(1) DEFINITIONS. In this section: (b) “Case,” other than when used in the term “case management services,” means a family or person who meets all of the following criteria: 1. The family or person is any of the following: a. A family or person who has been the subject of a report under s. 48.981 and with respect to whom the individual making the investigation or the intake worker assigned to the family or person has determined that all of the conditions in subd. 2. exist. b. An Indian child who has been the subject of a report under s. 48.981 about which an Indian tribe that has received a grant under this section has received notice, including but not limited to notice provided to a tribal agent under s. 48.981 (3) (bm) , and with respect to whom an individual designated by the Indian tribe has determined that all of the conditions in subd. 2. exist. c. A family that includes a person who has contacted a county, city, private agency, or Indian tribe that has been awarded a grant under this section or, in a county having a population of 750,000 or more that has been awarded a grant under this section, the county, city, private agency, or a licensed child welfare agency under contract with the department requesting assistance to prevent poor birth outcomes or abuse or neglect of a child in the person’s family and with respect to which an individual responding to the request has determined that all of the conditions in subd. 2. exist. 2. The family or person has been determined to meet all of the following conditions: a. There is a substantial risk of poor birth outcomes or future abuse or neglect of a child in the family if assistance is not provided. b. The child and the child’s parent or the person primarily responsible for the child’s care are willing to cooperate with an informal plan of support and services. c. It does not appear that a petition will be filed under s. 48.25 alleging that a child in the family is in need of protection or services under s. 48.13 and, if an Indian child is involved, it also does not appear that there will be a similar proceeding in tribal court relating to abuse or neglect of the Indian child. (cm) “Culturally competent” means the ability to understand and act respectfully toward, in a cultural context, the beliefs, interpersonal styles, attitudes and behaviors of persons and families of various cultures. (f) “Intake worker” means any person designated to provide intake services under s. 48.067. (gm) “Private agency” means an organization operated for profit or a nonstock corporation organized under ch. 181 that is a nonprofit corporation, as defined in s. 181.0103 (17). (h) “Reservation” means land in this state within the boundaries of a federally recognized reservation of an Indian tribe or within the bureau of Indian affairs service area for the Ho-Chunk Nation. (2) FUNDS PROVIDED. (a) If a county, city, private agency, or Indian tribe applies and is selected by the department under sub. (5) to participate in the program under this section, the department shall award, from the appropriation under s. 20.437 (1) (ab), a grant annually to be used only for the purposes specified in sub. (4) (a) and (am). The minimum amount of a grant is $10,000. The county, city, private agency, or Indian tribe shall agree to match at least 25 percent of the grant amount annually in funds or in-kind contributions. (b) The department shall determine the amount of a grant awarded to a county, city, private agency, or Indian tribe under this section in excess of the minimum amount based on the need of the county, city, private agency, or Indian tribe for a grant and the capacity of the county, city, private agency, or Indian tribe to participate in the program under this section, as determined by the department. (c) The department shall allocate 10 percent of the funds available from the appropriation account under s. 20.437 (1) (ab) in each fiscal year for grants under this section to counties, cities, private agencies, or Indian tribes that have not previously received those grants. (3) JOINT APPLICATION PERMITTED. Any combination of 2 or more counties, cities, private agencies, or Indian tribes may submit a joint application to the department. (4) PURPOSE. (a) Grants; flexible funds, training and case management. The grants awarded under this section shall be used for all of the following purposes: 1. To establish or maintain the fund under sub. (6) (b) 1. 2. To establish or maintain the fund under sub. (6) (b) 2. 4. To pay expenses incurred in connection with attending training activities related to the program under this section. No more than $1,500 of the grant amount may be used for this purpose in the 12 months following receipt of a grant. 4m. To reimburse a case management provider under s. 49.45 (25) (b) for the amount of the allowable charges under the Medical Assistance program that is not provided by the federal government for case management services provided to a Medical Assistance beneficiary described in s. 49.45 (25) (am) 9. who is a child and who is a member of a family that receives home visitation program services under par. (b) 1. (am) Grants; start-up costs and capacity building. In the first year in which a grant under this section is awarded to a county, city, private agency, or Indian tribe, the county, city, private agency, or Indian tribe may use a portion of the grant to pay for start-up costs and capacity building related to the program under this section. The department shall determine the maximum amount of a grant that a county, city, private agency, or Indian tribe may use to pay for those start-up costs and that capacity building. (b) Home visitation program services. 