Statement for the Record: Evaluating Efforts to Help Families Support Their Children and Escape Poverty
On July 17, the Ways and Means Human Resources Subcommittee held a hearing on evidence-based programs, What Really Works: Evaluating Current Efforts to Help Families Support Their Children and Escape Poverty. The Pew Charitable Trusts submitted a written statement for the record, providing a summary of recently released Pew-commissioned research on home visiting and an overview of our partnership with states as they work to strengthen their home visiting systems.
Pew strongly encourages members of the Subcommittee and Congress more broadly, to support reauthorization of the Maternal, Infant and Early Childhood Home Visiting (MIECHV) program, the only federal dedicated funding stream for home visiting programs.
As expressed through testimony at the hearing, Jon Baron, president of the Coalition for Evidence-Based Policy, supported evidence-based voluntary home visiting programs, citing evidence that these programs not only significantly improve quality of life for participants, but also reduce their use of public assistance. Mr. Baron also endorsed expanding funding for MIECHV.
Statement to the U.S. House Committee on Ways and Means, Subcommittee on Human Resources
Thank you for the opportunity to share a statement for the record with the House Ways and Means Subcommittee on Human Resources as part of the July 17, 2013, record on Evaluating Efforts to Help Families Support Their Children and Escape Poverty. We applaud the Subcommittee for their leadership and share your commitment to ensuring that states are investing in what works.
The Pew Charitable Trusts (Pew) is a global research and public policy organization, operating as an independent, non-partisan, non-governmental organization dedicated to serving the public. Our work lays the foundation for effective policy solutions by informing and engaging citizens, linking diverse interests to pursue common cause and insisting on tangible results. Our projects encourage efficient, responsive governments – at the local, state, national and international levels – serving the best interests of the people.
In his opening statement, Chairman Reichert noted that, “Congress and the Administration should fund what works so we can deliver better results to those in need.” We agree and strongly encourage members of the Subcommittee and Congress more broadly, to support reauthorization of the Maternal, Infant and Early Childhood Home Visiting (MIECHV) program. This program, as was noted during the hearing, is uniquely designed and highly-effective in delivering improved outcomes for children and their families. This statement for the record provides a summary of recently released, Pew-commissioned research on home visiting and an overview of our partnership with states as they work to strengthen their home visiting systems. Both reinforce the call for reauthorization of MIECHV.
New home visiting research deepens understanding of how to achieve success
Voluntary, home visiting is an effective, evidence-based and cost-efficient way to ensure that children have the opportunity to grow up healthy, ready to learn and able to become productive members of society. Importantly, high quality programs can also yield improved educational and employment outcomes for mothers, equipping families with needed tools to move beyond poverty. Well-designed and well-implemented programs have been shown to improve the lives and future prospects of children and families and to yield positive returns on taxpayer investments.
Neuroscientists tell us that our experiences as infants and toddlers greatly affect later life. The years up to age three are a unique and critical developmental period in brain growth. Researchers have found that our parents’ actions (or inaction), and the environment they provide, shape the brain’s fundamental capacity during this “once in a lifetime” developmental period. In other words, our potential isn’t something we’re just born with, it’s also built up by what our parents do—the way they interact with us, speak with us, nurture and play with us. Sharing knowledge like this and, more importantly, teaching parents how they can apply it while raising their child, is an essential part of home visiting.
For families facing difficult situations, the information and support home visitors provide have proven to improve outcomes for children and parents. Decades of research on home visiting have shown important gains in school achievement and health and large decreases in rates of low birth-weight babies, infant mortality, and involvement with the criminal justice system.
These outcomes matter, for families, for communities and for taxpayers.
As part of our commitment to advance quality home visiting across the country, the Pew Charitable Trusts, with generous support from the Doris Duke Charitable Foundation and the Children’s Services Council of Palm Beach County, sponsored independent research to build the evidence needed to inform policymakers’ decisions, and to advance effective practice in home visiting programs.
This new research points to the importance of program quality and target population—and the interactions between them—in determining ultimate outcomes for children and families. The critical question has become not just “What works?” but “What works for whom under what circumstances?”
The Pew-commissioned research begins to answer this key question, provide new mechanisms by which states can evaluate the effectiveness and appropriateness of their home visiting investments, and identify needed improvements.
Key findings from our research:
- Being truly evidence-based is an ongoing process that goes beyond model selection to include continuous data monitoring, analysis, feedback, experimentation, and testing in order to improve quality and maximize outcomes for children and families.
