Five Key Moments: Hearing on the Maternal, Infant, and Early Childhood Home Visiting (MIECHV) Program

WASHINGTON, D.C. - In a Ways and Means Work & Welfare Subcommittee hearing examining the Maternal, Infant, and Early Childhood Home Visiting (MIECHV) program, home visitors, parents, and other expert witnesses highlighted the positive impact home visits have on maternal and child health outcomes. MIECHV offers evidence-based, preventive services and support to parents prior to the birth of their child and during the first five years of a child's life. The program served 79,000 families with 1 million home visits across the country in fiscal year 2025. National evaluations show that MIECHV improves the health and well-being of pregnant women and new moms, supports early childhood development, and reduces rates of child abuse and neglect.

The program was last reauthorized for five years in 2022 in honor of the late Representative Jackie Walorski, a champion of MIECHV and the then-Ranking Member of the Work and Welfare Subcommittee. The reauthorization increased federal investments and added a state match requirement and also included reservations for workforce support, technical assistance, and research. Funding for the program expires October 1, 2027.

Home Visiting Provides Early Support and Lifelong Impact: "That's the First Thing That I've Ever Completed in My Life."

More than 24 federally-approved evidence-based home visiting models, such as Changent (formerly known as Nurse-Family Partnership), Parents as Teachers, and Healthy Families America are eligible to receive MIECHV funding. Home visits from trained professionals give expectant mothers the support and tools they need and help new parents bridge the gap to recognize key milestones of child development and how to support early learning.

One witness told a touching story of how home visits helped one mother earn the confidence to know she could raise her child in a safe home.

Rep. Darin LaHood (IL-16): "Can you describe some of the outcomes and impacts on families who you serve who voluntarily receive MIECHV services?"

Mendy Smith, Vice President at Brightpoint, Illinois: "The hardest part about serving rural families is getting there and informing them about what home visiting is. What MIECHV allowed us to do is to get to those communities, hire staff from those communities, actually knowing who and where things are, so that we can get the outcomes that we're going to talk about today. We've seen increases in breastfeeding initiation, in domestic violence screenings, in connecting families to resources for jobs and housing…

"I want to give one example of a family that I did get to work with back in the day. She was so excited to show me the first home that she ever put her name on a lease. I got to go there with her, and she walked to every room, wanting to show me every single thing there. I got back to the living room, and on the wall, there was a picture of her and her child, and a picture of a piece of paper in a frame of something that she completed in her home visiting time. She said that's the first thing that I've ever completed in my life. Home visiting did that for me…I'm even more happy to say two years after, when she graduated, that wall was full of not only pictures, but accomplishments."

Time Is of the Essence: Congress Must Reauthorize MIECHV

MIECHV funding expires on October 1, 2027, and unless Congress acts to reauthorize the program, the home visits that have a demonstrated record of helping expectant mothers and children could be put at-risk. In fiscal year 2025, 83 percent of caregivers were screened for intimate partner violence, 81 percent of mothers received depression screenings, and 77 percent of children with developmental delays received timely services. Chairman Jason Smith (MO-08) called for a full reauthorization of the program so families and children continue to receive critical services.

Chairman Jason Smith (MO-08): "This program is only authorized through fiscal year 2027, and should Congress fail to reauthorize it, these services do not just continue on autopilot or at current funding levels - they stop…Families who need our help will lose access to support that has a track record of success in improving lives. I'm hopeful, given the bipartisan nature of this program, that we can act to make meaningful reforms and reauthorize MIECHV in a very timely manner."

"More Time with Families and Less Time on Paperwork": Benefits of Reducing Administrative Burden

In 2022 as part of MIECHV's reauthorization, Congress required the Department of Health and Human Services (HHS) to reduce the administrative burden by 15 percent for MIECHV awardees. HHS has surpassed that goal, reducing the administrative burden by 38 percent. A decline in paperwork and administrative burden means more resources and time can be devoted to home visits and dedicated care for expectant mothers, families, and children.

Rep. Rudy Yakym (IN-02): "In your experience, how has reduction in administrative burden benefited home visitors while maintaining program quality?"

Patricia West, Iowa MIECHV program director: "That's an excellent question, and something that we consider all of the time in Iowa. The reduction in administrative burden has been felt strongly at the state level. We felt really strongly about ensuring that was passed down to our local implementing agencies, and in turn to our home visitors, so that they could spend more time with families and less time on paperwork. The data is important; proving results is important; but we want our home visitors spending time with families and supporting them in all of the ways that you've heard here today. It is a priority of ours, not just through this reauthorization, but in the future to try to maintain and keep those administrative burden levels down."

"What Happens if This Program Goes Away?"

The 2022 reauthorization increased the total number of home visits by 23 percent and total participants by 15 percent. MIECHV services are targeted to vulnerable families, like pregnant women under the age of 21, families with a history of child abuse or neglect, and children with developmental delays. Witnesses from across the country, who serve these families in various ways, all agreed that expiration of MIECHV would seriously harm beneficiaries.

Rep. Aaron Bean (FL-04): "What happens if this program goes away?"

Mendy Smith, Vice President at Brightpoint, Illinois: "You're looking at a 30 to 50 percent chance of those children going into foster care without this additional help from home visiting…Child welfare numbers will go up as well as mental health service needs."

Shemya Wilson, Ohio Changent Ambassador: "If this program does not continue, there will still be a whole lot of violence. By having this program, we decrease the violence in the neighborhoods, giving those parents the opportunity to have access to someone who can coach them through those emotions and hard parts of parenting."

Patricia West, Iowa MIECHV Program Director: "If MIECHV funding went away, it would have a huge impact in Iowa…If MIECHV went away, over 800 families would go unserved and not have those supports and people to help them understand what parenting is like."

The Power of Home Visiting: "Keeping My Son Alive was the Goal"

To ensure MIECHV services are meeting program goals, there are six statutory benchmark areas with 19 performance measures that awardees must meet. This is a key attribute of the MIECHV program to ensure accountability and deliverable, measurable results for families. One of these benchmarks includes a reduction in child injuries and maltreatment such as the number of children who are always placed to sleep on their backs. Home visitors play a critical role in equipping parents with knowledge to build their parenting skills.

Rep. Max Miller (OH-07): "Your testimony describes how your Nurse Family Partnership helped you through real fears about your son's safety as a new mom, including concerns about SIDS… can you share what support looked like and how it gave you the confidence to care for your son and get through those times?"

Shemya Wilson, Ohio Changent Ambassador: "In my history, I have two siblings that passed away from SIDS [Sudden Infant Death Syndrome] as early as two or three months. So, I've known all along about ABCs, and the risks of that, making sure that [the child] is alone on their back in the crib… But, what my nurse has done for me, is letting me know about the strengths that I already have which was fighting against SIDS… she also taught me to stay away from drugs so that also keeps him alive as well as checking on the baby throughout the night and throughout the day, and where he should not be sleeping… doing all those things gave me the confidence to know my son was going to be okay, even in those moments where I couldn't believe it. Just wanting to fight and keep my son alive was the goal."