States and the New Federal Home Visiting Initiative
An assessment from the starting line
The resulting report, States and the New Federal Home Visiting Initiative: An Assessment from the Starting Line, along with the Pew Home Visiting Inventory, provides state leaders, agency administrators and program directors with individual state snapshots and a national overview of home visiting programs, models and funding.
With the new federal Maternal, Infant, and Early Childhood Home Visiting (MIECHV) program beginning to make grants to states to improve and expand home visitation, these data and Pew's findings and recommendations give policy makers—for the first time—a much-needed account of home visiting investments and programs as well as strategies to maximize federal and state resources.
Together, the report and inventory will help state and federal policy makers evaluate current home visiting approaches, compare systems across states, prepare for the upcoming infusion of MIECHV grant dollars and make informed decisions to ensure the best results for families and strongest returns to taxpayers.
NATIONAL OVERVIEW
National Overview
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.
Funding strategies
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
Nurse-Family Partnership
Parents as Teachers
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.
Policy Recommendations
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.
Definitions
For the purposes of creating an inventory of comparable programs, Pew defined “home visiting” as a voluntary, sustained effort that:
- Pairs new and expectant families with home visitors who provide parenting information and connections to community-based services and support during pregnancy and throughout early childhood;
- Delivers services primarily in the family's home, although programs may complement home visits with socialization activities such as group classes and parent outings; and
- Is supported through state allocations (using either state or federal dollars).
Excluded from the survey were programs that employ home visiting as a strategy but do not fully satisfy the definition above, such as:
- Involuntary visits resulting from a child protective services investigation or a court order;
- Programs targeting children four or older, unless they are enrolled before the age of two;
- Programs that use home visiting as a component of a broader family support strategy but do not identify the home as the primary location for service delivery (such as Family Resource Centers or other primarily center-based initiatives;
- Home-based services delivered as required by the federal Individuals with Disabilities Education Act (IDEA);
- Federal funding allocated directly to localities and not state-administered, such as Healthy Start and Early Head Start; and
- Funding from private organizations and communities.
State Home Visiting Programs
For the purposes of this inventory, a state home visiting “program” is defined as an initiative that:
- Is administered through state agencies—such as health and human services—that direct funding to local communities to support service delivery, articulate standards and regulations, set performance measures and provide oversight and infrastructure;
- Delivers services mainly in families' homes, though visits may be complemented with socialization activities such as group classes and parent outings;
- Receives support through state allocations, using either state or federal dollars.
Federally Approved, Evidence-based Home Visiting Models
Healthy Families America
Healthy Families America (HFA) is designed to serve families at-risk for child abuse and neglect. The home visitor provides parent education and support, linkages to community resources and child development screenings. [1]
Nurse-Family Partnership
The Nurse-Family Partnership (NFP) provides home visitation services to low-income, first-time mothers by registered nurses beginning early in pregnancy and continuing through the child's second year of life. The program targets a wide range of outcomes, with a focus on maternal and child health and family self-sufficiency. [2]
Parents as Teachers
Parents as Teachers (PAT) focuses on supporting a parent's role in promoting school readiness and healthy development. PAT visitors provide information on children's development, teach parents to encourage their child's learning, provide referrals to community resources when needed and conduct screenings of children's development, health, hearing and vision. [3]
Spending Per Low-Income Child
The estimated number of children age 0-3 whose families live at or below 125 percent of poverty line. These estimates are derived from the Current Population Survey Table Creator and represent a three-year average between 2007 and 2009.
[1] http://www.healthyfamiliesamerica.org/about_us/index.shtml
[2] http://www.nursefamilypartnership.org/assets/PDF/Policy/Sprinkle_Written_testimony (page 1)
[3] http://www.parentsasteachers.org/about/what-we-do
[4] http://www.parent-child.org/about-us/vision-mission/
[5] http://www.parent-child.org/downloads/WhatWeDo.pdf
METHODOLOGY
Methodology
The Pew Center on the States surveyed all 50 states and the District of Columbia about home visiting funding and polices as of fiscal year 2009-2010.
