Reauthorizing the Federal Home Visiting Program Was the Right Thing to Do
By Katharine B. Stevens
Blog
April 20, 2015
Last week, the Senate reauthorized the Maternal, Infant and Early Childhood Home Visiting (MIECHV) program with a strongly bipartisan vote of 92 to eight, following a House vote this past March of 392 to seven supporting the program. Policymakers are on the right side of history. Voluntary home visiting programs, while not as well-known as Head Start or state pre-K, may be the single most promising approach to improving the lives of America’s most disadvantaged young children.
Home visiting helps young, low-income mothers during pregnancy and through the critical first years of their babies’ lives—building mothers’ competence in caring for their children and themselves, and enabling parents to better fulfill their role as their children’s “first teachers.” These programs aim to shore up fragile families and, when done well, can make a large positive difference both in parents’ self-sufficiency and in children’s later academic and social outcomes.
The Nurse-Family Partnership (NFP) is the most carefully designed and rigorously evaluated home visiting model. Three randomized controlled trials, continued over decades, have shown that NFP achieves extraordinary results for both children and their parents. Among the three trials, rates of child abuse for treated children were cut in half compared to children not in the program. Toddlers’ language delays were reduced by over half. Fathers’ participation in the household increased by 68%. Mothers were twice as likely to be employed when their child was two years of age, and over twice as likely to be married 15 years later. By the child’s fifteenth birthday, both mothers and children had over 60% fewer arrests. One respected study found that the NFP produced net savings of $17,000 per family served.
Through the MIECHV reauthorization, states will receive $800 million over 2016 and 2017 to provide low-income mothers with home visiting services that aim to improve maternal and child health, prevent child abuse and neglect, encourage positive parenting, and promote child development and school readiness. MIECHV is a particularly good federal program, combining state flexibility with an evidence-based approach: states choose the home visiting models that best meet the needs of their own at-risk communities, but only evidence-based models with strong track records are eligible for federal funding.
At the same time, though, as Jon Baron, president of the Coalition for Evidence-Based Policy has recently warned, MIECHV is currently “a leaky bucket.” Over the first three years of funding, some home visiting models have proved much more successful than others in practice. Using models that have been shown to be effective in the past is a good start. But ongoing evaluation of program impact is absolutely essential in order to ensure that funds are promptly redirected from approaches that don’t work to those that do.
MIECHV is now a big-win/big-lose proposition, and getting it right will require diligence and careful oversight from states receiving funding. If carried out well—meaning that states enforce rigorous standards for effectiveness in local implementation—it will transform millions of children’s lives for the better while accomplishing something equally important: showing that an evidence-based federal program can achieve positive results on the ground. If carried out badly, however, it will fail to help children while bolstering the argument that federal programs just don’t work.
The federal government has done its part by funding MIECHV. Now it’s up to the states to do theirs by ensuring the program is executed well.
See Also
Video ~ January 30, 2020
Op-Ed ~ July 14, 2016
Op-Ed ~ April 26, 2016