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Maternal, Infant, and Early Childhood Home Visiting Program
ACF-IM-HS-10-05

INFORMATION MEMORANDUM

TO: Head Start and Early Head Start Grantees and Delegate Agencies

SUBJECT: Maternal, Infant, and Early Childhood Home Visiting Program

INSTRUCTION:

Purpose

This memorandum is to inform Head Start and Early Head Start grantees of the new Maternal, Infant, and Early Childhood Home Visiting Program authorized by Section 511 of Title V of the Social Security Act, as added by the Patient Protection and Affordable Care Act of 2010, and to encourage them to participate in the planning and implementation of this program at the State and local levels.

Background

On June 10, 2010, the Health Resources and Services Administration (HRSA) and the Administration for Children and Families (ACF) issued a Funding Opportunity Announcement (FOA) for the new Maternal, Infant, and Early Childhood Home Visiting Program, created by Section 511 of the Patient Protection and Affordable Care Act (ACA) of 2010 (Pub. L. 111-148).

The overall goals of the Maternal, Infant, and Early Childhood Home Visiting Program grants to States and territories are to 1) strengthen and improve maternal and child health programs; 2) improve service coordination for at-risk communities; and 3) identify and provide comprehensive home visiting services to families who reside in at-risk communities. The new program responds to the diverse needs of children and families in communities at risk and provides an unprecedented and unique opportunity for collaboration and partnership at the Federal, State, and community levels to improve health and development outcomes for at-risk children and families through evidence-based home visiting programs.

The funds are intended to assure effective coordination and delivery of critical health, development, early learning, child abuse and neglect prevention, and family support services to these children and families through home visiting programs. The program would enable States to utilize what is known about effective home visiting services to provide evidence-based programs to deliver services that promote outcomes such as improvements in maternal and prenatal health, infant health, and child health and development; reduced child maltreatment; improved parenting practices related to child development outcomes; improved school readiness; improved family socio-economic status; improved coordination of referrals to community resources and supports; and reduced incidence of injuries, crime, and domestic violence. Under the home visiting program, grants will be made to States to deliver effective evidence-based early childhood home visiting programs to pregnant women, expectant fathers, and parents and primary caregivers of young children birth to kindergarten entry in communities identified through statewide needs assessments as being at risk.

Although there is a range of different early childhood home visiting models, home visiting programs use home visiting as the primary strategy for the delivery of services to families. These services can include providing information about parenting, health, and child development, linking families to other community services and resources, and providing social supports. Through the efforts of a home visitor such as a nurse, social worker, or paraprofessional to engage and establish a strong relationship with the family or primary caregiver, it is hoped that home visiting programs will result in short- and long-term positive outcomes for children and families.

The State grant program provides an exciting opportunity for States and the Federal government to work together to both deploy proven programs and continue to build upon the existing evidence base. Based on a careful review of available research evidence on home visiting interventions, HRSA and ACF have developed and submitted for public comment criteria for evidence of effectiveness for home visiting models that are likely to improve outcomes for children and families. The program models that States choose to implement must also be linked to the benchmark areas of improvement specified in the ACA.

HRSA and ACF intend that the Maternal, Infant, and Early Childhood Home Visiting Program will result in a coordinated system of early childhood home visiting, which has the capacity to provide infrastructure and supports to assure high-quality, evidence-based practice, in every State. This program is also intended to play a crucial role in the national effort to build quality, comprehensive State- and community-wide early childhood systems for pregnant women, parents and caregivers, and young children and, ultimately, to improve health and development outcomes.
This program provides an opportunity for Head Start and Early Head Start programs to participate at the State level, in the development of the coordinated system for delivering comprehensive services through home visiting programs.

Needs Assessment Requirement

Section 511(b) of Title V of the Social Security Act, as amended by ACA, requires States to conduct a statewide needs assessment that is separate from the needs assessment required under section 505(a) of Title V for the MCH Services Block Grant. This needs assessment must be coordinated with and take into account the needs assessments required by (1) the Title V MCH Block Grant program, (2) the community-wide strategic planning and needs assessments conducted in accordance with section 640(g)(1)(C) of the Head Start Act, and (3) the inventory of current unmet needs and current community-based and prevention-focused programs and activities to prevent child abuse and neglect, and other family resource services operating in the State required under section 205(3) of Title II of the Child Abuse Prevention and Treatment Act (CAPTA).

Funding Opportunity Announcements and Federal Register Notice

The first FOA for the Maternal, Infant, and Early Childhood Home Visiting Program, for States was published on June 10, 2010, provided instructions to States on submitting an application for 2010 funding. It included instructions for States in assessing the availability of data for completing the statewide needs assessment, identifying additional information needing to be collected, specifying how the State plans to go about conducting the needs assessment over all, and meeting requirements for a Maternal, Infant, and Early Childhood Home Visiting grant. The State application under this FOA was due July 9, 2010 and required signoff by the State’s Head Start State Collaboration Director, among others.