The survey asked three critical policy questions:
- Investment: How much are states investing in home visiting? What are the scale, breadth and range of state-directed funds? What strategies are states using to fund programs?
- Evidence base: Does the state use empirical standards or evidence of program effectiveness to drive funding allocation decisions and to what extent?
- Evaluation: How do states hold local programs accountable for meeting performance measures?
Because many states do not track outcomes, this study did not consider or evaluate the merit of individual programs, models or services. Forthcoming, independent, Pew-funded research will explore some of these topics and seek to answer critical questions of quality and effectiveness that can guide state efforts to maximize investments. Additionally, the standards that will accompany new federal funding will outline specific criteria for selecting models and delivering services.
Data Sources
As a first point of contact in the state, Pew interviewed the State Maternal and Child Health Early Childhood Comprehensive Systems (ECCS) Coordinator, who represents the federal designee to coordinate states' early childhood systems. In some cases, the ECCS coordinator served as an informant about a specific program, and referred the data collector to other agencies that may oversee home visiting programs.
Because home visiting programs are often administered across different agencies in the state, Pew also contacted multiple state agencies to gather information about programs that may not be housed in the Maternal Child Health office, including Departments of Early Learning, Children's Trusts, the lead Child Abuse Prevention Agencies and any Children's Cabinets or Children's Bureaus.
Data collectors conducted phone interviews with staff at these agencies and used information from interviews to complete surveys. A draft of each completed survey was returned to agency staff to verify data and fill in any gaps. After data collection was finished, data were summarized and returned to program staff to verify.
Data collection period:
Data were collected between December 2009 and May 2010, and focused on funding for FY2009-2010. Some programs may have experienced agency cuts during the course of the year, which are reflected in the final data when possible. Unless noted, service population data is from FY2009, which often was the most recent data available during the data collection period.
Per capita spending:
To assess the size and scale (geographic breadth) of state investments, Pew examined state funding in proportion to the number of low-income children. The per capita expenditure was calculated by dividing a state's home visiting investment by the number of estimated low-income infants and toddlers who live at or below 125 percent of poverty, based on the U.S. Census's Current Population Survey.
Accuracy and Comprehensiveness
To ensure the accuracy of the data presented in this report, Pew staff implemented numerous quality control measures. First, Pew identified multiple informants to verify data. When possible, all data were compared with publicly available documents, such as legislative reports, agency budget documents and evaluation reports. Second, all agency staff were given the opportunity to review the final survey and a fact sheet summarizing the data. In August 2010, the U.S. Department of Health and Human Services released a list of the new governor-appointed designees to lead states' efforts on home visiting. As a final data check, Pew sent summaries of all of a state's programs to the state home visiting lead for verification.
