Darby O’Donnell, JD and the AfPA Governmental Affairs Team Alliance for Patient Access (AfPA)

On February 4th, President Donald Trump stood before a joint session of Congress and delivered his annual State of the Union Address. Although no laws or regulations were directly created from the address, it gave the American people a glimpse into the priorities of the Administration for the coming year. As expected, access to healthcare and drug costs were featured.

A highlight of the speech for maternal and infant health advocates was President Trump’s call for an additional $50 million to fund neonatal research. The $50 million request would help ensure that premature babies are given the opportunity to thrive despite their many challenges and extensive, treatment needs at birth.

In the second week of February, the President will submit the Administration’s Fiscal Year 2021 budget proposal. Although it is not yet known what will be included in the President’s FY 2021 budget proposal, new and continuing programs to support maternal and infant health are likely to be included. These programs include:

• Funding for Maternal, Infant, and Early Childhood Home Visiting Services

The MIECHV Program funds support communities to provide voluntary, evidence-based home visiting services to women during pregnancy, and to parents with young children up to kindergarten entry. The MIECHV Program supports pregnant women and families, particularly those considered at-risk, as they raise children who are physically, socially, and emotionally healthy and ready to succeed.

Of note, “over the past seven years, the MIECHV Program has provided over [five] million home visits. Almost three-fourths of families participating in the program had household incomes at or below 100 percent of the Federal Poverty Level, and 76 percent of adults and children relied on Medicaid or the Children’s Health Insurance Program.” (1)

• Funding for Maternal Health

Through the State Maternal Health Innovation (State MHI) Program, the Health Resources & Services Administration (HRSA) awards funding (approximately $18.7 million in new funding was released in September 2019) through nine cooperative agreements to assist states in addressing disparities in maternal health and improving maternal health outcomes, with an emphasis on preventing and reducing maternal mortality and severe maternal morbidity. (2)

Also, the Supporting Maternal Health Innovation (Supporting MHI) Program that serves as both a national resource center and provides “capacity-building assistance to HRSA’s maternal health grantees and other stakeholders as they engage in efforts to reduce maternal mortality and severe maternal morbidity through innovative and evidence-informed strategies.” Last year the program was implemented through $2.6 million in HRSA awards to grantees.

Finally, the Alliance for Innovation on Maternal Health (AIM) – Community Care Initiative, a nearly $2 million HRSA program in 2019, to increase the reach of an existing AIM program, by focusing on maternal safety in outpatient/ non-hospital settings and addressing preventable maternal mortality among pregnant and postpartum women in a community-based setting.

• Gabriella Miller Kids First Act

Launched in 2015, the Gabriella Miller Kids First Pediatric Research Program focuses on the relationships between birth defects and childhood cancer. Since its enactment, 26 patient cohorts have been chosen for the program, and more will be chosen in the near future. The program revolves around whole-genome sequencing in children’s birth defects and childhood cancer. The goal is to discover new clinical pathways through whole-genome sequencing. (3)

• Maternal, Infant and Early Childhood Home Visiting Program (MCHB)

The MCHB, in conjunction with the Administration for Children and Families, funds states to create volunteer-based programs aimed at increasing health and awareness in the community. These programs create the opportunity for health, social service, and child development professionals to plan regular visits to homes and allow parents to create a better environment for their children, while also improving their family’s overall health. (4)

Looking into Fiscal Year 2021

Taking a dive into what has been appropriated previously can give insight into what to expect from the upcoming appropriations cycle. However, while the process begins in February, final funding and priorities will not be known until November or December 2020.

As mentioned above, the President’s proposed FY 2021 budget is expected to be submitted to Congress shortly. At that point, advocates will have more clarity on the Administration’s intent to fund and support programs that support maternal and infant health needs.

Congress will thereafter have its role in using the budget as a blueprint, determining their roadmap on funding the programs mentioned above, and/or creating new programs to serve the health outcomes of mothers and children.

References:

1. https://www.hhs.gov/about/news/2019/09/12/hhs-awards374-million-programs-supporting-maternal-child-health.html
2. https://commonfund.nih.gov/kidsfirst
3. https://mchb.hrsa.gov/maternal-child-health-initiatives/homevisiting-overview