Home visiting programs grow in popularity, show promise for families

Sep. 12, 2013 @ 04:03 PM

Pam Dardess was thrilled when someone approached her at the hospital to schedule a nurse home visit after the birth of her second child, Maya, in 2011. “I feel like it’s another safety net to have someone looking out for her … because I was really concerned that at 36 weeks (gestation) she might have some issues, and things we wouldn’t even necessarily know to look for.”

Dardess was happy to sign up, but she was also a little surprised. It is not every family that has an opportunity for a no-cost nurse visit after having a baby, but that may be changing. Home visiting programs have been popular in other parts of the world for centuries, but have not played a prominent role in American public health until recently. Home visiting programs got a big boost when the Maternal, Infant, and Early Childhood Home Visiting (MIECHV) Program was authorized after the passage of the Affordable Care Act (ACA) in 2010. An exhaustive study of home visiting programs around the world showed that they improve a variety of family well-being measures such as better child and maternal health, positive parenting skills, increased connections to community resources, greater school readiness, increased self-sufficiency and reduced child abuse. With that, MIECHV selected 13 programs approved to be replicated around the country through 1.5 billion in grants over five years. 
Durham is lucky to have two voluntary programs in varying length and eligibility. They are Healthy Families Durham and Early Head Start - Home Based. Healthy Families visits families from ages 0-3 with parenting pressures (such as teen pregnancy, single parents or domestic violence). Early Head Start can visit families in the same age range and must meet Federal eligibility requirements such as having low-income.

Unlike Durham Connects, which is universal and is available to everyone regardless of income or circumstance, the other programs typically require families to have special needs or challenges. This creates a nice link between Durham Connects, which offers a short-term home visit for all parents to other more intensive home visiting programs for parents who need or want extra parenting support. In fact, Durham Connects makes the most referrals to Healthy Families and Early Head Start - Home Based. Durham Connects is a newer private nonprofit program that does not receive federal MIECHV funds. 

While federal and state support for home visiting programs has increased overall, some Durham programs are being hurt by “sequestration,” mandatory federal budget cuts. Early Head Start - Home Based has received cuts, laid off one employee and eliminated one position through attrition, and cut spaces for 20 families. Despite the limits, Early Head Start has rolling enrollment and is still taking applications for its home visiting program, which currently has a short waiting list.
For parents like Pam Dardess, the assistance by Durham Connects was welcome.  “I knew that I was at heightened risk for post partum depression this time, having had postpartum depression with my first daughter. So I think it was really helpful to have (the nurse) come in and give me the postpartum depression screener … because there is a lot of time between the time you leave the hospital and your postpartum visit.”
Dardess said she didn’t have the same depression issues after Maya was born, but it was because she was educated and aware about what to look for, and her home visiting nurse was part of that support system.
Overall, research shows that high-quality home visiting programs like Durham Connects and MIECHV-funded programs support families to become stronger and more self-sufficient members of a community.


Durham Connects – Available to all parents of newborns who live in Durham County. Provide a nurse-home visit free of charge.  For more information, visit www.durhamconnects.org
Healthy Families – Available to pregnancy through age 3 by referral and have documented needs.  Especially helpful to teen and single mothers and those with financial struggles or family violence. For more information visit www.ccfhnc.org
Early Head Start – Available for parents and children ages 0-3. Must meet low-income requirements. Professional or self referral.  Contact Elisabeth Hargrove at: 919-419-3474 x313 or visit www.ccfhnc.org
Family Support Program – A program of the Exchange Club Family Center.  Available by professional or self-referral. www.exchangefamilycenter.org