AN ACT RELATING TO HEALTH AND SAFETY -- THE RHODE ISLAND FAMILY HOME--VISITING ACT (Changes annual reporting requirements for the state’s family home-visiting program and also impacts appropriation and spending of funds in order to access maximum federal funding for these programs.)

S2845

2026 -- S 2845
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STATE OF RHODE ISLAND
IN GENERAL ASSEMBLY
JANUARY SESSION, A.D. 2026
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A N A C T
RELATING TO HEALTH AND SAFETY -- THE RHODE ISLAND FAMILY HOME--
VISITING ACT

Introduced By:
Senators Valverde, Mack, DiMario, DiPalma, Urso, Murray, Ujifusa,
Quezada, and Acosta

Date Introduced:
March 04, 2026

Referred To:
Senate Finance
It is enacted by the General Assembly as follows:
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SECTION 1. Legislative findings.
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The general assembly hereby finds that:
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(1) A child's first experiences and relationships set the foundation for development and
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learning that leads to success in school and in life.
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(2) Voluntary, high-quality home-visiting programs help families learn about and connect
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to essential resources, adjust to parenthood, build parenting skills, and address challenges
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commonly faced by young families.
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(3) For at least four (4) decades, Rhode Island’s First Connections program, overseen by
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the department of health and funded primarily through Medicaid billing, has been providing free,
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voluntary, statewide home-visiting to expectant mothers and families with newborns, infants, and
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toddlers. Families typically receive one to four (4) home visits. Between 2021 and 2024, the number
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of families receiving at least one First Connections visit declined by 42%. In 2024, 1,970 families
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received services, approximately 32% of those referred.
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(4) Following the establishment of the federal Maternal, Infant, and Early Childhood Home
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Visiting (MIECHV) program in 2010, Rhode Island expanded home-visiting services to fund
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implementation of nationally-recognized evidence-based program models that connect pregnant
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and parenting families with a designated support person who guides them through the early stages
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of raising a family. Home visiting is voluntary, free, and tailored to meet families where they are

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and help them achieve their goals to raise healthy, happy children. Each of these proven models is
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designed to provide multi-year, consistent, flexible, relationship-based services to a family starting
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in the third trimester of pregnancy or soon after the birth of a child.
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(5) In 2022, the federal MIECHV funding was reauthorized and now includes a twenty-
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five percent (25%) state match requirement to receive increased funds. Most states have been able
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to meet or exceed the state match and have received additional federal funds. In 2024 and 2025,
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the first two (2) years of the state match challenge, Rhode Island did not meet the full state match
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challenge and was unable to draw down the full federal MIECHV grant.
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(6) Starting in 2023, the department of health began requiring all evidence-based family
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home visiting providers and programs to implement Medicaid fee-for-service billing for each
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encounter for every mother or child who has Medicaid insurance. Medicaid billing and other
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funding challenges led to a 32% decline in the number of families in Rhode Island receiving
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evidence-based home visiting services and the closure of 7 home visiting programs since 2021.
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SECTION 2. Section 23-13.7-2 of the General Laws in Chapter 23-13.7 entitled "The
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Rhode Island Family Home-Visiting Act" is hereby amended to read as follows:
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23-13.7-2. Home-visiting system components.
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(a) The Rhode Island department of health shall coordinate the system of early childhood
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home-visiting services in Rhode Island and shall work with the department of human services and
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department of children, youth and families to identify effective, evidence-based, home-visiting
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models that meet the needs of vulnerable families with young children.
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(b) The Rhode Island department of health shall implement a statewide home-visiting
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system that uses evidence-based models proven to improve child and family outcomes. Evidence-
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based, home-visiting programs must follow with fidelity a program model with comprehensive
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standards that ensure high-quality service delivery, use research-based curricula, and have
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demonstrated significant positive outcomes in at least two (2) of the following areas:
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(1) Improved prenatal, maternal, infant, or child health outcomes;
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(2) Improved safety and reduced child maltreatment and injury;
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(3) Improved family economic security and self-sufficiency;
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(4) Enhanced early childhood development (social-emotional, language, cognitive,
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physical) to improve children’s readiness to succeed in school.
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(c) The Rhode Island department of health shall implement a system to identify and refer
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families prenatally, or as early after the birth of a child as possible, to voluntary, evidence-based,
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home-visiting programs. The referral system shall prioritize families for services based on risk
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factors known to impair child development, including:

