MIECHV Data & Continuous Quality Improvement

Maternal, Infant, and Early Childhood Home Visiting (MIECHV) Program awardees collect and report on performance data to track their program’s performance, identify areas for improvement, and ensure services are resulting in measurable improvement for families and communities.

Awardees submit annual and quarterly performance reports, develop and implement plans for continuous quality improvement (CQI), and submit documentation to meet certain statutory requirements related to demonstrating improvement. Demonstration of improvement must be achieved in at least four of six benchmark areas. In addition, awardees make plans for implementing data exchange standards for improved data interoperability.

MIECHV also promotes rigorous evaluation at the national, state, and local levels and supports research infrastructure in the field. For more information, visit the MIECHV Evaluation & Research page.

Health Equity Assessment Leveraging Performance Measurement (HEAL-PM)

In partnership with NORC at the University of Chicago (NORC), a not-for-profit research organization, HRSA's MCHB and ACF are conducting the HEAL-PM project. The goal of the HEAL-PM project is to examine how the MIECHV performance measurement system can better monitor and understand how awardees document and assess changes in health disparities over time to measure progress towards health equity (i.e., the absence of disparities or avoidable differences among groups in health status and health outcomes) in home visiting. Specifically, this project aims to understand how the MIECHV Program performance measurement system can transition to integrate a health equity framework.

This project seeks to answer three key questions:

1. How can the social and structural determinants of health (SSDOH) be used to provide context to MIECHV Program performance measures data, using a health equity measurement framework?
2. How can performance measures better reflect HRSA's commitment to advancing health equity within the existing statutorily defined benchmark areas?
3. What aspects of data collection and Technical Assistance (TA) must be considered when promoting the collection and assessment of MIECHV Program data within a health equity framework?

Resource documents

• HEAL-PM Enhancements in the Maternal, Infant, and Early Childhood Home Visiting Program Interested Parties Discussion Summary Memo (PDF - 707 KB) provides a summary of a series of engagements conducted in 2022 with MIECHV awardees and Tribal MIECHV grantees to gather information about priorities for measuring and assessing health equity in their programs.
• HEAL-PM Enhancements in the MIECHV Program Interested Parties Summary Memo Year 2 Engagement (PDF - 1 MB)
• HEAL-PM Environmental Scan Summary Report - Final Report February 2023 (PDF - 2 MB)

Annual performance reporting

HRSA requires MIECHV Program grantees to collect and report data on their program’s performance for demographic, service utilizations, select clinical indicators of program participants and six statutorily defined benchmark areas. The MIECHV performance measurement system includes a total of 19 measures across the six benchmark areas:

• Improvements in maternal, newborn, and child health;
• Prevention of child injuries, child abuse, neglect, or maltreatment and reductions of emergency room visits;
• Improvements in school readiness and child academic achievement;
• Reductions in crime or domestic violence;
• Improvements in family economic self-sufficiency; and
• Improvements in the coordination and referrals for other community resources and supports.

Summary of MIECHV Program Performance Measures (PDF - 137 KB)

Resource documents (updates effective starting FY 2022)

Beginning with the FY 2022 reporting period (starting October 1, 2021), HRSA updated the annual MIECHV performance reporting forms in order to include revised reporting categories and specifications related to participant demographics, service utilization, and select clinical indicators. HRSA has also added two optional measures to collect information on substance use screenings and referrals. Additional technical assistance resources, including a webinar recording, summary of changes, and list of validated screening tools, are available on the MIECHV Awardee Learning Library (MALL) or by contacting your TARC TA Specialist.

• Form 1 - Demographic Performance Measures (PDF - 372 KB) (Includes demographic, service utilization, and select clinical indicators) *
• Form 2 - Benchmark Performance Measures (PDF - 329 KB) (Includes performance indicators and systems outcome measures)*
• Form 1 Toolkit - Demographic, Service Utilization, and Select Clinical Indicators (PDF - 697 KB) (Updated May 2022)
• Form 2 Toolkit - Performance Indicators and Systems Outcomes (PDF - 1 MB) (Updated May 2022)
• FAQs: Demographic, Service Utilization, and Select Clinical Indicators and Performance Indicators and Systems Outcomes (PDF - 1 MB)
• Guidance on Identifying Missing Data (PDF - 162 KB)
• Home Visiting Model Developer Performance Measurement Crosswalk (PDF - 1 MB)
• Grantee Performance Measurement Data Collection and Analysis Plan Template (PDF - 188 KB)

Training videos

• MIECHV Quarterly and Annual Reports Help Video

Webinars

• Strategies for Improving Data Quality and Addressing Missing Data (February 14, 2019) Transcript (PDF - 128 KB)

Quarterly performance reporting

MIECHV awardees must submit quarterly performance reports which serve to assist HRSA in monitoring grants and providing oversight.

The forms include a select number of service utilization and staffing measures, which have the potential to change frequently. 

• Form 4 – Quarterly Data Collection (PDF - 81 KB) - Note that the due date for this form has been revised to 45 days after the end of the data collection period. Key terms and definitions have been updated to clarify instructions on Table A.2 Place-Based Services.
• Form 4 - Quarterly Performance Reporting Frequently Asked Questions

MIECHV American Rescue Plan Act reporting

MIECHV awardees who received American Rescue Plan Act (ARP) funding (X11 awards) must submit quarterly and annual reports which serve to assist HRSA in monitoring grants and providing oversight.

Quarterly progress reporting submissions will be narrative reports, unique to the ARP grant that include descriptions of the scope of activities across the seven categories of allowable uses of funds, including updates on progress in achieving project goals and objectives. Beginning in April 2022, awardees will be able to use HVIS to report quarterly performance data on service utilization and staffing using Form 4.

