42 U.S.C. § 711 — Maternal, infant, and early childhood home

Page 2449 TITLE 42—THE PUBLIC HEALTH AND WELFARE § 711 2010—Subsec. (a). Pub. L. 111–148, § 2954(1), substituted ‘‘each of fiscal years 2010 through 2014’’ for ‘‘fiscal year 1998 and each subsequent fiscal year’’. Subsec. (d). Pub. L. 111–148, § 2954(2), substituted ‘‘2010 through 2014’’ for ‘‘1998 through 2003’’ in first sentence and inserted ‘‘(except that such appropriation shall be made on March 23, 2010, in the case of fiscal year 2010)’’ before period at end of second sentence. 2003—Subsec. (d). Pub. L. 108–40 substituted ‘‘2003’’ for ‘‘2002’’. Statutory Notes and Related Subsidiaries EFFECTIVE DATE OF 2018 AMENDMENT Pub. L. 115–123, div. E, title V, § 50502(b), Feb. 9, 2018, 132 Stat. 227, provided that: ‘‘The amendment made by this section [amending this section] shall take effect as if enacted on October 1, 2017.’’ EFFECTIVE DATE OF 2003 AMENDMENT Amendment by Pub. L. 108–40 effective July 1, 2003, see section 8 of Pub. L. 108–40, set out as a note under section 603 of this title. ESTABLISHING NATIONAL GOALS TO PREVENT TEENAGE PREGNANCIES Pub. L. 104–193, title IX, § 905, Aug. 22, 1996, 110 Stat. 2349, provided that: ‘‘(a) IN GENERAL.—Not later than January 1, 1997, the Secretary of Health and Human Services shall establish and implement a strategy for— ‘‘(1) preventing out-of-wedlock teenage pregnancies, and ‘‘(2) assuring that at least 25 percent of the commu- nities in the United States have teenage pregnancy prevention programs in place. ‘‘(b) REPORT.—Not later than June 30, 1998, and annu- ally thereafter, the Secretary shall report to the Con- gress with respect to the progress that has been made in meeting the goals described in paragraphs (1) and (2) of subsection (a).’’ § 711. Maternal, infant, and early childhood home visiting programs (a) Purposes The purposes of this section are— (1) to strengthen and improve the programs and activities carried out under this sub- chapter; (2) to improve coordination of services for at risk communities; and (3) to identify and provide comprehensive services to improve outcomes for families who reside in at risk communities. (b) Requirement for all States to assess statewide needs and identify at risk communities (1) In general Each State shall, as a condition of receiving payments from an allotment for the State under section 702 of this title, conduct a state- wide needs assessment (which may be separate from but in coordination with the statewide needs assessment required under section 705(a) of this title and which shall be reviewed and updated by the State not later than October 1, 2020) that identifies— (A) communities with concentrations of— (i) premature birth, low-birth weight in- fants, and infant mortality, including in- fant death due to neglect, or other indica- tors of at-risk prenatal, maternal, new- born, or child health; (ii) poverty; (iii) crime; (iv) domestic violence; (v) high rates of high-school drop-outs; (vi) substance abuse; (vii) unemployment; or (viii) child maltreatment; (B) the quality and capacity of existing programs or initiatives for early childhood home visitation in the State including— (i) the number and types of individuals and families who are receiving services under such programs or initiatives; (ii) the gaps in early childhood home vis- itation in the State; and (iii) the extent to which such programs or initiatives are meeting the needs of eli- gible families described in subsection (l)(2); and (C) the State’s capacity for providing sub- stance abuse treatment and counseling serv- ices to individuals and families in need of such treatment or services. (2) Coordination with other assessments In conducting the statewide needs assess- ment required under paragraph (1), the State shall coordinate with, and take into account, other appropriate needs assessments con- ducted by the State, as determined by the Sec- retary, including the needs assessment re- quired under section 705(a) of this title (both the most recently completed assessment and any such assessment in progress), the com- munitywide strategic planning and needs as- sessments conducted in accordance with sec- tion 9835(g)(1)(C) of this title, and the inven- tory of current unmet needs and current com- munity-based and prevention-focused pro- grams and activities to prevent child abuse and neglect, and other family resource serv- ices operating in the State required under sec- tion 205(3) of the Child Abuse Prevention and Treatment Act [42 U.S.C. 5116d(3)]. (3) Submission to the Secretary Each State shall submit to the Secretary, in such form and manner as the Secretary shall require— (A) the results of the statewide needs as- sessment required under paragraph (1); and (B) a description of how the State intends to address needs identified by the assess- ment, particularly with respect to commu- nities identified under paragraph (1)(A), which may include applying for a grant to conduct an early childhood home visitation program in accordance with the require- ments of this section. (c) Grants for early childhood home visitation programs (1) Authority to make grants In addition to any other payments made under this subchapter to a State, the Sec- retary shall make grants to eligible entities to enable the entities to deliver services under early childhood home visitation programs that satisfy the requirements of subsection (d) to eligible families in order to promote improve- ments in maternal and prenatal health, infant health, child health and development, par- Page 2450 TITLE 42—THE PUBLIC HEALTH AND WELFARE § 711 enting related to child development outcomes, school readiness, and the socioeconomic status of such families, and reductions in child abuse, neglect, and injuries. (2) Authority to use initial grant funds for planning or implementation An eligible entity that receives a grant under paragraph (1) may use a portion of the funds made available to the entity during the first 6 months of the period for which the grant is made for planning or implementation activities to assist with the establishment of early childhood home visitation programs that satisfy the requirements of subsection (d). (3) Authority to use grant for a pay for out- comes initiative An eligible entity to which a grant is made under paragraph (1) may use up to 25 percent of the grant for outcomes or success payments related to a pay for outcomes initiative that will not result in a reduction of funding for services delivered by the entity under a child- hood home visitation program under this sec- tion while the eligible entity develops or oper- ates such an initiative. (4) Grant amounts (A) Base grants (i) In general (I) General rule With respect to each of fiscal years 2023 through 2027 for which an eligible entity not referred to in subsection (k)(2)(A) is awarded a base grant under this section, the amount of the grant payable to the eligible entity for the fis- cal year is the amount described by clause (ii) of this subparagraph with re- spect to the eligible entity, except as provided in subclause (II) of this clause. (II) Substitution of successor eligible en- tity for predecessor If the 1st fiscal year for which an eligi- ble entity is awarded a base grant under this section for a program operated in a State is among fiscal years 2024 through 2027, the amount described by clause (ii) with respect to the eligible entity is the amount of the base grant for which a program operated in the State was eligi- ble under this subparagraph for fiscal year 2023. (ii) Amount described (I) General rule Subject to the succeeding provisions of this clause, the amount described by this clause with respect to an eligible entity is— (aa) the amount made available under subsection (k) for base grants for fiscal year 2023 that remains after making the reservations required by subsection (k)(2) or any other reduc- tions required by Federal law for fiscal year 2023; multiplied by (bb) the percentage of children in all States who have not attained 5 years of age (as determined by the Secretary on the basis of the data most recently available before fiscal year 2023) that is represented by the number of such children in the State in which the eli- gible entity is operating a program pursuant to this section (as so deter- mined). (II) Adjustments to ensure stable funding If the amount otherwise payable to an eligible entity under subclause (I) for fis- cal year 2023 is less than 90 percent, or greater than 110 percent, of the amount payable under this section to the eligible entity for the program for fiscal year 2021, the Secretary shall increase the amount otherwise so payable to 90 per- cent, or decrease the amount otherwise so payable to 110 percent, as the case may be, of the amount otherwise so pay- able. (III) Adjustment to ensure all base grant funds are allocated If the amount described by subclause (I)(aa) is different than the total of the amounts otherwise described by sub- clause (I) after applying subclause (II), the Secretary shall increase or decrease the amounts otherwise so described after applying subclause (II) by such equal percentage as is necessary to reduce that difference to zero. (IV) Minimum base grant amount Notwithstanding the preceding provi- sions of this clause, the amount de- scribed by this clause with respect to an eligible entity shall be not less than $1,000,000. (B) Matching grants (i) Amount of grant (I) General rule With respect to each of fiscal years 2024 through 2027 for which an eligible entity not referred to in subsection (k)(2)(A) is awarded a