Legislation that would extend the federal home visiting program for another five years, which was included in a final budget bill that was passed by Congress earlier today, also includes provisions that would authorize the use of pay-for-outcomes transactions in the program.
The extension of the Maternal, Infant, & Early Childhood Home Visiting (MIECHV) program was included in the final version of the bill. The pay-for-outcomes provisions are in Section 50605 of the MIECHV section of the law.
The provisions are optional, but if they are used they must meet the following requirements:
(4) Pay for outcomes initiative.–The term `pay for outcomes initiative’ means a performance-based grant, contract, cooperative agreement, or other agreement awarded by a public entity in which a commitment is made to pay for improved outcomes achieved as a result of the intervention that result in social benefit and direct cost savings or cost avoidance to the public sector. Such an initiative shall include–
(A) a feasibility study that describes how the proposed intervention is based on evidence of effectiveness;
(B) a rigorous, third-party evaluation that uses experimental or quasi-experimental design or other research methodologies that allow for the strongest possible causal inferences to determine whether the initiative has met its proposed outcomes as a result of the intervention;
(C) an annual, publicly available report on the progress of the initiative; and
(D) a requirement that payments are made to the recipient of a grant, contract, or cooperative agreement only when agreed upon outcomes are achieved, except that this requirement shall not apply with respect to payments to a third party conducting the evaluation described in subparagraph (B).
The provisions would reauthorize MIECHV through 2022. The program technically expired late last year, which has reportedly caused some states to freeze new enrollments. The program is one of a handful of federal initiatives that are evidence-based.