March 26, 2014 — Maternal and child health advocates are urging Congress to extend funding for an expiring maternal and child home visiting program by attaching a reauthorization to legislation that would reform how Medicare reimburses physicians, CQ Roll Call reports.
The Maternal, Infant and Early Childhood Home Visiting Program was established in 2010 under the Affordable Care Act (PL 111-148) and authorized for funding through Sept. 30, 2014. The program provides grants to states to support voluntary home visit programs designed to provide parenting help to teenage parents, low-income households and other high-risk families. Program volunteers also help connect families with counseling services for domestic violence or substance misuse, medical services, shelters and other resources.
Under the program, states are required to use 75% of the federal funding on one of 13 evidence-backed programs, while the remaining 25% can be spent on new programs. States that do not have any of the approved programs can disburse the money to not-for-profit groups.
Programs that receive funding have to demonstrate success on several measures, including improved maternal and infant health; prevention of child abuse, injuries and neglect; a reduction in the number of child visits to hospital emergency rooms; improved school preparedness and achievement; reduced rates of crime and domestic violence; improved rates of economic self-sufficiency among participating families; and improved coordination with other community resources.
Carrie Fitzgerald, senior policy adviser for health at First Focus, said the program has widespread support among physicians, educators and business leaders. In addition, law enforcement tends to support the program because research has demonstrated that participants are less likely to be abused or commit crimes, CQ Roll Call reports.
According to CQ Roll Call, advocates are hoping to attach a five-year renewal of the program to legislation to change Medicare's physician reimbursement policies, known as the "doc fix."
Advocates said they also would be satisfied if a temporary extension were included in a short-term "patch" for the Medicare payment system, particularly because it seems increasingly unlikely that Congress will pass a comprehensive "doc fix" bill in the near future. House and Senate leaders have agreed on a policy that would reform the payment system, called the sustainable growth rate formula, but they have not agreed on a way to fund it. Supporters of the home visiting program are targeting the SGR efforts because it is considered to be one of the few health-related measures that lawmakers need to pass this year. Advocates have argued that waiting for other legislation -- such as the fiscal year 2015 continuing resolution, likely to be debated in August -- would lead states to start winding down their MIECHV programs either by rejecting new applicants or curtailing services to current participants (Phenicie, CQ Roll Call, 3/25).