Lifeline for Federal Home Visiting Program In Senate Spending Bill, Not in House Plan

The Senate’s continuing resolution (CR) includes a five-year level extension of the Maternal, Infant and Early Childhood Home Visiting (MIECHV) program, which funds states to place professionals with new and expecting mothers.

The House version, released yesterday, does not include any short-term or long-term extension for the program. So the Senate’s inclusion of the program, at $400 million per year through 2o22, gives it some chance at stabilizing before what many now agree will be a period of significant disruption for home visiting if MIECHV goes any longer without a reauthorization.

“We need to get this through the final bill this week,” said Fran Benton, spokesperson for Nurse-Family Partnership, one of the national home visiting models approved for funding under the federal program, in an e-mail sent to Youth Services Insider. “If MIECHV doesn’t get reauthorized, some Nurse-Family Partnership programs will have to stop enrolling new families in poverty next month (March) and will be forced to end these programs very soon. Nurses are worried about their jobs and having to leave families at a time when they need the support most.”

In an interview published today by The Chronicle of Social Change, an executive in charge of home visiting for a major provider in Iowa said that uncertainty about the future of MIECHV has already caused disruptions in hiring and will soon prompt cuts or eliminations of home visiting programs in the state.

“One of the real possibilities, if this does not get reauthorized in the next continuing resolution, is that programs may have to suspend the enrollment of new families,” said Nancy Krause, director of early childhood for Lutheran Services in Iowa. “There are real ethical concerns if we do not have a guarantee that we will be able to serve families on a long-term basis. When you bring in families with past trauma, trust and consistency are critical. You actually can end up harming them more than when you found them.”

MIECHV was piloted under President Bush, became part of the Affordable Care Act in 2010, and in recent years has been funded at $400 million per year. But the program expired in September, and Congress failed to reach an agreement on either a two-year or five-year reauthorization of it.

The danger of program cuts has loomed since December, when MIECHV was not included in the first of several last-minute deals to keep the government open.

“We’re not going to panic, and we don’t want locals to be in panic,” said Staci Croom-Raley, executive director of HIPPY USA, in a December interview with The Chronicle. “But now we’re starting to have new conversations with locals as to, ‘Tell us the number you may have to stop serving’ without MIECHV. And, ‘How will this affect you in terms of enrolling?’”

House Republicans passed a bill that would extend MIECHV for five years at $400 million, but would require states to fully match the money by the fifth year. Home visiting advocates have objected to the plan, which they say would cause significant decreases in MIECHV spending in states that do not locally fund home visiting.

The Senate Finance Committee introduced a reauthorization that would simply extend the program as is at $400 million for five years, and then developed a two-year extender to be included in spending deals. But neither iteration of a lifeline for MIECHV has moved yet.

The Home Visiting Coalition has circulated a call to action asking MIECHV supporters to push Senators to include an extension for the program in that chamber’s continuing resolution plan.

“We are not giving up on MIECHV or the children and families it serves, and neither should you. We have not come this far to give up now,” said the message. “There is still a chance to get MIECHV reauthorized in the continuing resolution. Please take a moment to call, e-mail and tweet your member of Congress.”

“We are hopeful that the Senate…will include a 5-year reauthorization of MIECHV in the final iteration of the CR,” said Diedra Spires, CEO of the nonprofit Dalton Daley Group. “The expiration of the MIECHV program is no longer bearable, children and families are being impacted.”

Karen Howard, vice president of early childhood policy at First Focus, said there is a “real opportunity” for the Senate to include the home visiting program.

“We have heard from senate offices that they would like to include all of the extenders on the CR, not just select programs,” Howard said, referring to extender provisions for programs that expired at the end of September when the fiscal year changed.

This time last year, advocates for MIECHV reauthorization were confident that, because of the bipartisan support for home visiting, the program would not only be extended five years, but could receive a doubling of its funding to $800 million. But fissures in the two parties’ views became evident when Republican members of the House Ways and Means committee introduced the match bill without any Democrats as co-sponsors.

“Since 2005, MIECHV has been uniquely bipartisan, until today,” said Rep. Danny Davis (D-Ill.), at a hearing on the bill back in September.

While reauthorization of MIECHV was not included in the House plan, it did include enactment of the Family First Prevention Services Act, a major foster care finance reform bill that would open up a federal entitlement for foster care to include services meant to prevent the use of foster care in some cases, while limiting federal spending on the use of congregate and group care for foster youth.

Note: This article was updated on February 7.

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John Kelly, Editor in Chief, The Chronicle of Social Change
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John Kelly is editor-in-chief of The Chronicle of Social Change. Reach him at