Home visiting program gets a funding reprieve — here’s why that matters for kids

Home visiting programs for low-income families are off the chopping block for now.

On Friday, Congress passed a spending bill that reauthorizes funding for the bipartisan-supported Maternal, Infant and Early Childhood Home Visiting (MIECHV) program. The program offers low-income, at-risk mothers guidance in parenting, and served about 160,000 families in 2016. The resolution earmarks $400 million a year over five years to support evidence-based home visiting programs.

The budget deal brings relief to agencies whose future was in jeopardy after Congress missed a September 30 deadline to reauthorize the program. MIECHV, which started in 2010 with the passage of the Affordable Care Act, has provided more than 3.3 million home visits over the past five years. Home visits bring social workers and nurses into new parents’ lives and provide a swath of services, including support for mothers experiencing depression, early identification of developmental delays in children, and helps identify families at risk of abuse and violence. The program also supports tribal home visits.

This all matters because the MIECHV is the largest federal source of funding for home visiting programs, and in many states the only one. “If funding were reduced or eliminated, 1 million home visits might be affected each year, and states might be forced to disenroll families,” said Lori Freeman, CEO of the Association of Maternal and Child Health Programs. “These are families across the country in every state, many of whom live below poverty level and are high risk for negative health and developmental outcomes, including child maltreatment, substance abuse, and mental health disorders.”

Even now, despite the evidence of the program’s effectiveness, funding reaches only a small percentage of eligible families. Advocates say that only about 3 percent of families who need such programs actually receive services.

There is a broad research base showing such programs deliver results. The Nurse-Family Partnership, one of the biggest of the home visiting programs, started in 1970. A recent study of 700 mothers looked at the effects of the visiting program. The study, conducted by University of Chicago economist James Heckman and colleagues, found that boys whose mothers participated show lasting benefits at age 12, at which point they outperformed the control group in reading and math. The mothers in the program are typically young and unmarried, with a high school education and a median income of $9,000.

“The program is a lifeline for many at-risk families seeking support to improve health outcomes, increase school readiness, and build stronger relationships,” Freeman said. MIECHV links parents and children to much-needed medical, public health, and social services such as parent education, childcare, housing and employment supports, and substance abuse and mental health services. “Home visiting works,” said Freeman, “and the MIECHV program is demonstrating results.”

Those positive outcomes include increased breastfeeding, reduced substance use, reduced child injuries, increased household income and employment, and increased referral to crucial family services, the organization reports. With home visits, it’s easier to do sensitive screenings that often don’t work in traditional clinical care settings, said Freeman.

All of these factors have significant impacts on children and families, especially those who are at a disadvantage when it comes to education, health and socioeconomic circumstances. Nearly three-quarters of participating families had an income at or below the federal poverty guidelines, and 66 percent of the adult participants in such programs had a high school diploma or less education in 2016.

Home visits also have an economic benefit: According to the RAND Corporation, every $1 invested in home visits can yield up to $5.70 in return for the highest-risk families served.

I visited one such home visiting program during my reporting on programs to increase language use in struggling families for the 2016 National Fellowship from the Center for Health Journalism. In Houston, Play and Learning Strategies (PALS) sends parent educators for 90-minute sessions in homes to help parents engage with their infants in the best way possible. The session I observed also sent fresh snacks, and a plan to talk about healthy food as part of the curriculum.

When I was shadowing a coach in Houston, I saw the power of home visits first hand. Parents who wouldn’t be likely to participate in educational training in a health care setting were eager to learn in the comfort of their own homes. Everyone seemed relaxed, happy and gaining skills. Those skills have the potential to follow kids and improve their lives for decades.

[Photo by Wyncliffe via Flickr.]