two women and a smiling baby girl

commentary

(The RAND Blog)

January 8, 2014

Support for Implementing Home Visiting Under the Affordable Care Act

by Teryn Mattox, Sarah B. Hunter, M. Rebecca Kilburn

The Affordable Care Act (ACA) is often described as “unprecedented” for a number of reasons. One such component of the law that hasn't gained a lot of media attention is the ACA's funding for home visiting programs. This groundbreaking provision is the first time in U.S. history that federal funds have been issued explicitly for home visiting.

Home visiting programs match the parents of young children with trained specialists who provide information, social support, parental skill instruction, and more.

Research regarding the vast potential of home visiting is mounting; high-quality, evidence-based programs can have long-lasting positive impacts on child development, school readiness, and child and maternal health. They can also prevent child maltreatment.

Despite the availability of new federal dollars and boosts from state and private-sector funders, some communities and states may struggle to implement home visiting programs, particularly if they must do so from scratch or significantly “scale up” existing programs. Moreover, the ACA funding for home visiting emphasizes choosing evidence-based models and conducting ongoing evaluation—areas in which community providers may lack experience.

Fortunately, a new RAND resource can help: the Getting To Outcomes® for Home Visiting manual.

The GTO-HV manual is a step-by-step guide for stakeholders who are developing home visiting programs for the first time. Communities with existing programs can also use the manual to help guide program planning, implementation, evaluation, continuous quality improvement, and sustainability efforts.

Developed using the Getting To Outcomes® evidence-based framework, the manual includes checklists, worksheets, narrative examples from an imaginary community, and other resources to help states and communities plan, implement, evaluate, improve, and sustain their programs.

While the inclusion of home visiting programs as a key prevention strategy may not be part of typical ACA news coverage, it presents a clear opportunity to greatly improve the lives of parents and children.

Now it's up to state and local stakeholders to proceed using the best available evidence to promote the best possible outcomes for children and families.


Teryn Mattox is a senior project associate, Sarah B. Hunter is a senior behavioral scientist and M. Rebecca Kilburn is a senior economist at the nonprofit, nonpartisan RAND Corporation.

Commentary gives RAND researchers a platform to convey insights based on their professional expertise and often on their peer-reviewed research and analysis.