LegiStorm

Summary:

Health care reform legislation passed by the House in November 2009 (H.R. 3962) and in the Senate in December 2009 (H.R. 3590) would authorize and provide funds for grants to states to provide home visiting services, on a voluntary basis, to families with young children. (For a comparison of selected provisions in those proposals, see Table 4). There is no current law program that provides grants to states exclusively for home visiting programs. The Obama Administration requested authorization and funding for such a program as part of its FY2010 budget request. This proposal was not included in the President's FY2011 budget request, although the Administration has indicated its expectation that the pending health care reform legislation will be enacted. Home visiting is a strategy for delivering support and services to families or individuals in their homes. This report deals exclusively with home visiting as a service strategy for families with young children or those expecting children. There are a variety of early childhood home visitation models. These models typically seek to positively impact one or more outcomes across three main domains: maternal and child health; early childhood social, emotional, and cognitive development; and family/parent functioning. Depending on the particular model of early home visitation being used, the visitors may be specially trained nurses, other professionals, or paraprofessionals. Visits, which often occur weekly, may begin during a woman's pregnancy or some time after the birth of a child and may continue until the child reaches his/her second birthday (in some cases) or enters kindergarten. Participation of families is voluntary. Early childhood home visitation programs are in operation in all 50 states and the District of Columbia. The current combined public and private annual investment in these services has been estimated at between $750 million and $1 billion. This funding supports services for an estimated 400,000-500,000 families, or about 3% of all families (17.4 million) with children under six years of age. In addition to private and state and local public funds provided for early childhood home visitation, a number of federal programs have been tapped to support home visitation programs. Among others, these include Medicaid, the Temporary Assistance for Needy Families block grant, the Social Services Block Grant, the Promoting Safe and Stable Families program, Community-Based Grants to Prevent Child Abuse and Neglect, Even Start, Part C early intervention services for infants under the Individuals with Disabilities Education Act, the Maternal and Child Health Block Grant, Healthy Start, and Early Head Start. The current popularity of early childhood home visitation draws, in some measure, from newer research on how the human brain develops and, specifically, the significance of prenatal and early childhood environments to later life outcomes. Further, since at least the 1960s, a variety of home visiting programs have undergone evaluations to test their effectiveness. While the results have been mixed, some research has shown results that promise both immediate and longer term benefits to children and their families, including improvements in birth outcomes, enhanced child cognitive development and academic success, and strengthened child-parent interactions. Overall, researchers caution that home visiting is not a panacea, but many have encouraged its use as part of a range of strategies intended to enhance and improve early childhood. This report will be updated as warranted.