Notice2021-20853
Statutory Requirements and Process Standardization: Maternal, Infant, and Early Childhood Home Visiting (MIECHV) Program Model Eligibility Review
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Published
September 27, 2021
Issuing agencies
Health and Human Services DepartmentHealth Resources and Services Administration
Abstract
HRSA, in partnership with the Administration for Children and Families (ACF) within HHS, oversees the MIECHV Program, which supports voluntary, evidence-based home visiting services during pregnancy and to families with young children up to kindergarten entry. HRSA proposes to standardize a process for also assessing Home Visiting Evidence of Effectiveness (HomVEE)-approved home visiting models against the MIECHV statutory requirements for a model to determine which of the HomVEE- approved models can be used to implement the MIECHV Program.
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<title>Federal Register, Volume 86 Issue 184 (Monday, September 27, 2021)</title>
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[Federal Register Volume 86, Number 184 (Monday, September 27, 2021)]
[Notices]
[Pages 53329-53331]
From the Federal Register Online via the Government Publishing Office [<a href="http://www.gpo.gov">www.gpo.gov</a>]
[FR Doc No: 2021-20853]
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DEPARTMENT OF HEALTH AND HUMAN SERVICES
Health Resources and Services Administration
Statutory Requirements and Process Standardization: Maternal,
Infant, and Early Childhood Home Visiting (MIECHV) Program Model
Eligibility Review
AGENCY: Health Resources and Services Administration (HRSA), Department
of Health and Human Services (HHS).
ACTION: Request for public comment.
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SUMMARY: HRSA, in partnership with the Administration for Children and
Families (ACF) within HHS, oversees the MIECHV Program, which supports
voluntary, evidence-based home visiting services during pregnancy and
to families with young children up to kindergarten entry. HRSA proposes
to standardize a process for also assessing Home Visiting Evidence of
Effectiveness (HomVEE)-approved home visiting models against the MIECHV
statutory requirements for a model to determine which of the HomVEE-
approved models can be used to implement the MIECHV Program.
DATES: Comments on this request for public comment should be received
no later than November 26, 2021.
ADDRESSES: Submit your comments to <a href="/cdn-cgi/l/email-protection#c3abacaea6b5aab0aab7aaada483abb1b0a2eda4acb5"><span class="__cf_email__" data-cfemail="325a5d5f57445b415b465b5c55725a4041531c555d44">[email protected]</span></a> with ``MIECHV
Model Eligibility'' in the subject line.
SUPPLEMENTARY INFORMATION:
Invitation to comment: HRSA invites comments regarding this notice.
To ensure that your comments are clearly stated, please identify the
section of this notice that your comments address.
1.0 Background
The MIECHV Program provides voluntary, evidence-based home visiting
services to pregnant people and families with young children up to
kindergarten entry living in at-risk communities.\1\ States,
jurisdictions, certain non-profit organizations, and Tribal entities
are eligible to receive funding from the MIECHV Program to implement
service delivery model(s) that meet statutory requirements, including
HHS criteria for evidence of effectiveness.<SUP>2 3</SUP>
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\1\ The MIECHV Program is authorized by Social Security Act,
Title V, Sec. 511; Section 50601 of the Bipartisan Budget Act of
2018 (Pub. L. 115-123) (BBA) extended appropriated funding for the
MIECHV Program through FY 2022.
\2\ In current practice, HHS uses the HomVEE review to conduct a
thorough and transparent review of the home visiting research
literature and provide an assessment of the evidence of
effectiveness for home visiting program models that target families
with pregnant people and children from birth to kindergarten.
Information about the HomVEE review is at <a href="https://homvee.acf.hhs.gov/">https://homvee.acf.hhs.gov/</a>.
\3\ By law, state and jurisdictional awardees must spend the
majority of their MIECHV Program grants to implement evidence-based
home visiting models, with up to 25 percent of funding available to
implement a model that conforms to a promising and new approach to
achieving the benchmark areas specified in Social Security Act,
Title V, Sec. 511 (d)(1)(A) and the participant outcomes described
in Social Security Act, Title V, Sec. 511 (d)(2)(B), has been
developed or identified by a national organization or institution of
higher education, and will be evaluated through well-designed and
rigorous process.
