Help Me Grow ..................................................................................................................................................................... 3

The Current State of Affairs .................................................................................................................................................... 4

Statewide and Local Planning Efforts .................................................................................................................................. 4

Prior Financial Planning for Expansion of Home Visiting Through Medicaid ...................................................................... 5

Engrossed Substitute House Bill 1109 was signed into law on May 21, 2019, by Governor Jay Inslee. In Section 225 is a

specifically look at the feasibility of leveraging other types of funds, including Medicaid and Title IV-E to offer this model.

age five. (ii) $56,000 of the general fund — state appropriation for fiscal year 2020 and $539,000 of the general

voluntary brief newborn home visiting program. The program must meet the diverse needs of Pierce county

residents and, therefore, it must be flexible, culturally appropriate, and culturally responsive. The department,

in collaboration with the nonprofit organization, must examine the feasibility of leveraging federal and other

fund sources, including federal Title IV-E and Medicaid funds, for home visiting provided through the pilot. The

Based on the legislative criteria of using a nationally recognized model that offers a voluntary, brief home visiting

During the initial home visit, a nurse conducts a physical health assessment of the mother and newborn, screens families

for potential risk factors associated with mother’s and infant’s health and well-being and may offer direct assistance

home visiting; a medical home; social support services such as the Women, Infants, and Children (WIC) Nutrition plan or

Supplemental Nutrition Assistance Program (SNAP); or an active resource and referral system such as a Help Me Grow

staff collaborate with local agencies that serve families with children from birth to age 5 years.

Dissemination of the Family Connects model is a collaborative endeavor between the Duke Center for Child & Family

funds and monitoring the progress of this pilot. DCYF is an agency focused on the well-being of children, youth and

prevent illness and injury, promote healthy places to live and work, provide information to help people make good

with a goal to enhance public child welfare agencies while creating new opportunities for states to receive federal

reimbursements for services that aide in preventing children from entering foster care and improve the well-being of

children already in the system.

and inspire communities to achieve their collective goals for children and families.

implemented with articulated design and standards and that can be evaluated according to those designs and standards.

home visiting programs. The home visiting programs reach pregnant women, expectant fathers and parents and

caregivers of children under the age of 5. It is administered by the Health Resources and Services Administration (HRSA)

in collaboration with the Administration for Children and Families (ACF). To be eligible for MIECHV funding, a program

program for all families of newborns regardless of income or socioeconomic status. The model assists in earlier

assessment of family need and increases child well-being by bridging the gap between family needs and community

resources. A Family Connects® nurse visitor will connect with every family of a newborn (mother, father, foster parents,

kinship caregiver and other family structures with a newborn) in their home. Family Connects® is shown to improve

family well-being, including reducing emergency medical care for infants and improving parent behavior and the quality

Additionally, in Pierce County as in other areas where it is active, the nurse will connect all interested families with the

Help Me Grow referral network. Nurses regularly address maternal and infant health concerns, home safety issues,

care access, parenting education, family planning, financial concerns, social support and more through assessment.

Universal reach addresses community norms related to help-seeking or accessing services by normalizing that all families

demographic risk does not address all families with vulnerabilities and needs. The cost for implementation of Family

early light touch home visiting and assessment services, an increased need is anticipated for referral to case

healthy development through families.

resources. The federal Centers for Medicare & Medicaid Services (CMS) is responsible for approving each state’s

Medicaid State Plan, including waivers, and monitoring state compliance with federal Medicaid regulations. In

Washington State, Medicaid is called Apple Health and is provided free or at low cost on a sliding scale to eligible

Medicaid requirements for reimbursement. Federal regulations currently do not authorize proprietary home visiting

models in their entirety, although some medically necessary home-based services may be allowed. In a 2016 joint

, CMS and Health Resources & Services Administration (HRSA) encouraged states to look for ways to pair

Medicaid, state dollars and private resources to create and fund a home visiting benefit package.

In designing a home visiting program, state agencies should work together to develop an appropriate package of

services to be provided to their beneficiaries. This package may consist of Medicaid-coverable services in tandem with

additional services available through other federal, state or privately funded programs. Each federal, state, and private

Medicaid has the potential to fund specific discrete services within Family Connects for the Medicaid enrolled

in the child welfare system through increased investments in prevention services. It is also known by its most recent

authorizing legislation, the Family First Prevention Services Act (FFPSA). The funding cycle is 12 months and uses an

Home Visiting Evidence for Effectiveness (HOMVEE) list as meeting the U.S. Health and Human Services criteria for an

groups that will be eligible will be families that have had screened-in child welfare calls who have chosen to participate

in voluntary services, and several specialized groups of pregnant women and children under the age of 18 who have

coverage, and specifically for the individual and small group health plans, must cover the

happened with the Office of Insurance Commissioner (OIC) or any of the commercial insurance plans, based on a quick

scan of potential services available and potentially Medicaid eligible services, staff from OIC identified the following

range of services as having parallels under the essential health benefits:

not include counseling in the absence of illness, other than family counseling for a child or adolescent with a

Medicaid, private commercial insurance only covers a portion of the population and would only pay for their covered

scale of the work.

In Pierce County, First 5 FUNdamentals and their partners have worked to leverage their local government and

implementation plan will look like specifically for their region. The funding provided by the budget proviso allows them

in the first year to complete six months of implementation planning and then serve approximately 375 families. There

are seven birthing locations in the county and approximately 12,000 children born annually. The work of the first

quality and seamless product for families.

Areas that have a high Medicaid birth rate will likely be good demonstration sites for where to begin to build braided

funding streams to pay for the services that families need using Medicaid strategies. Conversely, areas with low

Medicaid birthrates will have a higher burden to attract other funding sources such as philanthropy and state funding.

hospital/town/city/county. However, other programs are rolling out at a large scale such as the entire state of Oregon

and the city of Chicago. Operating at a smaller level gives programs more flexibility with their funding, as is evident by

through a statewide infrastructure that would support local efforts.

available for all families in Washington. The introduction of a statewide Family Connects system will allow families a

point of entry into common services available for families with young children: early learning, quality child care,

This is where the HMG system will come into play. However, without an expansion of services that are currently

provided in communities across the state, there will be a gap in capacity for the increased number of children and

families who need further assistance. A network of services must be created, enhanced or expanded to connect families

security, traditional-intensive home visiting services, early intervention, quality child care and preschools among other

local resources that may be specific to each community.

assessed, identified, referred and served.

private insurance and Title IV-E, however they may be available in the future. While none of them are available today,

efficiently and effectively to serve the population.

specialize in this model if the expansion is expected. DCYF will also need to revisit their Title IV-E state plan annually to