Inventory Data
|
Program |
FY10 Program Funding |
Administering Agency |
Source of Funds |
Models Used |
|
Alabama (FY10 Total State Funding: $803,000 — State Spending Per Low-Income Child: $13) |
||||
|
Child Abuse Prevention |
$803,000 |
Department of Child Abuse and Neglect Prevention; Department of Children's Affairs |
Tobacco settlement funds (Children's First Trust Fund); Education Trust Fund; CBCAP; TANF; Mentoring Children of Promise; State general funds |
Broad early childhood funds; specific to program selected by community |
|
Alaska (FY10 Total State Funding: $0 — State Spending Per Low-Income Child: $0) |
||||
|
Arizona (FY10 Total State Funding: $27,476,000 — State Spending Per Low-Income Child: $222) |
||||
|
Early Childhood Development Initiative |
$19,176,000 |
First Things First |
Tobacco Tax |
Multiple national models, with some locally developed |
|
Healthy Families Arizona |
$6,200,000 |
Department of Economic Security |
State lottery |
Healthy Families America |
|
Health Start Program |
$2,100,000 |
Department of Health Services |
State lottery |
State-developed program |
|
Arkansas (FY10 Total State Funding: $1,186,000 — State Spending Per Low-Income Child: $20) |
||||
|
Arkansas Better Chance for School Success Fund |
$732,000 |
Division of Child Care and Early Childhood Education |
State general funds; TANF |
Parents as Teachers |
|
Child Abuse Prevention Grants |
$454,000 |
Children's Trust Fund |
CBCAP; surcharge on marriage license fees |
Specific to home visiting model program selected by community |
|
California (FY10 Total State Funding: Unavailable — State Spending Per Low-Income Child: Unable to calculate) |
||||
|
First 5 California County Commissions |
Unavailable |
First 5 California |
Tobacco tax |
Multiple national models, with some locally developed |
|
Colorado (FY10 Total State Funding: $14,848,000 — State Spending Per Low-Income Child: $270) |
||||
|
Nurse Home Visitor Program |
$14,037,000 |
Department of Public Health and Environment |
Tobacco settlement funds; Medicaid |
Nurse-Family Partnership |
|
Tony Grampsas Youth Services Program |
$811,000 |
Department of Public Health and Environment |
Tobacco settlement funds |
Broad early childhood funds; specific to program selected by community |
|
Connecticut (FY10 Total State Funding: $14,848,000 — State Spending Per Low-Income Child: $270) |
||||
|
Nurturing Families Network |
$9,000,000 |
Children's Trust Fund |
State general funds |
Parents as Teachers |
|
Case Management for Pregnant Women |
$349,000 |
Department of Public Health |
MCH Block Grant |
Case management |
|
Child First |
$292,000 |
Department of Children and Families |
State general funds |
State-developed program |
|
Healthy Choices for Women & Children |
$180,000 |
Department of Public Health |
State general funds; Children's Health Initiative |
Case management |
|
Delaware (FY10 Total State Funding: $3,809,000 — State Spending Per Low-Income Child: $290) |
||||
|
Smart Start |
$2,156,000 |
Department of Health & Social Services, Division of Public Health |
State general funds; MCH Block Grant |
State-developed program |
|
Parents as Teachers |
$1,122,000 |
Department of Education |
State general funds |
Parents as Teachers |
|
Nurse-Family Partnership |
$531,000 |
Department of Health & Social Services, Division of Public Health |
EBHV Grant; State general funds |
Nurse-Family Partnership |
|
District of Columbia (FY10 Total State Funding: $750,000 — State Spending Per Low-Income Child: $75) |
||||
|
Children and Family Services Agency |
$750,000 |
Department of Health |
General funds |
Specific to program selected by community |
|
Florida (FY10 Total State Funding: $18,114,000 — State Spending Per Low-Income Child: $77) |
||||
|
Healthy Families Florida |
$18,114,000 |
Department of Children and Families |
State general funds; TANF; CBCAP |
