On Wednesday, March 4, Parents as Teachers (PATs) held a briefing, “The Role Home Visiting Plays in Reducing,” to discuss the power and impact of home visiting during a time when the United States is dealing with a maternal health crisis.
Senator Bob Menendez (D-NJ) provided opening remarks stating that “home visiting is the best investment in families to get them on the right start.” He discussed how he fought tirelessly in 2008 during the health debate for home visiting, which can prevent child abuse and neglect and encourages positive parenting. “Home visiting delivers results for families, specifically those at risk and struggling with substance abuse, and can prevent entry into foster care,” stated Senator Menendez.
Panelists of experts included Aaliyah Samuel, board member of Parents as Teachers in Florida, Aminah Williams, Parents as Teachers home visitor in St. Louis, Missouri, Dr. Cynthia Minkovitz, representing the American Academy of Pediatrics, and Janet Horras from Iowa Department of Public Health.
Samuel opened up the briefing sharing her personal experience as a mother that experienced bias from first responders when she was 22 weeks pregnant with her first son, Caleb who died two days after birth because “the EMTs were more concerned with their plans after work then asking me how I was doing.” Samuels stated that as a school administrator in Arizona, she felt powerless, and the trauma she experienced is the reason why she became an advocate to educate policymakers about maternal mortality and promote implicit bias training for health professionals. Samuels and Williams, both African-American women, shared how the assumption of being a single mother and poor often dictates the service you receive. Williams, a Parents As Teachers recipient whose children are now adults, discussed why women need support as they navigate parenting.
Williams shared that her typical caseload consists of pregnant and parenting single, young, African-American women, who are often low-income and dealing with trauma such as intimate partner violence; however, they all want what is best for their children. PATs program is tailored to each family or parent, and families trust the home visitors over professionals because they feel heard and supported. Home visitors have regular contact with parents before birth, after, and during the postpartum period, which is essential to the parent and child because the focus is on healthy baby development as well as on the parent.
Created under the Affordable Care Act (ACA, PL 111-148), the Maternal, Infant, and Early Childhood Home Visiting (MIECHV) program provides funding to all states to promote the use and expansion of home visitation programs. The House has passed legislation that would double federal funding for MIECHV from $400 million per year to $800 million per year by 2022 and increase tribal set-aside funding from 3-6%. MIECHV provides families with social supports and addresses parental supports and parenting, as well as reduces child protection intervention. MIECHV is a two-generational approach that addresses family needs and serves only about 150,000 of the 18 million parents and expectant parents eligible for services.
In Iowa, the availability and quality of health professionals is a growing problem because of the inability to recruit professionals, specifically in areas that are not “metro” and for a diverse demographic population. Horras spoke about how family physicians provide prenatal care and that more babies are born in the emergency room. In Iowa, where Senator Chuck Grassley (R-IA) has championed home visiting models, the Department of Public Health has supported many initiatives that have provided access and information for parents to services and supports. Count the Kicks is a free app that teaches pregnant women how to advocate for their needs and their babies and record the baby’s kicks.
Dr. Minkovitz stated that “we know that home visiting works.” The focus on prevention and the continuum of care for families is vital for addressing the social determinants of health. Everyone recommends that MIECHV should be expanded and that we have a long way to go, stated Dr. Minkovitz in preventing adverse health outcomes, such as maternal mortality or morbidity.
