Systems and Financing

Quality child care and early education programs address the full range of child development needs, which requires their linkage with health and nutrition services, family support, and early intervention at both the state and local level. States may need to develop new governance and financing structures that assure that all the parts of a system are working in a coordinated way. Such systems encourage horizontal connections across systems--for example, child care, Head Start, state pre-kindergarten programs, and early intervention services--as well as vertical connections of services from birth to 5 to provide continuity and coordination for children as they grow. CLASP encourages states to move toward more integrated governance and financing systems and to think across systems to make the best use of resources and design an early childhood system that best meets the needs of all children and families.

Mar 27, 2015  |  PERMALINK »

House Passes Important Extension for Home Visiting

By Stephanie Schmit

Yesterday, the U. S. House of Representatives passed the “Medicare Access and CHIP Reauthorization Act of 2015,” which provided a bipartisan, long-term solution for Medicare payments to physicians (this legislation is referred to as the Sustainable Growth Rate (SGR) repeal bill–and more informally as the “doc fix” bill) and reauthorized for an additional two years the Children’s Health Insurance Program (CHIP), scheduled to expire in September. The legislation also reauthorized the Maternal, Infant, and Early Childhood Home Visiting (MIECHV) program—which is slated to expire March 31, 2015—at current funding levels of $400 million per year. Overall, the legislation is an important win for vulnerable children and families across the country.

MIECHV, a federal and state partnership that has had broad bipartisan support, provides voluntary, evidence-based family- and child-related home visiting programs in every state. The bill will extend the program to March 2017. MIECHV targets high-risk families who are most likely to benefit from intensive home visiting services, which use trained professionals (often nurses, social workers, or parent educators) to help parents acquire the skills to promote their children’s development. The home visiting programs also help families connect to necessary services, such as health care or community resources, and monitor child development and progress on developmental milestones.

Our recent report, based on interviews with 20 states and 2 tribal grantees, highlights many early successes from MIECHV and demonstrates how its federal funding is being used to expand home visiting services to reach more families while also building the infrastructure to support well-coordinated and effective home visiting programs. Corresponding state profiles describe how grantees are evaluating the direct impact of home visiting and expanding and improving services for vulnerable communities. Complementing our qualitative research is a recently released brief and series of state profiles from the federal Department of Health Resources and Services Administration (HRSA), which administers MIECHV, highlighting quantitative data and other demographic information. The report shows that MIECHV home visiting programs in all 50 states, DC, and five territories served 115,500 parents and children (from birth to kindergarten entry) in 787 counties in FY 2014. Additionally, the first report from a federally mandated study on the program was recently released and showed early findings on what home visiting models are being used, who the recipients are, what needs they have, and other demographic information. With the two-year extension for MIECHV included in the House bill, continued data collection and reporting can assess the value of the program for vulnerable young children and families, adding to the growing body of evidence that includes this latest data.

The House took an important step by extending MIECHV, but continued funding depends on the Senate taking similar action. President Obama has already signaled that he will sign the bill when it reaches his desk. MIECHV has brought evidence-based home visiting services to more vulnerable children in the most at-risk communities. Our report has shown how essential MIECHV has been for the development of statewide home visiting systems, with states building the infrastructure needed to support lasting, effective programs. Research validates the notion that home visiting programs can enhance parenting and support young children’s early development--and can do so with significant public cost savings. The Senate should pass the Medicare Access and CHIP Reauthorization Act of 2015 and continue its commitment to investing in evidence-based home visiting to promote positive, long-term outcomes for children, families, and the nation.

The Senate is expected to take up the bill upon return from recess in April.

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