Association for Public Policy Analysis & Management

The Federal Maternal, Infant, and Early Childhood Home Visiting Program (the Federal Home Visiting Program), administered by the Health Resources and Services Administration and the Administration for Children and Families, funds states, territories and tribal entities to implement voluntary evidence-based home visiting programs that provide pregnant women and caregivers of children from birth to kindergarten entry with the knowledge, skills and resources to raise children who are ready to learn.

Authorized in the Patient Protection and Affordable Care Act, Home Visiting Program grantees are required to implement home visiting models that meet a defined standard for evidence of effectiveness. Further, authorizing legislation calls upon grantees to demonstrate quantifiable, measurable outcomes in six benchmark areas: improved maternal and child health, prevention of child injuries, child abuse, neglect, or maltreatment, and reduction of emergency department visits; improvement in school readiness and achievement; reduction in crime or domestic violence; improvement in family economic self-sufficiency; and improvement in the coordination and referrals for other community resources and supports. As a result, the federal Home Visiting Program has served as a key lever in support of comprehensive early childhood systems development and enhancement in grantee states, territories, and tribal entities.

To build the capacity to implement evidence-based models with fidelity and demonstrate measurable improvements in the benchmark areas, grantees have invested resources to strengthen their early childhood system infrastructure. Specifically, grantees have increased the effectiveness and reach of their early childhood systems through a variety of activities, including:

• Improving coordination across state agencies and within local communities to meet the needs of at risk families;
• Developing statewide data systems to collect process and outcome data across multiple local agencies, some of which enable longitudinal data tracking;
• Establishing centralized intake systems and processes to efficiently connect families with a single point of entry and reduce duplication of services;
• Building a trained home visiting workforce prepared to assess and meet the needs of families;
• Conducting local evaluations to inform ongoing quality improvement and increase knowledge in the field; and
• Leveraging other Federal and state investments to maximize impact.  

The presentation will highlight how the Federal Home Visiting Program, a key part of the President’s Early Learning Initiative, has contributed to enhancements in statewide early childhood systems in service to underserved pregnant women and caregivers and their children from birth to kindergarten entry. Further, the presentation will discuss grantees’ successes and challenges in building infrastructure to support scale up of evidence-based home visiting and rigorous measurement to demonstrate its impact.