In 2010, the federal Affordable Care Act initiated the Maternal, Infant, and Early Childhood Home Visiting (MIECHV) Program. This program, most recently extended through FY 2017, provides federal funding to states so they can provide home visiting programs built on evidence-based models.
MIECHV grants support programs that serve vulnerable pregnant mothers and parents and promote the physical and mental health development of infants and children. The program centers on 6 benchmarks:
- Improve maternal, newborn, and child health;
- Prevent child injuries, child abuse, neglect or maltreatment, and reduce emergency room visits;
- Improve school readiness and child academic achievement;
- Reduce crime or domestic violence;
- Improve family economic self-sufficiency; and
- Improve the coordination and referrals for other community resources and supports
If you’re being funded by a MIECHV grant, making sure your program outcomes reflect those benchmarks is critical to success. Here are 4 tips for making sure your program is hitting these critical benchmarks.
MIECHV emphasizes and supports evidence-based family support programs and requires states to spend the bulk of funds on national program models that have already demonstrated their effectiveness against rigorous criteria. As the 2015 report to Congress on the MIECHV program notes, each national program model aims to serve at-risk families, such as those with low incomes. However, each focuses on different types of risk. For example, Nurse-Family Partnership targets first-time mothers, Healthy Families America focuses on families at risk of child maltreatment or with behavioral health issues, and Early Head Start seeks to serve a broad group of low-income families.
Selecting a model should begin with a clear understanding of the priorities of the individual communities where it will be implemented. Spend time researching various program models under consideration, exploring the program’s history, and the evidence of effectiveness. Identify program models that prioritize the same outcomes and risks that you’ve identified as important to the families the program will serve. This ensures a strong foundation for success and ensures that your evaluation and data collection will align with MIECHV requirements and the existing program research for your model.
The MIECHV funding requirements have given grantees discretion to define improvement in each benchmark area in terms that are meaningful for their individual programs. This allows individual agencies to measure and report outcomes in a way that reflects individual contexts and different stages of implementation.
Invest time in this process, and take advantage of the support and technical assistance provided by MIECHV. The Design Options for Home Visiting Evaluation (DOHVE) project specifically works with MIECHV to provide grantees with evaluation and data collection support and guidance. As the DOHVE team explains,
“Using appropriate indicators and measurement tools is necessary to be able to accurately and consistently collect evidence of successful program results. The importance of good measurement is brought home by the understanding that the findings resulting from these indicators will inform subsequent action to continuously improve your program. Accordingly, careful consideration is needed at all steps throughout the process of indicator and measurement tool selection.”
As you walk through this process, remember, it is important to both identify what is being measured and define how it will be measured. Some metrics may require a specific measurement tool. For example, screening program participants for signs of depression might require a measurement tool like the Beck Inventory or the Edinburgh scale. Make sure your data collection plan includes the people responsible for collecting the data, the collection frequency, data sources, and the method to be utilized.
MIECHV explains, “Ideally, grantees should explore systems that are user-friendly, can handle the capacity required, will allow for measurement of the given constructs and other important measures related to the benchmark areas, and are accessible to all who will be using it.”
Even if your agency or program has already implemented an MIS, it’s important to take the time to evaluate its capacity to capture the necessary indicators and outcomes. A system like ETO Software for Health & Social Services allows programs to seamlessly integrate case and program management with data collection, analysis and reporting.
When it comes to MIS systems, seamless simplicity is about more than just having a user-friendly system. The better integrated your data collection system is with front-line operations, the more reliable it will be in capturing important measurements and providing accessible analysis and reporting. At the end of the day, that accessibility will allow for ongoing evaluation and improvement throughout the course of the program, not just during “grant report season.”
While the program activities are at the heart of your efforts, MIECHV explains that the implementation system is “the link between intended and actual service delivery”. A successful implementation system has 4 key components:
Staff Development – Home visitors need to be prepared to help families across the range of outcomes captured by the MIECHV benchmarks. Staff development should prepare them to evaluate each family’s needs across these areas and identify the local programs that can provide strategies and tools to help.
Clinical Support – Local programs can provide home visitors with expert advice from clinical consultants. This expert advice can provide critical support in addressing the complex challenges that face at risk and disadvantaged families. Make sure home visiting staff knows how to access this vital resource.
Links to Community Resources – Almost by definition, home visiting programs must work with other organizations to identify eligible families and to connect them with needed services. Continue to develop strong partnerships with local programs and organizations so the families you serve benefit from all available resources.
Administrative Support – As noted above, a robust, user-friendly management information system is critical for internal program monitoring and data tracking. Implementing a system that integrates data collection with case management provides a central place where home visitors can document visits, identify referrals to local programs, and monitor outcomes. Make sure you have a system in place that supports your efforts and your staff.
Demonstrating improvement for each of the MIECHV benchmarks is obviously an important funding requirement for home visiting programs. More importantly, these benchmarks are based on extensive, evidence-based approaches to improving the physical and mental health development of infants and children. We’re excited to support you as your programs open the doors for at-risk families and children!