- Programs need to maintain a strong focus on relevant content areas (such as parenting skills and children’s cognitive development) in order to achieve positive outcomes for children and families.
Within the context of individual studies, researchers also found:
- In addition to other benefits, high-quality home visiting can significantly improve first-graders’ school readiness and reduce the rate at which they repeat first grade.
- At-risk mothers who already have children can benefit from home visiting as much as first-time mothers can.
Pew’s partnership with states provides critical lessons in “what works” for improving outcomes for at-risk families and children
Pew applauds Congress for recognizing the value of investing in voluntary, evidence-based home visiting through MIECHV. Importantly, the legislation struck a thoughtful balance – allowing for tailoring and innovation at the state level and providing accountability and technical support at the federal level – that has yielded a strong state-federal partnership. MIECHV provides a critical framework of accountability for ensuring that the federal investment truly yields improved outcomes for children and families. This same kind of framework is needed to bolster the investments states have long been making in home visiting to ensure that there is one coordinated system of home visiting operating within a state. Building one system will help ensure that program quality, effectiveness and accountability are consistent, regardless of funding stream.
For that reason, and informed by the growing body of implementation research including that which is summarized above, Pew has been partnering with states to enact legislation that builds upon MIECHV and better positions states to more effectively and efficiently leverage the array of funding streams. Ten states have enacted legislation that builds upon the MIECHV legislation: Arkansas, Connecticut, Iowa, Kentucky, Maryland, Michigan, New Mexico, Ohio, Texas, and Vermont.
In general, the legislation does the following three things:
First, it clearly defines the purpose and expected outcomes of the state’s home visiting investment. This is vital to ensuring that programs target the families and work toward the outcomes that are the state’s highest priorities. It is also key to creating a system that fairly measures the performance of all programs.
Next, the legislation invests taxpayer dollars in home visiting programs that have a proven record of success. Once a state knows which families it wants to serve and the outcomes it seeks, policy makers should look for programs with solid evidence to meet those objectives.
And finally, the state’s responsibility does not end at reviewing the evidence and picking the programs to fund. As Congress recognized in the MIEHCV program, ensuring effectiveness means states must track public dollars and outcomes across all programs, even those that have demonstrated solid results in the past. States are working to establish that same infrastructure for their home visiting system more broadly to ensure that the programs they are funding actually “move the needle” on the goals they’ve set. For example, are they reducing infant mortality or resulting in kids being more ready for school?
MIECHV also encourages states to invest 25 percent of funds in promising programs that are still being evaluated. Pew strongly supports this because it allows the state to promote innovations that may help families for whom programs with stronger evidence haven’t worked or been tested. Additionally, a few states have innovative long standing programs that are ready to be rigorously evaluated. And, importantly, funding innovation may identify ways the state can achieve results comparable to more established programs at less cost.
Pew shares your commitment to investing in what works along with ongoing monitoring and measurement of the effectiveness of programs. Voluntary, evidence-based home visiting is proven to help families support their children and escape poverty. In addition to the real and lasting impact these programs have on the families they serve, research shows that these investments can yield returns on taxpayer dollars. We believe it is critical to continue learning from the research and for the federal government to continue encouraging states to improve the systems that monitor program outcomes.
To that end, we note the looming need for reauthorization of the MIECHV program. As noted by Jon Baron, President of the Coalition for Evidence-Based Policy, in his testimony before the Subcommittee, the MIECHV program exemplifies the kind of smart investment that yields strong returns. We encourage members of the House of Representatives to support reauthorization of this highly-effective program.
 LeCroy, C. W., & Krysik, J. (2011). Randomized trial of the Healthy Families Arizona home visiting program. Children and Youth Services Review, 33(10): 1761-1766.
 DuMont, K., K. Kirkland, S. Mitchell-Herzfeld, S. Ehrhard-Dietzel, M. Rodriguez, E. Lee, C. Layne, and R. Greene, Final Report: A Randomized Trial of Healthy Families New York (HFNY): Does Home Visiting Prevent Child Maltreatment? 2010. As of February 2011:http://www.ncjrs.gov/pdffiles1/nij/grants/232945.pdf and Karoly, LA, Kilburn, MR, and Cannon, JS. Lynn A., M. Rebecca Kilburn, and Jill S. Cannon, Early Childhood Interventions: Proven Results, Future Promise (Santa Monica, CA: The RAND Corporation, 2005).