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Statewide summit, research study point to need for more home visiting programs in North Carolina

Nearly 99 percent of North Carolina’s children do not receive services from home visiting (HV) programs, a new study from the Jordan Institute for Families (University of North Carolina at Chapel Hill School of Social Work) reveals. 
More than 300 child development professionals across the state are working to change that. This month, they’ll meet in Greensboro (Oct. 22–23) for the 2018 North Carolina Home Visiting Summit, hosted by Smart Start, the Jordan Institute for Families and North Carolina Public Health. They’ll examine the results of the study and explore ways to increase the number of families served by HV programs.
Home visiting programs provide one or more home visits by health and child development professionals (often nurses) to families with children between birth and age 6. Although home visits are appropriate for all families, they are most often provided to families who are low wealth, have teen parents, have a history of child abuse or neglect or have children with special needs.
“Early home visiting programs provide a critical lifeline to families during a critical time of child development,” explained Paul Lanier, an associate professor at UNC School of Social Work. “This supportive relationship can make all the difference in whether parents and their children have what they need to be healthy and ready to learn.
“Unfortunately, right now, there is a huge unmet need in our state for these services.”
In North Carolina, only Durham, Forsyth and Guilford counties offer at least one home visit to all families. Statewide, only 6,379 children received home visits in 2016. There are about 573,000 children ages birth–6 in North Carolina, so only one percent of the state’s children received one or more home visits.
The data comes from the NC Landscape Study of Early Home Visiting Programs, a first-of-its-kind study in North Carolina. ChildTrust Foundation, The Duke Endowment, the John Rex Endowment and the Winer Family Foundation collaborated to fund the UNC study.
The statewide research revealed that 70 percent of home visits in North Carolina were provided by private, nonprofit organization. Of the programs surveyed, nearly 72 percent reported having a waitlist for home visits.
Most HV programs in North Carolina are based on one of several nationally-available programs, including Parents as Teachers, Early Head Start (Home-Based), ChildFirst, Family Connects and the Adolescent Parenting Program. Although the programs vary in content, all include coaching for parents on how to respond appropriately to the child’s physical, emotional and behavioral needs.
In addition, some programs offer clinical screening for child health and development and for maternal depression, putting parents in contact with community agencies that can help address specialized needs. Others offer socialization activities for children and peer support for parents.
The cost of delivering a HV program is about $2,200 per family, depending on the program content. In North Carolina, funding for HV programs comes from a variety of sources, including state funding (42 percent), federal funding (32 percent), local funding (5 percent) and other sources (21 percent).
“As funders, we have seen firsthand the need for an established early childhood system in our state where families would find a range of early childhood interventions to meet the challenges faced in these critical years,” said Liz Winer, head of the Winer Family Foundation, on behalf of the four funding partners of the study.
“Home visiting can play a significant role in that system, and we believe this landscape analysis will serve as a launching point for a larger, coordinated investment in home visiting by public and private funders, policy makers and advocates as part of building a comprehensive system of care and support,” Winer added. “We can and must do better to meet the needs of North Carolina’s children and families.”
Katherine Bryant with the UNC Center for Maternal and Infant Health and Paul Lanier, Sarah Verbiest and Gerard Chung with the UNC School of Social Work conducted the North Carolina study. They used data from program reports, a statewide survey and individual interviews with program leaders to develop a comprehensive overview of North Carolina’s potential to offer HV programs on a broader scale. Representatives from the funders and from Chapin Hall, Child Trends, National Home Visiting Consortium, North Carolina Division of Public Health and Prevent Child Abuse America served as the advisory board for the study.
Lanier and his colleagues hope that the study will serve as a wake-up call for North Carolina policymakers.
“We need a statewide strategy to make sure that services are available across the state to all families,” Lanier said. “Local communities are in the best position to determine which programs should be delivered and how to connect families.
“But a family’s ZIP code should not determine whether they have basic access to something we know is good for individual and public health.”
HV leaders believe that the North Carolina Home Visiting Summit is a step in the right direction. During the two-day summit, HV service providers will participate in educational sessions that include “Setting and Reaching Family Goals,” “The Intersection of Culture and Interpersonal Violence,” “Understanding Child Behavior,” “Father Engagement” and other topics. They’ll also learn more about the NC Landmark Study of Early Home Visiting Programs and see how their own programs could fit into a statewide approach. 
The NC Landmark Study of Early Home Visiting Programs full report, executive summary and link to interactive maps with county data is available here:

Maternal and Child Home Visiting

Information on the 2018 North Carolina Home Visiting Summit is available here: