Investing in What Works: Voluntary Home Visiting Programs

On Thursday, Health and Human Services Secretary Kathleen Sebelius announced $224 million in grants to states to provide evidence-based, voluntary home visiting programs for some of our most vulnerable children and families.  For those who haven’t followed this important new initiative, which President Obama first proposed on the campaign trail, here’s a quick recap.

Rigorous research has shown that high-quality home visiting programs – through which at-risk families can choose to receive home visits from trained professionals like nurses and social workers – can make a positive difference for children and families on a range of outcomes, including child health and development, school readiness, and parent employment, as well as helping to prevent child abuse and neglect.  In addition, independent non-partisan organizations estimate that every dollar spent on evidence-based home visitation yields significant savings to federal, state, and local governments.

President Obama first promised a large-scale investment in home visiting during his 2008 presidential campaign.  In his first Budget in the spring of 2009, he proposed directing significant new resources to states to support evidence-based home visiting.  The Administration then collaborated with Congress on legislation creating the Maternal, Infant, and Early Childhood Home Visiting Program, which was enacted as part of the Affordable Care Act in 2010.  The new program will provide a total of $1.5 billion over five years for evidence-based home visiting.  It relies on a tiered evidence structure that focuses investments in programs that have been rigorously evaluated and shown to have positive impacts on children and families, while also supporting the development and evaluation of other promising approaches.

So we’re happy to have announced the first round of major grants under the new initiative.  Forty-nine states, the District of Columbia, and five territories will receive formula grants to build out their home visiting efforts and provide services to at-risk children and families.  In addition, nine states successfully competed to receive $66 million to expand their implementation of evidence-based home visiting programs, and 13 states won $34 million to develop their programs and move them further along the evidence trajectory.  Together, these programs will serve an estimated 27,700 families next year.  As the programs learn from experience, we plan to do so as well, and we look forward to another round of grants next year.

This program is not only an important step forward for helping at-risk families. It also is an example of how we can design programs to maximize impact and save taxpayer dollars.

At a time when federal, state, and local budgets are shrinking, it’s more important than ever to spend every penny well.  Nowhere is our responsibility greater than when we’re creating opportunity for children in need.  If we know a program works, we should use it; if we think it has real potential, we should rigorously evaluate it; and if we know it doesn’t work, we should cut it out.  The evidence-based home visiting initiative is part of a new generation of federal programs aiming to put that common sense into action.  The details are hard, and, as always, they matter.  But this approach holds great promise for children, for families, and for America. 

Robert Gordon is the Executive Associate Director of the Office of Management and Budget