 9 arre/s by age #ae among _m o!r improv$ *ild heal? & developm5t outcomes comp>$ to c\nt]p>ts 9 a control gr\p4 7#h7 ,p>ticipants 9 ! ,nurse-,family ,p>tn]%ip's programs h also %[n increas$ self-suffici5cy by family memb]s 7& less utilization ( ,f$]al programs71 g5]at+ a #ab1cjj sav+s 9 ! supplem5tal nutrition assi/ance program "u ! ,food & ,nutrition ,act ( #bjjh 7#g ,u4,s4,c4 #bjaa et seq47 & sav+s ( #aa1eaa 7valu$ ) respect to #bjjf7 "u ! tempor>y assi/ance = ne$y families program "u title ,,iv ( ! ,social ,security ,act 7#db ,u4,s4,c4 #fja et seq47 ) respect to *ildr5 betwe5 ! ages ( #j ?r\gh #ab4 7#i7 ,healthy,steps1 an int]discipl9>y p$iatric prim>y c>e model has be5 %[n to increase *ild safety1 on "t vacc9ations1 age-appropriate p>5tal engagem5t1 s*ool read9ess1 & connections to community res\rces4 7#aj7 ,sev]al ,/ates f9ance "p ( _! home visit+ programs ?r\gh ! ,m$icaid program "u title ,,xix ( ! ,social ,security ,act 7#db ,u4,s4,c4 #acif et seq471 b su* program c\ld be utiliz$ to support m eligible families4 ,"o /udy %[$ t if all eligible *ildr5 & families 7 enroll$ 9 evid5ce-bas$ programs1 ,/ates c\ld save up to #b1djj1jjj1jjj comb9$ & ! ,f$]al ,gov]nm5t c\ld save up to #hac1jjj1jjj ov] #aj ye>s4 7#aa7 ,p$iatric-bas$ sett+s t incorporate developm5tally ori5t$ s]vices su* z promot+ e>ly read+1 connection to community-bas$ s]vices1 positive p>5t-*ild int]action1 & guidance on behavior managem5t h %[n to increase p>ticipation 9 well-*ild visits & are associat$ ) high levels ( p>5t satisfaction4 7#ab7 ,families p>ticipat+ 9 ! ,heal?y ,families ,am]ica home visit+ program h se5 impacts )9 "o ye> or less1 includ+ a #dh p]c5t r$uction 9 babies born ) l[ bir? weight & increas$ heal?y p>5t behaviors1 su* z a #da p]c5t r$uction 9 alcohol use4 ,mo!rs p>ticipat+ 9 su* program 7 m ?an five times z likely to cont9ue _! education4 #c4 ,/ate option to provide = mat]nal1 infant1 & e>ly *ildhood home visit+ programs ,title ,,xix ( ! ,social ,security ,act 7#db ,u4,s4,c4 #acif et seq47 is am5d$ by add+ at ! end ! foll[+ new section3 #aidh4 ,/ate option to provide = mat]nal1 infant1 & e>ly *ildhood home visit+ programs 7a7 ,9 ,g5]al ,not)/&+ section #aijb7;a77#a7 7relat+ to /atewid5ess71 section #aijb7;a77#aj77;,b7 7relat+ to comp>ability71 & any o!r provision ( ?is title = :i* ! ,secret>y det]m9es x is necess>y to waive 9 ord] to implem5t ?is section1 beg9n+ on ,janu>y #a1 #bjah1 a ,/ate1 at its option z a ,/ate plan am5dm5t1 may provide = m$ical assi/ance "u ?is title to eligible families ?r\gh s]vices furni%$ "u e>ly *ildhood home visitation programs or p$iatric-bas$ s]vices t satisfy ! requirem5ts ( subsection 7b7 9 ord] to promote improvem5ts 9 mat]nal & pr5atal heal?1 infant heal?1 *ild heal? & developm5t1 p>5t+ relat$ to *ild developm5t outcomes1 s*ool read9ess1 & ! socioeconomic /atus ( su* families1 & r$uctions 9 *ild abuse1 neglect1 & injuries4 7b7 ,program requirem5ts ,! requirem5ts ( ?is subsection = an e>ly *ildhood home visitation program conduct$ pursuant to ?is section are z foll[s3 7#a7 ,quantifiable1 measurable improvem5t 9 b5*m>k areas 7,a7 ,9 g5]al ,! e>ly *ildhood home visitation program e/abli%es1 subject to ! approval ( ! ,/ate1 quantifiable1 measurable #c- & #e-ye> b5*m>ks = demon/rat+ t ! program results 9 improvem5ts = ! eligible families p>ticipat+ 9 ! program 9 ea* ( ! foll[+ areas3 7i7 ,improv$ mat]nal & newborn heal?4 7ii7 ,prev5tion ( *ild injuries1 *ild abuse1 neglect1 or maltreatm5t1 & r$uction ( em]g5cy dep>tm5t visits4 7iii7 ,improvem5t 9 s*ool read9ess & a*ievem5t4 7iv7 ,r$uction 9 crime or dome/ic viol5ce4 7v7 ,improvem5ts 9 family economic self-suffici5cy4 7vi7 ,improvem5ts 9 ! coord9ation & ref]rals = o!r community res\rces & supports4 7,b7 ,demon/ration ( improvem5ts aft] #c ye>s 7i7 ,report to ! secret>y ,n lat] ?an #cj days aft] ! end ( ! #crd ye> 9 :i* ! ,/ate conducts ! program1 ! ,/ate submits to ! ,secret>y a report demon/rat+ improvem5t 9 at lea/ #d ( ! areas specifi$ 9 subp>agraph 7,a74 7ii7 ,te*nical assi/ance 7,i7 ,9 g5]al ,! ,secret>y %all provide a ,/ate requir$ to develop & implem5t an improvem5t plan "u clause 7ii7 ) te*nical assi/ance to develop & implem5t ! plan4 ,! ,secret>y may provide ! te*nical assi/ance directly or ?r\gh grants1 contracts1 or coop]ative agreem5ts4 7,,ii7 ,advisory panel ,! ,secret>y %all e/abli% an advisory panel = purposes ( obta9+ recomm5dations reg>d+ ! te*nical assi/ance provid$ to ,/ates 9 accordance ) subclause 7,i74 7iii7 ,no improvem5t or failure to submit report ,if ! ,secret>y det]m9es aft] a p]iod ( "t specifi$ by ! ,secret>y t a ,/ate has fail$ to demon/rate any improvem5t 9 ! areas specifi$ 9 subp>agraph 7,a71 or if ! ,secret>y det]m9es t a ,/ate has fail$ to submit ! report requir$ "u clause 7i71 ! ,secret>y %all )draw approval ( ! ,/ate plan am5dm5t involv$4 7,c7 ,f9al report ,n lat] ?an ,decemb] #ca1 #bjbb1 ! ,/ate %all submit a report to ! ,secret>y demon/rat+ improvem5ts 7if any7 9 ea* ( ! areas specifi$ 9 subp>agraph 7,a74 7#b7 ,improvem5ts 9 outcomes = individual families 7,a7 ,9 g5]al ,! program is design$1 ) respect to an eligible family p>ticipat+ 9 ! program1 to result 9 ! p>ticipant outcomes describ$ 9 subp>agraph 7,b7 t ! ,/ate id5tifies on ! basis ( an individualiz$ assessm5t ( ! family1 are relevant = t family4 7,b7 ,p>ticipant outcomes ,! p>ticipant outcomes describ$ 9 ?is subp>agraph are ! foll[+3 7i7 ,improvem5ts 9 pr5atal1 mat]nal1 & newborn heal?1 includ+ improv$ pregnancy outcomes4 7ii7 ,improvem5ts 9 *ild heal? & developm5t1 includ+ ! prev5tion ( *ild injuries & maltreatm5t & improvem5ts 9 cognitive1 language1 social-emotional1 & physical developm5tal indicators4 