ࡱ> CEB'` `bjbj{P{P 4"::` *2!*#*#*#*#*#*#*$+h<.G*G*\*u u u "!*u !*u u %!( P&=&!*r*0*&.j.4!(!(.(l>,u $!G*G*_ *$@D@ Summary -- New Federal Funding for Home Visiting The Patient Protection and Affordable Care Act (PPACA), enacted 3/23/10, establishes Maternal, Infant, and Early Childhood Home Visiting Programs as a new Section 511 of Title V of the Social Security Act of 1935 as amended. Funding: PPACA authorizes five years of funding: FY 2010-$100M; FY 2011-$250M; FY 2012- $350M; FY 2013-$400M; FY 2014-$400M. If administered as formula grant based on MCH Block Grant formula, Marylands share might be as much as 1.6%, or $1.5M in FY 2010 and $6M by FY 2014. However, PPACA language unclear whether this will be a formula grant to states based on percent of children in poverty, or a competitive grant program. Federal Leadership: PPACA specifies that two federal agencies collaborate on administering the new program Health Resources and Services Administration (HRSA) and the Administration for Children and Families (ACY)but does not specify a lead agency. A lead federal agency has not yet been designated, although a new Home Visiting National Director, Audrey Yowell (from HRSA/MCHB) has been named. Advocacy: Various national advocacy organizations are urging leadership for designation of one of these agencies in preference to the other; they are also urging that Governors, rather than federal agency, select designate which state agency will administer the federal funding. Both HRSA and ACF currently administer parts of the Title V program and both agencies have supported evidence-based or evidence-supported home-visitation models, including funding of research that has provided the evidence. HRSA is aligned with the Nurse-Family Partnership model (rigorously evaluated), while ACF is aligned with the Healthy Families America model (evidence-supported with rigorous evaluation in process). Federal Requirements: PPACA requires a separate needs assessment that must be completed by the Title V MCH program and submitted no later than 6 months after enactment (9/23/10) as a condition of award for receiving Title V (Sections 502-509) MCH Block Grant funding. The needs assessment must be separate from but include content from the most current MCH Block Grant 5-Year Needs Assessment (in process, due on 7/15/10) Needs Assessment: The needs assessment must identify communities with concentrations of : prematurity, low birthweight births, and infant mortality; poverty; crime; domestic violence; high rates of high-school drop-outs; substance abuse; unemployment, and child maltreatment. The needs assessment must specifically contain information from needs assessments required under the Head Start Act and the Child Abuse and Prevention Treatment Act. It must also address the quality, capacity and gaps in existing home visitation programs. Evidence-Based Programs: PPACA specifies that least 75% of funding in grants to states must be allocated for evidence-based home visitation programs, which defined in detail in PPACA; no more than 25% of funding can be used for models that are not evidence-based but conform to a promising and new approach that has been developed by a national or institution of high learning and that will be evaluation thru a well-designed and rigorous process. Existing Programs: Maryland is currently home to several home-visiting models that are (or claim to be) evidence-based, evidence-supported, are currently being evaluated and/or are promising new model as with national organization or academic ties. 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