Key Findings

Pew’s analysis of the survey data revealed five top-level findings that state leaders should consider when deciding how to improve the efficacy and efficiency of home visiting investments and in preparing to deploy new federal grant dollars.

• Most home visiting funding was not adequately tracked at the state level. 

In FY2010, states made almost $1.4 billion available for home visiting programs. Of these dollars, states could not document the use of $575 million, or more than 40 percent of available funds. States that dedicated funds exclusively for home visiting (categorical funding) effectively tracked spending of $462 million. States that provided broad-based funding to local communities to support a variety of child and family services could document only the allocation of $337 million—$52 million to home visiting and $285 million to other services. Collection of spending data was likely more robust at the local level, but states too infrequently required reporting and tracking of statewide expenditures. To ensure the most effective investments, states must more efficiently track taxpayer money supporting specific programs.

• States frequently provided funding with few, if any, requirements that programs invest in models with a proven record of success. 

Leading home visiting models have been subjected to rigorous testing with scientifically validated control groups. Evidence-based models do not come with guarantees, but when well implemented they have a proven record of effectiveness and return on public investments. Yet, 58 percent of FY2010 state funding (48 programs in 32 states) was provided with minimal guidance regarding selection of models, quality standards or expected outcomes. In these instances, service-delivery decisions such as curricula, training and caseloads were left to local discretion, and states could not ensure program quality or cost effectiveness.

• States did not adequately monitor publicly funded programs to ensure effectiveness. 

States generally did not provide enough oversight of programs to guarantee that services are of high quality, reach targeted populations and deliver desired results. Most states did not provide even basic data on program performance, such as the cost of the program, the number of visits per family and, most important, if parents and families who received services did better. Programs should be required to track both program performance and child and family outcomes, and states need to use those data to inform funding and policy decisions.

• States did not consistently target at-risk families, where the return on investment is highest. 

While states can choose to serve more families, prioritizing high-risk populations yields the best return on public investments. Yet, more than half of available home visiting funding—nearly $727 million—was allocated to programs without state-designated eligibility requirements. States can do more to provide clear guidelines about who is eligible for services and to ensure that state dollars are directed as intended.

• In every state, far too few at-risk families got home visiting services. 

No state had either sufficient funding or the infrastructure to reach all of its highest-risk families. To reap meaningful savings from home visiting investments, state funding must be sufficient to significantly lower the rates of costly problems.

Report Assets