7iii7 ,improvem5ts 9 p>5t+ skills4 7iv7 ,improvem5ts 9 s*ool read9ess & *ild academic a*ievem5t4 7v7 ,r$uctions 9 crime or dome/ic viol5ce4 7vi7 ,improvem5ts 9 family economic self-suffici5cy4 7vii7 ,improvem5ts 9 ! coord9ation ( ref]rals =1 & ! provision (1 o!r community res\rces & supports = eligible families1 consi/5t ) ,/ate *ild welf>e ag5cy tra9+4 7#c7 ,core compon5ts ,! program includes ! foll[+ core compon5ts3 7,a7 ,s]vice deliv]y model or models 7i7 ,9 g5]al ,subject to clause 7ii71 ! program is conduct$ us+ "o or m ( ! s]vice deliv]y models describ$ 9 item 7aa7 or 7bb7 ( subclause 7,i7 or 9 subclause 7,,ii7 select$ by ! ,/ate3 7,i7 ,! model con=ms to a cle> consi/5t home visitation model t has be5 9 exi/5ce = at lea/ #c ye>s & is rese>*-bas$1 gr\nd$ 9 relevant empirically-bas$ k1 l9k$ to program det]m9$ outcomes1 associat$ ) a national organization or in/itution ( high] education t has compreh5sive home visitation program /&>ds t ensure high quality s]vice deliv]y & cont9u\s program quality improvem5t1 & has demon/rat$ significant 7& 9 ! case ( ! s]vice deliv]y model describ$ 9 item 7aa71 su/a9$7 positive outcomes1 z describ$ 9 ! b5*m>k areas specifi$ 9 p>agraph 7#a77;,a7 & ! p>ticipant outcomes describ$ 9 p>agraph 7#b77;,b71 :5 evaluat$ us+ well-design$ & rigor\s-- 7aa7 r&omiz$ controll$ rese>* designs1 & ! evaluation results h be5 publi%$ 9 a pe]-review$ j\rnal2 or 7bb7 quasi-exp]im5tal rese>* designs4 7,,ii7 ,! model con=ms to a promis+ & new approa* to a*iev+ ! b5*m>k areas specifi$ 9 p>agraph 7#a77;,a7 & ! p>ticipant outcomes describ$ 9 p>agraph 7#b77;,b71 has be5 develop$ or id5tifi$ by a national organization or in/itution ( high] education1 & w be evaluat$ ?r\gh well-design$ & rigor\s process4 7ii7 ,majority ( grant funds us$ = evid5ce-bas$ models ,a ,/ate may n use m ?an #be p]c5t ( ! am\nts paid to ! ,/ate = a fiscal ye> "u section #aijc7;a7 = purposes ( conduct+ a program describ$ 9 subsection 7a7 us+ ! s]vice deliv]y model describ$ 9 clause 7i77,,ii74 7iii7 ,crit]ia = evid5ce ( effectiv5ess ( models ,! ,secret>y %all e/abli% crit]ia = evid5ce ( effectiv5ess ( ! s]vice deliv]y models & %all ensure t ! process = e/abli%+ ! crit]ia is transp>5t & provides ! opportunity = public comm5t4 7,b7 ,additional requirem5ts 7i7 ,! program adh]es to a cle>1 consi/5t model t satisfies ! requirem5ts ( be+ gr\nd$ 9 empirically-bas$ k relat$ to home visit+ & l9k$ to ! b5*m>k areas specifi$ 9 p>agraph 7#a77;,a7 & ! p>ticipant outcomes describ$ 9 p>agraph 7#b77;,b7 relat$ to ! purposes ( ! program4 7ii7 ,! program employs well-tra9$ & compet5t /aff1 z demon/rat$ by education or tra9+1 su* z nurses1 social work]s1 educators1 *ild developm5t speciali/s1 or o!r well-tra9$ & compet5t /aff1 & provides ongo+ & specific tra9+ on ! model be+ deliv]$4 7iii7 ,! program ma9ta9s high quality