Healthy Families America |
|
Georgia (FY10 Total State Funding: $2,294,000 — State Spending Per Low-Income Child: $12) |
||||
|
System of Care Grant Program |
$1,310,000 |
Governor's Office for Children & Families |
CBCAP; State general funds |
Broad early childhood funds; home visiting programs must meet state-developed standards |
|
SafeCare |
$984,000 |
Department of Human Services |
TANF |
SafeCare |
|
Hawaii (FY10 Total State Funding: $1,320,000 — State Spending Per Low-Income Child: $120) |
||||
|
Healthy Families |
$1,320,000 |
Department of Health |
TANF |
Healthy Families America |
|
Idaho (FY10 Total State Funding: $0 — State Spending Per Low-Income Child: $0) |
||||
|
Illinois (FY10 Total State Funding: $21,870,000 — State Spending Per Low-Income Child: $124) |
||||
|
Healthy Families Illinois |
$10,123,000 |
Department of Human Services |
State general funds |
Healthy Families America |
|
Parents Too Soon |
$6,940,000 |
Department of Human Services |
State general funds |
Healthy Families, Nurse-Family Partnership, Parents as Teachers |
|
Targeted Intensive Case Management |
$4,807,000 |
Department of Human Services |
State general funds |
Case management |
|
Indiana (FY10 Total State Funding: $50,999,000 — State Spending Per Low-Income Child: $520) |
||||
|
Early Childhood Block Grant/Infant & Toddler |
Unavailable |
State Board of Education |
State general funds |
Multiple national models, with some state developed |
|
Healthy Families Indiana |
$35,346,000 |
Department of Children and Families |
TANF |
Healthy Families America |
|
Community Partners for Child Safety |
$15,653,000 |
Department of Child Services/Kids First Trust |
Kids First Trust Fund; CBCAP; PSSF/Title IV- B; Special fees |
State-developed program |
|
Iowa (FY10 Total State Funding: $15,879,000 — State Spending Per Low-Income Child: $441) |
||||
|
Community Empowerment: Family Support |
$10,194,000 |
Department of Management |
State general funds |
Multiple national, state, and locally-developed models |
|
Family Development and Self-Sufficiency Program |
$4,947,000 |
Department of Management |
TANF; State general funds |
Localities select program |
|
Healthy Opportunities for Parents to Experience Success/Healthy Families Iowa |
$738,000 |
Department of Public Health |
State general funds |
Healthy Families America |
|
Iowa Child Abuse Prevention Program |
Unavailable |
Department of Human Services |
PSSF/Title IV-B; TANF; State general funds; Birth certificate fees |
Multiple national, state, and locally-developed models |
|
Community Partnerships for Protecting Children |
Unavailable |
Department of Human Services |
State general funds |
Multiple national, state, and locally-developed models |
|
Kansas (FY10 Total State Funding: $11,331,000 — State Spending Per Low-Income Child: $202) |
||||
|
Parents as Teachers |
$7,567,000 |
Department of Education |
Tobacco settlement funds/Children's Initiative Fund; State general funds |
Parents as Teachers |
|
Early Childhood Block Grant |
$1,950,000 |
Children's Cabinet and Trust Fund |
Tobacco settlement funds/Children's Initiative Fund |
Multiple national models |
|
Healthy Start Home Visitor |
$1,151,000 |
Department of Health and Environment |
Tobacco settlement funds/Children's Initiative Fund; State general funds; MCH Block Grant |
State-developed program |
|
Smart Start |
$629,000 |
Children's Cabinet and Trust Fund |
Tobacco settlement funds/Children's Initiative Fund |
Multiple national models |
|
Child Abuse Prevention Grants |
$34,000 |
Children's Cabinet and Trust Fund |
CBCAP; License fees |
Multiple national models |
|
Kentucky (FY10 Total State Funding: $31,685,000 — State Spending Per Low-Income Child: $391) |
||||
|
Health Access Nurturing Development Services (HANDS) |
$31,685,000 |
Department for Public Health |
State general funds (tobacco settlement); Medicaid |
