Home Visiting Programs Work: Here’s the Proof

As a career advocate for children, I applaud Los Angeles County’s innovative efforts to reduce child abuse by integrating public health nurses into its child protection assessment process.

At First Focus Campaign for Children, a non-partisan national children’s advocacy group, we support the county’s forward-thinking efforts, but also encourage county officials to expand evidence-based home visiting programs, which have been proven to prevent child maltreatment and promote resilient, strong families that nurture the healthy development of children.

Voluntary, evidence-based home visiting programs around the country pair over-burdened pregnant women and mothers – who are typically single, poor, minority and young from communities of concentrated disadvantage – with specially trained nurses, social workers, and other professionals, who come to their homes to help them access prenatal care and other health services. These include assistance with enrollment in nutritional, housing and other critical programs needed to ensure their babies get the best start possible.

Home visitors are not just care coordinators; they play a vital role in working one-on-one with mothers to improve their parenting skills, strengthen their support and coping systems, and promote their infant’s healthy development so that they become their child’s first and most important educator.

The program also helps mothers develop realistic plans to remain in school, obtain higher education, and eventually become gainfully employed. When parents are economically stable, their children benefit.

Home visiting has also been proven to reduce a host of troubling problems, including child maltreatment, preventable childhood injuries, domestic violence, arrests and juvenile delinquency. In fact, the Nurse-Family Partnership program, one of the most rigorously tested home visiting models, has more than three decades of data that proves it can reduce child abuse and neglect by as much as 48 percent. The program has helped reduce emergency room visits for preventable injuries during the child’s first two years by 56 percent.

In a California-specific analysis, the Nurse-Family Partnership model was found to have reduced child maltreatment by 29 percent, infant deaths by 56 percent, and crime and arrests by 43 percent, producing a net savings in state and federal spending of $38,000 per child served. Other home visiting programs, such as Healthy Families America, also have data-driven evidence of their ability to reduce child maltreatment by improving parenting skills, strengthening the bond between mother and child, reducing delinquency, and promoting self-sufficiency.

California is getting a lot of things right. The state has implemented both of these early prevention home visiting models as part of the federally-supported initiative called the Maternal, Infant and Early Childhood Home Visiting (MIECHV) Program. Since its enactment in 2010, California has received approximately $113 million in funding from MIECHV, which has allowed the state to leverage its own funding to provide home-visiting services to 3,172 families annually in 24 counties.

But the state could do much, much more. The need for these services is far greater than the funding. Nationally, MIECHV funds services for just 2 percent of the eligible population of children and families in need, and less than 7 percent of California’s children and families who could benefit. With more funding for MIECHV, potentially thousands of instances of child abuse, neglect and injuries, as well as the lifelong consequences they often carry, could be prevented.

Next year, MIECHV will expire unless Congress acts to reauthorize it. That’s why we’re proud to be a part of the national Home Visiting Coalition, a diverse group of national and state advocates working to support continued federal funding for home visiting programs. As an initial request, the coalition recommends that Congress extend MIECHV for five years and double its current funding to allow states to expand these proven services to serve more children and families.

Without question, we know this initiative works to reduce maltreatment and strengthen families by improving their health, education and economic stability, while saving taxpayer resources. Strong families make strong communities, and strong communities make a strong nation.

It’s a bi-partisan approach we can all get behind.

Karen Howard is vice president of early childhood policy for First Focus Campaign for Children, a non-partisan advocacy organization dedicated to making children and families the priority in federal policy and budget decision. First Focus is a co-convener of the Home Visiting Coalition.