On March 23, 2010, President Obama signed the Patient Protection and Affordable Care Act,
which included, among other critical provisions, $1.5 billion in mandatory funding over 5 years
for high quality, evidence-based, voluntary early childhood home visitation services. This
investment will significantly expand home visitation services, helping to ensure that more
children have the opportunity to grow up healthy, safe, ready to learn and able to become
productive members of society. In addition, the law requires all states, as a condition of
receiving existing Maternal and Child Health Services Block grant funds in FY 2011, to conduct
a statewide needs assessment to identify at-risk communities, and determine the capacity of
existing early childhood visitation programs, substance abuse treatment, and counseling services.
The Maternal, Infant, and Early Childhood Home Visiting Program is designed to: 1) strengthen
and improve the programs and activities carried out under the Maternal and Child Health
Services block grant, 2) improve coordination of services for at-risk communities, and 3) identify
and provide comprehensive services to improve outcomes for families who reside in at risk
communities. At-risk communities will be identified by the statewide assessment.
...
Definition of At-Risk Communities.
Premature birth;
According to the guidance of the home visiting needs
assessment, at-risk counties (communities) in Missouri were identified with concentrations of 11
areas specified in the guidance. These areas include
Low-birth-weight infants;
Infant mortality, including infant death due to neglect;
Poverty;
Crime;
Domestic violence;
High rates of high-school drop-outs;
Substance abuse;
Unemployment;
Child maltreatment; and
Other indicators of at risk prenatal, maternal, newborn, or child health.
...
The Missouri Division of Alcohol and Drug Abuse (ADA) is the state authority responsible for
developing and implementing a statewide response addressing substance abuse problems
impacting Missouri families and communities. Through collaborative efforts, ADA works with
other state and local agencies to ensure that the response is comprehensive and appropriate. The
Division provides programming for prevention, intervention, treatment, and recovery
management of substance abuse disorders through a statewide network of community-based
service providers. The Division of ADA contracts with 44 treatment providers with a total of
239 service locations statewide. Annually, about 48,300 Missourians receive substance abuse
treatment through the ADA network. Funding for these treatment services is from Medicaid,
federal block grant, state general revenue, and other grants and funding sources. An estimated
14,500 Missourians receive substance abuse treatment outside of the ADA network of care.12
This would include services provided by private providers, the Department of Veterans Affairs,
the Department of Defense, and other governmental entities. In total, an estimated 63,000
Missourians or about 14% of those who need treatment receive treatment (Table 32).