State-developed program |
|
Louisiana (FY10 Total State Funding: $12,363,000 — State Spending Per Low-Income Child: $167) |
||||
|
Nurse-Family Partnership |
$12,300,000 |
Department of Health and Hospitals |
TANF; MCH block grant; Medicaid; State general funds |
Nurse-Family Partnership |
|
Children's Trust Fund |
$63,000 |
Children's Trust Fund |
CBCAP; duplicate birth certificate fees |
Broad early childhood funds; specific to program selected by community |
|
Maine (FY10 Total State Funding: $9,740,000 — State Spending Per Low-Income Child: $400) |
||||
|
Maine Families |
$5,200,000 |
Department of Health and Human Services |
Tobacco settlement funds |
Parents as Teachers; Healthy Families America |
|
Maine Public Health Nursing |
$4,540,000 |
Department of Health and Human Services |
State general funds; MCH Block Grant |
State-developed program |
|
Maryland (FY10 Total State Funding: $4,590,000 — State Spending Per Low-Income Child: $92) |
||||
|
Healthy Families |
$4,590,000 |
Department of Education |
TANF |
Healthy Families America |
|
Massachusetts (FY10 Total State Funding: $13,584,000 — State Spending Per Low-Income Child: $234) |
||||
|
Healthy Families |
$10,538,000 |
Department of Early Education and Care/Children's Trust Fund |
State general funds; TANF |
Healthy Families America |
|
Parent-Child Home Program |
$1,800,000 |
Department of Early Education and Care |
TANF; CCDF Grant |
Parent-Child Home Program |
|
Early Intervention Partnership Program |
$715,000 |
Department of Public Health |
MCH Block Grant; Medicaid |
State-developed program |
|
Fresh Start |
$531,000 |
Department of Public Health |
State general funds; EBHV Grant |
State-developed program |
|
Michigan (FY10 Total State Funding: $21,458,000 — State Spending Per Low-Income Child: $234) |
||||
|
Maternal Infant Health Program |
$16,000,000 |
Department of Community Health |
Medicaid |
State-developed program |
|
Zero to Three Secondary Prevention |
$4,000,000 |
Department of Human Services |
TANF |
Specific to program selected by community |
|
Childhood Lead Poisoning Prevention Program |
$1,358,000 |
Department of Community Health |
State general funds; MCH Block Grant; Centers for Disease Control and Prevention |
State-developed program |
|
Children's Trust Fund |
$100,000 |
Department of Human Services |
CBCAP |
Broad early childhood funds; specific to program selected by community |
|
Great Parents, Great Start |
Unavailable |
Department of Education |
State general funds |
Broad early childhood funds; specific to program selected by community |
|
Minnesota (FY10 Total State Funding: $7,785,000 — State Spending Per Low-Income Child: $124) |
||||
|
Family Home Visiting |
$7,785,000 |
Department of Health |
TANF; State general funds |
Localities select program |
|
Early Childhood Family Education |
Unavailable |
Department of Education |
State general funds |
State-developed program |
|
Missouri (FY10 Total State Funding: $28,095,000 — State Spending Per Low-Income Child: $316) |
||||
|
Parents as Teachers |
$23,918,000 |
Department of Elementary and Secondary Education |
State general funds |
Parents as Teachers |
|
Stay at Home Parent Program |
$2,884,000 |
Department of Social Services |
Gaming fees |
Localities select program |
|
Building Blocks of Missouri |
$1,043,000 |
Department of Health and Senior Services |
MCH block grant |
Nurse-Family Partnership |
|
Missouri Community-based Home Visiting Program |
$250,000 |
Department of Health and Senior Services |
MCH block grant |
State-developed program |
|
Mississippi (FY10 Total State Funding: $0 — State Spending Per Low-Income Child: $0) |
||||
|
Montana (FY10 Total State Funding: $591,000 — State Spending Per Low-Income Child: $42) |
||||
|
Public Health Home Visiting Program |
$591,000 |
Department of Public Health and Human Services |
State general funds; Special state funds |
