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 View From Washington

The Path to Home Visiting Program Reauthorization

By Brent Ewig, MHS
Director of Public Policy & Government Affairs, AMCHP

At the end of March, the U.S. Congress passed and the president signed the so called ‘Doc Fix’ bill that includes a six month extension for the MIECHV program. This represents a solid interim victory and reflects the work of a broad coalition of stakeholders. Thanks to each of you that participated in the National Day of Action and weighed in with elected officials. This step reflects nascent bipartisan support to continue this vital program to improve outcomes for vulnerable families. It provides Congress additional time to consider a longer-term reauthorization before Mar. 31, 2015 – the new expiration date.

Perhaps most importantly, it provides some insight and encouragement that despite the extreme partisanship and gridlock in Washington, DC, programs that are evidence-based and that encompass life course concepts such as early programming, critical periods and protective factors can be translated into investments that will make a difference for some of America’s most vulnerable families and communities.

Just a few days after the temporary extension passed, the House Ways and Means Committee Subcommittee on Human Resources convened a hearing to "begin thinking about next steps." This hearing (testimony available here) demonstrated strong bipartisan support for the concept of home visiting. This committee is chaired by Rep. Dave Reichert (R-WA) who happens to be a former sheriff and spoke about how his support for MIECHV is based on his belief that investments in programs like home visiting help prevent the societal problems that sheriffs deal with on a daily basis when families are not supported and children suffer from neglect and abuse.

During his opening statement, Chairman Reichert also laid out three important areas for potential change we will watch moving forward, saying:

"We also need to think about whether the program’s mix of supporting proven and promising approaches continues to makes sense. And we should consider whether this program should continue to have 100 percent federal funding, especially since some of the positive outcomes we hope to see will benefit our state partners. For my part, I am interested in how we can apply the basic discipline of this program – which uses taxpayer funds to support what we know works to help children and families – to other government programs that today can’t say the same thing."

The last comment about using the frame of ‘what we know works’ to justify use of taxpayer funds reflects both the confidence in the evidence base for home visiting, and also provides a helpful reminder of the need to ensure that we are documenting the evidence base for services provided by the more flexible Title V MCH Services Block Grant. Work underway now to refine the Title V performance measures and include process and structure measures should help us make this case.

As for a longer home visiting reauthorization, AMCHP staff are continuing to work with a broad coalition of stakeholders to strategize now on how to assure a longer reauthorization when the next Congress revisits the issue in early 2015.