NCSL Fact Sheet on Health Reform Implementation

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State At Risk Communities Assessment

This program mandates that each state condcut a statewide needs assesment identifying at risk communiites.

 Citation: Title I, IV, Sec. 2951

Statutory Directive : Mandates that each state conduct a statewide needs assessment identifying at risk communities.

Expected Completion Date:  September 2010

Funding: No federal funding is provided to support this activity.

Program Summary 

  • Mandates that each state conduct a statewide needs assessment identifying at risk communities.
  • Completion of this assessment will be a condition for receipt of each state’s MCH block grant.

The assessment must be completed within six months of the enactment of the Affordable Care Act and identify the following:

  1. Communities with a concentration of premature birth;
  2. low birth weight infants;
  3. at-risk for infant death due to neglect, or prenatal, maternal , newborn or child health;
  4. poverty; crime; domestic violence;
  5. high rates of high-school drop-outs;
  6. substance abuse; unemployment, or
  7. child maltreatment,

8. 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 family who receive services under the programs;

II.  the gaps in early childhood home visitation in the state, and

III. the extent to which the initiatives are meeting the needs of eligible families in the state, and

9.       The state’s capacity for providing substance abuse treatment and counseling services to individuals and families in need of treatment or services.

  • Directs each state to coordinate with other assessments including the assessment for the Maternal Child Block grant, the communitywide strategic planning and needs assessment for the Head Start Act, and inventory of current unmet needs.
  • Directs each state to submit with their assessment a description of how the state intends to address the needs identified, which may include an application for a grant to conduct an early childhood home visitation program.


Additional Information &Resources:  


NCSL staff contacts: Joy Johnson Wilson, Federal Affairs Counsel, Health Policy Director at  or Rachel B. Morgan RN, BSN, Senior Health Policy Specialist at

Published June 11, 2010