State-developed program |
|
Family Resource Centers |
Unavailable |
Children's Trust Fund |
CBCAP; Interest earnings from state child endowment; Divorce filing fees |
Broad early childhood funds; specific to program selected by community |
|
Nebraska (FY10 Total State Funding: $1,792,000 — State Spending Per Low-Income Child: $69) |
||||
|
Sixpence Early Learning Fund |
$1,051,000 |
Children and Families Foundation |
Earnings from Educational Lands and Trust Funds endowment |
Broad early childhood funds; home visiting programs must meet state-developed standards |
|
Home Visitation Program |
$600,000 |
Department of Health & Human Services |
State general funds |
Healthy Families America; Hawaii Healthy Start; Nurse-Family Partnership; Intensive Home Visiting for At-Risk Parents |
|
Child Abuse Prevention Grants |
$141,000 |
Children and Families Foundation |
CBCAP; PSSF/Title IV-B |
Broad early childhood funds; specific to program selected by community |
|
New Hampshire (FY10 Total State Funding: $1,598,000 — State Spending Per Low-Income Child: $228) |
||||
|
Home Visiting New Hampshire |
$1,582,000 |
Department of Health and Human Services |
TANF; Medicaid ; MCH Block Grant |
State-developed program |
|
Family Centers |
$16,000 |
Children's Trust Fund |
Children's Trust Fund endowment; CBCAP |
Broad early childhood funds; specific to program selected by community |
|
New Jersey (FY10 Total State Funding: $11,100,000 — State Spending Per Low-Income Child: $161) |
||||
|
Comprehensive Home Visiting Initiative |
$11,100,000 |
Department of Children and Families |
TANF; PSSF/Title IV-B; State general funds; EBHV Grant |
Healthy Families America; Nurse-Family Partnership; Parents as Teachers |
|
New Mexico (FY10 Total State Funding: $2,572,000 — State Spending Per Low-Income Child: $64) |
||||
|
New Mexico Home Visiting Services |
$2,572,000 |
Children, Youth and Families Department |
State general funds; ARRA |
State-developed program; specific to program selected by community |
|
New York (FY10 Total State Funding: $40,142,000 — State Spending Per Low-Income Child: $171) |
||||
|
Healthy Families New York |
$21,742,000 |
Office of Children and Family Services |
TANF; State general funds |
Healthy Families America |
|
Nurse-Family Partnership |
$11,600,000 |
Department of Health |
TANF (one-time only); Medicaid |
Nurse-Family Partnership |
|
Community Health Worker |
$4,800,000 |
Department of Health |
MCH Block Grant; State general funds; Medicaid |
State-developed program |
|
Healthy Mom, Healthy Baby |
$2,000,000 |
Department of Health |
State general funds |
Discretion given to home visitor |
|
Nevada (FY10 Total State Funding: $0 — State Spending Per Low-Income Child: $0) |
||||
|
North Carolina (FY10 Total State Funding: $9,033,000 — State Spending Per Low-Income Child: $61) |
||||
|
Smart Start: Family Support Initiatives |
$8,033,000 |
Department of Health and Human Services |
State general funds |
Multiple national models |
|
Nurse-Family Partnership |
$1,000,000 |
Department of Health and Human Services |
MCH block grant |
Nurse-Family Partnership |
|
North Dakota (FY10 Total State Funding: $250,000 — State Spending Per Low-Income Child: $50) |
||||
|
Healthy Families America |
$250,000 |
Department of Human Services |
State general funds |
Healthy Families America |
|
Ohio (FY10 Total State Funding: $26,569,000 — State Spending Per Low-Income Child: $134) |
||||
|
Help Me Grow |
$24,841,000 |
Department of Health |
State general funds |
Multiple national models, with some locally developed; programs must meet state- developed standards |
|
Infant Mortality Reduction Initiative |
$1,728,000 |
Department of Health |
State general funds; MCH block grant |
State-developed program |
|
Oklahoma (FY10 Total State Funding: $19,046,000 — State Spending Per Low-Income Child: $307) |
||||
|
