The Necessity of MIECHV Reauthorization

The Maternal, Infant, and Early Childhood Home Visiting (MIECHV) program is a voluntary, evidence-based program within the Health Resources and Services Administration at the Department of Health and Human Services (HHS) that is focused on giving parents the support they need to create a happy, healthy, and safe environment for their children. Home visitation can start in the prenatal period, giving expectant parents who face greater risks and barriers the tools to be the best parents they can be.

The MIECHV program serves families in all 50 states, the District of Columbia, and five U.S. territories and all MIECHV models share the common goals of:

• Improving maternal and child health,
• Preventing child injuries, abuse and neglect,
• Improving school readiness and achievement,
• Reducing crime and domestic violence,
• Improving family economic self-sufficiency, and 
• Improving coordination and referrals for community resources.

Cultivating good parenting habits from the prenatal period onward has a multitude of benefits for the family, the child, and society as a whole and the birth to five period is crucial for the physical, emotional, and social development of children. Home visitors meet with parents one on one from pregnancy through their child’s kindergarten entry to help lay the foundation for the health, education, development, and economic self-sufficiency of the entire family.

States tailor their MIECHV programs to meet community needs, with priority given to families with low incomes, families with parents who have a history of substance abuse and/or child abuse and maltreatment, and families with lower levels of educational attainment, etc. In FY 2020, 70% of families participating in the MIECHV program were at or below the federal poverty level, with 62% of adults having a high school diploma or less, 21% of households reporting a history of child abuse and maltreatment, and 14% of households reporting substance abuse. According to HRSA, more than 140,000 parents and children were served by MIECHV programs in FY20, and more than 925,000 home visits were conducted.

In recent years, some home visiting models have incorporated virtual service delivery (i.e. phone, text, email, and videoconferencing). Virtual home visits have helped to extend MIECHV’s reach to under-resourced and rural communities, prevent service delivery disruptions due to illness or weather, and provide more immediacy and flexibility. The pandemic greatly accelerated the use of virtual home visiting, allowing families to safely maintain vital connections during unprecedented circumstances.

Home Visiting Models

In FY2022, 20 models were approved for funding, which means they have met HHS criteria for effectiveness as well as statutory requirements for eligibility. The models vary in the type of families they target, as well as the number of home visits conducted during a set period of time. One model focuses on providing parents with child development knowledge and promoting healthy family functioning; another focuses on supporting the health, wellbeing, and self-sufficiency of low-income, first-time mothers with specially educated nurses. Others are focused on identifying the specific needs of the child and family then connecting each with the resources they need and coordinating care; or on promoting school readiness and supporting parents as their children’s first teacher. There may be multiple models operating within a state as MIECHV grantees must ensure that the model meets the needs of the communities and/or any target populations where they are working. MIECHV models are held to very high standards and are expected to achieve meaningful outcomes in benchmark areas and measures.

Learn more about each of the MIECHV-approved home visiting models here.

Tribal Communities

MIECHV also serves tribal communities through the Tribal Maternal, Infant, and Early Childhood Home Visiting (TMIECHV) program, which provides federal grants to tribes, tribal consortia, tribal organizations, and urban Indian organizations. This program is currently funded through a three percent set-aside from the overarching MIECHV program. There are currently five approved models, as the aim of TMIECHV is to provide the same support and strategies as the MIECHV program, but within a culturally-appropriate manner, understanding that the needs and challenges faced by these communities are often based in historical trauma and require a specialized set of programming.

Reauthorization

MIECHV was reauthorized in 2018 at a funding level of $400 million a year through FY2022 and will expire September 30, 2022. FFYF has partnered with other national organizations to help lead the National Home Visiting Coalition, a diverse group of organizations working to promote continued federal support of home visiting to strengthen communities and families across the country. The larger coalition has both state and national organizations and is working to advocate for reauthorization of MIECHV to ensure families receive the services they need.

MIECHV is the recognized gold standard in voluntary, evidence-based policymaking, however, federal funding for MIECHV has not increased since FY2013, which has diminished the ability of states to support families who are in need. After nearly a decade of level funding, the National Home Visiting Coalition recommends a five-year reauthorization that would increase funding by $200 million annually (reaching $1.4 billion in FY2027), which is critical to serving more families; doubling the MIECHV tribal set-aside from 3% to 6% to reach more families in American Indian and Alaska Native communities; and continuing to allow virtual home visiting implemented with model fidelity as a service delivery option for families who choose it. All of these improvements and funding increases are important to the success of the MIECHV program. Because, as effective as MIECHV is, it should be serving more families. Of the 18 million current and expectant parents who could benefit from MIECHV, only 140,000 currently benefit from the program.