Home visits for rural parents could be slashed if law expires

One of the items on Congress' long to-do list of things to accomplish before the fiscal year ends is reauthorizing federal funding for home visitation programs that support parents and infants.

The law supporting the Maternal, Infant and Early Childhood Home Visiting (MIECHV) program is set to expire Sept. 30. 

Some of the programs at greatest risk as this threat of funding loss looms are the 25 tribal organizations across the country. California is home to three such programs in Lake County, Alameda County and Riverside-San Bernardino counties.

"We do get nervous sometimes," said Priscila Jensen, program director of the Riverside‐San Bernardino County Indian Health Home Visiting Program, which started running in 2012. "At the same time, here, we can't stop programming, just waiting for that to get reauthorized, so we've been moving forward full steam ahead."

Since 2009, MIECHV has pumped $400 million dollars annually out to states and tribes to fund the work, including the entire $750,000 annual budget of the Riverside-San Bernardino program. It uses a home visiting model called Parents as Teachers, providing nurse visits, healthy and developmental screenings and group meetings for parents from infancy up until the child turns five.

Evidence-based programs like this have been shown to improve prenatal, maternal and infant health, improve school readiness and reduce domestic violence and neglect.

"Families have voiced they value understanding their child more, so being aware of those milestones and how they can promote their child’s development," said Jensen.

Around 115 Native American families living on reservations and in urban communities are served at any given time in San Bernardino and Riverside counties – some of the largest counties in the country. As of 2015, the tribal MIECHV programs provided 17,850 home visits nationally, serving 1,697 families.

"Especially for some of the families in the more rural reservations or communities, they don’t have access to a lot of resources, and the fact that we can travel to their home – they don’t have to travel an hour to get the services – is very much needed," Jensen added.

L.A. County offers wide range of home visiting programs, but only receives a sliver of federal MIECHV funding.

There’s bipartisan support in Congress for this approach to improving child outcomes and bills to reauthorize funds for five years are moving through both Houses. The House version would require states to match the federal funds received, which runs the risk that some states may not be able to accept funds. 

"What’s at stake, if Congress doesn’t reauthorize this program, is the very good thing they started in 2009 could start to unravel," said Karen Howard, vice president of early childhood policy, for First Focus and a co-convener of the Home Visiting Coalition, which includes around 50 organizations.

The Home Visiting Coalition is pushing Congress to actually double the amount of annual funding, which currently allows groups to serve under 5 percent of the population. Neither version currently includes an increase. 

With acknowledgements of support on both sides of the aisle, advocates are optimistic that the funding will at least be reauthorized, it's just a question of when.

"[It would be] a win under Congress's belt and they haven't had too many wins," said Howard, "and we are astounded and perplexed as to why they don't just get this done. But it's a strange legislative season. I wish I had a crystal ball."