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How Home Visiting Programs Save Lives and Communities

I recently attended a meeting with a number of home visitors who work in Oakland. There were about a dozen people packed into a little room, around a table loaded with sandwiches, to talk about their work. All of the home visitors work with parents of new babies, though they specialize in different approaches and populations. One of them, Julie, works with Spanish-speaking families who have experienced infant or fetal loss. Rita works with mothers who suffer from depression. Meg visits first time, low-income mothers.

Some of them are public health nurses, some are social workers, and some have received training in the model of the program for which they work. All of them go to the homes of parents, listen to their needs and experiences, and provide support, advice and guidance so that they are less isolated and their children have brighter futures.

The families they serve are lucky compared to many others just like them around the state.

Many people I know and talk to about these programs seem to think of them as a “nice to have” service. Maybe they remind more fortunate parents of the kinds of visits they received from friends and family members after the birth of a child.

But these programs provide much more than words of encouragement. They connect isolated women with services in their communities. They provide parents who do not have a positive parenting role model in their lives with tools for managing the stresses and frustrations of parenting. They help vulnerable parents deal with underlying problems of addiction or mental health issues.

And they have been proven to have tremendous, long-term effects on both the child and the mother. Nurse Family Partnership, the most-studied of these programs, improves prenatal health, decreases parental involvement in the criminal justice system, and improves children’s school readiness, according to multiple randomized, controlled trials. The program saves government money in many ways, including by reducing use of safety net programs like Medicaid and food stamps.

The data book we are releasing today makes it clear that these programs are not available to the majority of California families who might benefit from them. We estimate that only six percent of all California children living below the poverty level are reached by a home visiting program. Further, families in some counties are much more likely to benefit from home visiting than others. In 47 counties, 90 percent or more of the children in poverty do not benefit from a home visiting program. In a few counties, most low-income families are served.

Legislation introduced by Assemblymember Mullin would change these numbers. AB50 would provide counties with funding to initiate, continue or expand home visiting programs that pair nurses with pregnant, at-risk women. Counties will have to come up with matching dollars and demonstrate that they have the capacity to run the programs as specified. It is a thoughtful way to expand access to programs with proven health and societal effects and that would lead to reduced state spending.

Given the long-standing, rigorous evidence we have, this proposal should be a winner with Assemblymember Mullin’s colleagues and with the Governor. And it will greatly help the parents and children who are in need of support but haven’t been lucky enough to benefit from these powerful services. 

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