Harmful Provisions Jeopardize Extension of Effective Home Visiting Programs

A nationwide federal-state partnership that supports family- and child-related home visiting programs is slated to expire October 1, threatening a host of programs that strengthen high-risk families and save money over the long run. Today, the House Ways and Means Committee will consider two bills that would extend the program for five years, but each comes with problems — one has a state funding match requirement that could mean a loss of home visiting services in some states, and the other has a provision that’s intended to offset the extension’s cost by denying basic assistance to certain poor seniors and people with disabilities.

The Maternal, Infant, and Early Childhood Home Visiting Program (MIECHV) targets high-risk families that are most likely to benefit from intensive home visiting services, through which trained professionals (often nurses, social workers, or parent educators) help parents acquire the skills to promote their children’s development. In fiscal year 2017 MIECHV provided about $370 million in federal funds for states and localities to operate the programs. As of fiscal year 2016 (the latest year for which we have data), about 160,000 parents and children in nearly a thousand counties in all 50 states, the District of Columbia, and the territories received home visiting services — with more than 3.3 million visits since 2012.

If Congress lets MIECHV funding lapse, even for a short period, program operators likely would begin freezing enrollment, cutting services, and dismantling long-term program improvements, significantly undermining the program and disrupting service to extremely vulnerable families — especially children at high risk of toxic stress, which a growing body of research shows has lifelong negative consequences.

The bill to extend MIECHV would require a state match, which has never been a feature of the program. Although states could count other federal and state funds now used for home visiting toward the match, this provision likely could reduce the availability of home visiting services in high-risk communities. Poorer states with lower investments in home visiting may be unable to meet the matching requirement, forcing them to end or cut the home visiting services they now provide. Tribal programs would be especially vulnerable because of the limited financial resources available in many of these communities. Moreover, the President and Congress could later revise the match provision to reflect the historical practice of requiring state matching funds to come from state or local funds, further burdening the states.

Even more troubling is a second bill that the Ways and Means Committee is expected to marry with the home visiting bill to offset the cost of extending MIECHV. It calls for denying Supplemental Security Income (SSI) benefits to poor seniors and people with serious disabilities if there is an outstanding warrant against them for an alleged felony or alleged violation of probation or parole. It would reinstate a prior policy that denied needed basic assistance to vulnerable individuals whose law enforcement cases were inactive and that no jurisdictions were pursuing. Many individuals who would be denied benefits have mental illness and intellectual disabilities and often don’t know a warrant has been issued, in many cases because the jurisdictions that issued the warrant are not pursuing them.

When the prior policy was in effect, the warrants that triggered the benefit denial were frequently issued when individuals couldn’t pay a fine, court fee, or probation supervision fee, rather than for a more serious crime. The warrant databases are known to be error-prone, leaving those affected to sort out the mistake while they’re denied the basic assistance they need to afford rent and pay for food.

Moreover, the policy under consideration is unnecessary: SSI benefits are already barred for people fleeing from law enforcement (a narrower group than the over-broad proposal would affect), and the Social Security Administration already notifies law enforcement officials of the whereabouts of individuals with a warrant for an alleged felony or violation of probation or parole, so they can decide whether to pursue them or not.

Congress should extend the effective home visiting program without including a problematic matching requirement and this harmful offset. Home visiting programs promote children’s health and development and improve parenting skills while cutting the number of children in the social welfare, mental health, and juvenile corrections systems, with considerable cost savings for states, research shows.

MIECHV is unique in its focus on replicating practices with solid evidence of their effectiveness. By law, grantees must spend most of their grant funds to implement evidence-based home visiting models, with up to 25 percent of funding available to implement promising approaches that will undergo rigorous evaluation. Experts often tout as a model for how to use evidence to improve program outcomes and ensure government resources are spent wisely.

Failure to extend MIECHV would have unfortunate consequences for communities in every state, and the nation would lose the opportunity to continue to build the evidence base for these effective programs and expand them.