Background:

Home visiting programs deliver services in the home to parents and children and aim to alleviate the effects various family risk factors have on child development. Home visiting services share a focus on the importance of children's early years; the vital role parents play in shaping children's lives; and the belief that one of the best ways to reach families with young children is by bringing the services to them, rather than expecting those families to seek assistance in the community. Offering the services in the home eliminates barriers such as transportation and time and provides a more personalized experience by allowing families to interact in a comfortable and natural environment. Current research provides significant evidence of the effectiveness of home visiting programs as an early intervention strategy.

In 2007, with the enactment of Substitute Senate Bill 5830 (SSB 5830), the Legislature directed the funding of evidence-based and research-based voluntary home visiting programs to support parents in development of parenting skills and to improve outcomes for children. Also included in SSB 5830 were legislative findings relating to:

the research into the brain development of young children and the critical nature of child development between the ages of birth to 3;
the difficulties children face in catching-up when their social, emotional, physical, or cognitive development is compromised in their early years;
the significant number of children born into families with two or more risk factors that are linked to failure in school and beyond; and
the longitudinal research demonstrating that parents and children receiving voluntary home visiting services exhibit better birth outcomes; enhanced child development and improved school readiness; reduced frequency and severity of maltreatment; higher rates of school graduation and job retention; and reduced welfare dependence.

Thrive by Five Washington (Thrive) is a nongovernmental private-public partnership created in 2006 to mobilize public and private partners to advance development and learning of children from birth to age 5.

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Summary of Substitute Bill:

The Home Visiting Services Account (Account) is established in the custody of the State Treasurer. Funds in the Account consist of legislative appropriations and all other sources, and will be used for the following purposes:

providing state matching funds for partnership activities to implement home visiting services and the infrastructure necessary to develop, support, and evaluate evidence-based, research-based, and promising home visiting programs; and
administrative expenses.

The Director of the Department of Early Learning (DEL) is authorized to expend funds from the Account, and expenditures for administrative expenses are limited to legislative appropriation. The DEL is directed to contract with Thrive beginning July 1, 2010, to administer programs funded by the Account. The scope of programs and activities eligible for funding through the Account include but are not limited to:

home visiting services that enhance child well-being; alleviate the effects of poverty on child development; reduce incidence of child abuse and neglect; or promote school readiness for young children and their families; and
development and maintenance of infrastructure for home visiting programs, including training, quality improvement, and evaluation.

Thrive must convene an advisory committee to advise the partnership on research and the distribution of funds from the Account. A competitive bid process must be used to disperse funding from the Account. Currently, funded home visiting programs will be funded through the duration of existing contracts. The DEL will monitor performance and provide periodic reports to the Legislature and the Governor regarding the outcomes and utilization of the Account.

Organizations eligible to receive funding from the Account include:

local health departments;
non-profit, neighborhood-based, community, regional, and state wide organizations; and
federally recognized Indian tribes located in the state.

Substitute Bill Compared to Original Bill:

As compared to the original bill, the substitute bill:

clarifies the types of home visiting programs that may be funded through the Account and allows funding of programs that achieve one or more of the goals stated in the original bill;
clarifies that the contract with the private-public nongovernmental partnership will include administration of the program and infrastructure for developing, supporting, and evaluating the programs;
adds a requirement that an advisory committee be convened to advise the partnership on research and distribution of funds from the Account;
adds a requirement that a competitive bid process be used to disperse funding from the Account;
clarifies that existing home visiting programs will be funded through duration of current contracts;
adds a requirement that the DEL monitor performance and provide periodic reports to the Legislature and Governor regarding the utilization and outcomes of the Account;
specifies that health departments, rather than health boards, are eligible to receive funding for eligible programs; and
changes the date by which the DEL will contract with the private-public partnership for administration of the Account from the 2011-2013 biennium to July 1, 2010.

