Maternal and Infant Health Program
Division of Maternal and Infant Health
Michigan Department of Health and Human Services

Phone: (833)-MI4-MIHP
Email: MIHP@michigan.gov
Website: https://www.michigan.gov/mihp/

The Maternal Infant Health Program (MIHP) provides prenatal and postnatal home visiting to pregnant women and infants living in Michigan who are Medicaid beneficiaries. 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.

The Michigan Department of Health and Human Services (MDHHS) functions as the MIHP service office and administers the model. Local providers must comply with state and federal Medicaid guidelines in addition to MIHP model requirements.

Public health consultants with advanced degrees provide ongoing technical assistance. Consultants are available daily by phone and email to answer provider questions and to offer guidance. On-site consultation visits are also available upon request.

MIHP also produces an “MIHP Weekly Update” newsletter that offers guidance and answers questions. These updates are available on the MIHP website.

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.

MIHP’s goals are to reduce rates of maternal and infant morbidity and mortality by promoting healthy pregnancies, positive birth outcomes, and healthy growth and development for infants.

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 uses standardized plans of care to guide service delivery. The plans of care are available on the MIHP website.

MIHP maternal services include an assessment visit and up to nine additional monthly visits to implement the plan of care during pregnancy. Services conclude about 60 days postpartum. MIHP infant services also include an assessment and up to nine additional monthly visits in the first year of the child’s life to implement the plan of care. If needs persist, the infant may be eligible for an additional nine visits. Infant services must conclude before the infant reaches 18 months of age. Infants who are exposed to substances may receive up to 36 visits to help parents reduce or eliminate the infant’s exposure. Each home visit must last at least 30 minutes.

No information is available on adaptations or enhancements made to the model.

A network of MDHHS-certified providers in rural, urban, and native communities in Michigan provides MIHP services. MIHP providers include private practices, community-based organizations, hospitals, home health agencies, hospital-based clinics, federally qualified health centers, tribal agencies, and local public health departments.

The MIHP Certification Tool outlines fidelity standards. Each MIHP provider is evaluated on service delivery (for example, home visit dosage, completion of the risk assessment and development of a plan of care, and communications and coordination with the medical provider) as well as overall model compliance. Please contact the model developer for additional information about these standards.

The MIHP team is composed of a registered nurse and licensed social worker. MIHP providers must also employ or have a network of infant mental health specialists, board-certified lactation consultants, or registered dietitians to whom they can refer families, as needed. An MIHP program coordinator oversees each provider’s MIHP program. 

Nurses must be licensed as registered nurses and have at least one year of experience providing community health, pediatric, maternal, or infant nursing services. Social workers must be licensed and have at least one year of experience providing social services to families.

MDHHS does not have supervision requirements for MIHP programs. Each MIHP provider independently determines the level of administrative, clinical, and supportive supervision for home visiting staff. Reflective supervision, although not required, is recommended. MDHHS can provide technical assistance to local providers on how to supervise staff. MDHHS also provides guidance and training on reflective supervision.

New MIHP providers must attend a multi-day in-person orientation before initiating services in their community. The MIHP program coordinator or agency owner, the registered nurse, and licensed social worker must attend the training. MIHP provider staff must also complete a series of online trainings before providing services. Please contact the model developer for additional information about the pre-service training requirement.

MIHP requires providers to attend meetings and “community of practice” webinars every two months. The meetings and webinars update MIHP providers on model procedures, fidelity, and oversight, and give them information on the topic of maternal and infant risks and services. Optional online trainings are also available on topics such as perinatal oral health, trauma and toxic stress, fatherhood and supportive resources for fathers, and how socioeconomic conditions impact pregnancy outcomes. Please contact the model developer for additional information about the ongoing professional development requirement.