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Home > Advocacy > CWLA Testimony and Comments > CWLA Testimony on Home Visitation


Home Visitation

CWLA Testimony to the House Committee on Education and Labor for the Hearing on The Education Begins at Home Act (H.R. 2343)

June 11, 2008

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Chairman Miller, Representative McKeon and members of the Committee, the Child Welfare League of America submits this statement in support of HR. 2343, the Education Begins At Home Act. We thank the original sponsors of this legislation, Representatives Danny Davis and Todd Platts and all the bipartisan cosponsors who have joined them.

CWLA represents hundreds of state and local direct service organizations including both public and private, and faith-based agencies. Our members provide a range of child welfare services from prevention to placement services including adoptions, foster care, kinship placements, and services provided in a residential setting. CWLA's vision is that every child will grow up in a safe, loving, and stable family and that we will lead the nation in building public will to realize this vision.

As we have stated in other Congressional settings, CWLA believes the best way to ensure children are safe from all forms of maltreatment is to provide comprehensive, community-based approaches to protecting children and supporting and strengthening families. Public and private agencies, in collaboration with individual citizens and community entities, can prevent and remedy child maltreatment, achieve child safety, and promote child and family well being. There is no solution to addressing child abuse in our society short of a comprehensive approach that begins with preventive efforts and assures that we have a safe and permanent place for children who are the victims of abuse and neglect.

Home Visiting Models

Home visitation programs refer to different model programs that provide in-home visits to targeted vulnerable or new families. Home visitation programs-either stand-alone programs or center-based programs-serve at least 400,000 children annually between the ages of 0 and 5 but there is a need for us to do much more. The eligible families in these home visitation programs may receive services as early as the prenatal stage. Because a child's early years are the most critical for optimal development and provide the foundation necessary for success in school and life, home visiting can make a lifetime of difference. Nurses and other trained members of the community conduct home visits on a weekly, bimonthly, or monthly basis. Program goals include an increase in positive parenting practices, improvement in the health of the entire family, increase in the family's ability to be self-sufficient, and enhanced school readiness for the children.


Although we speak in support of HR 2343 because we feel home visitation can provide an important component in a continuum of care that we need in the child welfare field, we also know that these programs can assist in improving education and health outcomes for children. Home visitation can show improved outcomes in the areas of prenatal care, access to health care and improved rates of immunizations.

Whenever we engage in discussions in regard to our nation's child welfare system one of the first great challenges and debates is over how we can prevent abuse and neglect from taking place. All of us would prefer a system that can help a family before they ever become part of the more than 3.3 million reports of abuse and neglect filed annually and certainly before they become one of the more than 900,000 children who are substantiated as neglected and or abused each year. Research has shown that home visitation programs reduce abuse and neglect and juvenile delinquency, and ultimately save taxpayers over $50 billion annually.

We recognize the value both in human and economic terms, and the great benefits to our nation and to vulnerable families and children by enacting policies that prevent the need for ever placing a child in foster care. There is no simple model for prevention of child abuse and in fact we believe that a commitment to preventing child abuse will involve multiple efforts and strategies. Greater investment and support for home visitation is a critical part of such a strategy.
Currently home visitation programs rely on a range of federal, state and local funds. Unfortunately these funding sources can be unreliable, even for programs that are demonstrating effectiveness in a range of areas. In recent years states have utilized funding sources such as and including the Social Services Block Grant (SSBG), Title IV-B part 1, Child Welfare Services, Title IV-B part 2, Promoting Safe and Stable Families (PSSF), the Child Abuse Prevent and Treatment Act (CAPTA) state grants and Community-Based Family Resource and support grants. All of these funding sources are used to fund a range of other services, and all have been subject to reductions or proposed reductions in each of the last five budgets. This highlights the need for specific funding for home visiting programs to strengthen and stabilize the funding.

All families benefit from information, guidance, and help in connecting with resources as they meet the challenges of parenthood and family life. For families with limited resources, or those that face additional challenges, the need for support and assistance is even greater.

Families are central to child safety and well-being. Children develop the ability to lead productive, satisfying and independent lives in the context of their families. Family ties especially those between parent and child are extremely important in the development of a child's identity. Through interaction with parents and other significant family members, children learn and come to subscribe to their most cherished personal and cultural values and beliefs. They learn right from wrong, and gain competence and confidence. Family relationships must be nurtured and maintained to meet the needs of children for continuity and stability, which support healthy development.

