The pilot of a Michigan program created to help improve health outcomes for pregnant parents and their children shows positive impacts on families, including food and financial security and housing stability, according to a new report from the University of Michigan's Youth Policy Lab.
The report revealed that families participating in the Healthy Moms Healthy Babies pilot project, a Michigan Department of Health and Human Services program that provides enhanced home visiting services to pregnant individuals and new parents, were less likely to cut meals due to cost, forgo essential utilities or become homeless.
The report showed a 43% reduction in families reporting that they went without essential utilities in the last month and a 25% reduction in families meeting the definition of homelessness under the McKinney-Vento Homeless Assistance Act. Additionally, the likelihood of unemployed individuals reaching out to someone about a job increased by 62%.
The pilot program has been funded to expand these enhanced services to the full network of 75+ MDHHS Maternal and Infant Health Program home visiting agencies statewide.
"Our evaluation shows that the (Healthy Moms Healthy Babies) pilot provides crucial support to families in need and we were thrilled to see the new approach written into the governor's budget," said Robin Jacob, faculty co-director at the Youth Policy Lab and research professor at the U-M Institute for Social Research and Marsal Family School of Education.
"The pilot found that families served by home visiting agencies that were able to bill for enhanced services were less likely than families in the control group to report experiencing hardships. The program also appears to have almost eliminated the gap between white and Black families in the degree to which they felt that the home visiting program met their needs."
In agencies with enhanced billing, 90% of white families said the home visiting program fully met their needs, and 87% of Black families said the same, a gap of 3 percentage points, according to the report. In the control group agencies, which did not have the opportunity to bill for enhanced services, there was a 12-percentage point gap between white and Black families on this measure: 90% vs. 78%.
As part of a long-standing collaboration with the Maternal Infant Health Program, which supports the health and wellness of Medicaid-eligible families during pregnancy and infancy, U-M's Youth Policy Lab helped design and evaluate an enhanced billing program for the statewide home visiting program.
During the program, licensed social workers, registered nurses and lactation consultants provided home visiting services to pregnant people and infants, and developed a plan of care for the family to support healthy pregnancies and infant development.
Jacob said the goal of the project was to understand whether expanding the services for which MIHP providers can bill could better help serve families with high levels of need for basic services.
"The partnership between the Division of Maternal and Infant Health, the U-M Youth Policy Lab, and the Maternal Infant Health Program has resulted in interventions to support families that have been proven effective by rigorous evaluation," said Dawn Shanafelt, director of the Division of Maternal & Infant Health at MDHHS.
"The Maternal Infant Health Program is life-changing for thousands of families in Michigan each year. The success of the MIHP is the result of the home visiting professionals committed to healthier maternal and infant health outcomes."
Home visits
Home visiting programs are among the most well-supported social programs. Studies show these programs improve birth outcomes, child language and cognitive development; prevent child maltreatment; increase the use of preventive health care; and enhance parenting and the home environment.
Social determinants of health-such as economic stability, educational and health care quality, neighborhood conditions and social context-greatly influence individuals' health and well-being.
"This pilot project aimed to combine these elements by providing additional funds to home visiting programs to address families' social determinants of health more effectively," Jacob said. "YPL's evaluation of the pilot revealed that these extra resources effectively addressed social determinants and promoted equity among the families served."
Cost-effectiveness
The program is likely to be cost-effective. The researchers estimated that the reduction in homelessness alone is estimated to save $1,390,000, assuming a cost of $5,000 per homeless family per year. Additional benefits, including reduced food insecurity and anxiety, and fewer families going without essential utilities, boost the program's economic efficiency.
"Devoting additional time and resources to support those who deliver frontline social services can help them do their jobs more effectively and ultimately lead to positive impacts for the families they serve," Jacob said. "Now, MDHHS will be working to roll out the new billing guidance to all MIHP agencies."