Staff Summary of Public Testimony:

(In support) The benefits of home visiting are well recognized. We have been fortunate in this state that we have been able to invest in home visiting programs. The Council for Children and Families has built a very strong infrastructure for evidence-based home visiting services across the state, and Thrive has helped build part of that infrastructure. The goal of this bill is to replicate a very successful model we use in Washington to provide services to homeless families. Using that model, the combined state and private funding for programs serving homeless families has grown to over $26 million. The goal of this bill is to take the same approach to expanding home visiting services across Washington.

Home visiting is one of the most effective ways to strengthen the early parent-child bond and to support parents and caregivers in enhancing their child’s development and learning. Brain science tells us that the earliest learning takes place in the context of relationships. The foundation of academic learning and social and emotional competence is linked to the primary attachment between the parent or caregiver and his or her baby. Home visiting programs play an invaluable role in strengthening that primary bond by modeling and teaching the parent or caregiver to respond appropriately to his or her child. These programs also teach specific parenting skills, such as the importance of talking and reading to one’s child and how play can be used to strengthen cognitive skills.

There is a strong body of research that supports home visiting as a child abuse and neglect prevention strategy, but there is also a growing body of research that links evidence-based home visiting to school readiness. The Nurse Family Partnership Program, Parents and Teachers, the Parent Child Home Program, and Early Head Start all have demonstrated early learning outcomes, including improved language and cognitive abilities, and positive social, emotional, and self-regulation skills. These programs also increase the likelihood that developmental delays can be identified and resolved early.

Thrive supports the concept of a matching fund that would bring private resources to the table to match public resources for home visiting. Thrive’s Board of Directors supports home visiting and Thrive’s potential role in administering such a fund. We have private investors who have expressed a strong interest in providing private dollars to match the current state resources.

For nearly four years, the Bill & Melinda Gates Foundation (Gates Foundation) has worked with Thrive to support expanded access to high-quality and affordable early learning opportunities for at-risk children, as well as support and education for their families. High-quality home visiting programs are a critical part of an early learning system. Research tells us that home-based early learning can increase kindergarten readiness rates and long term academic success for children, as well as achieve many other long-term benefits. Yet we also know that too few children have access to these services. It is estimated that evidence-based home visiting programs reach only 2 percent of eligible Washington families who would choose to participate. But it is important to recognize that not all home visiting programs are created equal. To be effective, these programs must be designed with clear outcomes and coordinated with other services that prepare children to succeed in kindergarten and beyond.

An early learning matching fund would begin to address the issues of access and assuring quality. By consolidating the administration of home visiting services, Washington can begin to identify gaps in the services provided to at-risk children and build a shared infrastructure with common standards, assessments, and evaluations – paving the way for program expansion aligned to the goals of the statewide early learning plan. Equally important, the fund would pool and maximize the impact of public and private resources. Each sector would bring its unique strengths to create a unified system of home-based early learning for Washington.

Private funding can play the role of catalyst by helping to support the development of a system with infrastructure, standards, accountability metrics, and evaluation and building a home visiting framework that is robust and evidence-based. Public funding is the essential ingredient of support for ongoing service costs needed to ensure that effective programs reach the families most in need, and are brought to scale over time. Private money is short-term, but it can ensure that public resources are best utilized and effective over time. Combining the efforts of the public and private sectors joins their distinctive strengths and can ensure the strongest outcomes for children and families. The Gates Foundation is interested in supporting a matching fund that would be built upon state dollars for home visiting, and that would be administered by a public-private partnership.

Despite the most challenging budget in many years, we have an unprecedented opportunity to strengthen Washington’s commitment to home-based early learning. At the federal level, support for building strong, scalable systems in early learning has never been as strong. There will likely be opportunities for Washington to benefit from these federal opportunities, and we should be working now to prepare to be competitive. The creation of an early learning matching fund is a good step in that direction, and will help to build stronger, more measurable results on behalf of our state’s youngest learners.

The statewide Home Visiting Coalition strongly supports the expansion of evidence-based home visiting services for Washington families. Any transition in how current home visiting programs are being administered should build in appropriate elements to assure continuity of services to families. An advisory committee would also add value to the process of administering the expansion of programs.

(Opposed) None.