1. A county, city, private agency, or Indian tribe that is selected to participate in the program under this section shall offer all pregnant women in the county or city, the area in which that private agency is providing services, or the reservation of the tribe who are eligible for Medical Assistance under subch. IV of ch. 49 an opportunity to undergo an assessment through use of a risk assessment instrument to determine whether the person assessed presents risk factors for poor birth outcomes or for perpetrating child abuse or neglect. Persons who agree to be assessed shall be assessed during the prenatal period. The risk assessment instrument shall be developed by the department and shall be based on risk assessment instruments developed by the department for similar programs that are in operation. The department need not promulgate as rules under ch. 227 the risk assessment instrument developed under this subdivision. A person who is assessed to be at risk of poor birth outcomes or of abusing or neglecting his or her child shall be offered home visitation program services that shall be commenced during the prenatal period. Home visitation program services may be provided to a family with a child identified as being at risk of child abuse or neglect until the identified child reaches 3 years of age. If a family has been receiving home visitation program services continuously for not less than 12 months, those services may continue to be provided to the family until the identified child reaches 3 years of age, regardless of whether the child continues to be eligible for Medical Assistance under subch. IV of ch. 49. If risk factors for child abuse or neglect with respect to the identified child continue to be present when the child reaches 3 years of age, home visitation program services may be provided until the identified child reaches 5 years of age. Home visitation program services may not be provided to a person unless the person gives his or her written informed consent to receiving those services or, if the person is a child, unless the child’s parent, guardian, or legal custodian gives his or her written informed consent for the child to receive those services. 1m. No person who is required or permitted to report suspected or threatened abuse or neglect under s. 48.981 (2) may make or threaten to make such a report based on a refusal of a person to receive or to continue receiving home visitation program services under subd. 1. 3. A county, city, private agency, or Indian tribe that is pro- viding home visitation program services under subd. 1. shall provide to a person receiving those services the information relating to shaken baby syndrome and impacted babies required under s. 253.15 (6). (5) SELECTION OF COUNTIES, CITIES, PRIVATE AGENCIES, AND INDIAN TRIBES. The department shall provide competitive application procedures for selecting counties, cities, private agencies, and Indian tribes for participation in the program under this section. The department shall establish a method for ranking applicants for selection based on the quality of their applications. In ranking the applications, the department shall give favorable consideration to a county, city, private agency, or Indian tribe that submits a joint application under sub. (3). The department shall also provide application requirements and procedures for the renewal of a grant awarded under this section. The application procedures and the renewal application requirements and procedures shall be clear and understandable to the applicants. The department need not promulgate as rules under ch. 227 the application procedures, the renewal application requirements or procedures, or the method for ranking applicants established under this subsection. (6) CRITERIA FOR AWARDING GRANTS. In addition to any other criteria developed by the department, a county, city, private agency, or Indian tribe shall meet all of the following criteria in order to be selected for participation in the program under this section: (a) Home visitation program criteria. The part of an application, other than a renewal application, submitted by a county, city, private agency, or Indian tribe that relates to home visitation programs shall include all of the following: 1. Information on how the applicant’s home visitation program is comprehensive, incorporates practice standards that have been developed for home visitation programs by entities concerned with the prevention of poor birth outcomes and child abuse and neglect and that are acceptable to the department, and incorporates practice standards and critical elements that have been developed for successful home visitation programs by a nationally recognized home visitation program model and that are acceptable to the department. 2. Documentation that the application was developed through collaboration among public and private organizations that provide services to children and families, especially children who are at risk of child abuse or neglect and families that are at risk of poor birth outcomes, or that are otherwise interested in child welfare and a description of how that collaboration effort will support a comprehensive home visitation program. 3. An identification of existing poor birth outcome and child abuse and neglect prevention services that are available to residents of the county or city, the area in which the private agency is providing services, or the reservation of the Indian tribe and a description of how those services and any additional needed services will support a comprehensive home visitation program. 4. An explanation of how the home visitation program will build on existing poor birth outcome and child abuse and neglect prevention programs, including programs that provide support to families, and how the home visitation program will coordinate with those programs. 