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The Maternal, Infant, and Early Childhood Home Visiting (MIECHV) Program, administered by the Health Resources and Services Administration (HRSA) in collaboration with the Administration for Children and Families (ACF), supports voluntary, evidence-based home visiting services for at-risk pregnant women and parents with young children up to kindergarten entry. In February 2018, the MIECHV Program was allocated $400 million per year through fiscal year (FY) 2022 through the Bipartisan Budget Act of 2018 (BBA). The BBA also provided new authority to the MIECHV program to designate data exchange standards for information required to be electronically exchanged between the MIECHV state/territory agency and other agencies within the state/territory.
In order to determine state/territory and local program views regarding the data exchange standards that would be helpful in improving interoperability and information sharing between state/territory agencies, HRSA and ACF conducted five (5) regional listening sessions over June and July 2019. The purpose of these listening sessions was to engage the home visiting field in a conversation about how data exchange standards can help achieve long-standing goals of state/territory and local programs, such as better integration of data from home visiting programs with broader early childhood strategies and programs, improved interoperability among service delivery partners, and reduced data collection and reporting burdens. Listening session attendees included MIECHV state/territory administrators, representatives from state/territory agencies they partner with, staff from local home visiting programs, and representatives from home visiting models. The following report is a summary of the input from the field gathered at the listening sessions.
Key Findings and Highlights
At each meeting, attendees shared what data exchange and interoperability efforts they were currently involved in. Overall:
- More than half of the states/territories represented at the listening sessions reported being at the very beginning of thinking about how to exchange data, and many noted that they do not have any formal data sharing agreements in place. The one exception to this general observation is for the MIECHV annual reporting requirement related to child maltreatment data.
- The agency the MIECHV Program is housed in at the state/territory level impacts the Program’s level of integration with related agencies.
- The most common data integration project at the state/territory level is the Early Childhood Integrated Data Systems (ECIDS). A few states/territories also talked about pilot programs to access health information, and some states/territories discussed initiatives to create a Master Client Index (MCI) to enable merging records by leveraging a centralized set of demographic data.
- Preschool Development and Race-to-the-Top grants have been an important source of funding for data exchange efforts for many states. In addition, a legislative or political mandate can be a powerful catalyst for information sharing.
- While there were different interpretations among states/territories as to what data sharing requires consent, there was a consistent theme around the need to inform clients and gain their consent prior to sharing data.
In addition, attendees discussed and prioritized scenarios in which they would find it useful to have data exchange standards:
- Referrals: Home visitors’ referrals of children and families to other health and human services providers, and other service providers’ referrals of children and families to the home visiting programs.
- Outcomes and Longitudinal Data: The measurement of common outcomes across home visiting programs to support longitudinal studies of program effectiveness and value.
- Program and Administrative Data: Standards for defining how home visitors can gain access to data repositories in other health and human service agencies that will help the home visitor fully understand the needs of the child and family and improve services accordingly.
- Screening: Standards for exchanging screening data previously recorded for children and families who are clients of home visitors with other providers that collect and/or could benefit from knowing the results of the screening measures.
At the beginning of each meeting, state/territory representatives were asked to provide an overview of the current state of data sharing in their respective state/territory. Specifically:
- How does your state/territory currently share data as it relates to your MIECHV Program?
- What structures or systems are in place to support data sharing in your state/territory (e.g., integrated data systems, preschool development grants, MOUs, data governance bodies, etc.)?
- Briefly describe any data sharing agreements you have in place.
The second key objective of the listening sessions was to understand what standards the states and territories would find helpful in promoting information sharing across programs and agencies within their state/territory. A roundtable of data exchange and home visiting experts was convened in March 2019 and identified an initial set of twenty (20) data sharing scenarios that became a starting point for the discussions at the regional meetings. Regional meeting participants were then presented with these scenarios, and were asked to prioritize among these and to select 3-4 scenarios for further exploration, as well as suggest additional data sharing scenarios that would be helpful.
Pool, Ivy, Paul Wormeli, and Daniel Stein. 2020. Developing Data Exchange Standards for MIECHV Home Visiting Programs: Summary of Discussions from Five Regional Listening Sessions held June-July 2019. OPRE Report #2020-127. Washington, DC: Office of Planning, Research, and Evaluation, Administration for Children and Families, U.S. Department of Health and Human Services.
- Administration for Children and Families
- Health Resources and Services Administration
- Maternal, Infant, and Early Childhood Home Visiting Program