grant under this section, the Secretary shall increase the amount of the grant payable to the eligi- ble entity for the fiscal year under sub- paragraph (A) of this paragraph by the matching amount (if any) determined under subclause (II) of this clause with respect to the eligible entity for the fis- cal year and the additional matching amount (if any) determined under clause (iii) of this subparagraph with respect to the eligible entity for the fiscal year. (II) Matching amount (aa) In general Subject to item (bb) of this sub- clause, the matching amount with re- spect to an eligible entity for a fiscal year is 75 percent of the sum of— (AA) the total amount obligated by the eligible entity for home visiting services in the State for the fiscal year, from Federal funds made avail- able for the fiscal year under this subparagraph; and Page 2451 TITLE 42—THE PUBLIC HEALTH AND WELFARE § 711 (BB) the total amount so obligated by the eligible entity from non-Fed- eral funds, determined under sub- clause (III). (bb) Limitation The matching amount with respect to an eligible entity for a fiscal year shall not exceed the allotment under subclause (IV) for the State in which the eligible entity is operating a pro- gram under this section for the fiscal year. (III) Determination of obligations from non-Federal funds For purposes of this clause, the total amount obligated by an eligible entity from non-Federal funds is the total of the amounts that are obligated by the el- igible entity from non-Federal sources, to the extent that— (aa) the services are delivered in compliance with subsections (d)(2) and (d)(3); (bb) the eligible entity has reported the obligations to the Secretary; and (cc) the amount is not counted to- ward meeting the maintenance of ef- fort requirement in subsection (f). (IV) State allotments The amount allotted under this sub- clause for a State in which an eligible entity is operating a program under this section for a fiscal year is— (aa) the minimum matching grant allocation amount for the fiscal year; plus (bb)(AA) the amount (if any) by which the amount made available under subsection (k) for matching grants for the fiscal year that remains after making the reservations required by subsection (k)(2) or any other reduc- tion required by Federal law for the fiscal year exceeds the sum of the min- imum matching grant allocation amounts for all eligible entities for the fiscal year; multiplied by (BB) the percentage of children in all States who have not attained 5 years of age and are members of families with income not exceeding the poverty line (as determined by the Secretary on the basis of the most recently avail- able data) that is represented by the number of such children in the State (as so determined). (V) Minimum matching grant allocation amount Subject to subclause (VI), for purposes of subclause (IV), the minimum match- ing grant allocation amount for a fiscal year is— (aa) in the case of fiscal year 2024, $776,000; (bb) in the case of fiscal year 2025, $1,000,000; (cc) in the case of fiscal year 2026, $1,500,000; and (dd) in the case of fiscal year 2027, $2,000,000. (VI) Special rule If, after making any reductions other- wise required by law for a fiscal year, the amount made available for matching grants under this clause for the fiscal year is insufficient to provide the min- imum matching grant allocation amount to each eligible entity operating a pro- gram under this section for the fiscal year, the Secretary may make a propor- tionate adjustment to the minimum matching grant allocation amount for the fiscal year to accommodate the re- ductions. (ii) Submission of statement expressing in- terest in additional matching funds if available Before the beginning of a fiscal year for which an eligible entity desires a match- ing grant under this subparagraph for a program operated under this section, the eligible entity shall submit to the Sec- retary a statement as to whether the eligi- ble entity desires additional matching grant funds that may be made available under clause (iii) for the fiscal year. (iii) Carryover and reallocation of unobli- gated funds (I) In general If the Secretary determines that an amount allotted under clause (i)(IV) of this subparagraph for a fiscal year will not be awarded during the fiscal year, or that an amount made available under subsection (k)(1) for a fiscal year for matching grants will not be obligated by an eligible entity for the fiscal year, the amount shall be available for matching grants under this subparagraph for the succeeding fiscal year for eligible enti- ties that have made submissions under clause (ii) of this subparagraph for addi- tional matching grant funds from the amount. (II) State allotments The Secretary shall allot to each eligi- ble entity that has made such a submis- sion for a fiscal year— (aa) the total amount (if any) made available under subclause (I) for the fiscal year; multiplied by (bb) the percentage of children who have not attained 5 years of age and are members of families with income not exceeding the poverty line (as de- termined by the Secretary on the basis of the most recently available data) in all of the States in which any eligible entity that has made such a submis- sion is so operating a program, that is represented by the number of such children in the State (as so deter- mined) in which the eligible entity is operating such a program. Page 2452 TITLE 42—THE PUBLIC HEALTH AND WELFARE § 711 (III) Additional matching amount (aa) In general Subject to item (bb) of this sub- clause, the additional matching amount with respect to an eligible en- tity for a fiscal year is 75 percent of the sum of— (AA) the total amount obligated by the eligible entity for home visiting services in the State for the fiscal year, from Federal funds made avail- able for the fiscal year under this subparagraph; and (BB) the total amount so obligated by the eligible entity from non-Fed- eral funds, determined under clause (i)(III), that are not taken into account in deter- mining the matching amount with re- spect to the eligible entity under clause (i). (bb) Limitation The additional matching amount with respect to an eligible entity for a fiscal year shall not exceed the allot- ment under subclause (II) for the State in which the eligible entity is oper- ating a program under this section for the fiscal year. (5) Technical assistance The Secretary shall provide an eligible enti- ty that receives a grant under paragraph (1) with technical assistance in administering programs or activities conducted in whole or in part with grant funds. (d) Requirements The requirements of this subsection for an early childhood home visitation program con- ducted with a grant made under this section are as follows: (1) Quantifiable, measurable improvement in benchmark areas related to individual fam- ily outcomes (A) In general The eligible entity establishes, subject to the approval of the Secretary, quantifiable, measurable 3- and 5-year benchmarks for demonstrating that the program results in improvements for the eligible families par- ticipating in the program in the following areas: (i) Improved maternal and newborn health. (ii) Prevention of child injuries, child abuse, neglect, or maltreatment, and re- duction of emergency department visits. (iii) Improvement in school readiness and achievement. (iv) Reduction in crime or domestic vio- lence. (v) Improvements in family economic self-sufficiency. (vi) Improvements in the coordination and referrals for other community re- sources and supports. (B) Outcomes dashboards The Secretary shall, directly or by grant or contract, establish and operate a website accessible to the public that includes an an- nually updated dashboard that— (i) provides easy-to-understand informa- tion on the outcomes achieved by each eli- gible entity with respect to each of the benchmarks described in subparagraph (A) of this paragraph that apply to the eligible entity, which shall be based on only the data elements or types of data collected before December 29, 2022, unless admin- istering agencies and the Secretary agree pursuant to subsection (h)(6) that addi- tional data is required; (ii) includes a template provided by the Secretary that will enable comparison among eligible entities not referred to in subsection (k)(2)(A) of— (I) a profile of each eligible entity showing outcome indicators and how the outcomes compare to benchmarks de- scribed in subclause (II); (II) information on the outcome indi- cators and requisite outcome levels es- tablished for each eligible entity; (III) information on each model em- ployed in the program operated by each eligible entity, and regarding each benchmark area described in subsection (d)(1)(A) in which the model used by the eligible entity is expected to affect par- ticipant outcomes; (IV) the most recently available infor- mation from the report required by sub- paragraph (E) of this paragraph; (V) an electronic link to the State needs assessment under subsection (b)(1); and (VI) information regarding any penalty imposed, or other corrective action taken, by the Secretary against a State for failing to achieve a requisite out- come level or any other requirement im- posed by or under this section, and an in- dication as to whether the eligible entity is operating under a corrective action plan under subparagraph (E)(ii) of this paragraph, and if so, a link to the plan, an explanation of the reason for the im- plementation of the plan, and a report on any progress made in operating under the plan; (iii) includes information