4m. An explanation of how the applicant will encourage private organizations to provide services under the applicant’s home visitation program. 5. An explanation of how the applicant, in collaboration with local prenatal care coordination providers, will implement strategies aimed at achieving healthy birth outcomes, as determined by performance measures prescribed by the department and the department of health services, in the county, city, or reservation of the Indian tribe. 6. An identification of how the home visitation program is comprehensive and incorporates the practice standards and critical elements for successful home visitation programs referred to in subd. 1., including how services will vary in intensity levels depending on the needs and strengths of the participating family. 6m. An explanation of how the services to be provided under the home visitation program, including the risk assessment under sub. (4) (b) 1., will be provided in a culturally competent manner. 7m. A statement of whether the applicant intends to use a portion of the grant in the first year in which the grant is awarded to pay for start-up costs or capacity building related to the program under this section and an explanation of how the applicant would use any amounts authorized by the department under sub. (4) (am) for those purposes. (b) Flexible funds. 1. ‘Flexible fund for home visitation programs.’ The applicant demonstrates in the application that the applicant has established, or has plans to establish, if selected, a fund from which payments totaling not less than $250 per calendar year may be made for appropriate expenses of each family that is participating in the home visitation program under sub. (4) (b) 1. or that is receiving home visitation services under s. 49.45 (44). The payments shall be authorized by an individual designated by the applicant. If an applicant makes a payment to or on behalf of a family under this subdivision, one-half of the payment shall be from grant moneys received under this section and onehalf of the payment shall be from moneys provided by the applicant from sources other than grant moneys received under this section. 2. ‘Flexible fund for cases.’ The applicant demonstrates in the grant application that the applicant has established, or has plans to establish, if selected, a fund from which payments totaling not less than $250 for each case may be made for appropriate expenses related to the case. The payments shall be authorized by an individual designated by the applicant. If an applicant makes a payment to or on behalf of a person under this subdivision, one-half of the payment shall be from grant moneys received under this section and one-half of the payment shall be from moneys provided by the applicant from sources other than grant moneys received under this section. The applicant shall demonstrate in the grant application that it has established, or has plans to establish, if selected, procedures to encourage, when appropriate, a person to whom or on whose behalf payments are made under this subdivision to make a contribution to the fund described in this subdivision up to the amount of payments made to or on behalf of the person when the person’s financial situation permits such a contribution. 4. ‘Nonentitlement.’ No individual is entitled to any payment from a fund established under subd. 1. or 2. Nothing in this section shall be construed as requiring a county, city, private agency, or Indian tribe to make a determination described in sub. (1) (b) 2. A determination described in sub. (1) (b) 2. may not be construed to be a determination described in s. 48.981 (3) (c) 4. (c) Case management benefit. The applicant states in the grant application that it has elected, or, if selected, that it will elect, under s. 49.45 (25) (b), to make the case management benefit under s. 49.45 (25) available to the category of beneficiaries under s. 49.45 (25) (am) 9. who are children and who are members of families receiving home visitation program services under sub. (4) (b) 1. (d) Wraparound process. The applicant demonstrates in the grant application that the payments that will be made from the fund established under par. (b) 2. will promote the provision of services for the case by using a wraparound process so as to pro- vide those services in a flexible, comprehensive and individualized manner in order to reduce the necessity for court-ordered services. (e) Anticipated allocation. The applicant explains in the grant application how the applicant anticipates allocating moneys awarded under the grant among the purposes described in sub. (4) (a) 1., 2. and 4m. and, in an application other than a renewal application, the purposes described in sub. (4) (a) 1., 2. and 4m. and (am). (f) Reinvestment of Medical Assistance reimbursement. The applicant agrees to reinvest in the program under this section a portion of the reimbursement received by the applicant under the Medical Assistance program under subch. IV of ch. 49. The department and the applicant shall negotiate the amount of that reinvestment based on the applicant’s administrative costs for billing the Medical Assistance program for reimbursement for services provided under this section and the ratio of Medical Assistance reimbursement received for those services to the amount billed to the Medical Assistance program for those services. (g) Private agency applicant. If the applicant is a private agency, the applicant submits documentation with the grant application that demonstrates that the application is supported by a county or city and that a county or city will collaborate