The case for funding home visiting locally

It’s that time again: budget development season is here and funding is on everyone’s mind. Advocates are scrambling to finalize Fiscal Year 2019 budget asks, while DC agencies have put their pencils down on their own budget requests. In the backdrop of this shuffle, funding is at risk for important federal programs supporting young children and their families.

One such funding stream is the Maternal, Infant, and Early Childhood Home Visiting program, or MIECHV. Currently, with $1.6 million in FY 2017, MIECHV is the primary funding stream for home visiting in the District. However, federal funding is not a reliable and sustainable way to ensure that home visiting services are available for families of young children.

MIECHV authorization expired over a month ago on September 30, 2017, and Congress has not yet reauthorized it, despite widespread support for home visiting. So, what happens if we continue to rely on federal MIECHV dollars to fund home visiting in the District? Let’s explore 3 possible effects:

 

1. Loss of MIECHV would be devastating for home visiting in DC.

Home visiting advocates and Congressional staff are hopeful that MIECHV won’t be cut. However, at this late point in the process, a permanent failure to reauthorize is not off the table. If MIECHV were eliminated, the majority of public funding for home visiting in DC would be lost. Historically, withdrawal of public funding for local home visiting programs has resulted in in a shuttering of doors for defunded providers. Without a significant local funding source, a similar outcome is likely for MIECHV-funded programs.

2. Delayed reauthorization = lapse in services.

Congress has already let MIECHV expire. Continued delays could impede the Health Resources and Services Administration’s (HRSA) ability to distribute funds in time to prevent a gap in funding for MIECHV-funded staff and programs. This could result in challenges retaining home visitors (and therefore families) and a loss or lapse in services that families rely on.

3. Reauthorization may come with a costly catch.

Two bills to extend funding for home visiting have been introduced in Congress and are still pending. One comes with stipulations not present in previous iterations of MIECHV. Significantly, these include a dollar-for-dollar match that would require the District to allocate local funds to MIECHV implementation in the District. The passage of this bill would require significant local investment in home visiting without some of the benefits of a separate, local funding stream described below.

 

This is why we urge DC leaders to commit to a local investment of $2 million for the Department of Health to fund home visiting program implementation, administration and infrastructure development in FY18. We ask that this local investment primarily fund home visiting programs and support administration of this funding. A portion of this funding should also be dedicated to infrastructure support activities. This revenue source would ensure that local home visiting programs are equipped to serve families at the highest possible standards of quality and fit.

 

Local funding for home visiting would provide 3 opportunities for the District:

  1. Stability. The fluctuating federal funding landscape takes a toll on local home visiting programs and families. A local funding stream for home visiting would reduce these negative effects and would ensure that programs are able to continue providing services to families.
  2. Flexibility. Federal funding for home visiting is contingent upon stringent program implementation requirements based on home visiting research that may not be fully applicable in the DC context. These requirements restrict opportunities for innovation or modification of programs to better address the local context. Local funding would allow for DOH and local providers to collaborate to ensure that DC’s home visiting programs are designed to best meet DC families’ needs.
  3. Preservation of local investment in home visiting. Development of a local infrastructure for home visiting required significant investment at the outset of MIECHV implementation. Establishment of a local home visiting funding stream would ensure preservation of this investment in the event of a loss of federal home visiting funding.

 

Now, more than ever, it is clear that the District can no longer rely on federal investment in its children alone. Making space for home visiting in the budget is the only way to ensure that local families with young children receive the support services they need.

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