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(1) Adolescent parent(s);
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(2) History of prenatal drug or alcohol abuse;
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(3) History of child maltreatment, domestic abuse, or other types of violence;
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(4) Incarcerated parent(s);
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(5) Reduced parental cognitive functioning or significant disability;
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(6) Insufficient financial resources to meet family needs;
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(7) History of homelessness; or
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(8) Other risk factors as determined by the department.
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(d) The Rhode Island department of health shall issue a state home-visiting report due
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annually by March 1
of each year
that outlines the components of the state’s family home-visiting
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system
that shall
, including state and federal funding amounts and sources. This report shall be
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shared with the general assembly and
be made publicly available on the department’s website. The
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report shall include:
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(1) The number of families served by
First Connections, as defined by subsection (f) of
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this section, in each calendar year, and the number of families enrolled in
each evidence-based
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family home-visiting
model
at a common point-in-time for each of the last five (5) years
;
and
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(2) Demographic data on families served;
and
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(3) Duration of participation of families;
and
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(4) Cross-departmental coordination;
and
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(5) Outcomes related to prenatal, maternal, infant and child health, child maltreatment,
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family economic security, and child development and school readiness;
and
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(6) An annual estimate of the number of children born to Rhode Island families who face
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significant risk factors known to impair child development, and a plan including the fiscal costs
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and benefits to gradually expand access to
First Connections and
the existing evidence-based,
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family home-visiting programs in Rhode Island to all vulnerable families.
The annual plan shall
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include a projected three (3) year estimate of the available federal MIECHV grant funds, the state
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match required to access the full federal MIECHV grant available, the projected Medicaid fee-
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for-service billing and/or other funding strategies to sustain the programs and to meet expansion
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targets. The annual plan shall be designed to maximize use of the federal MIECHV grant and
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ensure providers have adequate funds to recruit and retain qualified staff;
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(7) The total annual federal MIECHV funding available, received, and spent by the state
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on direct home-visiting services by program model and the total spent on state administration for
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each of the last five (5) years;
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(8) The total annual funding for each program model by source of funding to include

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Medicaid fee-for-service state and federal funding, MIECHV federal funding, MIECHV state
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match funding, and any other funding by source for each of the last five (5) years for all models;
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and
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(9) Implementation successes and challenges, including those related to funding, provider
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contracts, provider staffing and turnover, and family enrollment and retention.
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(e) State appropriations for this purpose shall be combined with federal dollars to fund the
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expansion of evidence-based, home-visiting programs, with the goal of offering the program to all
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the state’s pregnant and parenting teens; families with a history of involvement with the child
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welfare system; and other vulnerable families.
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(f) First Connections, as used in this section, means the state-run home-visiting program
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administered by the department's office of family visiting and implemented by community
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nonprofit organizations providing rapid-response and short-term home visits for pregnant
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individuals and families with newborns and children up to age three (3). Families typically receive
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one to four (4) home visits delivered by registered nurses, community health workers and social
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workers. Home visiting staff assess medical, safety, and other family needs and connect families
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with services to meet their needs such as postpartum support, basic needs, and referrals to more
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comprehensive, multi-year, evidence-based home visiting and early intervention programs.
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(g) The executive office of health and human services shall pursue a Medicaid state plan
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amendment and allocate sufficient state general revenue, to increase Medicaid payment rates for
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family home visiting services by the amount recommended in the 2025 social and human service
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programs review report by the Rhode Island office of the health insurance commissioner. Rate
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increases shall be implemented on or before October 1, 2026.
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(h) Annually, the state shall allocate the minimum amount required to draw down
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maximum MIECHV federal dollars available for Rhode Island to the department, which shall be
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used for funding home-visiting services.
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SECTION 3. This act shall take effect upon passage.
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EXPLANATION
BY THE LEGISLATIVE COUNCIL
OF
A N A C T
RELATING TO HEALTH AND SAFETY -- THE RHODE ISLAND FAMILY HOME--
VISITING ACT
***
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This act would add the First Connections family home-visiting program as a provider under
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the statute and change the department of health’s annual reporting requirements regarding family
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home-visiting programs. This act would also direct the executive office of health and human
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services to increase Medicaid rates for early intervention service providers by the amount
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recommended in the 2025 rate review, appropriate the minimum amount of general revenue to
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access the maximum amount of federal MIECHV funds and direct the department to spend all
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available federal funds.
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This act would take effect upon passage.
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