Implementing Maternal Infant Health Program (MIHP) Meets HHS Criteria

Model implementation summary last updated: 2019

The information in this implementation report reflects feedback, if provided, from this model’s developer as of the above date. The description of the implementation of the model(s) here may differ from how the model(s) was implemented in the manuscripts reviewed to determine this model’s evidence of effectiveness. Inclusion in the implementation report does not mean the practices described meet the HHS criteria for evidence of effectiveness. Please see the Effectiveness button on the left for more information about any research on the effectiveness of the model, including any version(s) of the model with effectiveness research. Versions of the model that are described in the Adaptations and enhancements section of this implementation report may include (1) versions that were identified by the model’s developer and (2) versions that have been implemented by researchers and have manuscripts that HomVEE rated high or moderate, but that are not supported by the model’s developer.

Model overview

Theoretical approach

The Maternal Infant Health Program (MIHP) provides prenatal and postnatal home visiting to pregnant women and infants living in Michigan who are Medicaid beneficiaries. MIHP was designed to serve women and their children who receive Medicaid because they are more likely to experience adverse birth outcomes and higher rates of infant mortality and injury than families with private insurance. The model is based on the premise that early intervention can help mitigate the effects of delayed prenatal care, unintended pregnancy, and substance use during pregnancy.

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Implementation support

The Michigan Department of Health and Human Services (MDHHS) functions as the MIHP service office and administers the model. Local providers must comply with state and federal Medicaid guidelines in addition to MIHP model requirements.
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Intended population

MIHP serves pregnant women and infants up to 18 months old who live in Michigan and receive Medicaid. A pregnant woman or infant does not need to be receiving Medicaid at the time of MIHP enrollment, but must apply in order to receive ongoing services. MIHP offers assistance with the application process. Women may enroll in MIHP at any time during their pregnancy and receive services until 60 days postpartum. Families may enroll infants, even if the mother was not enrolled in MIHP during pregnancy.

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Targeted outcomes

MIHP’s goals are to reduce rates of maternal and infant morbidity and mortality by promoting healthy pregnancies, positive birth outcomes, and healthy growth and development for infants.
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Model services

MIHP offers home visiting by a team composed of a licensed social worker, a registered nurse, an infant mental health specialist, a lactation consultant, and a registered dietitian. MIHP services aim to supplement regular prenatal and infant care by offering tailored education and counseling, care coordination, and referrals. The model is designed to serve mothers during pregnancy and up to 60 days postpartum and infants before they reach 18 months of age; it serves mothers and infants separately based on their respective needs.

To initiate services, a licensed social worker or registered nurse conducts a risk assessment with the mother or infant. The assessments are designed to identify potential health risks and cover areas such as pregnancy and overall health history, basic needs, domestic violence, substance abuse, support systems, maternal mental health, and infant safety.

Based on findings from the risk assessment, the licensed social worker and registered nurse develop an individualized plan of care for the mother and/or infant. Registered dietitians, lactation consultants, and infant mental health specialists may contribute to the plan as needed. The plan of care identifies the needs of the mother and/or infant, outlines the desired outcomes, and describes the appropriate services to fulfill the family’s needs.

Based on the plan of care, either the licensed social worker or the registered nurse will serve as the primary home visitor, but each professional will visit the family at least once. Other MIHP team members may also conduct home visits. During the visits, the home visitor may provide the following services:

  • Assistance with basic needs;
  • Education on maternal and infant health;
  • Nutrition counseling for mothers and infants;
  • Breastfeeding support;
  • Parenting education;
  • Family planning education and referrals;
  • Transportation arrangements to appointments for health care, substance abuse treatment, or support services;
  • Referrals to community services such as childbirth education and parenting classes; and,
  • Coordination between MIHP providers, medical care providers, and Medicaid insurance plans.

The home visitor uses motivational interviewing techniques and works with the family to develop goals and a plan for achieving them.

MDHHS requires providers to make every effort to visit the mother or infant at home. The mother has the right to request that some visits take place at the MIHP provider’s office or at a mutually agreed-upon community location. For maternal services, MDHHS requires at least one visit to the mother’s home during the prenatal period to assess the mother, and at least one other home visit postpartum to observe infant care and nutrition and discuss family planning. For infants, MDHHS requires that the assessment and 80 percent of other visits to be conducted at the infant’s home. Across the state, most MIHP providers serve clients exclusively or primarily in the home; there are a few clinic-based providers that include a higher complement of office visits.

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Model intensity and length

MIHP maternal services include an assessment visit and up to nine additional monthly visits to implement the plan of care during pregnancy. Services conclude about 60 days postpartum. MIHP infant services also include an assessment and up to nine additional monthly visits in the first year of the child’s life to implement the plan of care. If needs persist, the infant may be eligible for an additional nine visits. Infant services must conclude before the infant reaches 18 months of age. Infants who are exposed to substances may receive up to 36 visits to help parents reduce or eliminate the infant’s exposure. Each home visit must last at least 30 minutes.
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MIHP is implemented in all 83 Michigan counties.
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Adaptations and enhancements

No information is available on adaptations or enhancements made to the model.
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Implementation notes

The information contained on this page was last updated in August 2019. Recommended further reading lists the sources for this information. In addition, the information contained in this profile was reviewed for accuracy by the MDHHS MIHP staff in April 2019. HomVEE reserves the right to edit the profile for clarity and consistency.

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