PRINTER'S NO. 2404
No. 1721 Session of 1990
INTRODUCED BY JONES, BELAN, DAWIDA, FATTAH, MUSTO, PORTERFIELD,
SALVATORE AND WILLIAMS, JUNE 29, 1990
REFERRED TO PUBLIC HEALTH AND WELFARE, JUNE 29, 1990
AN ACT
1 Requiring the Department of Health to provide services to
2 improve maternal, infant and family health.
3 The General Assembly of the Commonwealth of Pennsylvania
4 hereby enacts as follows:
5 Section 1. Short title.
6 This act shall be known and may be cited as the Comprehensive
7 Health Initiative to Improve Health Outcome for Pregnant Women
8 and Their Families Act, otherwise known as the "CHILD" Program
9 Act.
10 Section 2. Declaration of policy.
11 The General Assembly hereby finds and declares that:
12 (1) All pregnant women should be provided access to
13 prenatal care, labor and delivery and postpartum services
14 appropriate to their need.
15 (2) The maternity care system must be designed and
16 dedicated to drawing all women into prenatal care and
17 providing them with an appropriate array of health and social
1 services throughout pregnancy, childbirth and the postpartum
2 period.
3 (3) The provision of prenatal care services is not only
4 strongly and clearly associated with improved pregnancy
5 outcomes, but is also cost-effective, having been estimated
6 to save $3.38 in direct medical care during the first year of
7 an infant's life for each $1 in prenatal care.
8 (4) Outreach services to increase the use of prenatal
9 care must be part of a comprehensive plan to strengthen the
10 maternity care system.
11 (5) The Commonwealth has implemented the "Healthy
12 Beginnings," the "Healthy Beginnings Plus" and the "Maternal
13 and Child Health Services Block Grant" programs which are
14 designed to improve the maternity system.
15 Section 3. Definitions.
16 The following words and phrases when used in this act shall
17 have the meanings given to them in this section unless the
18 context clearly indicates otherwise:
19 "Department." The Department of Health of the Commonwealth.
20 "Outreach services." Those services designed to identify
21 pregnant women and link them to prenatal care, otherwise known
22 as casefinding services, and those services designed to offer
23 support and assistance to help women remain in care once
24 enrolled, otherwise known as social support services.
25 "Provider." An entity which provided outreach services.
26 Section 4. Program.
27 (a) Establishment.--The department shall establish and
28 develop under this act programs of outreach services for
29 pregnant women.
30 (b) Solicitation of proposals.--The department shall solicit
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1 proposals to provide outreach services under this act. Providers
2 shall submit proposals in the form and manner required by the
3 department.
4 (c) Proposal selection criteria.--The department shall
5 target for outreach services those communities with a
6 disproportionately large number of high-risk pregnancies. In
7 selecting proposals, the department shall consider, among other
8 factors, the extent by which the communities to be served have
9 infant mortality or low birth weight rates which exceed the
10 Statewide averages.
11 (d) Program elements.--Outreach services funded under this
12 act shall include the following program elements:
13 (1) Outreach workers who canvas in carefully defined
14 target areas and seek clients among well-defined high-risk
15 target groups.
16 (2) Outreach workers who are able to communicate
17 effectively with members of the target groups.
18 (3) Telephone hotline and referral services that can
19 make prenatal appointments during the initial call and can
20 provide assistance to callers in arranging needed maternity,
21 health and social services.
22 (4) Television and radio spots and posters and other
23 written information tailored to and easily understood by the
24 target groups, explaining the benefits of prenatal care, the
25 need to begin such care early in pregnancy and how
26 individuals can enroll in prenatal care.
27 (5) A system for referring pregnant women to "Healthy
28 Beginnings Plus" and "Maternal and Child Health Services
29 Block Grant" providers enrolled with the Department of Public
30 Welfare.
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1 (6) A system for referring pregnant women to, and
2 providing outreach services to pregnant women already
3 receiving services at, WIC agencies, family planning clinics,
4 housing programs, county assistance offices, job-training
5 programs, schools, shelters for the homeless, drug and
6 alcohol treatment programs and centers and other health and
7 social services providers.
8 (7) Efforts to encourage current program participants to
9 recruit additional participants from their friends, neighbors
10 and relatives.
11 (8) Home visiting by outreach workers as a means to
12 follow up on missed appointments and as a means of providing
13 social supports to pregnant women. The number of such home
14 visits may not be limited but the department may require
15 adequate documentation of the need for visits that exceed a
16 preset target established for individuals in the high-risk
17 group of which the pregnant woman is a member.
18 (9) Transportation on an as-needed basis for prenatal
19 and postpartum care. Under no circumstances shall a provider
20 require that a pregnant woman provide more notice of her need
21 for transportation than notice she has received for her need
22 for a prenatal care visit.
23 (10) Ambulance services to the pregnant woman's chosen
24 delivery site.
25 (11) Initial and ongoing training and supervision of
26 outreach workers on the benefits of prenatal care, the need
27 to begin such care early in pregnancy and the referral
28 systems established by the provider.
29 (e) Establishing target groups.--The department shall
30 identify the sociodemographic characteristics and geographic
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1 locations of women who obtain insufficient prenatal care and
2 shall use this information in establishing the target areas and
3 the high-risk target groups to receive outreach services.
4 Section 5. Demonstration projects.
5 The department may initiate demonstration projects to test
6 ways to provide outreach services and prenatal care, as well as
7 conduct specific research into ways to best provide outreach
8 services and prenatal care in both urban and rural communities.
9 Section 6. Public awareness campaign.
10 The department shall develop and implement, either directly
11 or by contract, a long-term public awareness campaign to educate
12 Pennsylvanians about the importance of prenatal care for healthy
13 mothers and infants and the need to begin such care early in
14 pregnancy. The campaign should be directed, at least, to
15 schools, the media, family planning, health care settings,
16 religious centers and social services agencies. Additional
17 public awareness campaigns should be directed to those target
18 areas and high-risk target groups identified in section 4(e).
19 All public awareness campaigns shall include specific
20 instructions on where to go and whom to call for prenatal care.
21 Section 7. Annual meeting for comments and suggestions.
22 The department shall annually convene a meeting of all
23 providers who have received funds under this act and other
24 interested parties to receive comments and suggestions on ways
25 to improve outreach services and the availability of prenatal
26 care.
27 Section 8. Report.
28 The department shall report annually to the General Assembly
29 as to its activities and expenditures under this act, the
30 activities of providers who have received funds under this act,
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1 the number of women served, the recommendations made at the
2 annual meeting provided for in section 7 and the recommendations
3 of the department as to ways to improve outreach services and
4 the availability of prenatal care.
5 Section 9. Effective date.
6 This act shall take effect July 1, 1991.
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