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Congress must advance critical home visiting policies that support children, families


As a pediatrician, parent, and grandmother, I know that the birth of a child is one of life’s most joyful moments. I also know that parenting, especially those early years, comes with unique stresses and challenges, and I especially empathize with families with young children who have been more isolated and unable to rely on their family, friends, and communities to help support them because of the pandemic.

As we all know, it takes a village. But not all parents are surrounded by this support. Some parents may have even experienced trauma in their own childhood and want to do all they can to ensure a different upbringing for their children. That’s why the federal Maternal, Infant, and Early Childhood Home Visiting (MIECHV) program is so essential, and why pediatricians thank the U.S. House of Representatives for recently passing the bipartisan Jackie Walorski Maternal and Child Home Visiting Reauthorization Act of 2022 (H.R. 8876). With only a few weeks left this congressional session and the program set to expire on Dec. 16, it is critical that lawmakers do not miss this opportunity to ensure the policies in this legislation become law.

In my decades of practice, I’ve cared for many families who have benefitted from home visiting services. MIECHV funds voluntary, evidence-based home visiting programs, which pair families looking for additional support and mentoring with trained home visitors such as nurses, social workers, community health workers, and educators. It creates partnerships within the community to set families up for success. Home visitors can make sure an infant is meeting developmental milestones, teach new parents about child development, make sure an infant has a safe sleep environment, and so much more. The early days of the pandemic made it difficult for new parents to interact with other families, making the role of home visitors even more vital.

As pediatricians, there is only so much time we can spend with families during an appointment, and so home visiting complements the work we do to help ensure families have the support they need when they leave our clinic or practice.

The American Academy of Pediatrics has long supported MIECHV. Evidence-based home visiting programs improve child health, well-being, and development. Like pediatrics, it emphasizes prevention. These programs work to prevent maltreatment, foster child development, promote school readiness and improve long-term academic outcomes, and even support parents’ development of educational and work-related skills.

Despite its proven success, this program has never received an increase in funding, limiting its ability to reach all families who would benefit. In fact, MIECHV currently serves fewer than 5 percent of eligible families. But now, Congress has an opportunity to change this with the Jackie Walorski Maternal and Child Home Visiting Reauthorization Act.

Named in honor of the late-Rep. Jackie Walorski (R-Ind.), a longstanding champion of the MIECHV program, this reauthorization bill passed the House withresounding bipartisan support. It would increase funding for the program during the next five years and double the funding set-aside to serve more American Indian and Alaska Native families. It would also build on the successes of virtual home visiting that emerged during the pandemic so that families can have added flexibility, with assurance that the services meet the program’s rigorous quality standards.

Congress must ensure these vital policies are included as part of any comprehensive year-end legislation. It is time we make sure that all eligible families can receive the lifelong benefits that home visiting can offer.

Moira Szilagyi, MD, PhD, FAAP, is president of the American Academy of Pediatrics.


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