Practice to Policy: Support for Home Visiting is a Bipartisan Victory for Families

Every day social innovators and social innovation organizations across the country are measurably impacting communities and individuals. This Practice to Policy blog series lifts up the voices of the more than 70 organizations that make up the America Forward Coalition and our broader social innovation network by highlighting the outcomes-based solutions to our country’s most pressing social problems and why these solutions must be reflected in our federal policies. Today we will hear from the Council for Strong America about the significance of the long-term reauthorization of the evidence-based Maternal, Infant, and Early Childhood Home Visiting Program (MIECHV) evidence-based pregnant women and their children.

In a world where political spin is the norm, data remains impartial.

Over the past few years, evidence-based policymaking has provided one of the few examples in which Congress has found common ground. The Bipartisan Budget Act of 2018, passed on February 9th, was a historic win for evidence-based policymaking for a number of reasons, among them that it included a five-year reauthorization for a relatively small federal program called the Maternal, Infant, and Early Childhood Home Visiting (MIECHV) Program.

Home visiting pairs a nurse or other trained professional with pregnant women and families to help provide support and coaching to ensure their babies are physically, socially, and emotionally healthy and ready to learn. Various home visiting models have been studied at length, and the results are clear that these programs work.

Council for a Strong America, a nonprofit comprised of law enforcement, military, business, faith and sports leaders focused on ensuring the next generation grows up healthy, educated, and prepared to succeed, is a strong supporter of home visiting programs and MIECHV. This two-generational approach helps to create a healthy, safe, and engaging environment for children at a time in their young lives during which they undergo their fastest rate of brain development. The outcomes, ranging from better public safety to reduced infant mortality and hospital visits, to improved workforce and educational benefits, are all critical components of breaking generational cycles of poverty and child abuse.

The longest-running study of home visiting followed participants in a home visiting model called the Nurse-Family Partnership for over two decades. The study showed that the program cut child abuse and neglect in half. It also found that it reduced crime for both the mothers and the children later in life.

The MIECHV Program began in 2010 and mandated at least 75% of its funding be spent on evidence-based programs, and the rest spent on promising programs. To be evidence-based, programs had to be grounded in research, rigorously studied, in existence for at least three years, and run by a credible national organization. This innovative funding structure has ensured that MIECHV dollars have not only been spent on what works, but they have also encouraged innovation.

The reauthorization last week came after the program had expired on September 30, 2017, marking the first time MIECHV funding had ever been allowed to lapse. Fortunately, this reauthorization is for five years, the longest reauthorization to date, which will give states and providers much-needed certainty and consistency moving forward.

Another exciting development is that this reauthorization included language that will, for the first time, allow states to enter into performance-based contracts for home visiting and use up to 25 percent of their MIECHV dollars for success/outcome payments. This approach often referred to as the “Pay for Success” model, targets dollars towards programs that work. While the state of South Carolina was able to launch a four-year Pay for Success initiative around home visiting in 2016, it required a hard-fought waiver from the federal government. This legislative change will make it much easier for states to utilize this performance-based contracting model and should lead to further investment and innovation in home visiting programs around the country.

The Bipartisan Budget Act of 2018 also included wins for evidence-based policy with passage of the Social Impact Partnerships to Pay for Results Act, as well as the Family First Prevention Services Act. These policies, along with MIECHV, will allow governments at the federal, state and local levels to focus more resources on programs that have been shown to work or have shown great promise. While there is usually much agreement on the outcomes we hope to see through policy, such as healthier, well-educated children and reductions in poverty, there are often deep political chasms on what policies or programs can help us get there as a country.

These evidence-based approaches have brought together policymakers from both sides of the aisle, and these victories should serve as an important foundation for more bipartisan work and a continued focus on results to achieve outcomes we all want.

This post is part of America Forward’s Practice to Policy blog series. Follow along on Twitter with #Practice2Policy and catch up on the series here.

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