By Kristin Roadman, CTIPP Intern and Masters in Public Health Graduate Student
OCTOBER 3RD UPDATE: Thankfully, after months of advocacy, Congress passed legislation to extend the MIECHV program. Unfortunately, Congress only extended it to December 16, 2022, and did not include the additional funding CTIPP asked for. This short term extension gives us more time to organize and advocate.
Fortunately, Congressmembers in the U.S. House of Representatives just introduced the Jackie Walorski Maternal and Child Home Visiting Reauthorization Act to increase funding and reauthorize the program. CTIPP endorsed this legislation, which is advancing through the Chamber right on time.
With the December cliff approaching, please urge Congress to extend and improve this critical program (and encourage others to do the same!).
It is critical that the U.S. Congress reauthorize and expand the Maternal Infant Early Childhood Home Visiting (MIECHV) program, which is set to expire on September 30, 2022. MIECHV provides pregnant people and families access to equitable, convenient, and quality health care in communities that face greater risks and barriers to achieving positive maternal and child health outcomes.
Through home visits, parents learn childcare skills and gain knowledge that encourages healthy and thriving families. We must limit the disruption of services by urging Congress to reauthorize and expand MIECHV to reach more families.
We know that MIECHV reduces maternal mortality and pre-term birth, lessens child neglect and abuse instances, and saves taxpayer money in the first year of a child’s life. Evidenced-based home visiting programs are also proven to help parents break the cycles of trauma and poverty by promoting positive parenting techniques to help raise children who are physically, socially, and emotionally healthy and ready to learn.
The coordination of care and referrals that address the family's overall needs can also help reduce racial and ethnic disparities and eliminate assumptions about a family’s life by creating clear communication across their health care team.
Why does this matter? The MIECHV program reaches vulnerable families that are at risk for poor family and child outcomes. According to the Human Resources & Services Administration, of those served, 70% of families had household incomes at or below the federal poverty level, while 21% of households reported a history of child abuse or maltreatment, and 14% reported substance misuse. During home visits, families and trained specialists develop trusting relationships that support collaborative approaches to address system shortcomings and set goals for the future, like identifying childcare solutions and finding and retaining employment.
Without the reauthorization of MIECHV, tens of thousands of families will lose access to support that increases economic self-sufficiency and lessens adverse childhood experiences. Of the 18 million pregnant people and families who could benefit from the program, less than five percent participate. By investing more in MIECVH, we can strengthen communities by improving outcomes for children and their families.
That’s why we are urging Congress to pass a bipartisan reauthorization bill to continue and expand home visiting with three critical components in alignment with the National Home Visiting Coalition:
Increase MIECHV over the next five years by $200 million annually, to a total of $1.4 billion annually. The expansion will reach more families in high-risk communities, improve maternal health outcomes, and better address workforce challenges over the next five years.
Raise the Tribal set-aside from three percent to six percent to reach more families in tribal communities. The pandemic has further highlighted inequities within the American Indian and Alaska Native (AIAN) communities as data released by the Center for Disease Control and Prevention (CDC) saw a 2.5 percent decline among the AIAN population in 2021, with a cumulative drop of 6.5 years since 2020.
Continue to allow virtual home visiting as an approved option for service delivery to families. Offering the virtual option in addition to traditional in-home visits promotes family choice, increases accessibility, and allows for flexibility while supporting workforce and retention.
Arias, E., Betzaida, T.V., Kochanek, K., & Ahmad, F.B. (2022, August). Provisional Life Expectancy Estimates for 2021. The Centers for Disease Control and Prevention. https://www.cdc.gov/nchs/data/vsrr/vsrr023.pdf
Home Visiting Coalition. (n.d.). America’s Families are Raising Our Future, Home Visiting makes us stronger. https://nationalhomevisitingcoalition.org/wp-content/uploads/1-HVC_Reauthorization-Final.pdf
Lewy, D., & Casua, A. (2021, October). Addressing Racial and Ethnic Disparities in Maternal and Child Health Through Home Visiting Programs. Center for Health Care Strategies. https://www.chcs.org/media/Addressing-Racial-Ethnic-Disparities-Maternal-Child-Health-Home-Visiting-Programs.pdf
Maternal, Infant, and Early Childhood Home Visiting (MIECHV). (2021, December). Health Resources & Services Administration, Maternal & Child Health. Retrieved August 30, 2022, from https://mchb.hrsa.gov/programs-impact/programs/home-visiting/maternal-infant-early-childhood-home-visiting-miechv-program
Explore all of the National Home Visiting Coalition's resources