States and the New Federal Home Visiting Initiative
An Assessment from the Starting Line
In light of the survey findings, Pew offers five recommendations to help states prepare to deploy new federal resources and get the highest returns on their investments in home visiting.
- Require the tracking of all home visiting funds.
Policy makers should require home visiting programs to track and document the use of funds, whether broad-based or categorical, to guide allocation decisions and help both local- and state-level agencies manage resources efficiently, avoid duplication, ensure quality and deliver services effectively.
- Insist on—and invest in—programs with a foundation in research.
Policy makers should look to the federal guidance on the appropriate use of evidence to ensure that models and standards are data-driven and rigorously evaluated, and should require that at least 75 percent of public home visiting funding supports evidence-based delivery models. Mandates for use of evidence must be accompanied by sufficient resources to ensure that models are implemented with fidelity.
- Support and require programs to monitor performance and evaluate key outcomes.
Policy makers should both mandate and provide necessary resources and training to enable local and state programs to coordinate services, monitor performance measures and track participant outcomes using criteria aligned with federal benchmarks.
- Set clear, evidence-based eligibility guidelines and develop systems to ensure compliance.
Policy makers should identify target populations using risk factors outlined in the federal initiative; require and fund administering agencies to ensure that programs adhere to established eligibility standards, especially in states with limited guidance, for use of state early childhood funds; and ensure the continuity of services as family circumstances change.
- Use the best available data about families to determine appropriate home visiting allocations and to establish a realistic plan for expansion.
As they prepare for the new federal dollars, state policy makers should look to cost-benefit, demographic and other data to determine the number of eligible families, existing program capacity and potential long-term savings; identify available funding streams, including Medicaid, Temporary Assistance to Needy Families, public health and early childhood resources; ensure that allocations are sufficient to serve the entire target population; and allow time for agencies to build capacity and conduct outreach to targeted families.