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Universal Home Visiting to Cut Costs and Ensure Healthy Families

Support for pregnant moms and very young kids has been called “the most cost-effective” way to improve lives. Maternal, infant, and early childhood home visits improve children’s health and save money for families and states by reducing health and education costs. This responsive policy helps families feed their kids, find affordable healthcare or childcare, get back to work, and otherwise meet their needs through individualized at-home attention for new or growing families from trained professionals.

Frequently Asked Questions
Who does this help?
This policy benefits all Americans. It cuts costs on healthcare, social services, criminal justice, and more. A remarkably effective government program, studies find that maternal home visits improve overall quality of health care for parents and children over the long-term, reduce the need for government intervention, and even reduce incarceration rates fifteen years later.
Is this high cost to the state?
No. States can use federal funding to pay for this policy.
Partners
  • Early childhood advocates
  • Working and low-income families advocates
  • Education advocates
  • Fiscal watchdogs
Opposition
  • None noted
Model Policy
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SECTION 1 (TITLE):
This act shall be known as the Universal Home Visiting Act
SECTION 2 (PURPOSE):
This act establishes a universal home visiting program and evidence-based home visiting programs to eligible families.
SECTION 3 (PROVISIONS):

a) It is the goal of [STATE] to offer evidence-based home visiting programs universally to eligible families.

b) Accordingly, within 100 days the DEPARTMENT is directed to produce and post publicly a plan to make substantial progress annually over five years toward offering evidence-based home visiting programs universally to eligible families.

c) The plan may include:

i) Expansion of existing home visiting programs;

ii) Proposed applications for federal and foundation grant funding;

iii) “Pay for Success” social impact bonds;

iv) Any other programs the DEPARTMENT identifies that would result in an efficient expansion of home visiting service offerings, including seeking opportunities to expand offerings to long-term foster care, families with newly adopted children, and new family, friend, and neighbor (FFN) care providers. The plan should target expansion of home visiting programs by at least 20% per year.

d) The plan should detail which actions the DEPARTMENT can pursue on its own without additional legislative action, and, within 60 days of the plan’s publication, the DEPARTMENT shall commence those programs.

e) For aspects of the plan that would require additional action by the legislature, the Department shall include in the plan specific requests and outlines of legislative action needed, including budget requests.

f) Within 120 days of enactment, the DEPARTMENT shall begin the process to promulgate regulations to establish processes for automatic enrollment in home visiting programs for eligible families upon the birth, long-term fostering, or adoption of a child, and via visits to a primary care doctor, obstetrician, gynecologist, and other medical providers, including through:

i) A checkbox or similar mechanism on the birth registration forms for hospital and out of hospital births for parents and guardians to [provide their consent to enroll in] a home visiting program.

ii) A checkbox or similar mechanism on the paperwork for eligible long-term foster care and new adoptions for parents and guardians to [provide their consent to enroll in] a home visiting program.

iii) A checkbox or similar mechanism on the paperwork for postpartum care and annual pediatric and gynecological exams to [provide their consent to enroll in] a home visiting program.

iv) Following an applicant requesting enrollment under these sections, DEPARTMENT shall cross-reference existing information to the extent possible to determine eligibility and contact the applicant to discuss any additional informational needs and how to proceed with enrollment if eligible. The DEPARTMENT shall ensure the universal home visiting program is included within any integrated application process for public services offered by the State.

g) The DEPARTMENT shall develop and execute an outreach plan within one year of enactment of this bill to notify family, friend, and neighbor (FFN) caregivers of their eligibility for home visiting programs.

h) Definitions

i) “Universal home visiting program” or “home visiting program” as defined in this section means an evidence-based home visiting model that is proven to improve child health and be cost effective, as measured by the federal Home Visiting Evidence of Effectiveness (HomVEE) program.

ii) “Eligible families” means families who are eligible for home visiting services under a service delivery model included in the definition in (i), long-term foster care parents, families with newly adopted children of any age, and family, friend, and neighbor (FFN) caregivers.

iii)“Long-term foster care” means an out-of-home placement in which there is a long-term contractual foster care agreement between the foster parents and the department that is approved by the juvenile court and in which the foster parents commit to raise a ward in substitute care or youth offender until the age of majority.

iv) “Family, friend, and neighbor (FFN) care provider” is defined as a non-parent who is caring for a small number of children in a home setting and who is legally exempt from regulation, including but not limited to kith & kin care, informal care, relative care, license-exempt care, or unlicensed care.

i) [State] has a compelling interest in protecting privacy and the protection of personal information. In administering this Act, state and local agencies, businesses, and any other entity, shall only request data necessary to administer this Act and retain it only as required to administer and achieve the purposes of the Act. Any personal information or data collected or obtained in the course of administering this Act shall be shared only in a manner that has been deidentified and aggregated to the greatest extent allowable while still in compliance with federal eligibility requirements and every allowable effort shall be made to revoke access to such data should programs be eliminated or should there be an ineligibility determination. Personal information or data collected or obtained in the course of administering this Act shall not be otherwise disclosed without the informed consent of the individual, a warrant signed by a [state] judge or federal judge, lawful court order administered within [state] or a lawful federal court order, or subpoena administered within [state] or federal subpoena, or unless otherwise required by federal or state statute. Personal information or data may be considered deidentified if it cannot reasonably be used to infer information about, or otherwise be linked to, a particular individual or household.

j) The provisions of this act are severable. If any provision of this act or its application is held invalid, that invalidity shall not affect other provisions or applications that can be given effect without the invalid provision or application.