Maternal Infant Health Program (MIHP)
Model effectiveness research report last updated: 2019
MIHP was designed to serve women and their children who receive Medicaid because they are more likely to 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 help mitigate the effects of delayed prenatal care, unintended pregnancy, and substance use during pregnancy.
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 aim to supplement regular prenatal and infant care by offering tailored education and counseling, care coordination, and referrals. The model is designed to serve mothers during pregnancy and up to 60 days postpartum and infants before they reach 18 months of age; it serves mothers and infants separately based on their respective needs.
To initiate services, a licensed social worker or registered nurse conducts a risk assessment with the mother or infant. The assessments are designed to identify potential health risks and cover 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 mother and/or infant. 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 mother and/or infant, 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, but each professional will visit the family at least once. 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 mothers and infants;
- Breastfeeding support;
- Parenting education;
- Family planning education and referrals;
- Transportation arrangements to appointments for health care, substance abuse treatment, or support services;
- Referrals to community services such as childbirth education and parenting classes; and,
- Coordination between MIHP providers, medical care providers, and Medicaid insurance plans.
The home visitor uses motivational interviewing techniques and works with the family to develop goals and a plan for achieving them.
MDHHS requires providers to make every effort to visit the mother or infant at home. The mother has the right to request that some visits take place at the MIHP provider’s office or at a mutually agreed-upon community location. For maternal services, MDHHS requires at least one visit to the mother’s home during the prenatal period to assess the mother, and at least one other home visit postpartum to observe infant care and nutrition and discuss family planning. For infants, MDHHS requires that the assessment and 80 percent of other visits to be conducted at the infant’s home. Across the state, most MIHP providers serve clients exclusively or primarily in the home; there are a few clinic-based providers that include a higher complement of office visits.
MIHP serves pregnant women and infants up to 18 months old who live in Michigan and receive Medicaid. A pregnant woman or infant does not need to be receiving Medicaid at the time of MIHP enrollment, but must apply in order to receive ongoing services. MIHP offers assistance with the application process. Women may enroll in MIHP at any time during their pregnancy and receive services until 60 days postpartum. Families may enroll infants, even if the mother was not enrolled in MIHP during pregnancy.