relating to those eligible entities for which funding is reserved under subsection (k)(2)(A), with modifications as necessary to reflect tribal sovereignty, data privacy, and participant confidentiality; and (iv) protects data privacy and confiden- tiality of participant families. (C) Demonstration of improvements after 3 years (i) Report to the Secretary Not later than 30 days after the end of the 3rd year in which the eligible entity conducts the program, the entity submits to the Secretary a report demonstrating improvement in at least 4 of the areas specified in subparagraph (A). (ii) Corrective action plan If the report submitted by the eligible entity under clause (i) fails to demonstrate Page 2453 TITLE 42—THE PUBLIC HEALTH AND WELFARE § 711 1 So in original. Probably should be followed by a period. improvement in at least 4 of the areas specified in subparagraph (A), the entity shall develop and implement a plan to im- prove outcomes in each of the areas speci- fied in subparagraph (A), subject to ap- proval by the Secretary. The plan shall in- clude provisions for the Secretary to mon- itor implementation of the plan and con- duct continued oversight of the program, including through submission by the enti- ty of regular reports to the Secretary. (iii) Technical assistance (I) In general The Secretary shall provide an eligible entity required to develop and imple- ment an improvement plan under clause (ii) with technical assistance to develop and implement the plan. The Secretary may provide the technical assistance di- rectly or through grants, contracts, or cooperative agreements. (II) Advisory panel The Secretary shall establish an advi- sory panel for purposes of obtaining rec- ommendations regarding the technical assistance provided to entities in accord- ance with subclause (I). (iv) No improvement or failure to submit report If the Secretary determines after a pe- riod of time specified by the Secretary that an eligible entity implementing an improvement plan under clause (ii) has failed to demonstrate any improvement in the areas specified in subparagraph (A), or if the Secretary determines that an eligi- ble entity has failed to submit the report required under clause (i), the Secretary shall terminate the entity’s grant and may include any unexpended grant funds in grants made to nonprofit organizations under subsection (h)(2)(B). (D) Final report Not later than December 31, 2015, the eligi- ble entity shall submit a report to the Sec- retary demonstrating improvements (if any) in each of the areas specified in subpara- graph (A). (E) Demonstration of improvements in subse- quent years (i) Continued measurement of improve- ment in applicable benchmark areas The eligible entity, after demonstrating improvements for eligible families as spec- ified in subparagraphs (A) and (C), shall continue to track and report, not later than 30 days after the end of fiscal year 2020 and every 3 years thereafter, informa- tion demonstrating that the program re- sults in improvements for the eligible fam- ilies participating in the program in at least 4 of the areas specified in subpara- graph (A) that the service delivery model or models selected by the entity are in- tended to improve. (ii) Corrective action plan If the eligible entity fails to demonstrate improvement in at least 4 of the areas specified in subparagraph (A), as compared to eligible families who do not receive services under an early childhood home visitation program, the entity shall de- velop and implement a plan to improve outcomes in each of the areas specified in subparagraph (A) that the service delivery model or models selected by the entity are intended to improve, subject to approval by the Secretary. The plan shall include provisions for the Secretary to monitor implementation of the plan and conduct continued oversight of the program, in- cluding through submission by the entity of regular reports to the Secretary. (iii) Technical assistance The Secretary shall provide an eligible entity required to develop and implement an improvement plan under clause (ii) with technical assistance to develop and implement the plan. The Secretary may provide the technical assistance directly or through grants, contracts, or coopera- tive agreements. (iv) No improvement or failure to submit report If the Secretary determines after a pe- riod of time specified by the Secretary that an eligible entity implementing an improvement plan under clause (ii) has failed to demonstrate any improvement in at least 4 of the areas specified in subpara- graph (A), or if the Secretary determines that an eligible entity has failed to submit the report required by clause (i), the Sec- retary shall terminate the grant made to the entity under this section and may in- clude any unexpended grant funds in grants made to nonprofit organizations under subsection (h)(2)(B). (2) Improvements in outcomes for individual families (A) In general The program is designed, with respect to an eligible family participating in the pro- gram, to result in the participant outcomes described in subparagraph (B) that the eligi- ble entity identifies on the basis of an indi- vidualized assessment of the family, are rel- evant for that family. (B) Participant outcomes The participant outcomes described in this subparagraph are the following: (i) Improvements in prenatal, maternal, and newborn health, including improved pregnancy outcomes 1 (ii) Improvements in child health and de- velopment, including the prevention of child injuries and maltreatment and im- provements in cognitive, language, social- emotional, and physical developmental in- dicators. (iii) Improvements in parenting skills. (iv) Improvements in school readiness and child academic achievement. (v) Reductions in crime or domestic vio- lence. Page 2454 TITLE 42—THE PUBLIC HEALTH AND WELFARE § 711 2 So in original. The comma probably should not appear. (vi) Improvements in family economic self-sufficiency. (vii) Improvements in the coordination of referrals for, and the provision of, other community resources and supports for eli- gible families, consistent with State child welfare agency training. (3) Core components The program includes the following core components: (A) Service delivery model or models (i) In general Subject to clause (ii), the program is conducted using 1 or more of the service delivery models described in item (aa) or (bb) of subclause (I) or in subclause (II) se- lected by the eligible entity: (I) The model conforms to a clear con- sistent home visitation model that has been in existence for at least 3 years and is research-based, grounded in relevant empirically-based knowledge, linked to program determined outcomes, associ- ated with a national organization or in- stitution of higher education that has comprehensive home visitation program standards that ensure high quality serv- ice delivery and continuous program quality improvement, and has dem- onstrated significant,2 (and in the case of the service delivery model described in item (aa), sustained) positive outcomes, as described in the benchmark areas specified in paragraph (1)(A) and the par- ticipant outcomes described in para- graph (2)(B), when evaluated using well- designed and rigorous— (aa) randomized controlled research designs, and the evaluation results have been published in a peer-reviewed journal; or (bb) quasi-experimental research de- signs. (II) The model conforms to a promising and new approach to achieving the benchmark areas specified in paragraph (1)(A) and the participant outcomes de- scribed in paragraph (2)(B), has been de- veloped or identified by a national orga- nization or institution of higher edu- cation, and will be evaluated through well-designed and rigorous process. (ii) Majority of grant funds used for evi- dence-based models An eligible entity shall use not more than 25 percent of the amount of the grant paid to the entity for a fiscal year for pur- poses of conducting a program using the service delivery model described in clause (i)(II). (iii) Criteria for evidence of effectiveness of models The Secretary shall establish criteria for evidence of effectiveness of the service de- livery models and shall ensure that the process for establishing the criteria is transparent and provides the opportunity for public comment. (B) Use of grant to provide or support tar- geted, intensive home visiting services The program uses the grant to provide or support targeted, intensive home visiting services for the populations described in paragraph (5). (C) Additional requirements (i) The program adheres to a clear, con- sistent model that satisfies the require- ments of being grounded in empirically- based knowledge related to home visiting and linked to the benchmark areas specified in paragraph (1)(A) and the participant out- comes described in paragraph (2)(B) related to the purposes of the program. (ii) The program employs well-trained and competent staff, as demonstrated by edu- cation or training, such as nurses, social workers, educators, child development spe- cialists, or other well-trained and competent staff, and provides ongoing and specific training on the model being delivered. (iii) The program maintains high quality supervision to establish home visitor com- petencies. (iv) The program demonstrates strong or- ganizational capacity to implement the ac- tivities involved. (v) The program establishes appropriate linkages and referral networks to other com- munity resources and supports for eligible families. (vi) The program monitors the fidelity of program