with the private agency in providing services. (6g) CONFIDENTIALITY. (a) Except as permitted or required under s. 48.981 (2), no person may use or disclose any information concerning any individual who is selected for an assessment under sub. (4) (b), including an individual who declines to undergo the assessment, or concerning any individual who is offered services under a home visitation program funded under this section, including an individual who declines to receive those services, unless the use or disclosure is connected with the administration of the home visitation program or the administration of the Medical Assistance program under ss. 49.43 to 49.497 or unless the individual has given his or her written informed consent to the use or disclosure. (b) A county, city, private agency, or Indian tribe that is selected to participate in the program under this section shall provide or shall designate an individual or entity to provide an explanation of the confidentiality requirements under par. (a) to each individual who is offered an assessment under sub. (4) (b) or who is offered services under the home visitation program of the county, city, private agency, or Indian tribe. (6m) NOTIFICATION OF PARENT PRIOR TO MAKING ABUSE OR NEGLECT REPORT. If a person who is providing services under a home visitation program under sub. (4) (b) 1. determines that he or she is required or permitted to make a report under s. 48.981 (2) about a child in a family to which the person is providing those services, the person shall, prior to making the report under s. 48.981 (2), make a reasonable effort to notify the child’s parent that a report under s. 48.981 (2) will be made and to encourage the parent to contact a county department to request assistance. The notification requirements under this subsection do not affect the reporting requirements under s. 48.981 (2). (6r) HOME VISITATION PROGRAM INFORMATIONAL MATERIALS. Any informational materials about a home visitation program under sub. (4) (b) 1. that are distributed to a person who is offered or who is receiving home visitation program services under that program shall state the sources of funding for the program. (7) HOME VISITATION PROGRAM EVALUATION. (a) The department shall conduct or shall select an evaluator to conduct an evaluation of the home visitation program. The evaluation shall measure all of the following criteria in families that have participated in the home visitation program and that are selected for evaluation: 1. The number of poor birth outcomes and substantiated reports of child abuse and neglect. 2. The number of emergency room visits for injuries to children. 3. The number of out-of-home placements of children. 4. Immunization rates of children. 5. The number of services provided under s. 49.46 (2) (a) 2. to children. 6. Any other items that the department determines to be appropriate for evaluation. (ag) The department shall evaluate the availability of home visitation programs in the state and determine whether there are gaps in home visitation services in the state. The department shall cooperate with counties, cities, private agencies, and Indian tribes providing home visitation programs to address any gaps in services identified. (ar) Each county, city, private agency, and Indian tribe providing a home visitation program shall collect and report data to the department, as required by the department. The department shall require each county, city, private agency, and Indian tribe providing a home visitation program to collect data using forms prescribed by the department. (b) In the evaluation, the department shall determine the number of families who remained in the home visitation program for the time recommended in the family’s case plan. (c) Each county, city, private agency, and Indian tribe providing a home visitation program shall develop a plan for evaluating the effectiveness of its program for approval by the department. The plan shall demonstrate how the county, city, private agency, or Indian tribe will use the evaluation of its program to improve the quality and outcomes of the program and to ensure continued compliance with the home visitation program criteria under sub. (6) (a). The plan shall demonstrate how the outcomes will be tracked and measured. Under the plan, the extent to which all of the following outcomes are achieved shall be tracked and measured: 1. Parents receiving home visitation services acquiring knowledge of early learning and child development and interacting with their children in ways that enhance the children’s development and early learning. 2. Children receiving home visitation services being healthy. 3. Children receiving home visitation services living in a safe environment. 4. Families receiving home visitation services accessing formal and informal support networks. 5. Children receiving home visitation services achieving milestones in development and early learning. 6. Children receiving home visitation services who have developmental delays receiving appropriate intervention services. (8) TECHNICAL ASSISTANCE AND TRAINING. The department shall provide technical assistance and training to counties, cities, private agencies, and Indian tribes that are selected to participate in the program under this section. The training may not be limited to a particular home visitation model. The training shall include training in best practices regarding basic skills, uniform administration of screening and assessment tools, the issues and challenges that families face, and supervision and personnel skills for program managers. The training may also include training on data collection and reporting.
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