Evidence shows that children who experience maltreatment are at greater risk for adverse health effects and risky health behaviors when they reach adulthood. Many parents involved in the child welfare system do not intentionally harm their children; rather their lack of knowledge, skills, or resources has led them to harm their children. 4

Quality early childhood home visitation programs lead to several positive outcomes for children and families, including a reduction in child maltreatment. Annual data indicates that 40% of the more than 900,000 children who are substantiated as abused and neglected, but not removed from the home, never receive follow-up services. 5 There can be a number of reasons for these consistent statistics from year to year but one clear reason is that in some states follow-up services may not come until after a family has been placed on a wait list for services. More widely available and implemented home visitation could help address this drastic shortcoming. More serious is the fact that of the estimated 1,460 child deaths in 2005, 76.6% were younger than age 4. Another 13.4% were between the ages of 4 and 7. 6 Of the perpetrators of child maltreatment, 76.6% were parents. 7

Evidence For Home Visitation Models

Home visitation services stabilize at-risk families by significantly affecting factors directly linked to future abuse and neglect. Research shows that families who receive at least 15 home visits have less perceived stress and maternal depression, while also expressing higher levels of paternal competence. 8 Home visitation programs may also reduce the disproportionality or overrepresentation of children and families of color in the child welfare system, while improving outcomes for these families. Research shows that participating children have improved rates of early literacy, language development, problem-solving, and social awareness. These children also demonstrate higher rates of school attendance and scores on achievement and standardized tests. 9 Studies show that families who receive home visiting are more likely to have health insurance, seek prenatal and wellness care, and have their children immunized. 10

A study of the Missouri-based Parents As Teachers home visiting program examined the children enrolled in the program and found that by age 3, they were significantly more advanced in language, problem-solving, and intellectual and social abilities than children in comparable groups. 11 A study of the Nurse-Family Partnership showed a 79% reduction in child maltreatment among at-risk families compared to other families in a control group. That same study also indicated a number of other benefits in the areas of health, employment, and behavior. 12 Healthy Families America exists in more than 450 communities; Home Instruction for Parents of Preschool Youngsters is in 167 sites in 26 states; the Parent-Child Home Program has 137 sites nationally and 10 sites internationally; Early Head Start serves more than 62,000 children in 7,000 sites; and Parents as Teachers is located in all 50 states and serves more than 400,000 children. 13


Under the legislation, each governor would designate a lead state agency to oversee and implement the state program. The states can use their grants to supplement-but not replace-current state funding. The legislation does not dictate which, or how many, home visiting models may be used. If a state currently lacks a home visitation program, the funds can be used to develop a program. A state's grant funding award would be based on the number of children age 5 and younger living in the state. Applying states would submit a plan outlining their efforts to collaborate and coordinate among existing and new programs.

CWLA commends the Committee for its hearing today on home visiting-highlighting its successful outcomes for children and their families. Such successful outcomes of home visiting contributing to familial continuity, educational enrichment, as well as physical and mental health will be expanded by increased federal support. CWLA hopes that this hearing today is merely the next step building on the hearing from the last Congress and that the next steps taken by Congress will be to further home visitation initiatives nationally by passage of the legislation before you. This commitment will make the benefits of in-home visiting services accessible to many more families and improve outcomes for many more children.


  1. Chapin Hall Center for Children at the University of Chicago. (2006). Challenges to building and sustaining effective home visitation programs: Lessons learned from states. Available online. Chicago: Author. back
  2. Daro, D., Howard, E., Tobin, J., & Hardin, A. (2005). Welcome home and early start: An assessment of program quality and outcomes. Available online. Chicago: Chapin Hall Center for Children at the University of Chicago. back
  3. Fight Crime: Invest in Kids. (2003). New hope for preventing child abuse and neglect: Proven solution to save lives and to prevent future crime. Washington, DC: Author. back
  4. Child Welfare League of America. (2005). Research Roundup: Parenting. Washington, DC: Author. back
  5. Administration on Children Youth and Families. (2008). Child maltreatment 2006. Washington, DC:, US Government Printing Office. back
  6. Administration on Children Youth and Families. (2008). Child maltreatment 2006. Washington, DC: U.S. Government Printing Office. back
  7. Ibid. back
  8. Daro, D., Howard, E., Tobin, J., & Hardin, A. (2005). Welcome home and early start: an assessment of program quality and outcomes. Available online. Chicago, IL: Chapin Hall Center for Children at the University of Chicago. back
  9. Administration for Children and Families. (2003). Research to practice: Early Head Start home-based services. Washington, DC: Author. back
  10. Berkenes, J.P. (2001). HOPES healthy families Iowa FY 2001 services report. Great Falls, VA: Klagholz & Associates. back
  11. Pfannenstiel, J., & Setlzer, D. (1985). Evaluation report: New parents as teachers project. Overland Park, KS: Research and Training Associates. back
  12. Nurse-Family Partnership. (2005) Factsheet. Available online. Denver, CO: Author. back
  13. Prevent Child Abuse America. (2006). Early Childhood Home Visiting Programs. Chicago, IL: Author. back

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