FR 2025-00129

The document from the Federal Register involves an initiative by the Health Resources and Services Administration (HRSA), which is part of the Department of Health and Human Services (HHS). This initiative aims to introduce public comments on a survey to identify eligible home visiting service models for the Maternal, Infant, and Early Childhood Home Visiting (MIECHV) Program. These models must meet evidence-based criteria and statutory requirements outlined by HRSA. The invitation for public comments is intended to refine the methods used to determine eligibility and understand the impacts on various stakeholders, including eligible entities, families, and developers.

General Summary

The HRSA is issuing a notice to gather public input on its survey proposal. This survey is designed to identify home visiting service models that can be used under the MIECHV Program. The models selected must adhere to specific evidence and statutory criteria set forth by the agency. This initiative follows a reauthorization of the MIECHV program in December 2022. HRSA stresses that models are screened via a HomVEE (Home Visiting Evidence of Effectiveness) review to ensure compliance with updated statutory requirements. The public is encouraged to comment on the proposed information collection's efficacy, the burden estimates, and ways to enhance the quality of the survey.

Significant Issues and Concerns

There are several notable concerns in the document. Firstly, while the document outlines the purpose and methodology of the survey, it does not mention the estimated cost associated with the survey and model assessment. This omission could lead to potential unchecked spending or resource allocation issues. Additionally, the criteria used to judge the evidence-based nature of the models through the HomVEE process is not thoroughly defined, which could lead to ambiguities and misunderstandings.

Moreover, the legal and technical language surrounding the statutory requirements might pose comprehension challenges for non-experts. There is also a lack of clarity about the consequences faced by models failing to meet the requirements, other than losing eligibility. The process for model developers to appeal a negative determination lacks procedural transparency, and there is a concern about whether the outlined timelines for responses and evaluations (30 days for responses, 15 days for appeals, and 45 days for reassessment) might lead to operational delays.

Public Impact

Broadly, this initiative is one that may directly influence how federal funding for home visiting services is allocated and managed. The MIECHV Program plays a vital role in supporting families in at-risk communities by providing them with essential early childhood services. Ensuring that only evidence-based and statutory-compliant models are utilized reinforces the program's effectiveness and the responsible use of taxpayer money. However, uncertainties and lack of transparency in the review and selection process might diminish public trust and engagement with the program.

Stakeholder Impact

Specific stakeholders affected by this proposal include model developers, local implementing agencies, and communities using or dependent on MIECHV services. While the initiative assures a systematic evaluation process to guarantee that only the most effective models are utilized, the vague details on reassessment processes and consequences for non-compliant models might create anxiety among service providers about their continued eligibility and operational viability. Families participating in the MIECHV Program may experience continuity concerns if their local service model loses eligibility, requiring adjustments or transitions to alternative approved models.

Overall, while the HRSA’s efforts to systematize and standardize model eligibility reviews for the MIECHV Program have potential benefits, addressing these identified concerns with additional transparency and detailed procedural guidance is crucial for successful implementation and stakeholder assurance.