implementation to ensure that services are delivered pursuant to the speci- fied model. (vii) If the application submitted by the el- igible entity includes the assurance de- scribed in subsection (e)(10)(C) with respect to the program, the program provides in-per- son service consistent with the assurances. (4) Virtual home visits (A) In general A virtual home visit conducted under the program shall be considered a home visit for purposes of this section if the application for funding of the program submitted pursuant to this section most recently after the effec- tive date of this paragraph includes the ma- terial described in subsection (e)(10). (B) Standards for training applicable to vir- tual service delivery The standards for training requirements applicable to virtual service delivery under a home visiting model shall be equivalent to those that apply to in-person service deliv- ery under the model. (C) Reporting requirement A grant made under this section for the program may not be used for any virtual home visit during a year, unless the eligible entity to which the grant is made submits the report described in subsection (e)(8)(A) for the year. Page 2455 TITLE 42—THE PUBLIC HEALTH AND WELFARE § 711 (D) Virtual home visit defined In this section, the term ‘‘virtual home visit’’ means a visit conducted solely by use of electronic information and telecommuni- cations technologies. (E) Technical assistance If the Secretary finds that an eligible enti- ty has not complied with the assurance de- scribed in subsection (e)(10)(C), the Sec- retary shall, directly or through grants, con- tracts, or cooperative agreements, provide the eligible entity with such technical as- sistance as is necessary to assist the eligible entity in doing so. (5) Priority for serving high-risk populations The eligible entity gives priority to pro- viding services under the program to the fol- lowing: (A) Eligible families who reside in commu- nities in need of such services, as identified in the statewide needs assessment required under subsection (b)(1)(A), taking into ac- count the staffing, community resource, and other requirements to operate at least one approved model of home visiting and dem- onstrate improvements for eligible families. (B) Low-income eligible families. (C) Eligible families who are pregnant women who have not attained age 21. (D) Eligible families that have a history of child abuse or neglect or have had inter- actions with child welfare services. (E) Eligible families that have a history of substance abuse or need substance abuse treatment. (F) Eligible families that have users of to- bacco products in the home. (G) Eligible families that are or have chil- dren with low student achievement. (H) Eligible families with children with de- velopmental delays or disabilities. (I) Eligible families who, or that include individuals who, are serving or formerly served in the Armed Forces, including such families that have members of the Armed Forces who have had multiple deployments outside of the United States. (6) Limitation on use of funds for administra- tive costs (A) In general Except as provided in subparagraph (B) of this paragraph, an eligible entity to which funds are provided under subsection (c) or (h)(2)(B) shall not use more than 10 percent of the funds to cover the costs of administra- tion. (B) Authority to grant exceptions (i) In general The Secretary may authorize an eligible entity that meets a condition of clause (ii) of this subparagraph to exceed the per- centage limitation in subparagraph (A) with respect to a program conducted under this subsection by not more than 5 per- centage points, subject to such terms and conditions as the Secretary deems appro- priate. (ii) Conditions An eligible entity meets a condition of this clause if the eligible entity— (I) conducts the program by directly providing home visits to eligible families and without a sub-recipient; (II) in the fiscal year for which the grant for the program is made under this section, proposes to expand services in 1 or more communities identified in the statewide needs assessment under sub- section (b) and in which home visiting services are not provided; or (III) has conducted the program for fewer than 3 years. (e) Application requirements An eligible entity desiring a grant under this section shall submit an application to the Sec- retary for approval, in such manner as the Sec- retary may require, that includes the following: (1) A description of the populations to be served by the entity, including specific infor- mation regarding how the entity will serve high risk populations described in subsection (d)(4). (2) An assurance that the entity will give priority to serving low-income eligible fami- lies and eligible families who reside in at risk communities identified in the statewide needs assessment required under subsection (b)(1)(A). (3) The service delivery model or models de- scribed in subsection (d)(3)(A) that the entity will use under the program and the basis for the selection of the model or models. (4) A statement identifying how the selec- tion of the populations to be served and the service delivery model or models that the enti- ty will use under the program for such popu- lations is consistent with the results of the statewide needs assessment conducted under subsection (b). (5) The quantifiable, measurable benchmarks established by the State to demonstrate that the program contributes to improvements in the areas specified in subsection (d)(1)(A) that the service delivery model or models selected by the entity are intended to improve. (6) An assurance that the entity will obtain and submit documentation or other appro- priate evidence from the organization or enti- ty that developed the service delivery model or models used under the program to verify that the program is implemented and services are delivered according to the model specifica- tions. (7) Assurances that the entity will establish procedures to ensure that— (A) the participation of each eligible fam- ily in the program is voluntary; and (B) services are provided to an eligible family in accordance with the individual as- sessment for that family. (8) Assurances that the entity will— (A) submit annual reports to the Secretary regarding the program and activities carried out under the program that include such in- formation and data as the Secretary shall require, including the number of virtual home visits conducted under the program in Page 2456 TITLE 42—THE PUBLIC HEALTH AND WELFARE § 711 the year covered by the report, disaggregated with respect to each home vis- iting model under which the virtual home visits are conducted; and (B) participate in, and cooperate with, data and information collection necessary for the evaluation required under subsection (g)(2) and other research and evaluation ac- tivities carried out under subsection (h)(3). (9) A description of other State programs that include home visitation services, includ- ing, if applicable to the State, other programs carried out under this subchapter with funds made available from allotments under section 702(c) of this title, programs funded under sub- chapter IV, title II of the Child Abuse Preven- tion and Treatment Act [42 U.S.C. 5116 et seq.] (relating to community-based grants for the prevention of child abuse and neglect), and section 9840a of this title (relating to Early Head Start programs). (10) At the option of the eligible entity— (A) a description of any limitations or con- straints on virtual home visits under the program, including— (i) a description of the plan of the eligi- ble entity to encourage in-person home visits; and (ii) a description of the considerations to be used in determining when a virtual home visit is appropriate, including client consent, client preference, geographic lim- itations, model fidelity, and hazardous conditions including public health emer- gencies, weather events, health concerns for home visitors and client families, and other local issues; (B) an assurance that— (i) the virtual home visit is implemented as a model enhancement; or (ii) the Secretary has identified the home visit as part of an effective model or model adaptation, based on an evidence of effectiveness review conducted using the criteria established under subsection (d)(3)(A)(iii); and (C) an assurance to the Secretary that at least 1 in-person home visit shall be con- ducted for each client family under the pro- gram during the 12-month period that begins with the entry of the client family into the program, and during each succeeding 12- month period, except that any such period in which a public health emergency declared under Federal law, or under the law of the State in which the program is conducted, is in effect shall be extended by the length of time in which the declaration is in effect. (11) Other information as required by the Secretary. (f) Maintenance of effort (1) In general Notwithstanding any other provision of this section, the Secretary may not make a grant to an eligible entity under this section for a fiscal year if the total amount of non-Federal funds obligated by the eligible entity in the State in the fiscal year for a program operated pursuant to this section is less than the total amount of non-Federal funds reported to have been expended by any eligible entity for such a program in the State in fiscal year 2019 or 2021, whichever is the lesser. (2) Publication of amounts Not later than June 30, 2023, the Secretary shall cause to have published in the Federal Register the amount of non-Federal funds