The Maternal, Infant, and Early Childhood Home Visiting Program

The What, Where and How of Home Visiting

The Maternal, Infant, and Early Childhood Home Visiting program, which is set to expire in March, should be reauthorized so that it can continue to provide support for families and communities. The following questions and answers provide background on this critical, cost-saving program.

Q: What is the Maternal, Infant, and Early Childhood Home Visiting program?

A: The Maternal, Infant, and Early Childhood Home Visiting program, or MIECHV, is a federal/state partnership that funds family support programs known as home visiting because they take place in the homes of vulnerable families. These programs are a proven strategy for strengthening families and saving money.

Because children don’t arrive with instruction manuals, participating parents are those who lack the extended family support, experience, and knowledge of basic parenting skills that are critical to success during pregnancy and through the first few years of a child’s life. This voluntary program is for families that ask to be empowered with better knowledge, better health, and better opportunities for their children.

Decades of research show that these family support programs are effective and ultimately save money for taxpayers. When quality programs, carried out in local communities, are properly implemented, they lead to increased family self-sufficiency, lower health care costs, and reduced need for remedial education. For every dollar spent on these efforts, at least $2 in future spending is saved.

Q: Where did the program originate?

A: These family support and coaching programs have a long history of bipartisan support because they address issues that policymakers on both sides of the aisle agree are important. Republicans and Democrats have championed home visiting at the state level for three decades. In 2008, the first federal funding was appropriated under President George W. Bush. Additional funding was allocated to create MIECHV, the current federal/state partnership, in 2010.

Q: How is it administered?

A: MIECHV authorized $1.5 billion in investments over five years to be administered by the U.S. Department of Health and Human Services. It is coordinated by the Health Resources and Services Administration and the Administration for Children and Families. MIECHV is a federal/state partnership that is active in all 50 states and also has authorized grants for family support and coaching programs to Native American tribes and organizations.

The program gives states flexibility to identify the local problems they want to solve, such as infant mortality or school readiness. States then select their programs, which are locally implemented by the communities where the participating families live.

Q: How is the impact measured?

A: MIECHV was designed with a high degree of accountability. States track and measure effectiveness to make sure the programs are working as intended. The legislation requires that programs demonstrate improvement among participating families in the following areas: economic self-sufficiency; maternal and newborn health; prevention of child injuries, child abuse, neglect, or maltreatment and reduction of emergency department visits; school readiness and achievement; reduction in crime or domestic violence; and improvements in the coordination and referrals for other community resources and support.

There is a requirement that the majority of these programs be proven or “evidence-based,” meaning they have a track record of effectiveness based on rigorous scientific studies. There is also an emphasis on improving the knowledge base in this field. If a state chooses, 25 percent of its funding may be used to foster innovation by employing new and promising approaches.

Q: What has been the impact on states?

A: MIECHV has catalyzed improvements in states’ family support and coaching efforts. Since 2010, a total of 10 states—Arkansas, Connecticut, Iowa, Kentucky, Maryland, Michigan, New Mexico, Ohio, Texas, and Vermont—have passed legislation that creates similar accountability for their state home visiting investments.

State leaders agree that these family support and coaching programs are a sound strategy for strengthening families and saving money and that the programs cannot continue without the strong federal/state partnership established through MIECHV.