A popular federal program that pairs trained professionals with young and expecting mothers will expire unless Congress acts this week.
Maternal Infant and Early Childhood Home Visiting (MIECHV) was created in 2009 as part of the Affordable Care Act (ACA). It funds state-level programs aimed at preventing maltreatment by connecting expecting parents, and parents of very young children, with the assistance of trained professionals who come to them.
MIECHV was originally scheduled to end in September, but Congress approved an extension of MIECHV funding through March of 2015. Advocates had pushed for the program’s extension under an omnibus spending bill for 2015.
It now appears that the only chance to prevent at least a temporary closure for the program is H.R. 1470, a bill centered on repeal of the Medicare sustainable growth rate formula.
First Focus spokesman Ed Walz, whose organization leads a group called the Home Visiting Coalition, said the group is “hopeful” that MIECHV will be extended but it is “by no means a done deal.”
Closure of MIECHV would have little impact in the current fiscal year; all of the funds have been awarded. But it could immediately impact enrollment at the local level, and would certainly jeopardize future funding.
The Affordable Care Act invested $1.5 billion over five fiscal years (2010 to 2014) into home visitation, a drastic increase from the $13.9 million appropriated for home visitation in 2009.
There are 16 different approved models of home visitation for the federal MIECHV funds. All MIECHV-funded programs must be carried out by local agencies and must be voluntary, meaning that a state agency cannot require a parent to receive home visitation services.
MIECHV supported home visitation for 115,000 families in 787 U.S. counties last fiscal year, according to a recently released report by the Department of Health and Human Services
Many of the tenets of the ACA are politically controversial, but MIECHV has enjoyed bipartisan support. From a letter sent to Senate Finance Committee leadership by a group of Senators from both sides of the aisle:
“In order to ensure families and their children continue receiving these vital services, we strongly urge the program be continued, extended and the current funding level maintained.”
The letter also urges that MIECHV not be paid for by diverting funds from “other vitally important maternal and child health programs,” specifically noting the Social Services Block Grant.
The original funding for the MIECHV program escalated from $100 million in 2010 to $400 million in 2013 and 2014. In December, a group of 750 organizations and local politicians calling themselves the Home Visiting Coalition sent a letter to the House and Senate leadership asking for $400 million for MIECHV in fiscal 2015.
President Obama requested $500 million for MIECHV in his 2016 budget request.
Sen. Ron Wyden (D-Ore.), the ranking minority member on Senate Finance, told The Chronicle of Social Change in September that he had a “particular interest in home visiting. The evidence we’ve seen is that for at-risk moms, it’s something that works. That, to me, is something we ought to build around and expand.”
John Kelly is an editor for The Chronicle of Social Change