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Home Visiting Has Bipartisan Support. So Why Did the Federal Program Lapse?

Parent-Infant-Hand-Holding-Getty-600x400Blog.jpgRepublicans and Democrats have both sung the virtues of a federally-funded program that provides home-based support to vulnerable families. 

"For years, the Maternal, Infant, and Early Childhood Home Visiting program has promoted state and local solutions that improve the lives of low-income children and families," said Rep. Kevin Brady, a Republican from Texas, after the House passed a bill to reauthorize the program. 

After the Senate introduced a bill to keep the program funded, Sen. Bob Menendez of New Jersey, a Democrat, said last month that the program has helped more than 7,000 families in his state. "It is my hope that many thousands more will be able to access the important tools and resources provided through the home visits," he said in a press release. 

But on Sept. 30, the end of the fiscal year, the program lapsed. Though there is stated agreement on the value of home visiting, there's deep disagreement on how it should be paid for in the future.

The House wants state and local entities to match every federal dollar they receive. Though states do pay for home visiting, a one-to-one match has not been required before.  The Senate wants to maintain the current funding scheme. 

Advocates hope that Congress can quickly restore funding to the program, which served about 160,000 families in fiscal 2016.

"It's kind of shocking that they weren't able to come together and reauthorize it," said Holly Whitworth, the program manager for the Parents as Teachers home-visiting program that is overseen by Eastern Idaho Public Health in Idaho Falls.That program serves 50 families with a variety of needs, Whitworth said: Sometimes the parents have mental health problems or developmental delays; some are teen parents, and many struggle with housing or food insecurity. 

Through the home-visiting program, Whitworth said that trained counselors are able to connect families with social services, as well as provide them parenting advice and coaching.

The federal home-visiting program began as a small program during President George W. Bush's administration. However, it received a big boost during the Obama administration. It received $1.5 billion as a part of the Affordable Care Act in 2010, and when that funding ran out in 2015, the program received an additional $800 million over two years as a rider to a Medicare doctor-payment bill. That second extension is what expired. 

Research into home-visiting programs has noted its long-lasting benefits. Katharine Stevens, a research fellow at the American Enterprise Institute, has argued that home-visiting programs should be the focus of federal efforts, because they provide more of a boost for children than preschool. Nobel laureate James Heckman, after studying a home-visiting program based in the Memphis area, found that the positive effects lasted for years, particularly for boys. 

Both houses of Congress managed to introduce bills to keep the program going before the funding deadline. On the House side, a bill to reauthorize home-visiting at $400 million a year for five years with the state-match provision passed 214-209. Only two Democrats voted in favor of that bill. 

The Senate bill to fund the program for the same amount, but with no required state match, was introduced by a bipartisan group of Senators. The bill had not made it to a vote of the full body before time ran out.

The program money doesn't end immediately for the states; the federal Health Resources and Services Administration released home-visiting money late last month. In Idaho, Whitworth said there will be some funding left to continue working with the families who are currently enrolled, but the program can't recruit additional families without knowing that money will be available in the future. And there's also the counselors, who don't know if they will still have jobs once the money runs out, she said.

"We're hopeful that as soon as they get back that they'll get back to work and they'll reauthorize it immediately, understanding how vital it is for families to have that continuity," Whitworth said. 


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