Home visiting program for moms, kids faces funding cliff

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A woman with blond hair smiles as she holds a baby

Home visitor Beth Willis holds Cora Helm as an infant. Courtesy of Beth Willis.

(NewsNation) — Cora Helm was a healthy, happy baby in her first year of life. But what worried her mom, Jennifer, was that she wasn’t crawling. 

“She had this little scooting thing that she did … with one leg out, like across the floor,” said Beth Willis, a nurse and home visitor who worked with Jennifer and Cora for about three years.

She helped assure Helm that it was just a phase, and, years later, the two laugh about it. 

Willis and Helm met through the Nurse-Family Partnership (NFP) of North Carolina, one of hundreds of home visit programs throughout the country that pairs new parents with an expert who coaches them through pregnancy and the first few years of their child’s life. 

“I always knew every week what was going on with my body, and not just my body, but Cora inside my body,” Helm said. “It just gave me the confidence to be a good mom.”

Home visitors are often much more than their job description — providing health screenings, helping new parents apply for a new job or finding childcare so they can return to school.

“A lot of times we’re their only cheerleader,” Willis said. “We’re the only one saying, ‘You can do this. You’ve got this.’”

Across the country, home visiting programs reduce child neglect, abuse and poverty, while increasing education and economic stability for parents, often single mothers.

Two side by side photos of mom holding a baby and a mom next to a toddler
Single and first-time mom Jennifer Helm worked with a home visitor during pregnancy and the first two years of her daughter Cora’s life. (Courtesy of Jennifer Helm)

The results are impressive: 90% of babies are born full term, 92% of babies are immunized, and 62% of parents are employed by the end of the program, according to NFP data

Congress has pushed the decision whether to continue funding this program to December, a move that stands to impact an estimated 71,000 families across the U.S. 

What makes home visiting so successful, Willis says, is that it’s built on relationships.

“Not only (does) this program care about what the baby is doing, but it cares about what the mom is going through,” she said.

The ‘gold standard

More than a decade ago, federal lawmakers agreed to fund home visit programs as part of the Affordable Care Act, one of few areas that received bipartisan support. Today, home visiting programming are in all 50 states and most U.S. territories and is considered the gold standard for evidence-based, bipartisan policymaking.

The specifics of the program vary by state and community — and that’s the point. Some home visitors are teachers; others are social workers or nurses. Some visits begin during pregnancy through 2 years old; others start after birth but provide support through 5 years old. 

Beth Willis, left, and Jennifer Helm worked together through the Family-Nurse Partnership of North Carolina. (Courtesy Beth Willis)

“We know (the early years) is the optimal time for growth and development, where our babies’ brains are growing at the fastest rates,” said Diane Dellanno, a licensed clinical social worker with Advocates for Children of New Jersey. 

“Not all families have that support system in place,” she continued. “The beauty of these programs is that you can bring the people that would most relate to the families, right to the families.”

Down the road benefits

Numerous studies demonstrate the wide and long-lasting impacts on parents and children. An extensive review of programs across the country found home visiting positively impacted education through at least the fifth grade.

Other outcomes include

  • Better family health 
  • Less food and housing insecurity
  • Parents and children more likely to graduate high school
  • Fewer interactions with the juvenile justice system

Home visiting also saves taxpayers significant money long-term, she added, up to a $5.70 return on investment for every dollar spent. Still, existing resources are not sufficient, many home visitors say. 

“Right now we need to target it towards those (families) who might need these services the most,” Dellanno said. “But this is a service that almost everybody could benefit from.”

While it is unlikely Congress will not reauthorize the funding, many experts say the federal allotment needs to double to serve the high number of families in need.

Funding has not increased for a decade, with inflation whittling away at programs’ spending power by more than 25%. Many groups rely on state funding or private donations to retain qualified employees.

Increased funding could also add more programs in remote areas: home visitors reach only 27% of rural counties, and just 25 of the 574 federally recognized tribes. The program’s record of success more than justifies the hike, says Jennifer Harper, a nurse and Director of Federal Government Affairs for NFP.

“This is the type of program that everyone kind of aligns on; this is how we can target dollars to help people,” Harper said. “This is what government can do.”

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