Children First (Nurse-Family Partnership) |
$12,680,000 |
Department of Health |
State general funds; Medicaid |
Nurse-Family Partnership |
|
Start Right |
$3,915,000 |
Department of Health |
State general funds; CBCAP |
State-developed program |
|
Oklahoma Parents as Teachers |
$2,451,000 |
Department of Education |
State general funds |
Parents as Teachers |
|
Oregon (FY10 Total State Funding: $13,356,000 — State Spending Per Low-Income Child: $334) |
||||
|
Healthy Start/Healthy Families |
$9,121,000 |
Oregon Commission for Children and Families |
State general funds; Medicaid |
Healthy Families America |
|
Family Support and Connections |
$2,152,000 |
Department of Human Services |
State general funds; CBCAP; TANF |
State-developed program |
|
Maternity Case Management |
$1,402,000 |
Department of Human Services |
Medicaid |
Case management |
|
Babies First! |
$681,000 |
Department of Human Services |
State general funds |
State-developed program |
|
Pennsylvania (FY10 Total State Funding: $21,321,000 — State Spending Per Low-Income Child: $106) |
||||
|
Nurse-Family Partnership |
$11,178,000 |
Office of Child Development and Early Learning, Department of Public Welfare |
State general funds |
Nurse-Family Partnership |
|
Family Centers |
$6,741,000 |
Office of Children, Youth and Families, Department of Public Welfare |
State general funds; CBCAP; PSSF/Title IV-B |
Parents as Teachers |
|
Parent-Child Home Program |
$3,402,000 |
Office of Child Development and Early Learning, Department of Public Welfare |
PSSF/Title IV-B; State general funds |
Parent-Child Home Program |
|
Rhode Island (FY10 Total State Funding: $1,407,000 — State Spending Per Low-Income Child: $100) |
||||
|
Rhode Island Nurse-Family Partnership Initiative |
$650,000 |
Department of Health; Department of Children, Youth and Families; Department of Human Services |
EBHV; Family Care Community Partnerships; WIC; TANF |
Nurse-Family Partnership |
|
The First Connections Program |
$643,000 |
Department of Health |
State general funds; IDEA Part C; Medicaid |
Broad discretion given to home visitor using state-developed standards |
|
Children's Trusts Fund Grants |
$100,000 |
Department of Children, Youth and Families |
CBCAP |
Specific to program selected by community |
|
Child Opportunity Zones |
$14,000 |
Department of Education |
State general funds |
Discretion given to home visitor |
|
South Carolina (FY10 Total State Funding: $6,905,000 — State Spending Per Low-Income Child: $102) |
||||
|
First Steps |
$6,232,000 |
Department of Education |
State general funds |
Multiple national models, with some locally developed; programs must meet state-developed standards |
|
Nurse-Family Partnership |
$673,000 |
Children's Trust Fund |
EBHV Grant |
Nurse-Family Partnership |
|
Family Literacy |
Unavailable |
Department of Education |
State general funds |
Multiple national models, with some locally developed |
|
South Dakota (FY10 Total State Funding: Unavailable — State Spending Per Low-Income Child: Unable to calculate) |
||||
|
Bright Start |
Unavailable |
Department of Health |
TANF; Medicaid |
Nurse-Family Partnership |
|
Tennessee (FY10 Total State Funding: $12,113,000 — Spending Per Low-Income Child: $114) |
||||
|
Help Us Grow Successfully (HUGS) |
$6,500,000 |
Department of Health |
TennCare/Medicaid |
State-developed program |
|
Healthy Start/Hawaii Healthy Families America |
$3,000,000 |
Department of Health |
PSSF/Title IV-B |
Healthy Families America |
|
Nurse-Family Partnership |
$1,625,000 |
Department of Health |
State general funds; EBHV Grant |
Nurse-Family Partnership |
|
Child Health and Development Projects (CHAD) |
$538,000 |
Department of Health |
SSBG |
State-developed program |
|
Child Abuse Prevention Services |
$450,000 |
Department of Children's Services |
CBCAP; State general funds; License fees |
Localities select program |
