Home visiting programs work for young children, their parents and Oklahoma (Guest Blog: Paul Shinn)

Paul Shinn is Public Policy Analyst for CAP Tulsa, which helps families succeed through early childhood education and other support programs. He can be reached at pshinn@captc.org

Earlier this month a House committee passed HB 1063, which would suspend most of Oklahoma’s home visiting programs for pregnant women and young children. The bill’s author, Rep. Mark McCullough (R-Sapulpa), reported that after extensive research, he had determined that these programs do not work. However, evidence is overwhelming that home visiting programs do work and that the state needs to protect this important investment in our youngest and most vulnerable Oklahomans.

Home visiting programs are designed to improve the parenting skills of low-income and teen mothers and to provide the supports their children need to develop and be ready for school. Home visitors regularly monitor mother and child health, help parents better interact with and nurture children, track children’s development, and connect families with health and other resources they need.

Contrary to Rep. McCullough’s’ statements, there is a strong base of evidence showing that home visiting programs, particularly the ones we use in Oklahoma, work. In 2010, the U.S. Department of Health and Human Services (HHS) found 13 home visiting programs that are proven to improve child and family outcomes. Oklahoma has long invested in these successful programs, including Nurse-Family Partnership (which we call Children First in Oklahoma), Healthy Families America (Start Right in Oklahoma), Parents as Teachers, and home-based Early Head Start are all on this list.

Decades of careful evaluations have shown that home visiting programs affect children, families, communities, and the overall economy, in many ways (you can find the evaluations through the links in the preceding paragraph). Results are most dramatic in three areas of vital concern to Oklahomans: child welfare, elementary school performance, and economic growth. National studies and Oklahoma results show that:

• Both Nurse-Family Partnership and Healthy Families America reduce child abuse dramatically; Nurse-Family Partnership reduces costly injuries and emergency room visits for our youngest children.
• The programs improve young children’s vocabulary and physical and mental development. Parents as Teachers children are more likely to be enrolled in preschool and ready for kindergarten. Indeed, these children’s kindergarten readiness and third grade test scores equal those of peers who are not at risk. Nurse-Family Partnership’s children’s kindergarten readiness and third grade scores are much better than those of other at-risk children.
• Home visiting makes dramatic contributions to our economy.  Nurse-Family Partnership reduces mothers’ likelihood of receiving public assistance and Healthy Families America increases mothers’ educational goals and attainment and their employment.

Overall, home visiting is proven to return more to our economy than we spend. The most definitive study shows that we save over $5 for every $1 we spend on Nurse-Family Partnership. A detailed study by the State of Washington found average returns of $2.24 per dollar spent.

Because of our strong commitment to evidence-based home visiting and our proven results for families, HHS gave Oklahoma one of the largest grants to expand home visiting. HB 1063 would return these funds. That would be a big mistake, as this funding is pushing the state to deliver services more thoughtfully. Federal money is being used to expand the programs with the best evidence where they are needed most, fund “community connectors” that will be sure programs are fully subscribed and connect families with the services that will help them most, create a data system to measure short- and long-term impacts, measure kindergarten readiness for kids who have had home visiting, and thoroughly evaluate our programs.

We agree wholeheartedly with Rep. McCullough that we should take a strong look at government programs to be sure they work as intended.  We should also insist that even programs like home visiting, which we know work, be adjusted to work better. Improvements required by the Department of Health and Human Services grant are a good start. We should also increase caseloads to reduce the cost per family, do more to measure child outcomes, and strive to ensure families stay in the programs so they receive their full benefits. We should also open up programs to more competition so that qualified public and private agencies can deliver needed services at the lowest possible cost while being held to higher standards of effectiveness.

Let’s not throw out the babies with the bathwater, as HB 1063 would do. Instead, let’s make sure our babies get the best possible bath—strong and effective supports for a great start in life. 

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