Back 

Maternal Infant and Early Childhood Home Visiting

Maternal, Infant and Early Childhood Home Visiting Programs

Table of Contents

The purpose of the law is:

  • to strengthen and improve the programs and activities carried out under Title V of the Social Security Act (the Maternal and Child Health Services Block Grant),

  • to improve coordination and services for at-risk communities, and

  • to identify and provide comprehensive services to improve outcomes for families who reside in at-risk communities.


Updated July 2012

2 adults with a baby

A new federal maternal, infant and early childhood home visiting initiative was created by the Patient Protection and Affordable Care Act (H.R. 3590 and H.R. 4872). Section 2951 of the law amends Title V of the Social Security Act to authorize early childhood home visiting programs.

The law appropriated $1.5 billion over five years (from FY 2010 to FY 2014) to establish this program, which will be administered by the Health Resources and Services Administration (HRSA), in collaboration with the Administration for Children and Families (ACF).

HRSA and ACF intend the program to result in a coordinated system of early childhood home visiting in every state that has the capacity and commitment to provide the needed infrastructure and supports to ensure a high-quality, evidence-based practice.

The federal law and agency guidance provide details about the steps states must take to participate in the grant opportunity. The law also establishes a maintenance of effort requirement for existing home visiting programs or initiatives as a condition for the new grant. Additional details regarding the process and timeline for states to complete the requirements and apply for the funding opportunities are included below.

The first funding opportunity announcement was released in June 2010 and required states to submit a plan to complete a needs assessment and a plan to develop a home visiting program. All states then were required to conduct and submit a home visiting needs assessment by September 20, 2010. Finally, states have the opportunity to apply for funds for their proposed program. This funding opportunity announcement was released February 8, 2011. The announcement provides guidance for submitting an updated state plan, defines criteria for identifying evidence-based models of home visiting and lists the models that meet those criteria.


Policymakers may want to think about:

  • How will legislators be involved in the process?
  • Where should the new federal funds be allocated?
  • Does the needs assessment identify gaps in services for at-risk families that could be addressed by the new funds?
  • How does the federal funding, with its tie to evidence-based programs, provide an opportunity to improve the effectiveness of the state’s existing programs?
  • How can the state leverage the federal funding and planning opportunity to encourage policymakers to think more broadly about the future of home visiting in their state?

 Timeline and Activities for the Maternal, Infant and Early Childhood Home Visiting Programs

 

Timeline                            
Activity

July 9, 2010

First Funding Opportunity Announcement (CFDA Number: 93.505)
An application for funding was announced on June 10, 2010, which required states to submit a plan for completing the needs assessment and a plan for developing the program in order to meet the criteria identified in the health reform law. The application was due on July 9, 2010.

July 21, 2010

The U.S. Department of Health and Human Services Allocated $88 million for the Home Visiting Program to Improve the Well-being of Children and Families

July 28, 2010

Tribal Maternal, Infant, and Early Childhood Home Visiting Grant Program Funding Opportunity Announcement
(CFDA Number: 93.508)  An application for funding was announced on June 24, 2010. The five-year awards will support the completion of community needs assessments, planning for and implementation of high-quality, culturally relevant, evidence-based home visiting programs in at-risk tribal communities, and participation in research and evaluation activities. The application was due on July 28, 2010.

August 16, 2010

State-Designated Contacts Released
The state-designated contacts for the Maternal, Infant and Early Childhood Home Visiting Program were released.

August 17, 2010

Comment Period on Proposed Evidence-Based Criteria
The Federal Register Notices, Vol. 75, No. 141 released on July 23, 2010 announced a comment period through August 17, 2010, on proposed criteria for evidence of the effectiveness of home visiting program models for pregnant women, expectant fathers, and primary caregivers of children from birth through entering kindergarten. Final criteria for evidence of effectiveness will be included in the final program announcement inviting eligible entities to apply for funding under the Affordable Care Act Maternal, Infant, and Early Childhood Home Visiting Program.

September 20, 2010

Supplemental Information Request (SIR) for the Submission of the Statewide Needs Assessment
States were required to respond to a second announcement (released August 19, 2010), which was the submission of the needs assessment itself. View the Health Resources and Services Administration’s webcast about the SIR.

September 28, 2010

Tribal Maternal, Infant and Early Childhood Home Visiting Program Grantees Announced
ACF in collaboration with HRSA announced the award of 13 grants totaling $3 million for the program. View the complete list of awards.

February 8, 2011

Final Funding Opportunity Announcement (Second SIR)
The third and final step is submission of an updated state plan for addressing the needs identified in the assessment. If a state chooses to apply for this home visiting funding, this submission should include the state's final designation of the targeted at-risk communities, a more detailed needs and resources assessment for the targeted communities, and a specific plan for home visiting services tailored to address those identified needs.  The SIR provides guidance for submitting an updated state plan, defines criteria for identifying evidence-based models of home visiting and lists the models that meet those criteria.  Submissions of an updated state plan are due within 90-120 days (May 9-June 8, 2011).  View the SIR here.  View the Transmittal Letter to States here.

June 1, 2011

HHS announced up to $99 million in competitive funding under the Maternal, Infant, and Early Childhood Home Visiting Program
This competitive grant funding will be awarded to eligible states and jurisdictions to support effective implementation of home visiting programs. Successful applicants will receive grants to expand services, as well as promote innovation and infrastructure development within their comprehensive, early childhood state systems. View the HHS press release here.  View the grant announcement here.

