On June 9, the House Ways and Means Subcommittee on Income Security and Family Support held a hearing on proposals to provide federal funding for early childhood home visitation programs.
Chair Jim McDermott (D-WA) introduced legislation to provide services for young families. Describing the measure, Rep. McDermott said, “Along with [Reps.] Danny Davis [D-IL] and Todd Platts [R-PA], I put forward legislation last week to take a more proactive approach to helping families. The Early Support for Families Act (H.R. 2667) would provide federal funding for home visitation programs to reduce child maltreatment, as well as to improve children’s health and school readiness…The Early Support for Families Act follows President Obama’s budget recommendation to provide grants to states to help them establish or expand voluntary home visitation programs for families with young children and families expecting children. Only programs using evidence-based models that have demonstrated positive effects on important child and parenting outcomes would be eligible for funding. Home visits could start during pregnancy and could be conducted by nurses, or social workers, or trained professionals. The visits would focus on providing information on child health, development and care, on parental training, and support, and on referral to other services.”
In opposing Rep. McDermott’s legislation, Ranking Member John Linder (R-GA) said, “Several of our witnesses will discuss how some visitation programs have shown some positive effect. We know that from programs already operating, often with federal and state money. But, obviously, our colleagues think it’s not enough, because it’s never enough.” He continued, “But if you add up all the federal and state funds states could spend on home visitation, it’s an incredible $244 billion per year. Obviously, states don’t spend all that money this way having other priorities, or now needing to cut other priorities. So we in Washington will create a new program that forces them to. Not a program that increases child abuse prevention funds that may be spent on home visitation, but a program whose funds must be spent on home visitation, and nothing else. And if states won’t spend this money, or can’t come up with their required share, the federal cash will be given to another state. So it’s Washington’s way or the highway. Except the children will be the ones who will really pay when the coming budget tsunami washes this and so many other programs away.”
In citing her support of Rep. McDermott’s legislation, Deborah Daro, research fellow at the Chapin Hall Center for Children at the University of Chicago, said, “The Early Support for Families Act dramatically increases federal investment in home-based services…Although no legislation comes with absolute guarantees, the Early Support for Families Act builds on an impressive array of knowledge regarding the efficacy of home visitation programs and creates an implementation culture that emphasizes quality and continuous program improvement. Among the bill’s most important features are the following: mandatory funding to the states to strengthen the strategy’s sustainability; channeling these dollars to programs demonstrating strong evidence of effectiveness; requiring states to identify how these programs will complement and draw upon existing community efforts; and requiring the collection and use of information to enhance practice and policy.”
Dr. Daro also highlighted elements of home visitation programs that have produced positive outcomes. “Although positive outcomes continue to be far from universal, families enrolled in these home visitation programs, as compared to participants in a formal control group or relevant comparison population, report fewer acts of abuse or neglect toward their children over time, engage in parenting practices that support a child’s positive development, and make life choices that create more stable and nurturing environments for their children. Home visitation participants also report more positive and satisfying interactions with their infants and more positive health outcomes for themselves and their infants. One home visitation model that initiates services during pregnancy has found that by age 15 the children who received these visits as infants reported significantly fewer negative events (e.g., running away, juvenile offenses and substance abuse).” Dr. Daro continued, “Home visits begun later in a child’s development also have produced positive outcomes. Toddlers who have participated in home visitation programs specifically designed to prepare them for school are entering kindergarten demonstrating at least three factors correlated with later academic success — social competency, parental involvement, and early literacy skills. Longitudinal studies of home visitation services that begin at this developmental stage have found positive effects on school performance and behaviors through sixth grade as well as lower high school dropout and higher graduation rates.”
Jeanne Brooks-Gunn, professor of Child Development at Teachers College and the College of Physicians and Surgeons at Columbia University, testified that “As a developmental psychologist, I have spent the last 30 years examining the life courses of families, both parents and their children, with a special focus on what might be termed vulnerable families. These would include families whose parents are young, are poor, are unmarried, and/or have low educational levels…The families being considered today are those with young, first-time mothers. Each year, almost one-half of million children are born into these families. Young, first-time mothers, as a group, have relatively low levels of education, which limits their access to stable, well-paid employment. These mothers, often living in precarious economic circumstances, are also more likely to exhibit harsh parenting, inconsistent parenting, and insensitive parenting, all of which are associated with lower cognitive and emotional capacities of their children than mothers who are older and have more education. The children of young mothers are also more likely to experience child abuse or neglect than those born to older, more educated parents. In brief, young, first-time mothers are likely to have low levels of education and more financial hardship as well as to exhibit less optimal parenting. Their children, in turn, are less likely to develop the capacities necessary for success in school and in later life. All three outcomes (maternal education, parenting behavior, and child capabilities) have been, and should be, targets of intervention.”
In outlining strategies for enhancing young families’ lives, Dr. Brooks-Gunn said, “Several different types of programs have been developed for improving young mothers’ education and parenting capabilities, as well as their children’s school readiness. Each has demonstrated effectiveness, although not every program has been effective. Maternal education programs provide supports and incentives for the continued education of young mothers. Welfare demonstration programs focusing on maternal education report small to modest impacts on education, as have some home visiting programs and some programs offering home-visiting services to the parents and center-based educational services to the children. A variety of programs, usually home-based, demonstrate modest consistent effects on parenting capabilities (reductions in harsh parenting and increases in sensitive parenting). Many, but not all, programs provide such evidence. Some programs also have, as their aim, preventing child abuse and neglect. Of those programs that look at child abuse and neglect directly (i.e., substantiated cases), only a few have reduced child abuse and neglect. However, given the incidence of child abuse and neglect, program evaluations often do not have the power to detect such differences (while they do have the power to detect differences in parenting capabilities). Home-visiting programs often target child health and safety, child cognitive development, and maternal mental health. Child health and safety have been enhanced by several programs. Fewer home-visiting programs have altered child cognitive development (unless they are coupled with center-based child care; but see, for exceptions, the Nurse Family Partnership in Denver and Memphis and Early Head Start and one Healthy Families evaluation).”
Joan Sharp, executive director of the Council for Children and Families of Washington in Seattle, Washington; Cheryl D’Aprix, senior family support worker at the Starting Together Program in Canastota, New York; and Sharon Sprinkle, nurse consultant for the Nurse Family Partnership in Denver, also testified.