sup]vision to e/abli% home visitor compet5cies4 7iv7 ,! program demon/rates /rong organizational capacity to implem5t ! activities involv$4 7v7 ,! program e/abli%es appropriate l9kages & ref]ral networks to o!r community res\rces & supports = eligible families4 7vi7 ,! program monitors ! fidelity ( program implem5tation to ensure t s]vices are deliv]$ pursuant to ! specifi$ model4 7#d7 ,priority = s]v+ high-risk populations ,! ,/ate gives priority to provid+ s]vices "u ! program to ! foll[+3 7,a7 ,eligible families :o reside 9 communities 9 ne$ ( su* s]vices1 z id5tifi$ 9 ! /atewide ne$s assessm5t requir$ "u subsection 7d77#a77;,a74 7,b7 ,l[-income eligible families4 7,c7 ,eligible families :o are pregnant wom5 :o h n atta9$ age #ba4 7,d7 ,eligible families t h a hi/ory ( *ild abuse or neglect or h _h int]actions ) *ild welf>e s]vices4 7,e7 ,eligible families t h a hi/ory ( sub/ance abuse or ne$ sub/ance abuse treatm5t4 7,f7 ,eligible families t h us]s ( tobacco products 9 ! home4 7,g7 ,eligible families t are or h *ildr5 ) l[ /ud5t a*ievem5t4 7,h7 ,eligible families ) *ildr5 ) developm5tal delays or disabilities4 7,i7 ,eligible families :o1 or t include individuals :o1 are s]v+ or =m]ly s]v$ 9 ! ,arm$ ,=ces1 includ+ su* families t h memb]s ( ! ,arm$ ,=ces :o h _h multiple deploym5ts outside ( ! ,unit$ ,/ates4 7c7 ,/ate plan am5dm5t requirem5ts ,a ,/ate seek+ ! approval ( a ,/ate plan am5dm5t "u ?is section %all submit ! am5dm5t to ! ,secret>y = approval1 9 su* mann] z ! ,secret>y may require4 ,! ,/ate plan am5dm5t %all include ! foll[+3 7#a7 ,a description ( ! populations to be s]v$ by ! e>ly *ildhood home visitation program involv$1 includ+ specific in=mation reg>d+ h[ ! program w s]ve high risk populations describ$ 9 subsection 7b77#d74 7#b7 ,an assurance t ! ,/ate1 9 c>ry+ out ! program1 w give priority to s]v+ l[-income eligible families & eligible families :o reside 9 at-risk communities id5tifi$ 9 ! /atewide ne$s assessm5t requir$ "u subsection 7d77#a77;,a74 7#c7 ,! s]vice deliv]y model or models describ$ 9 subsection 7b77#c77;,a7 t ! ,/ate w use "u ! program & ! basis = ! selection ( ! model or models4 7#d7 ,a /atem5t id5tify+ h[ ! selection ( ! populations to be s]v$ & ! s]vice deliv]y model or models t ! ,/ate w use "u ! program = su* populations is consi/5t ) ! results ( ! /atewide ne$s assessm5t conduct$ "u subsection 7d74 7#e7 ,! quantifiable1 measurable b5*m>ks e/abli%$ by ! ,/ate to demon/rate t ! program contributes to improvem5ts 9 ! areas specifi$ 9 subsection 7b77#a77;,a74 7#f7 ,an assurance t ! ,/ate w obta9 & submit docum5tation or o!r appropriate evid5ce f ! organization or entity t develop$ ! s]vice deliv]y model or models us$ "u ! program to v]ify t ! program is implem5t$ & s]vices are deliv]$ accord+ to ! model specifications4 7#g7 ,assurances t ! ,/ate w