Family Home Visiting

Family Home Visiting Program

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Family Home Visiting Overview

For at least 100 years, home visiting has been used as a service delivery strategy to improve the health and well-being of families. Home visiting has been shown to make a difference by increasing tax revenues while decreasing costs within the education, social service and criminal justice systems.[1, 2, 3] Home visiting has also demonstrated a decrease in child abuse and neglect, decreased tobacco and alcohol use during pregnancy, increased breastfeeding rates, reductions in subsequent pregnancies, increased labor force participation by parents, and increased family income.[1, 2] The Centers for Disease Control and Prevention (CDC) Task Force on Community Preventive Services reviewed 25 studies on home visiting and concluded, "there is strong evidence to recommend home visitation to reduce child maltreatment".[1]

Program Goal

The 2007 legislature amended the Family Home Visiting (FHV) statute originally passed in 2001 (Minnesota Statutes, section 145A.1) and increased Temporary Assistance for Needy Families (TANF) funding to Community Health Boards (CHBs) and Tribal Governments to support the services provided under the statute. The goal of the FHV program is to foster healthy beginnings, improve pregnancy outcomes, promote school readiness, prevent child abuse and neglect, reduce juvenile delinquency, promote positive parenting and resiliency in children, and promote family health and economic self-sufficiency for children and families.

What is the need in Minnesota?

The need for home visiting in Minnesota is demonstrated by the following maternal and child health statistics for the state:

  • 8.4 percent of single term births were preterm (2012)
  • 3.9 percent of pregnant women received inadequate or no prenatal care (2012)
  • The birth rate for teens 15-17 years was 9.1 per 1,000 and 18-19 years was 36.1 per 1,000 (2010-2012)
  • 33 percent of births were to unmarried mothers
  • 7.9 percent of the mothers giving birth had a low education level [4] (2012)
  • 70,000 children under 5 years of age were living in poverty (2011)
  • 4,434 (3.5 per 1,000) children 17 years and younger were abused or neglected [5] (2011)

Grant Program

The State provides oversight, guidance and statewide evaluation of FHV programs administered at the local level. Grants are distributed to local public health departments and tribal governments on a formula basis.

Grant funded FHV programs serve families at or below 200 percent of federal poverty guidelines and who are families with: adolescent parents; a history of alcohol or drug abuse; a history of child abuse and neglect, domestic abuse or other types of violence; reduced cognitive functioning; a lack of knowledge of child growth and development stages; low resiliency to adversity and environmental stressors; insufficient financial resources to meet family needs; a history of homelessness, and a risk of long-term welfare dependence or family instability due to employment barriers. In addition, Minnesota's FHV programs begin serving clients prenatally whenever possible.

A public health nursing assessment is carried out during the initial home visit; ongoing visits are conducted by nurses and/or trained home visitors. Supporting healthy parent-child relationships is a key role of the home visitor. Families also receive information on infant care, child growth and development, parenting approaches, disease prevention, preventing exposure to environmental hazards and support services available in the community.

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Workgroups within the Family Home Visiting Program

The Minnesota Department of Health (MDH) Family Home Visiting (FHV) program convenes an advisory group and a variety of workgroups to facilitate effective implementation of FHV programming; communication among the MDH FHV program, local public health departments, tribal governments and other early childhood partners; and gather guidance and support in developing and implementing FHV services across the state.

Family Home Visiting (FHV) Advisory Group

  • Facilitates communication between the MDH FHV program and local and tribal public health and other early childhood partners
  • Identifies action steps to advance the recommendations of the Maternal and Child Health Advisory Task Force's Family Home Visiting Advisory Workgroup

Family Home Visiting (FHV) Evaluation Workgroup

  • Facilitates communication between the MDH FHV program and local public health regarding evaluation of the program
  • Considers how the FHV program evaluation can best meet the needs of stakeholders
  • Identifies a process for submitting evaluation change requests
  • Identifies a process for MDH to use when considering change requests to the FHV evaluation, including periodicity for the review process
  • Develops criteria by which change requests are prioritized (i.e., costs, unique needs of data systems, complexity, relevance to FHV statute, supporting science, etc.)
  • Reviews change requests to the FHV evaluation
  • Reports to the MDH FHV Advisory Committee on recommendations regarding potential changes to the FHV evaluation

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Families Seeking Home Visiting Services

If you are a pregnant or have children under 3 years old, home visiting may be available through your local public health department. For your local contact: Find a Local Health Department or Community Health Board.


References

  1. CDC Task Force on Community Prevention Services. First reports evaluating the effectiveness of strategies for preventing violence; early childhood home visitation. MMWR, October 3, 2003.
  2. Kitzman, H., Olds, D. L., et al. Enduring effects of nurse home visitation on maternal life course: A 3-year follow-up of a randomized trial. JAMA. April 19, 2000. 284(15):1983-1989.
  3. Isaacs, J. 2007. Cost effective interventions in children. Washington, D.C.: The Brookings Institution.
  4. Minnesota Department of Health, 2012 Minnesota County Health Tables.
  5. Children’s Defense Fund Minnesota, 2013 Minnesota Kids Count Data Book.