Pew: States Should Invest in Research-Backed Home Visiting Programs to Capitalize on New Federal Funds

States making investments in voluntary home visiting programs too rarely use evidence of effectiveness to inform their policy decisions, according to a new report by the Pew Center on the States' Home Visiting Campaign.

States and the New Federal Home Visiting Initiative: An Assessment from the Starting Line looks at the extent to which all 50 states and the District of Columbia are supporting evidence-based program models. It also considers how well each is tracking whether public expenditures are yielding expected outcomes. The report concludes that oversight and funding for home visiting are inadequate to provide at-risk families with effective home visiting services and to give taxpayers the best return on their investment.

The first-of-its-kind study comes at a time when many states are receiving the initial installments of a $1.5 billion, five-year federal funding stream to support home visiting programs, but many are not prepared to capture or maximize the additional investment. To do so, the Pew report says states must quickly and significantly improve the quality, administration and oversight of their home visiting programs.

“With the new federal investment, policy makers have a real incentive to dramatically improve the efficiency of their existing home visiting systems by tying public dollars to programs proven to be effective,” said campaign director Libby Doggett.

Voluntary home visiting is an evidence-based prevention program that pairs parents with trained professionals to provide information and support during pregnancy and throughout their child's first three years—a critical developmental period. When well implemented and targeted to families who benefit most, it has been shown to return up to $5.70 for every tax dollar invested.

In 2010, as part of the Patient Protection and Affordable Care Act, Congress established the Maternal, Infant, and Early Childhood Home Visiting Program, a significant national commitment—$1.5 billion over five years—to expand and improve state-administered home visitation. This new investment promotes developing promising models and enhancing existing evidence-based programs, and it signals federal recognition that states' costliest social problems are rooted in this early period of life.

“This is a golden moment for the field,” Doggett said. “The federal government has outlined what states need to do to maximize the benefits we know these programs provide. We're hoping states make great strides in building strong home visiting programs backed by research.”

Top findings include:

• Most home visiting funding was not adequately tracked at the state level.
• States frequently provided funding with few, if any, requirements that programs invest in models with a proven record of success.
• States did not adequately monitor publicly funded programs to ensure effectiveness.
• States did not consistently target at-risk families, where the return on investment is highest.
• In every state, far too few at-risk families received home visiting services.

Pew's report provides policy makers with recommendations to build efficient, high-quality home visiting programs that can generate positive returns for taxpayers and families and make the most of new federal resources.

To access the full report, please visit States and the New Federal Home Visiting Initiative.

The Pew Center on the States is a division of The Pew Charitable Trusts that identifies and advances effective solutions to critical issues facing states. Pew is a nonprofit organization that applies a rigorous, analytical approach to improve public policy, inform the public and stimulate civic life.