June 21, 2011

Funding Opportunity Announcement (Funding opportunity number HRSA-11-187)
An application for funding was announced on June 21, 2011, which solicits funding applications for states to continue the formula-based grant program. The application is due July 21, 2011. View the announcement here.

September 22, 2011

HHS announces $224 million to support evidence-based home visiting programs to help parents and children
The U. S. Department of Health and Human Services awarded $224 million in grants to 49 states, the District of Columbia and five territories to support voluntary home visiting programs. $124 million in grants was awarded for FY 2011, based on a formula, to 49 states and six jurisdictions. In addition, nine states were awarded $66 million in four-year competitive expansion grants to increase the scale or scope of each state’s existing high-quality home visiting programs and services. An additional $34 million in two-year development grants was awarded to 13 states to build on each state’s existing, modest home visiting efforts. For more information, view the U.S Department of Health and Human Services press release here.

April 3, 2012

HHS announces additonal support for children and families
The U.S. Department of Health and Human Services awarded a total of nearly $72 million in grants to 10 states to provide voluntary home visiting services to families. Colorado, Connecticut, Iowa, Kentucky, Minnesota, New Jersey, Pennsylvania, Tennessee, Virginia and Washington will use the funds to expand or develop new home visiting programs, using proven strategies to support families and improve children’s health and development. The grants range from $3.7 million to $9.4 million per state. For more information, view the U.S. Department of Health and Human Services press release here.

June 19, 2012 Funding Opportunity Announcement (Funding Opportunity Number: HRSA-12-163)

An application for funding was announced on June 19, 2012, which solicits funding applications for nonprofit organizations in North Dakota and Wyoming proposing to provide services under the Maternal, Infant and Early Childhood Home Visiting program. The applications are due July 19, 2012. View the announcement here.

July 9, 2012

Funding Opportunity Announcement (Funding Opportunity Number: HRSA-12-156)
An application for funding was announced on July 9, 2012, which solicits funding applications for competitive development grants to states totaling $12 million. The deadline to apply is August 9, 2012.  Four to eight states will receive an award, ranging from $1 to $3 million, to expand and/or enhance their existing programs.  View the announcement here.

 


Investing in Families Through State Home Visiting Programs

In June 2012, NCSL held the "Investing in Families Through State Home Visiting Programs" meeting in Hartford, Connecticut.  The meeting provided an overview of the Child FIRST home visiting program in Connecticut, an overall picture of the home visiting system in Connecticut, an update of home visiting as it relates to the federal budget and the Patient Protection and Affordable Care Act, and information about legislative policy options related to home visiting data, infrastructure and funding issues.  For the full agenda, inculding speaker presentations, please click here.

 

What Legislators Need to Know About New Federal Home Visiting Funding Webinar

An archive of this 60-minute webinar, hosted by NCSL on April 1, 2011, is currently unavailable. 

The web briefing described the current landscape of state home visiting programs, identified steps that states are taking right now to update their state plans and apply for funding, and highlighted ways that state policymakers can get involved as their state makes important decisions about where and how to allocate home visiting resources. The webinar features presentations by NCSL and the Pew Center on the States and Representative Ruth Kagi who highlighted Washington’s home visiting strategies. In response to the approaching deadline for submitting state home visiting plans, NCSL’s Jack Tweedie highlighted key policy questions and options for legislator participation in the state planning and implementation process.

NCSL Home Visiting Alert

NCSL has summarized several key components of the federal home visiting initiative in a Home Visiting Alert. In addition to providing background on home visiting and the research on effectiveness of home visiting programs, the Alert summarizes the federal home visiting initiative, funding levels for states, important timeline for states and steps that states must take to qualify for federal home visiting funds. In addition, the Alert identifies Key Questions that state legislators can ask about their states’ home visiting programs.

Adobe PDF logoTo view PDF files, you must install Adobe Acrobat ReaderNCSL Home Visiting Alert (PDF File - 7 pages)

Additional Resources

NCSL's Health Reform Implementation Resources

Fact Sheet on Health Reform: Grants for Early Childhood Home Visitation Programs
NCSL, June 11, 2010

Fact Sheet on Health Reform: State At-Risk Communities Assessment
NCSL, June 11, 2010

Health Reform and Women, Children and Adolescents
NCSL webpage

Early Childhood Overview
NCSL webpage

Affordable Care Act: Maternal, Infant, and Early Childhood Home Visiting Program
Health Resources and Services Administration webpage

Home Visiting Evidence of Effectiveness
U.S. Department of Health and Human Services webpage

Maternal, Infant, and Early Childhood Home Visiting Program
Maternal and Child Health Bureau Webcast, June 17, 2010

Pew Inventory of State Home Visiting Programs

A Compendium of Local Health Department Home Visitation Program Case Studies
National Association of County and City Health Officials, August 2010

 

If you would like additional information about state implementation of the federal home visiting initiative, please contact NCSL’s Children and Families Program or NCSL's Health Program.
Contact information for HRSA and ACF: homevisiting@hhs.gov and tribal.homevisiting@hhs.gov

 

Share this: 
NCSL Summit 2014
We are the nation's most respected bipartisan organization providing states support, ideas, connections and a strong voice on Capitol Hill.

NCSL Member Toolbox

Denver

7700 East First Place
Denver, CO 80230
Tel: 303-364-7700 | Fax: 303-364-7800

Washington

444 North Capitol Street, N.W., Suite 515
Washington, D.C. 20001
Tel: 202-624-5400 | Fax: 202-737-1069

Copyright 2014 by National Conference of State Legislatures