ex- pended as described in this section that has been reported by each eligible entity not re- ferred to in subsection (k)(2)(A) for each of fis- cal years 2019 and 2021. (3) Grace period The Secretary may, in exceptional cir- cumstances, allow an eligible entity a period to come into compliance with this subsection. The Secretary shall provide technical assist- ance to any eligible entity to assist the entity in doing so. (g) Evaluation (1) Independent, expert advisory panel The Secretary, in accordance with sub- section (h)(1)(A), shall appoint an independent advisory panel consisting of experts in pro- gram evaluation and research, education, and early childhood development— (A) to review, and make recommendations on, the design and plan for the evaluation re- quired under paragraph (2) within 1 year after March 23, 2010; (B) to maintain and advise the Secretary regarding the progress of the evaluation; and (C) to comment, if the panel so desires, on the report submitted under paragraph (3). (2) Authority to conduct evaluation On the basis of the recommendations of the advisory panel under paragraph (1), the Sec- retary shall, by grant, contract, or inter- agency agreement, conduct an evaluation of the statewide needs assessments submitted under subsection (b) and the grants made under subsections (c) and (h)(3)(B). The evalua- tion shall include— (A) an analysis, on a State-by-State basis, of the results of such assessments, including indicators of maternal and prenatal health and infant health and mortality, and State actions in response to the assessments; and (B) an assessment of— (i) the effect of early childhood home vis- itation programs on child and parent out- comes, including with respect to each of the benchmark areas specified in sub- section (d)(1)(A) and the participant out- comes described in subsection (d)(2)(B); (ii) the effectiveness of such programs on different populations, including the extent to which the ability of programs to im- prove participant outcomes varies across programs and populations; and (iii) the potential for the activities con- ducted under such programs, if scaled broadly, to improve health care practices, eliminate health disparities, and improve health care system quality, efficiencies, and reduce costs. (3) Report Not later than March 31, 2015, the Secretary shall submit a report to Congress on the re- Page 2457 TITLE 42—THE PUBLIC HEALTH AND WELFARE § 711 sults of the evaluation conducted under para- graph (2) and shall make the report publicly available. (h) Other provisions (1) Intra-agency collaboration The Secretary shall ensure that the Mater- nal and Child Health Bureau and the Adminis- tration for Children and Families collaborate with respect to carrying out this section, in- cluding with respect to— (A) reviewing and analyzing the statewide needs assessments required under subsection (b), the awarding and oversight of grants awarded under this section, the establish- ment of the advisory panels required under subsections (d)(1)(B)(iii)(II) and (g)(1), and the evaluation and report required under subsection (g); and (B) consulting with other Federal agencies with responsibility for administering or evaluating programs that serve eligible fam- ilies to coordinate and collaborate with re- spect to research related to such programs and families, including the Office of the As- sistant Secretary for Planning and Evalua- tion of the Department of Health and Human Services, the Centers for Disease Control and Prevention, the National Institute of Child Health and Human Development of the National Institutes of Health, the Office of Juvenile Justice and Delinquency Preven- tion of the Department of Justice, and the Institute of Education Sciences of the De- partment of Education. (2) Grants to eligible entities that are not States (A) Indian Tribes, Tribal Organizations, or Urban Indian Organizations The Secretary shall specify requirements for eligible entities that are Indian Tribes (or a consortium of Indian Tribes), Tribal Organizations, or Urban Indian Organiza- tions to apply for and conduct an early childhood home visitation program with a grant under this section. Such requirements shall, to the greatest extent practicable, be consistent with the requirements applicable to eligible entities that are States and shall require an Indian Tribe (or consortium), Tribal Organization, or Urban Indian Organi- zation to— (i) conduct a needs assessment similar to the assessment required for all States under subsection (b); and (ii) establish quantifiable, measurable 3- and 5-year benchmarks consistent with subsection (d)(1)(A). (B) Nonprofit organizations If, as of the beginning of fiscal year 2012, a State has not applied or been approved for a grant under this section, the Secretary may use amounts appropriated under paragraph (1) of subsection (k) that are available for expenditure under paragraph (3) of that sub- section to make a grant to an eligible entity that is a nonprofit organization described in subsection (l)(1)(B) to conduct an early childhood home visitation program in the State. The Secretary shall specify the re- quirements for such an organization to apply for and conduct the program which shall, to the greatest extent practicable, be con- sistent with the requirements applicable to eligible entities that are States and shall re- quire the organization to— (i) carry out the program based on the needs assessment conducted by the State under subsection (b); and (ii) establish quantifiable, measurable 3- and 5-year benchmarks consistent with subsection (d)(1)(A). (3) Research and other evaluation activities (A) In general The Secretary shall carry out a continuous program of research and evaluation activi- ties in order to increase knowledge about the implementation and effectiveness of home visiting programs, using random as- signment designs to the maximum extent feasible. The Secretary may carry out such activities directly, or through grants, coop- erative agreements, or contracts. (B) Requirements The Secretary shall ensure that— (i) evaluation of a specific program or project is conducted by persons or individ- uals not directly involved in the operation of such program or project; and (ii) the conduct of research and evalua- tion activities includes consultation with independent researchers, State officials, and developers and providers of home vis- iting programs on topics including re- search design and administrative data matching. (4) Report and recommendation Not later than December 31, 2015, the Sec- retary shall submit a report to Congress re- garding the programs conducted with grants under this section. The report required under this paragraph shall include— (A) information regarding the extent to which eligible entities receiving grants under this section demonstrated improve- ments in the areas specified in subsection (d)(1)(A); (B) information regarding any technical assistance provided under subsection (d)(1)(B)(iii)(I), including the type of any such assistance provided; and (C) recommendations for such legislative or administrative action as the Secretary determines appropriate. (5) Data exchange standards for improved interoperability (A) Designation and use of data exchange standards (i) Designation The head of the department or agency responsible for administering a program funded under this section shall, in con- sultation with an interagency work group established by the Office of Management and Budget and considering State govern- ment perspectives, designate data ex- Page 2458 TITLE 42—THE PUBLIC HEALTH AND WELFARE § 711 change standards for necessary categories of information that a State agency oper- ating the program is required to electroni- cally exchange with another State agency under applicable Federal law. (ii) Data exchange standards must be non- proprietary and interoperable The data exchange standards designated under clause (i) shall, to the extent prac- ticable, be nonproprietary and interoper- able. (iii) Other requirements In designating data exchange standards under this paragraph, the Secretary shall, to the extent practicable, incorporate— (I) interoperable standards developed and maintained by an international vol- untary consensus standards body, as de- fined by the Office of Management and Budget; (II) interoperable standards developed and maintained by intergovernmental partnerships, such as the National Infor- mation Exchange Model; and (III) interoperable standards developed and maintained by Federal entities with authority over contracting and financial assistance. (B) Data exchange standards for Federal re- porting (i) Designation The head of the department or agency responsible for administering a program referred to in this section shall, in con- sultation with an interagency work group established by the Office of Management and Budget, and considering State govern- ment perspectives, designate data ex- change standards to govern Federal report- ing and exchange requirements under ap- plicable Federal law. (ii) Requirements The data exchange reporting standards required by clause (i) shall, to the extent practicable— (I) incorporate a widely accepted, non- proprietary, searchable, computer-read- able format; (II) be consistent with and implement applicable accounting principles; (III) be implemented in a manner that is cost-effective and improves program efficiency and effectiveness; and (IV) be capable of being continually upgraded as necessary. (iii) Incorporation of nonproprietary stand- ards In designating data exchange standards under this