Association for Public Policy Analysis & Management

Prior to receiving Federal Home Visiting Program funds, states conducted assessments to determine which communities needed home visiting services based on concentrations of premature birth, school dropouts, substance abuse, or other indicators, to report on the quality and capacity of existing home visiting programs, and to discuss any gaps or duplications in existing services. States also had to create plans that indicated which communities and models the state planned to fund.

As part of the Mother and Infant Home Visiting Program Evaluation (MIHOPE), the national evaluation of the Federal Home Visiting Program, states’ needs assessments and plans were analyzed to determine the extent to which home visiting services were available prior to the Federal Home Visiting Program, which communities were identified by states as in need of home visiting, and which evidence-based models and promising approaches states planned to support. To shed greater light on states’ decision-making process, MIHOPE also interviewed state administrators about how the needs assessments were developed and used to determine where and how to spend Home Visiting Program funds.

MIHOPE found that state administrators used a complex process to choose where to spend funds. The needs assessment process helped identify high-risk communities, but was not the only source of information used in decision-making. For example, some states balanced need with the ability of local areas to adequately implement home visiting services, based on state assessments of local infrastructure and capabilities.

MIHOPE’s analysis of the needs assessments and plans also found:

• States found many areas with unmet needs and focused funds on those areas.
• States targeted funding towards communities that generally had higher rates of premature birth, poverty, unemployment, and child maltreatment than the state overall.
• Home visiting services were already available in the vast majority of these communities, but they were not serving all families in need and were not necessarily operating in the specific neighborhoods where the newly expanded evidence-based services would be provided.
• States planned to use Home Visiting Program funds primarily to support evidence-based models, and most states used the funds to expand evidence-based models already in operation in the state rather than to fund new models.

This presentation will discuss the results of the analysis of the states needs assessments and plans, as well as describe the information and processes state administrators used to make decisions about how to use Home Visiting Program funds.