Maternal Infant Health Program (MIHP)

The Maternal Infant Health Program (MIHP) serves pregnant people and infants living in Michigan who are Medicaid beneficiaries. The model seeks to reduce rates of maternal and infant morbidity and mortality by promoting healthy pregnancies, positive birth outcomes, and healthy growth and development for infants. 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 is designed to supplement regular medical prenatal and infant care by offering tailored education and counseling, care coordination, and referrals. MIHP pregnancy-related services include an assessment visit and up to nine additional monthly visits to implement the plan of care during pregnancy and postpartum. MIHP services for infants and their caregivers include an assessment and up to nine monthly visits to implement the plan of care. If needs persist, the infant and caregiver may be eligible for an additional nine visits. Services conclude once the infant reaches 18 months of age. Infants who are exposed to substances may receive a total of 36 visits until the child is 18 months of age or when Medicaid eligibility ends. Each home visit must last at least 30 minutes.

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The Maternal Infant Health Program (MIHP) provides prenatal and postnatal home visiting to pregnant people and infants living in Michigan who are Medicaid beneficiaries. MIHP is a benefit of Medicaid insurance and was designed to serve pregnant people as well as infants and their caregivers who may 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 mitigate the effects of delayed prenatal care, unintended pregnancy, and substance use during pregnancy, and promote healthy birth outcomes and infant growth and development.

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.

Public health consultants with advanced degrees provide ongoing technical assistance. Consultants are available daily by phone and email to answer providers’ questions and to offer guidance. On-site visits are also available upon request.

The MIHP service office produces the MIHP Bi-Weekly Update newsletter, which offers guidance and answers to questions. These updates are available on the MIHP website.

MIHP providers may enroll pregnant people and infants up to 12 months old who live in Michigan and are eligible to receive Medicaid. A pregnant person or infant does not need to be receiving Medicaid at the time of MIHP enrollment but must apply to receive ongoing services. MIHP providers offer assistance with the application process.

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 supplement regular medical prenatal and infant care by offering tailored education and counseling, care coordination, and referrals.

To initiate services, a licensed social worker or registered nurse conducts a risk assessment with the pregnant person or caregiver of the infant. The assessment identifies potential health risks and covers 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 pregnant person or the infant and their caregiver. 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 pregnant person or infant and their caregiver, 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. Each professional will visit the family at least once during the program. 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 the pregnant person or the infant and their caregiver; 
• Breastfeeding support;
• Parenting education;
• Family planning education and referrals;
• Transportation arrangements for health care appointments, substance abuse treatment, or support services;
• Referrals to community services such as childbirth education and parenting classes;
• Coordination between MIHP providers, medical care providers, and Medicaid insurance; and
• Motivational interviewing to help the family develop goals and an action plan for achieving them. 

MDHHS advises that home visits be provided as early as possible to maximize the potential of early intervention. MDHHS requires providers to make every effort to conduct home visits in person in the pregnant person’s or the infant and caregiver’s home. However, the pregnant person or the caregiver has the right to request that some visits take place at the MIHP provider’s office, virtually, or at an agreed-upon location in the community.

During the COVID-19 pandemic, MIHP adapted the service delivery model to include virtual service delivery. Virtual service delivery was integrated as a standard component of the model in May 2023. MIHP providers may offer up to 40 percent of their visits virtually—although, across the state, most MIHP providers serve clients exclusively or primarily in the home. A few clinic-based providers include a higher complement of office visits.

MDHHS uses standardized plans of care to guide MIHP service delivery. The plans of care are available on the MIHP website.

MIHP pregnancy-related services include an assessment visit and up to nine additional monthly visits to implement the plan of care during pregnancy and postpartum. Services for infants and their caregivers also include an assessment and up to nine monthly visits to implement the plan of care. If needs persist, the infant may be eligible for an additional nine visits. Services conclude once the infant reaches 18 months of age.

Infants who are exposed to substances may receive a total of 36 visits to help caregivers reduce or eliminate the infant’s exposure. Services conclude at 18 months of age or when Medicaid eligibility ends.

Each home visit must last at least 30 minutes.

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

A network of MDHHS-certified providers in rural, urban, and Native communities in Michigan provides MIHP services. MIHP providers include private practices, community-based organizations, hospitals, home health agencies, hospital-based clinics, federally qualified health centers, tribal agencies, and local public health departments.

The MIHP Certification Tool outlines fidelity standards. Each MIHP provider is evaluated on service delivery—this could include, home visit dosage, completion of the risk assessment, development of a plan of care, and communications and coordination with medical providers—as well as overall model compliance. Please contact the model developer for additional information about these standards.

The MIHP team is composed of a registered nurse and licensed social worker. MIHP providers must also employ or have a network of infant mental health specialists, board-certified lactation consultants, and registered dietitians to whom they can refer families, as needed. An MIHP program coordinator oversees each provider’s MIHP program. 

Nurses must be licensed as registered nurses and have at least one year of experience providing community health, pediatric, maternal, or infant nursing services. Social workers must be licensed and have at least one year of experience providing social services to families.

MDHHS does not have supervision requirements for MIHP home visitors. Each MIHP provider independently determines the level of administrative, clinical, and supportive supervision for home visiting staff. Reflective supervision, although not required, is recommended. MDHHS can provide technical assistance to local providers on how to supervise staff. MDHHS also provides guidance and training on reflective supervision. No information is available on the supervision or support offered to supervisors.

Before a new MIHP provider initiates services in its community, the program coordinator, the registered nurse, and the licensed social worker must attend an orientation. MIHP provider staff must also complete a series of online trainings before providing services. Please contact the model developer for additional information about the pre-service training requirement.

MDHHS requires MIHP provider staff to attend annual meetings and offers monthly “community of practice” webinars for home visitors and community partners. The meetings and webinars provide updates on model procedures, fidelity, and oversight as well as information on maternal and infant risks and services. Optional online trainings are available on topics such as perinatal oral health, trauma and toxic stress, fatherhood and supportive resources for fathers, and how socioeconomic conditions impact pregnancy outcomes. Please contact the model developer for additional information about the ongoing professional development requirement.

Maternal and Infant Health Program
Division of Maternal and Infant Health
Michigan Department of Health and Human Services

Phone: 833-MI4-MIHP
Email: MIHP@michigan.gov
Website: https://www.michigan.gov/mihp/