|
Texas (FY10 Total State Funding: $8,900,000 — State Spending Per Low-Income Child: $15) |
||||
|
Texas Nurse-Family Partnership |
$8,900,000 |
Health and Human Services Commission |
State general funds; TANF |
Nurse-Family Partnership |
|
Prevention and Early Intervention Division |
Unavailable |
Department of Family and Protective Services |
State general funds; PSSF/Title IV-B; CBCAP; Children's Trust Fund |
Broad early childhood funds; specific to program selected by community |
|
Utah(FY10 Total State Funding: $1,469,000 — State Spending Per Low-Income Child: $37) |
||||
|
Office Home Visiting |
$614,000 |
Department of Health |
EBHV Grant |
Multiple national models |
|
Child Abuse Prevention Funds |
$591,000 |
Department of Human Services |
CBCAP; PSSF/Title IV-B |
Multiple national models, with some state developed |
|
P-5 Home Visiting |
$264,000 |
Department of Health |
MCH block grant |
Localities select program |
|
Children's Trust Fund |
Unavailable |
Department of Human Services |
Birth certificate fees |
Broad early childhood funds; specific to program selected by community |
|
Vermont(FY10 Total State Funding: $5,209,000 — State Spending Per Low-Income Child: $1,042) |
||||
|
Healthy Babies Kids & Families |
$2,645,000 |
Agency for Human Services |
Medicaid; State general funds |
Discretion given to home visitor |
|
Early Childhood and Family Mental Health |
$2,564,000 |
Agency for Human Services |
Medicaid; State general funds |
Discretion given to home visitor |
|
Children's Trust Fund Foundation |
Unavailable |
Agency for Human Services |
State general funds |
Broad early childhood funds; specific to program selected by community |
|
Virginia(FY10 Total State Funding: $10,451,000 — State Spending Per Low-Income Child: $100) |
||||
|
Healthy Families Virginia |
$5,400,000 |
Department of Social Services |
TANF; State general funds |
Healthy Families America |
|
CHIP of Virginia |
$2,550,000 |
Department of Health |
State general funds |
Parents as Teachers; Bright Futures |
|
Resource Mothers |
$2,501,000 |
Department of Health |
MCH block grant; Medicaid; State general funds |
Resource Mothers |
|
Washington(FY10 Total State Funding: $1,180,000 — State Spending Per Low-Income Child: $18) |
||||
|
Evidence-Based Home Visiting |
$1,180,000 |
Council for Children and Families |
State general funds |
Nurse-Family Partnership; Parents as Teachers; Parent-Child Home Program; Parenting Partnership |
|
West Virginia(FY10 Total State Funding: $2,755,000 — State Spending Per Low-Income Child: $106) |
||||
|
Right from the Start |
$2,005,000 |
Department of Health and Human Resources |
Medicaid; MCH block grant |
State-developed program with discretion given to the home visitor |
|
In-Home Family Education Program |
$750,000 |
Department of Health and Human Resources |
CBCAP; State general funds |
Healthy Families America; Maternal Infant Health Outreach Workers; Parents as Teachers |
|
Wisconsin(FY10 Total State Funding: $2,910,000 — State Spending Per Low-Income Child: $106) |
||||
|
Empowering Families of Milwaukee |
$1,424,000 |
Department of Children and Families |
TANF; Project LAUNCH grant |
Locally-developed program |
|
Family Foundations |
$986,000 |
Department of Children and Families |
State general funds |
Specific to program selected by community |
|
Racine Home Visiting Program |
$250,000 |
Department of Health Services |
State general funds |
Specific to program selected by community |
|
Milwaukee Nurse-Family Partnership |
$250,000 |
Department of Health Services |
MCH block grant |
Nurse-Family Partnership |
|
Wyoming(FY10 Total State Funding: $3,252,000 — State Spending Per Low-Income Child: $650) |
||||
|
Public Health Nurses Infant Home Visitation Services |
$3,252,000 |
Department of Health |
TANF; MCH block grant |
Nurse-Family Partnership |
ADDITIONAL RESOURCES
Article
Article