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The MIECHV authorizing statute specifies that a model selected by
an eligible entity must include certain key components, including that
it ``conform to a clear consistent home visitation model that has been
in existence for at least 3 years and is research-based, grounded in
relevant empirically-based knowledge, linked to program determined
outcomes, associated with a national organization or institution of
higher education that has comprehensive home visitation program
standards that ensure high-quality service delivery and continuous
program quality improvement.'' \4\ In addition, the MIECHV-funded
program must adhere to statutory standards applicable to model use,
including adherence ``to a clear, consistent model that satisfies the
requirements of being grounded in empirically-based knowledge related
to home visiting and linked to the benchmark areas specified in
[statute] and the participant outcomes described in [statute] related
to the purposes of the program.'' \5\ Home visiting programs could not
achieve the standards described in the program's authorizing statute
without the support of home visiting models.
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\4\ Social Security Act, Title V, Sec. 511(d)(3)(A)(i)
\5\ Social Security Act, Title V, Sec. 511(d)(3)(B)
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HRSA, in collaboration with ACF, has developed a proposed
transparent and standardized process for assessing home visiting
service delivery model(s) against statutory requirements to determine
model eligibility for implementation through the MIECHV Program.
Through this notice, HRSA seeks to provide public notice of the
proposed process and gather public comment, including from
stakeholders. Since the establishment of this process may affect
critical decision-making, and to better understand the implications of
these changes for various stakeholders, HRSA seeks public comment on
the proposed process for assessing home visiting models against the
MIECHV statutory requirements. HRSA will consider these comments in
finalizing this process.
2.0 Process for Assessing Eligibility Against Statutory Requirements
for a Home Visiting Model
This notice presents statutory requirements for a MIECHV service
delivery model and the proposed process to assess home visiting models
against each MIECHV statutory requirement. Then, the notice will
present the proposed process, with timeline, for collecting information
to assess whether the model(s) meet these requirements and therefore
can be used to implement the MIECHV Program.
2.1 Model Eligibility Requirements
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Statutory citation
Requirement Standard used of requirement
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REQUIREMENT (1): Model is There is evidence Social Security
appropriate for voluntary of model Act, Title V,
service provision. effectiveness in Sec.
a voluntary 511(e)(7)(A).
setting.
REQUIREMENT (2): The model The model conforms Social Security
conforms to a clear consistent to HomVEE's Act, Title V,
home visitation model. definition of an Sec.
early childhood 511(d)(3)(A)(i)(I
home visiting ).
model.
REQUIREMENT (3): The model . . . The model is Social Security
has been in existence for at currently active Act, Title V,
least 3 years. and was first Sec.
developed at 511(d)(3)(A)(i)(I
least 3 years ).
ago;.
OR
The model is
inactive and was
first developed
at least 3 years
before a model
developer stopped
providing
implementation
support;
OR
The model was
implemented as a
demonstration
project that
lasted at least 3
years.
[[Page 53330]]
REQUIREMENT (4): The model . . . The model is Social Security
is research-based [and] evidence-based Act, Title V,
grounded in relevant and grounded in Sec. 511
empirically-based knowledge. relevant (d)(3)(A)(i)(I).
empirically-based
knowledge, per
the HHS HomVEE
criteria for
evidence of
effectiveness.
REQUIREMENT (5): The model . . . The model has Social Security
has demonstrated significant . demonstrated Act, Title V,
. . positive outcomes . . . significant Sec. 511
when evaluated using well- positive outcomes (d)(3)(A)(i)(I).
designed and rigorous . . . when evaluated,
research designs. per the HHS
HomVEE criteria
for evidence of
effectiveness.
REQUIREMENT (6): The model [is] The model was Social Security
associated with a national developed by, is Act, Title V,
organization or institution of currently Sec. 511
higher education (IHE) . . .. supported by, OR (d)(3)(A)(i)(I).
is currently
being evaluated
by, a national
organization \6\
or IHE\7\.
REQUIREMENT (7): The national This requirement Social Security
organization or IHE with which is met if Act, Title V,
the model is associated has Requirement 6 is Sec. 511
comprehensive home visitation met. (d)(3)(A)(i)(I).
program standards that ensure AND...............
high quality service delivery (A) The
and continuous program quality organization or
improvement. IHE can provide
implementing
agencies with
documentation of
its home
visitation
program standards
associated with
the model that
ensure high
quality service
delivery (such as
fidelity
standards or
implementation
guidance);.
AND
(B) The model
supports
continuous
program quality
improvement (such
as through the
use of specific
processes,
systems, or
tools).
REQUIREMENT (8): Employ well- (A) The model Social Security
trained and competent staff. requires that Act, Title V,
home visiting Sec.
staff, including 511(d)(3)(B)(ii).
home visitors and
home visiting
supervisors,
receive pre- AND
in-service
training. Staff
must include, at
a minimum, home
visitors and home
visiting
supervisors.
