Around this time in 2017, federal funding for home visiting—a program that builds long-term connections between trained counselors and at-risk families—had lapsed, ensnared in disagreements between the House and the Senate over how the program should be funded at the state level.
But a February budget deal gave the federal program, known as Maternal, Infant and Early Childhood Home Visiting, or MIECHV, an infusion of $400 million over five years. With the prospect of drastic budget cuts now on the back burner, advocates are taking time to show how effective these early connections can be.
Federal support of home visiting began during the George W. Bush administration and was expanded during the Obama administration. Studies have shown strong evidence of effectiveness with a direct connection to later academic achievement. For example, Nobel Prize-winning economist James Heckman found that a home-visiting program produced cognitive benefits that were measurable for years, particularly for boys. And an American Enterprise Institute analysis found that programs that support family, infants and young children show stronger benefits than preschool, which focuses solely on 4-year-olds.
A New Snapshot of Home Visiting Nationwide
One recent report, the Home Visiting Yearbook for 2018, offers a look at the little more than 300,000 families who were served last year. The majority of families, 60 percent, were white, with 21 percent black, and 8 percent of multiple races. Thirty percent were Hispanic and Latino, and 72 percent spoke English as their first language. Home-visiting programs were in place in all 50 states and the District of Columbia, and served 53 percent of U.S. counties.
In addition to federal money, states supported home visiting through tobacco settlements and taxes, lotteries, and direct allocations from state budgets.
The ages of children in the families served was fairly divided: about a third were under 1 year old; a third were 1-to 2- years old; and a third were 3- to 5-years-old.
Far more families than 300,000 who received services face the kinds of stressors home visiting was meant to address, the yearbook said. Those factors include having an infant under a year old, an income below the federal poverty threshold ($25,100 for a family of four), being a mother or pregnant woman under the age of 21, being single, and having less than a high school education.
In 2017, close to four million pregnant women or families met at least two of those five criteria, the yearbook noted.
“Even though we know the need is great, there is an incredible amount of work going on,” said Allison Meisch, the deputy project director for the National Home Visiting Resource Center, which compiled the report.
Digging Into Home Visiting Research
A different advocacy group, the Association of State and Tribal Home Visiting Initiatives, has also released a report, Research for Results:The Power of Home Visiting. Instead of offering a picture of home visiting, this document explores results from 33 studies that look at outcomes in several areas, including maternal and infant health, school readiness, and family economic self-sufficiency.
Laurel Aparacio, the director of Early Impact Virginia, noted that traditionally home visiting has been aimed at first-time mothers. But that focus has left out many other families who could benefit. Her organization, an umbrella group for home visiting programs in the state, has used research to show that home visiting is effective even for families with more than one child.
“That’s one of those places where we’ve been able to work with research” to expand our reach, Aparicio said.
The report also offers profiles of those who have benefited from the program, such as Danielle, a first-time mother in Iowa who asked that her last name not be used. She connected with a registered nurse, Beth Meyer, through a home-visiting program called the Nurse-Family Partnership. Meyer met with Danielle weekly to talk about developmental stages of pregnancy, infancy, and toddlerhood. The program worked with Danielle until her child was two.
The pregnancy help was useful, but it was after her son was born that the home-visiting help really came through for her, Danielle said.
“I didn’t have any idea of what to do with this tiny little person I created,” Danielle said. “I didn’t know anything about being a parent, and instinct only goes so far.” Meyer was a constant lifeline, responding to texts and calls.
“It is very helpful, to just have these first two years of someone helping me and guiding me and telling me it’s okay, you’re going to be okay,” Danielle said.