States and the New Federal Home Visiting Initiative
An Assessment from the Starting Line
The Pew Center on the States surveyed state agency leaders in all 50 states and the District of Columbia and inventoried their state home visiting programs, models, funding and polices for fiscal year 2009-2010. The following picture of nationwide home-visiting investments emerged:
State home visiting programs
46 states and the District of Columbia have some level of fiscal year 2009-2010 investment in home visiting.
Pew found a total of 119 home visiting programs across 46 states and the District of Columbia:
- 34 states support more than one home visiting program administered within and across their health, education and human service agencies
- 21 states administer three or more home visiting programs
- Four states—Alaska, Idaho, Nevada, Mississippi—do not administer home visiting programs
- The state health department was the most common administering agency of state-administered home visiting programs.
- State agencies administering home visiting programs: health department, children family services, education/early learning, children's trust fund, workforce/welfare, children's cabinet/council and other.
In fiscal year 2009-2010, states made $1.4 billion available to home visiting programs via two primary funding strategies: categorical funding and broad-based prevention funding
- Categorical funding: 43 states and the District of Columbia directed $462 million through dedicated, categorical funding streams narrowly defined by the state for the exclusive purpose of home visiting.
- Broad-based funding: 22 states made available $912 million in block grant-style funding through 29 programs to meet a range of objectives including child abuse prevention, parent education, school readiness and early childhood systems development. Under this strategy, communities may elect to use home visiting as a method of service delivery, but they are not required to do so by the states.
- Nineteen of the 29 broad-based programs were able to account for $52 million used by communities for home visiting; 10 programs were unable to identify their broad-based initiatives’ home visiting expenditures.
State funding strategy:
Sources of state support:
State general funds were the largest source of support for home visiting programs in fiscal year 2009-2010
Home visiting dollars are drawn from a variety of state sources—including general revenues, tobacco settlement funds and taxes—and federal streams, such as Temporary Assistance for Needy Families, the Maternal Child Health Block Grant and Medicaid.
- 98 state-administered programs (83 percent) reported funding sources
- State general funds—$182 million—were the most common funding source among categorically funded programs
- California’s tobacco tax-funded “First Five” initiative was the single largest source of the broad-based funding
State investments in evidence-based home visiting models:
A total of 39 programs reported investments of $266 million in fiscal year 2009-2010 in the three most widely used of the federally approved, evidence-based models: Healthy Families America, Nurse-Family Partnership and Parents as Teachers.
In contrast to “programs,” home visiting “models” refer to the specific curricula and content used by certain state or local programs. Federally approved, evidence-based models have evaluations using a high-quality, rigorous design. The three listed above not only meet this criterion but also have national organizations and require accreditation. In addition, many states have developed their own models, which may be adapted versions of the evidenced-based models or entirely original curricula created by a state or community. Get more information on each of the models.
Evidence-based Models Used:
Healthy Families America
Parents as Teachers