Data across all active Formula grants (X10) and ARP grants (X11) must be consolidated into one Annual Performance Report submission, due in October of each year. Families served using ARP funds must be included in your Annual Performance Report (Forms 1 and 2), which includes demographic, service utilization, and select clinical indicators and performance indicators and systems outcome measures.

Specific reporting requirements, including deadlines and instructions for submitting reports, are specified in the instructions document.

• MIECHV ARP Reporting Instructions
• MIECHV ARP Reporting FAQs
• MIECHV ARP Quarterly Progress Report Template (DOCX - 49 KB)
• Annual Reporting Forms (consolidated with MIECHV Formula Annual Report (X10)) - see Forms 1 and 2 under Annual Performance Reporting Resource Documents.

Home Visiting Budget Assistance Tool (HV-BAT)

Beginning in the FY 2021 project period, MIECHV awardees are required to collect and submit data using the Home Visiting Budget Assistance Tool (HV-BAT) once every three years. The HV-BAT is a tool for MIECHV awardees and local implementing agencies (LIAs) to collect and report comprehensive home visiting program costs incurred by LIAs during a 12-month period. HV-BAT data can help MIECHV awardees and LIAs:

• Monitor sub-recipient program operations
• Develop budgets and forecast the financial impact of expanding services
• Conduct economic evaluations
• Inform alternative funding strategies

Resource documents

• HV-BAT User Guide Overview (PDF - 118 KB)
• HV-BAT User Guide Volume I (PDF - 567 KB) (Includes instructions for MIECHV Awardees)
• HV-BAT User Guide Volume II (PDF - 1 MB) (Includes instructions for LIAs)

Additional HV-BAT technical assistance resources are available for MIECHV awardees by contacting their MIECHV Technical Assistance Resource Center (TARC) TA Specialist team.

Forms

• HV-BAT Tool (XLSX - 155 KB)*

Continuous quality improvement

• FY 2023 CQI Plan Guidance and Template (PDF - 507 KB)
• FY 2020 CQI Plan Updates and Building Capacity for CQI Coaching and LIA Support Webinar (January 21, 2020) Transcript (PDF - 155 KB)
• FY 2022 CQI Improvement Plan Guidance and Template

Home Visiting Collaborative Improvement and Innovation Network 3.0 (HV CoIIN 3.0)

The Home Visiting Collaborative Improvement and Innovation Network supports MIECHV awardees and local implementing agencies to build capacity to scale up tested interventions. Now in its third iteration, HRSA awarded $1.3 million to Education Development Center on September 1, 2022. During the five-year funding period, HV CoIIN 3.0 will continue to support skill building in continuous quality improvement and dissemination and scale-up of effective strategies to drive improvement. Find out more information at the HV CoIIN 3.0’s website.

Demonstration of improvement

MIECHV awardees are required to provide information to HRSA demonstrating that their programs result in improvement for eligible families in at least four of six benchmark areas following FY 2020 and every three years thereafter. Resources below are available for the FY 2023 Demonstration of Improvement.

• FY 2023 Demonstration of Improvement in Benchmark Areas Webinar Slides (PDF - 1 MB) (May 2023)
• MIECHV Demonstration of Improvement in Benchmark Areas (PDF - 211 KB) (Updated April 2023)
• Tip Sheet: Preparing for the FY 2023 Demonstration of Improvement (PDF - 164 KB)
• Demonstrating Improvement in Benchmark Areas Webinar*
• Demonstrating Improvement in Benchmark Areas Webinar Transcript (PDF)*
• MIECHV Program Guidance on Meeting Requirements to Demonstrate Improvement in Benchmark Areas (PDF - 270 KB)(Updated for FY 2023 Demonstration of Improvement)
• MIECHV Program Guidance on Meeting Requirements to Demonstrate Improvement in Benchmark Areas Frequently Asked Questions (FAQs) (PDF - 175 KB)(Updated for FY 2023 Demonstration of Improvement)
• Synthesis of Stakeholder Feedback Regarding MIECHV Statutory Changes for the Assessment of Awardee Improvement in Benchmark Areas (PDF)(Released 2019)

*This webinar was released in Fall of 2019 in preparation for the FY 2020 Demonstration of Improvement. The methodology for demonstrating improvement still applies, however timeframes mentioned are outdated. Please refer to the updated guidance for timeframes related to the FY 2023 Demonstration of Improvement.

Data exchange standards

The Bipartisan Budget Act of 2018 (Pub. L. 115-123) (BBA) extended the MIECHV Program and provided new authority for the Program to establish data exchange standards, which can be used to support federal reporting and facilitate the electronic exchange of data between the MIECHV state agency and other state agencies. By sharing data, MIECHV awardees can address key policy, programmatic, and research questions about the home visiting field that may not be answerable with current data infrastructures. The following resources are available to support MIECHV awardees that are interested in implementing data exchange standards in their state or territory.

• Coordinating Data Sharing Across Agencies (PDF - 264 KB)
• Now What? Steps for Using Interoperable Home Visiting Data (PDF - 338 KB)
• Communicating Effectively with Families about Data Sharing (PDF - 313 KB)
• Implementing Data Exchange Standards: A Toolkit for MIECHV Awardees (PDF - 571 KB)
• Developing Data Exchange Standards for MIECHV Home Visiting Programs (PDF - 189 KB)

*Note: Persons using assistive technology may not be able to fully access information in this file. For assistance, please email Elizabeth Firsten or call 267-591-2143.

Contact us

HRSA Home Visiting Program

HomeVisiting@hrsa.gov