e/abli% proc$ures to ensure t-- 7,a7 ! p>ticipation ( ea* eligible family 9 ! program is volunt>y2 & 7,b7 s]vices are provid$ to an eligible family 9 accordance ) ! individual assessm5t = t family4 7#h7 ,assurances t ! ,/ate w-- 7,a7 submit annual reports to ! ,secret>y reg>d+ ! program & activities c>ri$ out "u ! program t include su* in=mation & data z ! ,secret>y %all require2 & 7,b7 p>ticipate 91 & coop]ate )1 data & in=mation collection necess>y = ! evaluation requir$ "u subsection 7f77#b7 & o!r rese>* & evaluation activities c>ri$ out "u subsection 7h77#c74 7#i7 ,a description ( o!r ,/ate programs t include home visitation s]vices1 includ+1 if applicable to ! ,/ate1 programs c>ri$ out "u title ,v ) funds made available f allotm5ts "u section #ejb7;c71 programs fund$ "u title ,,iv1 title ,,ii ( ! ,*ild ,abuse ,prev5tion & ,treatm5t ,act 7relat+ to community-bas$ grants = ! prev5tion ( *ild abuse & neglect71 & section #fde;,a ( ! ,head ,/>t ,act 7relat+ to ,e>ly ,head ,/>t programs74 7#aj7 ,o!r in=mation z requir$ by ! ,secret>y4 7d7 ,requirem5t = ,all ,/ates ,to ,assess ,/atewide ,ne$s & ,id5tify ,at-,risk ,communities 7#a7 ,9 g5]al ,n lat] ?an #f mon?s aft] ! date ( ! enactm5t ( ?is section1 ea* ,/ate %all conduct a /atewide ne$s assessm5t 7:i* %all be sep>ate f ! /atewide ne$s assessm5t requir$ "u section #eje7;a77 t id5tifies-- 7,a7 communities ) conc5trations (-- 7i7 premature bir?1 l[-bir? weight infants1 & infant mortality1 includ+ infant dea? due to neglect1 or o!r indicators ( at-risk pr5atal1 mat]nal1 newborn1 or *ild heal?2 7ii7 pov]ty2 7iii7 crime2 7iv7 dome/ic viol5ce2 7v7 high rates ( high-s*ool drop-outs2 7vi7 sub/ance abuse2 7vii7 unemploym5t2 or 7viii7 *ild maltreatm5t2 7,b7 ! quality & capacity ( exi/+ programs or initiatives = e>ly *ildhood home visitation 9 ! ,/ate includ+-- 7i7 ! numb] & types ( individuals & families :o are receiv+ s]vices "u su* programs or initiatives2 7ii7 ! gaps 9 e>ly *ildhood home visitation 9 ! ,/ate2 & 7iii7 ! ext5t to :i* su* programs or initiatives are meet+ ! ne$s ( eligible families describ$ 9 subsection 7k77#b72 & 7,c7 ! ,/ate's capacity = provid+ sub/ance abuse treatm5t & c\nsel+ s]vices to individuals & families 9 ne$ ( su* treatm5t or s]vices4 7#b7 ,coord9ation ) o!r assessm5ts ,9 conduct+ ! /atewide ne$s assessm5t requir$ "u p>agraph 7#a71 ! ,/ate %all coord9ate )1 & take into acc\nt1 o!r appropriate ne$s assessm5ts conduct$ by ! ,/ate1 z det]m9$ by ! ,secret>y1 includ+ ! ne$s assessm5t requir$ "u section #eje7;a7 7bo? ! mo/ rec5tly complet$ assessm5t & any su* assessm5t 9 progress71 ! communitywide /rategic plann+ & ne$s assessm5ts conduct$ 9 accordance ) section #fdj7;g77#a77;,c7 ( ! ,head ,/>t ,act1 & ! inv5tory ( curr5t unmet ne$s & curr5t community-bas$ & prev5tion-focus$ programs & activities to prev5t *ild abuse & neglect1 & o!r family res\rce s]vices op]at+ 9 ! ,/ate requir$ "u section #bje7c7 ( ! ,*ild ,abuse ,prev5tion & ,treatm5t ,act4 7#c7 ,submission to ! secret>y ,ea* ,/ate %all submit to ! ,secret>y1 9 su* =m & mann] z ! ,secret>y %all require-- 7,a7 ! results ( ! /atewide ne$s assessm5t requir$ "u p>agraph 7#a72 & 7,b7 a description ( h[ ! ,/ate int5ds to address ne$s id5tifi$ by ! assessm5t1 p>ticul>ly ) respect to communities id5tifi$ "u p>agraph 7#a77;,a71 :i* may include submitt+ a ,/ate plan am5dm5t ) respect to an e>ly *ildhood home visitation program 9 accordance ) ! requirem5ts ( ?is section4 7e7 ,paym5ts 7#a7 ,9 g5]al ,exp5ditures made ) respect to provid+ s]vices describ$ 9 subsection 7a7 %all be treat$ z m$ical assi/ance = purposes ( section #aijc7;a74 7#b7 ,ma9t5ance ( ef=t ,am\nts receiv$ by a ,/ate "u section #aijc7;a7 = exp5ditures ) respect to provid+ ! s]vices describ$ 9 subsection 7a7 %all supplem5t1 & n supplant1 funds f o!r s\rces = e>ly *ildhood home visitation programs or initiatives4 7f7 ,evaluation 7#a7 ,indep5d5t1 exp]t advisory panel ,! ,secret>y1 9 accordance ) subsection 7g77#a77;,a71 %all appo9t an indep5d5t advisory panel consi/+ ( exp]ts 9 program evaluation & rese>*1 education1 & e>ly *ildhood developm5t-- 7,a7 to review1 & make recomm5dations on1 ! design & plan = ! evaluation requir$ "u p>agraph 7#b7 )9 #a ye> aft] ! date ( enactm5t ( ?is section2 7,b7 to ma9ta9 & advise ! ,secret>y reg>d+ ! progress ( ! evaluation2 & 7,c7 to comm5t1 if ! panel s desires1 on ! report submitt$ "u p>agraph 7#c74 7#b7 ,au?ority to conduct evaluation ,on ! basis ( ! recomm5dations ( ! advisory panel "u p>agraph 7#a71 ! ,secret>y %all1 by grant1 contract1 or int]ag5cy agreem5t1 conduct an evaluation ( ! /atewide ne$s assessm5ts submitt$ "u subsection 7d7 & ! grants made "u subsection 7h74 ,! evaluation %all include-- 7,a7 an analysis1 on a ,/ate-by-,/ate basis1 ( ! results ( su* assessm5ts1 includ+ indicators ( mat]nal & pr5atal heal? & infant heal? & mortality1 & ,/ate actions 9 response to ! assessm5ts2 & 7,b7 an assessm5t (-- 7i7 ! effect ( e>ly *ildhood home visitation programs on *ild & p>5t outcomes1 includ+ ) respect to ea* ( ! b5*m>k areas specifi$ 9 subsection 7b77#a77;,a7 & ! p>ticipant outcomes describ$ 9 subsection 7b77#b77;,b72 7ii7 ! effectiv5ess ( su* programs on diff]5t populations1 includ+ ! ext5t to :i* ! ability ( programs to improve p>ticipant outcomes v>ies across programs & populations2 & 7iii7 ! pot5tial = ! activities conduct$ "u su* programs1 if scal$ broadly1 to improve heal? c>e practices1 elim9ate heal? disp>ities1 & improve heal? c>e sy/em quality1 effici5cies1 & r$uce co/s4 7#c7 ,report ,n lat] ?an ,m>* #ca1 #bjbj1 ! ,secret>y %all submit a report to ,congress on ! results ( ! evaluation conduct$ "u p>agraph 7#b7 & %all make ! report publicly available4 