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 19900S1721B2404 - 2 -
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. 19900S1721B2404 - 3 -
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 19900S1721B2404 - 4 -
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, 19900S1721B2404 - 5 -
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. F4L35CHF/19900S1721B2404 - 6 -