AND
(B) The model
establishes
educational
requirements and/
or competencies
around knowledge,
skills,
abilities, and
experience to
ensure that
program staff are
able to deliver
the model.
REQUIREMENT (9): Maintain high (A) The model has Title V, Sec.
quality supervision to quality 511(d)(3)(B)(iii)
establish home visitor supervisory .
competencies. requirements to
establish and
maintain home
visitor
competencies,
including the
mode and
frequency of
supervision;
AND
(B) The model has
a documented plan
for supporting
and assessing the
quality of
supervision.
REQUIREMENT (10): Demonstrate The model has Title V, Sec.
strong organizational capacity ongoing support 511(d)(3)(B)(iv).
to implement the activities to implement the
involved. model, including
implementation
tailored to the
communities
served.
REQUIREMENT (11): Establish The model has Title V, Sec.
appropriate linkages and guidance OR a 511(d)(3)(B)(v).
referral networks to other process to
community resources and support local
supports for eligible families. implementing
agencies' ability
to establish and
document
appropriate
linkages and
referrals to
community
resources and
supports for
eligible MIECHV
program
participants.
REQUIREMENT (12): Monitor the (A) The model has Title V, Sec.
fidelity of program standards OR a 511(d)(3)(B)(vi).
implementation to ensure that system for
services are delivered pursuant monitoring
to the specified model. fidelity of
program
implementation on
an ongoing basis;
AND...............
(B) The model
provides training
OR training
materials for
supervisors and
home visitors on
fidelity
standards.
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2.2 Information Collection and Timeline
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\6\ A national organization may be in the United States
(including tribal nations or within any of the U.S. territories) or
non-U.S. based; an organization is ``national'' if it has an office
that is able to support implementation in two or more states,
tribes, territories, or regions, or similarly defined geographic
areas outside of the United States.
\7\ An IHE may be an accredited community college, college, or
university in the United States or another country.
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HRSA, in collaboration with ACF, proposes to conduct model
developer queries to gather information necessary for assessing models
against the MIECHV Program statutory requirements. Requirements related
to HHS evidence of effectiveness (see Section 2.1; requirements 1, 2,
4, and 5; above) are currently collected and assessed through the
HomVEE annual review process; HRSA has concluded that this process is
sufficient to assess these requirements and is not proposing
[[Page 53331]]
any changes to the HomVEE evidence review through this notice.
Following the publication of this notice, the associated comment
period, and publication of a final model eligibility review process,
HRSA anticipates assessing all models that have been determined to meet
the HHS criteria for evidence of effectiveness, as determined by HomVEE
review, against the statutory requirements for model implementation
through the MIECHV Program. HRSA intends to contact model developers
and request they provide information about model characteristics,
resources, and processes using a standard set of survey questions. HRSA
will assess information and resources provided by models against the
standards for each requirement, described above, to determine
eligibility for implementation through the MIECHV Program. Following
this initial review, all models determined to be eligible for
implementation through the MIECHV Program will be reassessed against
the statutory requirements for a model every 3 years.
As the HomVEE review determines that new models meet HHS criteria
for evidence of effectiveness, HRSA intends to assess these models
against the MIECHV statutory requirements. Any such model that does not
meet statutory requirements for implementation through the MIECHV
Program will be reassessed annually until the model either meets
remaining statutory requirements or a model developer indicates that
they no longer want the model to be assessed for implementation through
the MIECHV program.
HRSA anticipates applying the updated process for assessing model
eligibility against MIECHV statutory requirements beginning in Fiscal
Year (FY) 2024. Specifically, the updated process will apply to all
HomVEE-approved models to determine eligibility for implementation
through the MIECHV Program beginning in the FY 2024 MIECHV Notice of
Funding Opportunity.
3.0 Request for Information
Through this notice, HRSA is soliciting information from a broad
array of stakeholders on the proposed process for assessing home
visiting models against the MIECHV statutory requirements for a model
to determine eligibility for implementation through the MIECHV Program.
Responses to this notice will inform HRSA's ongoing discussion with
the aim of publishing a final process for assessing home visiting
models against statutory requirements. This notice is for information
and planning purposes only and should not be construed as a
solicitation or as an obligation on the part of HRSA or HHS.
Diana Espinosa,
Acting Administrator.
[FR Doc. 2021-20853 Filed 9-24-21; 8:45 am]
BILLING CODE 4165-15-P
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