MIAMI Program
Public Health Home Visiting ( PHHV ) provides home visiting services to high-risk pregnant women, their infants, and infants identified at risk for special health care needs. These services are part of the comprehensive efforts to improve maternal child health status in the state, as provided for in Montana's Initiative for the Abatement of Mortality in Infants (MIAMI) as outlined in SECTION 50-19-311, Montana Code Annotated (MCA).
MIAMI was passed in the 1989 Montana Legislature to:
• Ensure that mothers and children receive access to quality maternal health services
• Reduce infant mortality and the number of low birth weight babies (5½ pounds or less)
• Prevent the incidence of children born with chronic illnesses, birth defects, or severe disabilities as a result of inadequate prenatal care
Directives for improving birth outcome for pregnant women and decreasing the incidence of infant death are firmly grounded in the Federal Title V Maternal and Child Health mandates.
Common MIAMI definitions used by local PHHV projects and DPHHS
- Trimester of a pregnancy - a period of time lasting approximately 3 months (12 weeks)
- Gestational age (GA): period of development of the fetus during the 40 week (9 month) pregnancy , expressed in # of weeks of gestational age
- Normal birth weight: 2500 grams ( 5.5 lbs)
- Low birth weight: <2500 grams (5.5 lbs)
- Very low birth weight: <1500 grams (3.5 lbs)
- High Risk Pregnancy: a pregnancy with physiologic, psychological, or environmental factors existing in the mother or the fetus that imply a threat to either's health
- Common Maternal Risk factors include:
- medical conditions of the mother such as diabetes or infections
- sexually transmitted diseases or HIV/AIDS
- smoking
- use of alcohol or other drugs during pregnancy
- battering or other forms of abuse
- homelessness or multiple residences
- no financial support/limited income including no medical insurance
- no support from family or father of baby
- age of the mother, particularly if a teenager
Many clients may have more than one "risk" factor at the time of service.
- Common risk factors of the unborn fetus:
- exposure to maternal drug & alcohol use
- infections
- congenital anomalies
- Targeted Case Management: Service coordination for access to a variety of services including: medical, nutritional, and social services throughout the clients pregnancy.
MIAMI Legislation
50-19-301. Short title. This part may be cited as "The Montana Initiative for the Abatement of Mortality in Infants (MIAMI) Act".
History: En. Sec. 1, Ch. 649, L. 1989.
50-19-302. Purposes. The purposes of this part are to:
(1) assure that mothers and children, in particular those with low income or with limited availability of health services, receive access to quality maternal and child health services;
(2) reduce infant mortality and the number of low birth weight babies; and
(3) prevent the incidence of children born with chronic illnesses, birth defects, or severe disabilities as a result of inadequate prenatal care.
History: En. Sec. 2, Ch. 649, L. 1989.
50-19-303. Definitions. For purposes of this part, the following definitions apply:
(1) "Department" means the department of public health and human services provided for in 2-15-2201 .
(2) "Low income" means, with respect to an individual or family, income that does not exceed the official federal poverty threshold as defined by the federal office of management and budget and revised annually in accordance with section 673(2) of the Omnibus Budget Reconciliation Act of 1981.
(3) "Project" means the MIAMI project established in 50-19-311 .
(4) "Service provider" means a person, agency, or organization that has a contract to provide services under the MIAMI project.
History: En. Sec. 3, Ch. 649, L. 1989; amd. Sec. 121, Ch. 418, L. 1995; amd. Sec. 298, Ch. 546, L. 1995; amd. Sec. 7, Ch. 171, L. 1997.
50-19-304 through 50-19-310 reserved.
50-19-311. MIAMI project.
(1) There is a MIAMI project established in the department.
(2) Under the project, the department shall provide the following services:
(a) infant mortality review;
(b) morbidity review of births involving low birth weight babies;
(c) low birth weight prevention;
(d) assistance to low-income women and infants in gaining access to prenatal care, delivery, and postpartum care;
(e) referral of low-income women and children to other programs to protect the health of women and children, including:
(I) supplemental food programs for women, infants, and children;
(ii) family planning services; and
(iii) other maternal and child health programs;
(f) public education and community outreach to inform the public on:
(I) the importance of receiving early prenatal care;
(ii) the need for good health habits during pregnancy; and
(iii) the availability of special services for pregnant women and for children.
History: En. Sec. 4, Ch. 649, L. 1989; amd. Sec. 2, Ch. 634, L. 1991.
50-19-312. Repealed. Sec. 16, Ch. 171, L. 1997.
History: En. Sec. 6, Ch. 649, L. 1989; amd. Sec. 3, Ch. 634, L. 1991.
50-19-313 through 50-19-320 reserved.
50-19-321. Contracts for services.
(1) The department shall contract with service providers to provide services under the MIAMI project.
(2) In selecting service providers, the department shall take into consideration the past performance of the person, agency, or organization in providing similar services, the demonstrated effectiveness of the service provider in delivering comparable or related services, the fiscal accountability of the service provider, and such other factors as the department determines to be appropriate.
History: En. Sec. 7, Ch. 649, L. 1989.
50-19-322. Federal and other aid.
(1) The department may apply for and receive federal aid and other funding available for the MIAMI project.
(2) Federal funds and other funding as may be available are appropriated to the department for use in administering the provisions of this part.
History: En. Sec. 8, Ch. 649, L. 1989.
50-19-323. Coordination of programs. The department shall coordinate services under the MIAMI project with other services and programs in the state including:
(1) the early and periodic screening, diagnosis, and treatment services program under Title XIX of the federal Social Security Act;
(2) the Montana Medicaid program established in 53-6-101 ;
(3) programs administered with funds under the federal Maternal and Child Health Services Block Grant Act, Public Law 97-35, as may be amended; and
(4) the services of fetal, infant, and child mortality teams as provided in part 4 of this chapter.