paragraph, the Secretary shall, to the extent practicable, incorporate ex- isting nonproprietary standards, such as the eXtensible Mark up Language. (iv) Rule of construction Nothing in this paragraph shall be con- strued to require a change to existing data exchange standards for Federal reporting about a program referred to in this sec- tion, if the head of the department or agency responsible for administering the program finds the standards to be effective and efficient. (6) Reduction of administrative burden (A) In general The Secretary shall reduce the burden, on States and public and private implementing agencies at the local level, of administering this section, by— (i) reviewing and revising administrative data collection instruments and forms to eliminate duplication and streamline re- porting requirements for States, eligible entities referred to in subsection (k)(2)(A), and nonprofit organizations referred to in subsection (l)(1)(B), including timelines for submitting reports; (ii) conducting an analysis of the total number of hours reported by administering agencies on complying with paperwork re- quirements, and exploring, in consultation with administering agencies, ways to re- duce the number of hours spent by at least 15 percent; (iii) conducting a review of paperwork and data collection requirements for tribal grantees, and exploring, in consultation with tribes and tribal organizations, ways to reduce administrative burden, respect sovereignty, and acknowledge the different focus points for tribal grantees; (iv) collecting input from relevant State fiscal officials to align fiscal requirements and oversight for States and eligible enti- ties to ensure consistency with standards and guidelines for other Federal formula grant programs; and (v) consulting with administering agen- cies and service delivery model representa- tives on needed and unneeded data ele- ments regarding the dashboards provided for in subsection (d)(1)(B), consistent with the data requirements of such subsection. (B) Findings on paperwork reduction (i) Inclusion in report In the 1st report submitted pursuant to subsection (j) more than 18 months after December 29, 2022, the Secretary shall in- clude the findings of the Secretary with respect to the matters described in sub- paragraph (A). (ii) Implementation Within 2 years after complying with clause (i), the Secretary shall implement the findings referred to in clause (i). (i) Application of other provisions of subchapter (1) In general Except as provided in paragraph (2), the other provisions of this subchapter shall not apply to a grant made under this section. (2) Exceptions The following provisions of this subchapter shall apply to a grant made under this section to the same extent and in the same manner as such provisions apply to allotments made under section 702(c) of this title: Page 2459 TITLE 42—THE PUBLIC HEALTH AND WELFARE § 711 (A) Section 704(b)(6) of this title (relating to prohibition on payments to excluded indi- viduals and entities). (B) Section 704(c) of this title (relating to the use of funds for the purchase of technical assistance). (C) Section 706 of this title (relating to re- ports and audits), but only to the extent de- termined by the Secretary to be appropriate for grants made under this section. (D) Section 707 of this title (relating to penalties for false statements). (E) Section 708 of this title (relating to nondiscrimination). (F) Section 709(a) of this title (relating to the administration of the grant program). (j) Annual report to Congress By December 31, 2023, and annually thereafter, the Secretary shall submit to the Congress a written report on the grants made under this section for the then preceding fiscal year, which shall include— (1) an eligible entity-by-eligible entity sum- mary of the outcomes measured by the entity with respect to each benchmark described in subsection (e)(5) that apply to the entity; (2) information regarding any technical as- sistance funded under subparagraph (B) or (C) of subsection (k)(2), including the type of any such assistance provided; (3) information on the demographic makeup of families served by each such entity to the extent possible while respecting participant confidentiality, including race, ethnicity, edu- cational attainment at enrollment, household income, and other demographic markers as de- termined by the Secretary; (4) the information described in subsection (d)(1)(E); (5) the estimated share of the eligible popu- lation served using grants made under this section; (6) a description of each service delivery model funded under this section by the eligible entities in each State, and the share (if any) of the grants expended on each model; (7) a description of non-Federal expenditures by eligible entities to qualify for matching funds under subsection (c)(4); (8) information on the uses of funds reserved under subsection (k)(2)(C); (9) information relating to those eligible en- tities for which funding is reserved under sub- section (k)(2)(A), with modifications as nec- essary to reflect tribal data sovereignty, data privacy, and participant confidentiality; and (10) a list of data elements collected from el- igible entities, and the purpose of each data element in measuring performance or enforc- ing requirements under this section. (k) Appropriations (1) In general Out of any funds in the Treasury not other- wise appropriated, there are appropriated to the Secretary to carry out this section— (A) for fiscal year 2023, $500,000,000 for base grants; (B) for fiscal year 2024, $550,000,000, of which $500,000,000 shall be for base grants and $50,000,000 shall be for matching grants; (C) for fiscal year 2025, $600,000,000, of which $500,000,000 shall be for base grants and $100,000,000 shall be for matching grants; (D) for fiscal year 2026, $650,000,000, of which $500,000,000 shall be for base grants and $150,000,000 shall be for matching grants; and (E) for fiscal year 2027, $800,000,000, of which $500,000,000 shall be for base grants and $300,000,000 shall be for matching grants. (2) Reservations Of each amount made available for base grants and each amount made available for matching grants appropriated under this sub- section for a fiscal year (or portion of a fiscal year), the Secretary shall reserve— (A) 6 percent of such amount for purposes of making and administering grants to eligi- ble entities that are Indian Tribes (or a con- sortium of Indian Tribes), Tribal Organiza- tions, or Urban Indian Organizations; (B) 2 percent of such amount for purposes of providing technical assistance, directly or through grants or contracts— (i) for purposes as otherwise described in subsections (c)(5), (d)(1)(C)(iii), (d)(1)(E)(iii), and (d)(4)(E); and (ii) to entities referred to in subpara- graph (A) of this paragraph; (C) 2 percent of such amount for purposes of the provision of workforce support, reten- tion, and case management, including work- force-related technical assistance, to eligible entities, research and evaluation, and pro- gram administration, directly or through grants or contracts, of which the Secretary shall use not more than $1,500,000 to estab- lish and operate the Jackie Walorski Center for Evidence-Based Case Management; and (D) 3 percent of such amount for purposes of research and evaluation (directly or through grants or contracts), and for admin- istering this section (directly, through con- tracts, or otherwise). (3) Availability (A) In general Except as provided in subparagraph (B), funds made available to an eligible entity under this section for a fiscal year (or por- tion of a fiscal year) shall remain available for expenditure by the eligible entity through the end of the second succeeding fis- cal year after award. Any funds that are not expended by the eligible entity during the period in which the funds are available under the preceding sentence may be used for grants to nonprofit organizations under subsection (h)(2)(B). (B) Funds for pay for outcomes initiatives Funds made available to an eligible entity under this section for a fiscal year (or por- tion of a fiscal year) for a pay for outcomes initiative shall remain available for expendi- ture by the eligible entity for not more than 10 years after the funds are so made avail- able. (4) Allocation of funds To the extent that the grant amount award- ed under this section to an eligible entity is Page 2460 TITLE 42—THE PUBLIC HEALTH AND WELFARE § 711 determined on the basis of relative population or poverty considerations, the Secretary shall make the determination using the most accu- rate Federal data available for the eligible en- tity. (5) Disposition of excess funds reserved for re- search, evaluation, and administration To the extent that the amounts reserved under paragraph (2)(D) for a fiscal year are not obligated in the fiscal year, the Secretary may use the funds for any purpose described in this section or to offset any reduction with respect to this section that is required by Federal law. (l) Definitions In this section: (1) Eligible entity (A) In general The term ‘‘eligible entity’’ means a State, an Indian Tribe, Tribal Organization, or Urban Indian Organization, Puerto Rico, Guam, the Virgin Islands, the Northern Mar- iana Islands, and American Samoa. (B) Nonprofit organizations Only for purposes of awarding grants under subsection (h)(2)(B), such term shall include a nonprofit organization with an established record of providing early childhood home visitation programs or initiatives in a State or several States. (2) Eligible family The term ‘‘eligible family’’ means— (A) a woman who is pregnant, and the fa- ther of the child if the father is available; or (B) a parent or primary caregiver of a child, including grandparents or other rel- atives of the child, and foster parents, who are serving as the child’s primary caregiver from birth to kindergarten entry, and in- cluding a noncustodial parent who has an ongoing relationship with, and at times pro- vides physical care for, the child. (3) Indian Tribe; Tribal Organization The terms ‘‘Indian Tribe’’ and ‘‘Tribal Orga- nization’’, and ‘‘Urban Indian Organization’’ have the meanings given such terms in section 1603 of title 25. (4) Pay for outcomes initiative The term ‘‘pay for outcomes initiative’’ means a performance-based grant, contract, cooperative agreement, or other agreement awarded by a public entity in which a commit- ment is made to pay for improved outcomes achieved as a result of the intervention that result in social benefit and direct cost savings or cost avoidance to the public sector. Such an initiative shall include— (A) a feasibility study that describes how the proposed intervention is based on evi- dence of effectiveness; (B) a rigorous, third-party evaluation that uses experimental or quasi-experimental de- sign or other research methodologies that allow for the strongest possible causal infer- ences to determine whether the initiative has met its proposed outcomes as a result of the intervention; (C) an annual, publicly available report on the progress of the initiative; and (D) a requirement that payments are made to the recipient of a grant, contract, or co- operative agreement only when agreed upon outcomes are achieved, except that this re- quirement shall not apply with respect to payments to a third party conducting the evaluation described in subparagraph (B). (Aug. 14, 1935, ch. 531, title V, § 511, as added Pub. L. 111–148, title II, § 2951, Mar. 23, 2010, 124 Stat. 334; amended Pub. L. 113–93, title II, § 209, Apr. 1, 2014, 128 Stat. 1046; Pub. L. 114–10, title II, § 218, Apr. 16, 2015, 129 Stat. 153; Pub. L. 115–123, div. E, title VI, §§ 50601–50606(a), 50607, Feb. 9, 2018, 132 Stat. 228–231; Pub. L. 117–328, div. FF, title VI, § 6101(b)–(c)(3)(A), (c)(4)–(f)(2)(A), (g), (h)(1), Dec. 29, 2022, 136 Stat. 5953–5962.) Editorial Notes REFERENCES IN TEXT The effective date of this paragraph, referred to in subsec. (d)(4)(A), is Oct. 1, 2023, see section 6101(i)(2) of Pub. L. 117–328, set out as an Effective Date of 2022 Amendment note below. The Child Abuse Prevention and Treatment Act, re- ferred to in subsec. (e)(9), is Pub. L. 93–247, Jan. 31, 1974, 88 Stat. 4. Title II of the Act is classified generally to subchapter III (§ 5116 et seq.) of chapter 67 of this title. For complete classification of this Act to the Code, see Short Title note set out under section 5101 of this title and Tables. CODIFICATION December 29, 2022, referred to in subsecs. (d)(1)(B)(i) and (h)(6)(B)(i), was in the original ‘‘the date of the en- actment of this section’’ and ‘‘the date of the enact- ment of this Act’’, respectively, and in both cases the quoted language was translated as meaning the date of enactment of Pub. L. 117–328, which added subsecs. (d)(1)(B) and (h)(6), to reflect the probable intent of Congress. PRIOR PROVISIONS A prior section 711, act Aug. 14, 1935, ch. 531, title V, § 511, as added Jan. 2, 1968, Pub. L. 90–248, title III, § 301, 81 Stat. 927, which related to training of personnel for health care and related services for mothers and chil- dren, was omitted in the general revision of this sub- chapter by Pub. L. 97–35, title XXI, § 2192(a), Aug. 13, 1981, 95 Stat. 818. Another prior section 711, acts Aug. 14, 1935, ch. 531, title V, § 511, 49 Stat. 631; Aug. 10, 1939, ch. 666, title V, § 504, 53 Stat. 1380; 1946 Reorg. Plan No. 2, § 1, eff. July 16, 1946, 11 F.R. 7873, 60 Stat. 1095; Aug. 10, 1946, ch. 951, title IV, § 401(b)(4), 60 Stat. 986; Aug. 28, 1950, ch. 809, title III, pt. 3, § 331(c), pt. 6, § 361(e), 64 Stat. 551, 558; Aug. 28, 1958, Pub. L. 85–840, title VI, § 603(a), 72 Stat. 1055; Sept. 13, 1960, Pub. L. 86–778, title VII, § 707(a)(2)(A), 74 Stat. 995; Oct. 24, 1963, Pub. L. 88–156, § 3(a), 77 Stat. 273; July 30, 1965, Pub. L. 89–97, title II, § 202(a), 79 Stat. 353, authorized appropriations, for serv- ices for crippled children, of $25,000,000, $30,000,000, $35,000,000, $45,000,000, $50,000,000, $55,000,000, and $60,000,000 for fiscal years ending June 30, 1963, 1964, 1965, 1966, 1967, 1968, 1969, 1970 and thereafter respec- tively, prior to the general amendment of title V of the Social Security Act by Pub. L. 90–248, § 301, and was covered by former section 701 of this title. Provisions similar to those comprising former sec- tion 711 were contained in section 516 of act Aug. 14, 1935, ch. 531, title V, as added July 30, 1965, Pub. L. 89–97, title II, § 203(a), 79 Stat. 353 (formerly classified to section 716 of this title), prior to the general amend- ment and renumbering of title V of act Aug. 14, 1935, by Pub. L. 90–248, § 301. Page 2461 TITLE 42—THE PUBLIC HEALTH AND WELFARE § 711 AMENDMENTS 2022—Subsec. (b)(1)(B)(iii). Pub. L. 117–328, § 6101(f)(2)(A)(i), substituted ‘‘subsection (l)(2)’’ for ‘‘subsection (k)(2)’’. Subsec. (c)(4). Pub. L. 117–328, § 6101(c)(1)(A), amended par. (4) generally. Prior to amendment, text read as fol- lows: ‘‘The Secretary shall determine the period of years for which a grant is made to an eligible entity under paragraph (1).’’ Subsec. (d)(1). Pub. L. 117–328, § 6101(b)(1), substituted ‘‘benchmark areas related to individual family out- comes’’ for ‘‘benchmark areas’’ in heading. Subsec. (d)(1)(B), (C). Pub. L. 117–328, § 6101(b)(3), added subpar. (B) and redesignated former subpar. (B) as (C). Former subpar. (C) redesignated (D). Subsec. (d)(1)(D). Pub. L. 117–328, § 6101(b)(3), redesig- nated subpar. (C) as (D). Former par. (D) redesignated (E). Subsec. (d)(1)(D)(i). Pub. L. 117–328, § 6101(b)(2), sub- stituted ‘‘(C)’’ for ‘‘(B)’’. Subsec. (d)(1)(E). Pub. L. 117–328, § 6101(b)(3), redesig- nated subpar. (D) as (E). Subsec. (d)(3)(B). Pub. L. 117–328, § 6101(d), added sub- par. (B). Former subpar. (B) redesignated (C). Subsec. (d)(3)(C). Pub. L. 117–328, § 6101(d), redesig- nated subpar. (B) as (C). Subsec. (d)(3)(C)(vii). Pub. L. 117–328, § 6101(h)(1)(C), added cl. (vii). Subsec. (d)(4). Pub. L. 117–328, § 6101(h)(1)(B), added par. (4). Former par. (4) redesignated (5). Subsec. (d)(5). Pub. L. 117–328, § 6101(h)(1)(B), redesig- nated par. (4) as (5). Former par. (5) redesignated (6). Pub. L. 117–328, § 6101(e)(1), added par. (5). Subsec. (d)(6). Pub. L. 117–328, § 6101(h)(1)(B), redesig- nated par. (5) as (6). Subsec. (e)(8)(A). Pub. L. 117–328, § 6101(h)(1)(D), in- serted ‘‘, including the number of virtual home visits conducted under the program in the year covered by the report, disaggregated with respect to each home visiting model under which the virtual home visits are conducted’’ before semicolon. Subsec. (e)(10), (11). Pub. L. 117–328, § 6101(h)(1)(A), added par. (10) and redesignated former par. (10) as (11). Subsec. (f). Pub. L. 117–328, § 6101(c)(1)(B), amended subsec. (f) generally. Prior to amendment, text read as follows: ‘‘Funds provided to an eligible entity receiving a grant under this section shall supplement, and not supplant, funds from other sources for early childhood home visitation programs or initiatives.’’ Subsec. (h)(2)(B). Pub. L. 117–328, § 6101(f)(2)(A)(ii), substituted ‘‘subsection (k)’’ for ‘‘subsection (j)’’ and ‘‘subsection (l)(1)(B)’’ for ‘‘subsection (k)(1)(B)’’ in in- troductory provisions. Subsec. (h)(6). Pub. L. 117–328, § 6101(g), added par. (6). Subsec. (i)(2)(C) to (G). Pub. L. 117–328, § 6101(e)(2), re- designated subpars. (D) to (G) as (C) to (F), respec- tively, and struck out former subpar. (C) which read as follows: ‘‘Section 704(d) of this title (relating to a limi- tation on administrative expenditures).’’ Subsec. (j). Pub. L. 117–328, § 6101(f)(1), added subsec. (j). Former subsec. (j) redesignated (k). Subsec. (j)(1). Pub. L. 117–328, § 6101(c)(3)(A), added subpars. (A) to (E) and struck out former subpars. (A) to (H) which read as follows: ‘‘(A) $100,000,000 for fiscal year 2010; ‘‘(B) $250,000,000 for fiscal year 2011; ‘‘(C) $350,000,000 for fiscal year 2012; ‘‘(D) $400,000,000 for fiscal year 2013; ‘‘(E) $400,000,000 for fiscal year 2014; ‘‘(F) for fiscal year 2015, $400,000,000; ‘‘(G) for fiscal year 2016, $400,000,000; and ‘‘(H) for each of fiscal years 2017 through 2022, $400,000,000.’’ Subsec. (j)(2). Pub. L. 117–328, § 6101(c)(2)(A), sub- stituted ‘‘each amount made available for base grants and each amount made available for matching grants’’ for ‘‘the amount’’ in introductory provisions. Subsec. (j)(2)(A). Pub. L. 117–328, § 6101(c)(2)(B), sub- stituted ‘‘6’’ for ‘‘3’’, inserted ‘‘and administering’’ be- fore ‘‘grants’’, and struck out ‘‘and’’ at end. Subsec. (j)(2)(B) to (D). Pub. L. 117–328, § 6101(c)(2)(C), added subpars. (B) to (D) and struck out former subpar. (B) which read as follows: ‘‘3 percent of such amount for purposes of carrying out subsections (d)(1)(B)(iii), (g), and (h)(3).’’ Subsec. (j)(5). Pub. L. 117–328, § 6101(c)(4), added par. (5). Subsecs. (k), (l). Pub. L. 117–328, § 6101(f)(1), redesig- nated subsecs. (j) and (k) as (k) and (l), respectively. 