Costs vary by program model and needs of the family, they find

A team of researchers from the University of Georgia recently published a report for the U.S. Department of Health and Human Services (HHS) evaluating the costs of local home visiting programs.

Home visiting provides tailored support, resources and information to expectant parents and families with young children, and this approach has been shown to help support the health and development of children who grow up in low-income and lower resourced households.

Dr. Justin Ingels

“It’s simply someone who is trained to go into the home regularly and visit with the mother and child,” said Justin Ingels, a data analyst and epidemiologist at UGA’s College of Public Health (CPH) and a co-author on the report.

What the visitors do can be different, depending on the program model they are following, but the goal is to best support the mother and child, and therefore the child’s development. This could look like connecting the mother to local lactation consultants, specialized pediatric care, or basic parenting classes. Or it could also look like helping the family get connected to social services that help them access food or legal services.

If the household is healthy and supported, says Ingels, the child has a better shot at developing the skills they need to enter school.

In 2010, the U.S. Congress approved funding for the Maternal, Infant, and Early Childhood Home Visiting (MIECHV) Program. These funds would go to support local, qualified home visiting programs.

The legislation also required an evaluation of the MIECHV program. Faculty and staff within CPH were involved with the conception and design of the evaluation, dubbed the Mother and Infant Home Visiting Program Evaluation (MIHOPE), and Ingels took lead on the cost evaluation.

Ingels and his co-authors evaluated the four evidence-based models that 10 or more states chose in their fiscal year 2010 plans for MIECHV funding: Early Head Start—Home-based option, Healthy Families America, Nurse-Family Partnership, and Parents as Teachers.

They found that local program costs of serving a family in its first year varied widely, from $1,304 to $5,788 per year. The costs were linked to the number of home visits the family received. Overall, home visitor compensation was the largest expense for these programs.

If families required more frequent visits, costs were higher.

“And that’s ok. It’s what it takes to meet their needs,” said Ingels. “You need more of the home visitor’s time, and this person’s time is driving personnel costs. And I don’t think anyone has been able to say before, ‘yes that’s true.’”

He cautions any community or policymaker to draw conclusions regarding home visiting programs based on cost alone. Currently, HHS is conducting a cost-benefit analysis of MIECHV programs, which UGA advocated for.

“We know what was invested into these programs and their outcomes at a level of detail that wasn’t known before. And now there is this large data set that can be used for future evaluation,” said Ingels. “That’s important.”

Co-authors Phaedra Corso, now with Kennesaw State University, and Rebecca Walcott, who is now pursuing a doctorate at the University of Washington, worked with Ingels on this cost evaluation while at UGA.

The full report is available online: https://www.acf.hhs.gov/opre/report/costs-evidence-based-early-childhood-home-visiting-results-mother-and-infant-home

– Lauren Baggett

Posted on July 11, 2022.