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H H S Department of Health and Human Services
Health Resources and Services Administration
Maternal and Child Health

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Maternal, Infant, and Early Childhood Home Visiting Program

The Maternal, Infant, and Early Childhood Home Visiting program (MIECHV) facilitates collaboration and partnership at the Federal, State and community levels to improve health and development outcomes for at-risk children through evidence-based home visiting programs.

It is authorized by the Patient Protection and Affordable Care Act of 2010 (see pages 216-225).

What is Home Visiting?

A home visiting program is a program that includes home visiting as a primary service delivery strategy (excluding programs with infrequent or supplemental home visiting), and is offered on a voluntary basis to pregnant women or children birth to age 5 targeting one or more of the participant outcomes in the legislation including improved maternal and child health, prevention of child injuries, child abuse, or maltreatment, and reduction of emergency department visits, improvement in school readiness and achievement, reduction in crime or domestic violence, improvements in family economic self-sufficiency, and improvements in the coordination and referrals for other community resources and supports.

The MIECHV program is one of several service strategies embedded in a comprehensive, high-quality early childhood system that promotes maternal, infant, and early childhood health and development and that relies on the best available research evidence to inform and guide practice.

Home Visiting Providers

Through the home visiting program, nurses, social workers, or other trained home visitors meet with at-risk families in their homes, evaluate the families’ circumstances, and connect families to the type  of assistance  that can make a real difference in a child’s health, development, and ability to learn - such as health care, developmental services for children, early education, parenting skills, child abuse prevention, and nutrition education or assistance.

Priority Populations

Priority populations were determined by state and territorial grantees.  Criteria could include families that: (A) reside in communities in need of such services, as identified in the legislatively required statewide needs assessment; (B) have low-income; (C) include pregnant women who have not attained age 21; (D) have a history of child abuse or neglect , or those who have had interactions with child welfare services; (E) have a history of substance abuse, or need substance abuse treatment; (F) have users of tobacco products in the home; (G) have a history of, or have children with low student achievement; (H) have children with developmental delays or disabilities; and (I) include members of the military.

Program Goals

The MIECHV program is designed to (1) strengthen and improve the programs and activities carried out under Title V of the Social Security Act; (2) improve coordination of services for at-risk communities; and (3) identify and provide comprehensive services to improve outcomes for families who reside in at-risk communities.

The program is administered by the Health Resources and Services Administration (HRSA) in collaboration with the Administration for Children and Families (ACF) both agencies of the U. S. Department of Health and Human Services (HHS).  In addition to awarding funds to states/territories and tribes, HRSA and ACF are administering several other MIECHV activities to support the MIECHV program and grantees.

Grants to States, Jurisdictions and Tribes

MIECHV includes grants to states and six jurisdictions; and grants to Indian Tribes, Tribal Organizations, and Urban Indian Organizations.

Tribal Program

The Tribal MIECHV program mirrors the state program to the greatest extent practicable.   The goal of the program is to support the development of happy, healthy, and successful American Indian and Alaska Native children and families through a coordinated home visiting system. The MIECHV tribal grants are administered by ACF.

Collaboration among Federal, State, and Local Communities and Agencies

The MIECHV program responds to the diverse needs of children and families in communities at risk and provides an unprecedented opportunity for collaboration and partnership at the federal, state, and community levels to improve health and development outcomes for at-risk children through evidence-based home visiting programs.   Due to the multidisciplinary nature of the program, collaboration among various state agencies  and with local communities is strongly encouraged and in some cases required.

Federal and State Collaboration

At the federal level,  HRSA is collaborating with ACF, ensuring that each of these agencies’ expert areas are engaged in the home visiting effort.  In addition to awarding funds to states,territories and tribes, HRSA and ACF are administering several other MIECHV activities to support the MIECHV program and grantees.

At the State and community levels, the MIECHV program provides an opportunity for collaboration and partnership among agencies. The program serves as a focal point for collaboration with natural partners, where collaboration and integration may not have existed or has been challenging. The program requires collaboration with Title V agencies, child welfare agencies, State Advisory Councils, and many others.  Partnerships are being made in many states where these relationships previously did not exist. 

Benchmarks

The legislation establishing MIECHV requires   quantifiable, measurable improvements for the populations participating in the program. Grantees must demonstrate improvement in the following benchmark areas:

  • Improved maternal and newborn health;
  • Prevention of child injuries, child abuse, neglect, or maltreatment, and reduction of emergency department visits;
  • Improvement in school readiness and achievement;
  • Reduction in crime or domestic violence;
  • Improvements in family economic self-sufficiency; and
  • Improvements in the coordination and referrals for other community resources and supports.  
Early Childhood Comprehensive Systems

The Maternal, Infant and Early Childhood Home Visiting Program legislation mandates that home visiting programs be implemented within a comprehensive early childhood system. The Early Childhood Comprehensive Systems (ECCS) program helps to develop and improve such programs, which building the health and promote the optimal development of all children. 

Go to: Early Childhood Comprehensive Systems Program

A clinician with a mother and infant patient