2018—Subsec. (b)(1). Pub. L. 115–123, § 50603, in intro- ductory provisions, substituted ‘‘Each State shall, as a condition of receiving payments from an allotment for the State under section 702 of this title, conduct a statewide needs assessment (which may be separate from but in coordination with the statewide needs as- sessment required under section 705(a) of this title and which shall be reviewed and updated by the State not later than October 1, 2020)’’ for ‘‘Not later than 6 months after March 23, 2010, each State shall, as a con- dition of receiving payments from an allotment for the State under section 702 of this title for fiscal year 2011, conduct a statewide needs assessment (which shall be separate from the statewide needs assessment required under section 705(a) of this title)’’. Subsec. (c)(3) to (5). Pub. L. 115–123, § 50605(a), added par. (3) and redesignated former pars. (3) and (4) as (4) and (5), respectively. Subsec. (d)(1)(A). Pub. L. 115–123, § 50602(a), struck out ‘‘each of’’ before ‘‘the following areas’’ in introductory provisions. Subsec. (d)(1)(D). Pub. L. 115–123, § 50602(b), added sub- par. (D). Subsec. (d)(4)(A). Pub. L. 115–123, § 50604, inserted ‘‘, taking into account the staffing, community re- source, and other requirements to operate at least one approved model of home visiting and demonstrate im- provements for eligible families’’ before period at end. Subsec. (e)(5). Pub. L. 115–123, § 50602(c), inserted ‘‘that the service delivery model or models selected by the entity are intended to improve’’ before period at end. Subsec. (h)(4)(A). Pub. L. 115–123, § 50602(a), struck out ‘‘each of’’ before ‘‘the areas’’. Subsec. (h)(5). Pub. L. 115–123, § 50606(a), added par. (5). Subsec. (j)(1)(H). Pub. L. 115–123, § 50601, substituted ‘‘each of fiscal years 2017 through 2022’’ for ‘‘fiscal year 2017’’. Subsec. (j)(3). Pub. L. 115–123, § 50605(c), designated ex- isting provisions as subpar. (A) and inserted heading, substituted ‘‘Except as provided in subparagraph (B), funds’’ for ‘‘Funds’’, and added subpar. (B). Subsec. (j)(4). Pub. L. 115–123, § 50607, added par. (4). Subsec. (k)(4). Pub. L. 115–123, § 50605(b), added par. (4). 2015—Subsec. (j)(1)(F) to (H). Pub. L. 114–10 sub- stituted ‘‘for fiscal year 2015, $400,000,000;’’ for ‘‘for the period beginning on October 1, 2014, and ending on March 31, 2015, an amount equal to the amount pro- vided in subparagraph (E).’’ in subpar. (F) and added subpars. (G) and (H). 2014—Subsec. (j)(1)(F). Pub. L. 113–93, § 209(1), added subpar. (F). Subsec. (j)(2), (3). Pub. L. 113–93, § 209(2), inserted ‘‘(or portion of a fiscal year)’’ after ‘‘for a fiscal year’’. Statutory Notes and Related Subsidiaries EFFECTIVE DATE OF 2022 AMENDMENT Pub. L. 117–328, div. FF, title VI, § 6101(i), Dec. 29, 2022, 136 Stat. 5964, provided that: ‘‘(1) IN GENERAL.—Except as provided in paragraph (2), this section [amending this section and section 711a of this title and enacting provisions set out as notes under this section and section 1305 of this title] and the amendments made by this section shall take effect on October 1, 2022. ‘‘(2) VIRTUAL HOME VISITING PROVISIONS.—The amend- ments made by subsection (h) [amending this section] shall take effect on October 1, 2023.’’ Page 2462 TITLE 42—THE PUBLIC HEALTH AND WELFARE § 711a EFFECTIVE DATE OF 2018 AMENDMENT Pub. L. 115–123, div. E, title VI, § 50606(b), Feb. 9, 2018, 132 Stat. 231, provided that: ‘‘The amendment made by subsection (a) [amending this section] shall take effect on the date that is 2 years after the date of enactment of this Act [Feb. 9, 2018].’’ TRANSITION RULE Pub. L. 117–328, div. FF, title VI, § 6101(h)(2), Dec. 29, 2022, 136 Stat. 5964, provided that: ‘‘(A) IN GENERAL.—A virtual home visit conducted be- fore the effective date of the amendments made by this subsection [Oct. 1, 2023] under an early childhood home visitation program funded under section 511 of the So- cial Security Act [42 U.S.C. 711] shall be considered a home visit for purposes of such section. ‘‘(B) VIRTUAL HOME VISIT DEFINED.—In subparagraph (A), the term ‘virtual home visit’ means a visit con- ducted solely by use of electronic information and tele- communications technologies.’’ ALLOWING HOME VISITING PROGRAMS TO CONTINUE SERVING FAMILIES SAFELY Pub. L. 116–260, div. X, § 10, Dec. 27, 2020, 134 Stat. 2416, provided that: ‘‘(a) IN GENERAL.—For purposes of section 511 of the Social Security Act [42 U.S.C. 711], during the COVID–19 public health emergency period— ‘‘(1) a virtual home visit shall be considered a home visit; ‘‘(2) funding for, and staffing levels of, a program conducted pursuant to such section shall not be re- duced on account of reduced enrollment in the pro- gram; and ‘‘(3) funds provided for such a program may be used— ‘‘(A) to train home visitors in conducting a vir- tual home visit and in emergency preparedness and response planning for families served, and may in- clude training on how to safely conduct intimate partner violence screenings remotely, training on safety and planning for families served; ‘‘(B) for the acquisition by families enrolled in the program of such technological means as are needed to conduct and support a virtual home visit; and ‘‘(C) to provide emergency supplies to families served, regardless of whether the provision of such supplies is within the scope of the approved pro- gram, such as diapers, formula, non-perishable food, water, hand soap, and hand sanitizer. ‘‘(b) VIRTUAL HOME VISIT DEFINED.—In subsection (a), the term ‘virtual home visit’ means a home visit, as de- scribed in an applicable service delivery model, that is conducted solely by the use of electronic information and telecommunications technologies. ‘‘(c) AUTHORITY TO DELAY DEADLINES.— ‘‘(1) IN GENERAL.—The Secretary may extend the deadline by which a requirement of section 511 of the Social Security Act must be met, by such period of time as the Secretary deems appropriate, taking into consideration the impact of the COVID–19 public health emergency on eligible entity home visiting programs and the impact of families enrolled in home visiting programs. The Secretary may delay the dead- line for submission, waive performance measures, or allow for alternative data sources to be used to show improvement in performance in the manner provided in section 511(d)(1) of such Act. ‘‘(2) DELAY OF DEADLINE FOR STATEWIDE NEEDS AS- SESSMENT.—The Secretary may delay the October 1, 2020, deadline for reviewing and updating any needs assessment required by section 511(b)(1) or 511(h)(2)(A) of the Social Security Act, but any such delay shall not affect the timing for, or amount of, any payment to the State involved from the fiscal year allotments available to the State under section 502(c) of such Act [42 U.S.C. 702(c)]. ‘‘(3) GUIDANCE.—The Secretary shall provide to eli- gible entities funded under section 511 of the Social Security Act information on the parameters used in extending a deadline under paragraph (1) or (2) of this subsection. ‘‘(d) TIMELY RELEASE OF TITLE V FUNDS.—The au- thorities provided in this section shall not be inter- preted to authorize or require any delay in the timely release of funds under title V of the Social Security Act [42 U.S.C. 701 et seq.].’’ [For definitions of terms used in section 10 of div. X of Pub. L. 116–260, set out above, see section 2 of div. X of Pub. L. 116–260, set out as a note under section 629h of this title.] § 711a. Emergency assistance to families through home visiting programs (a) Supplemental appropriation In addition to amounts otherwise appro- priated, out of any money in the Treasury of the United States not otherwise appropriated, there are appropriated to the Secretary $150,000,000, to remain available through September 30, 2022, to enable eligible entities to conduct programs in accordance with section 711 of this title and sub- section (c) of this section. (b) Eligibility for funds To be eligible to receive funds made available by subsection (a) of this section, an entity shall— (1) as of March 11, 2021, be conducting a pro- gram under section 711 of this title; (2) ensure the modification of grants, con- tracts, and other agreements, as applicable, executed under section 711 of this title under which the program is conducted as are nec- essary to provide that, during the period that begins with March 11, 2021, and ends with the end of the 2nd succeeding fiscal year after the funds are awarded, the entity shall— (A) not reduce funding for, or staffing lev- els of, the program on account of reduced en- rollment in the program; and (B) when using funds to provide emergency supplies to eligible families receiving grant services under section 711 of this title, en- sure coordination with local diaper banks to the extent practicable; and (3) reaffirm that, in conducting the program, the entity will focus on priority populations (as defined in section 711(d)(4) of this title). (c) Uses of funds An entity to which funds are provided under this section shall use the funds— (1) to serve families with home visits or with virtual visits, that may be conducted by the use of electronic information and tele- communications technologies, in a service de- livery model described in section 711(d)(3)(A) of this title; (2) to pay hazard pay or other additional staff costs associated with providing home vis- its or administration for programs funded under section 711 of this title; (3) to train home visitors employed by the entity in conducting a virtual home visit and in emergency preparedness and response plan- ning for families served, and may include training on how to safely conduct intimate partner violence screenings, and training on safety and planning for families served to sup- port the family outcome improvements listed in section 711(d)(2)(B) of this title;