7g7 ,intra-,ag5cy collaboration ,! ,secret>y %all ensure t ! ,mat]nal & ,*ild ,heal? ,bureau & ! ,adm9i/ration = ,*ildr5 & ,families collaborate ) respect to c>ry+ out ?is section1 includ+ ) respect to-- 7#a7 review+ & analyz+ ! /atewide ne$s assessm5ts requir$ "u subsection 7d71 ! aw>d+ & ov]sight ( grants aw>d$ "u ?is section1 ! e/abli%m5t ( ! advisory panels requir$ "u subsections 7b77#a77;,b77iii77,,ii7 & 7f77#a71 & ! evaluation & report requir$ "u subsection 7f72 & 7#b7 consult+ ) o!r ,f$]al ag5cies ) responsibility = adm9i/]+ or evaluat+ programs t s]ve eligible families to coord9ate & collaborate ) respect to rese>* relat$ to su* programs & families1 includ+ ! ,(fice ( ! ,assi/ant ,secret>y = ,plann+ & ,evaluation ( ! ,dep>tm5t ( ,heal? & ,human ,s]vices1 ! ,c5t]s = ,disease ,control & ,prev5tion1 ! ,national ,in/itute ( ,*ild ,heal? & ,human ,developm5t ( ! ,national ,in/itutes ( ,heal?1 ! ,(fice ( ,juv5ile ,ju/ice & ,del9qu5cy ,prev5tion ( ! ,dep>tm5t ( ,ju/ice1 & ! ,in/itute ( ,education ,sci5ces ( ! ,dep>tm5t ( ,education4 7h7 ,rese>* & o!r evaluation activities 7#a7 ,9 g5]al ,! ,secret>y %all c>ry out a cont9u\s program ( rese>* & evaluation activities 9 ord] to increase k ab\t ! implem5tation & effectiv5ess ( home visit+ programs1 us+ r&om assignm5t designs to ! maximum ext5t feasible4 ,! ,secret>y may c>ry out su* activities directly1 or ?r\gh grants1 coop]ative agreem5ts1 or contracts4 7#b7 ,requirem5ts ,! ,secret>y %all ensure t-- 7,a7 evaluation ( a specific program or project is conduct$ by p]sons or individuals n directly involv$ 9 ! op]ation ( su* program or project2 & 7,b7 ! conduct ( rese>* & evaluation activities includes consultation ) indep5d5t rese>*]s1 ,/ate (ficials1 & develop]s & provid]s ( home visit+ programs on topics includ+ rese>* design & adm9i/rative data mat*+4 7#c7 ,report & recomm5dation ,n lat] ?an ,decemb] #ca1 #bjbj1 ! ,secret>y %all submit a report to ,congress reg>d+ ! programs conduct$ ) grants "u ?is section4 ,! report requir$ "u ?is p>agraph %all include-- 7,a7 in=mation reg>d+ ! ext5t to :i* ,/ates ) a ,/ate plan am5dm5t approv$ "u ?is section demon/rat$ improvem5ts 9 ea* ( ! areas specifi$ 9 subsection 7b77#a77;,a72 7,b7 in=mation reg>d+ any te*nical assi/ance provid$ "u subsection 7b77#a77;,b77iii77,i71 includ+ ! type ( any su* assi/ance provid$2 & 7,c7 recomm5dations = su* legislative or adm9i/rative action z ! ,secret>y det]m9es appropriate4 7i7 ,eligible family def9$ ,! t]m eligible family means-- 7#a7 a woman :o is pregnant1 & ! fa!r ( ! *ild if ! fa!r is available2 or 7#b7 a p>5t or prim>y c>egiv] ( a *ild1 includ+ gr&p>5ts or o!r relatives ( ! *ild1 & fo/] p>5ts1 :o are s]v+ z ! *ild's prim>y c>egiv] f bir? to k9d]g>t5 entry1 & includ+ a noncu/odial p>5t :o has an ongo+ relation%ip )1 & at times provides physical c>e =1 ! *ild4 4