A second FOA for States (estimated publication date of August 2010) will specify for States the requirements for conducting and submitting a needs assessment by September 1, 2010, including the requirements for coordination with other needs assessments such as the needs assessment conducted by Head Start grantees in accordance with section 640(g)(1)(C) of the Head Start Act.A third FOA for States (estimated publication date September 2010) will provide instructions to States for submitting a plan for responding to the results of the needs assessment, including a description and justification for the proposed program design, how proposed models meet the evidence-based criteria as part of its plan for addressing identified needs, and how the State will implement its program effectively and with fidelity to the selected home visiting model(s). The expected due date for this application is early FY 2011.

Prior to the issuance of the third FOA for States, HRSA and ACF will submit for public comment via a Federal Register Notice proposed criteria for assessing evidence of effectiveness of home visiting models. The final criteria for assessing evidence of effectiveness of home visiting models will be stated in the third FOA, and the State’s plan for the home visiting program grant must propose implementing a model (or models) that meets these criteria.

ACF and HRSA have also issued a separate funding opportunity announcement for Tribal Maternal, Infant, and Early Childhood Home Visiting Program discretionary grants to Tribes, Tribal Organizations, and Urban Indian Organizations on June 24, 2010. The program will emphasize and support successful implementation of high-quality, culturally-relevant home visiting programs that have demonstrated evidence of effectiveness in Tribal settings. Funds will support 5-year cooperative agreements to conduct community needs assessments, plan for and implement high-quality, evidence-based home visiting programs in at-risk Tribal communities, and participate in research and evaluation activities to build the knowledge base on home visiting among Tribal populations. Based on a careful review of available research evidence on home visiting interventions with Tribal populations, Health and Human Services (HHS) will develop and submit for public comment separate evidence-based criteria for this program for identifying home visiting models that are likely to improve outcomes for families in Tribal communities. The program is intended to:

• Support the development of healthy, happy, and successful American Indian and Alaska Native (AIAN) children and families through a coordinated, high-quality, evidence-based home visiting strategy and expand the evidence base around home visiting programs for AIAN populations.
• Support a coordinated system of early childhood home visiting in Tribal communities that has the capacity to provide infrastructure and supports to assure high-quality, evidence-based practice.
• Promote and strengthen cooperation and coordination among various programs that serve pregnant women, expectant fathers, young children, and families in Tribal communities (including American Indian and Alaska Native Head Start, Tribal child care, Indian Health Service, and Indian child welfare) and result in high-quality, comprehensive early childhood systems in every community.

Role of Head Start Grantees

As indicated above, the statewide home visiting needs assessments must coordinate with the community-wide strategic planning and needs assessments conducted in accordance with section 640(g)(1)(C) of the Head Start Act. This is the community-wide strategic planning and needs assessment conducted by local Head Start grantees and which involves other entities, including community organizations, and Federal, State, and local public agencies that provide services to children and families, including family support services; child abuse prevention services; protective services; foster care; services for families in whose homes English is not the language customarily spoken; services for children with disabilities; and services for homeless children.

The Office of Head Start encourages grantees to review the FOA issued on June 10, 2010 (available on www.grants.gov under CFDA # 93.505 and through HRSA’s website at http://www.hrsa.gov/grants/index.html) and to consider how to best reach out to the State agencies conducting the home visiting needs assessment, as well as the Head Start State Collaboration Offices (HSSCO), and ensure coordination with local Head Start programs, especially those already providing home visiting services. Contact information for HSSCOs can be found at http://eclkc.ohs.acf.hhs.gov/hslc/states/collaboration

Grantees are also encouraged to closely review the second and third FOAs to States, as well as the Federal Register Notice on proposed criteria for evidence of effectiveness, to determine how they might participate in the planning and implementation of this program at the State and local levels (including both participating in the needs assessment and ensuring that Head Start and Early Head Start programs are considered as part of the State’s home visiting program, to the extent possible). The Notice can be found at www.federalregister.gov.

Finally, AIAN Head Start and other grantees are encouraged to closely review the Tribal program FOA issued on June 24, 2010 to determine how they might participate in the planning and implementation of these programs, including participating in the needs assessment and ensuring collaboration and coordination with Head Start and Early Head Start programs. This FOA is available on www.grants.gov under CFDA # 93.508 and through ACF’s website at http://www.acf.hhs.gov/grants.

Questions on the Maternal, Infant, and Early Childhood Home Visiting Program may be directed to Audrey Yowell of HRSA and Moushumi Beltangady of ACF at homevisiting@hhs.gov. Questions on the Tribal Maternal, Infant, and Early Childhood Program may be directed to tribal.homevisiting@hhs.gov.

 

/ Yvette Sanchez Fuentes /

Yvette Sanchez Fuentes
Director
Office of Head Start
 

See PDF Version of Information Memorandum:
     Maternal, Infant, and Early Childhood Home Visiting Program [PDF, 40KB]