Home Visiting: A Lifeline During the Coronavirus Pandemic

A mother comforts her 2-month-old daughter in Medford, Massachusetts, on March 27, 2020.

During a White House briefing on Sunday, April 5, President Donald Trump told Americans to brace themselves for a peak in COVID-19 cases. As the novel coronavirus continues to spread across the country, a different type of public health concern is also gaining momentum: a mental health crisis fueled by uncertainty and fear over the disease’s spread, record-breaking unemployment, and intense loneliness brought on by physical distancing. As Child Trends points out in a recent blog post, research shows that, during times of crisis, there are increases in substance abuse, child abuse, and intimate partner violence—all of which have profound impacts on children’s development. Unlike with the novel coronavirus, which does not appear to target children as severely as adults, kids may be especially susceptible to this second public health threat.

All families, especially during challenging periods, need emotional and social support as well as advice on how to navigate parenthood. To support families through these challenges, communities across the country have invested in voluntary maternal and early childhood home visiting. These programs are a lifeline for many children and families—especially during crisis—because they connect them to skilled professionals such as nurses and social workers. These professionals develop trusting relationships that allow them to provide education and support services, including referrals to mental health services and nutrition assistance, before birth and throughout children’s earliest years. Moreover, home visitors have a vital role to play in helping families navigate disasters by promoting family preparedness and engaging in their communities’ disaster planning. Although home visits are traditionally conducted face to face in families’ homes or other locations that feel safe and comfortable for parents, some service providers also implement remote services, including virtual home visits.

What does home visiting need now?

Recognizing the critical role home visiting can play in mitigating the devastating impacts of the pandemic and its aftermath on families, the U.S. House of Representative’s Take Responsibility for Workers and Families Act began to answer this need by relaxing federal rules to allow MIECHV-funded programs to continue safely serving families and help meet families’ needs for connectivity and emergency supplies. Unfortunately, none of these provisions were ultimately included in the final version signed into law as the Coronavirus Aid, Relief, and Economic Security (CARES) Act. As lawmakers continue to develop legislation to address the pandemic, future action must include increased funding and flexibility for the MIECHV program. Congress should implement the following short-term recommendations developed by advocates, including the Home Visiting Coalition:

  • Prioritize a one-time $100 million appropriation for the MIECHV program.Home visitors need funds for training to deliver virtual services that enable home visiting from a distance. These funds can also be used to secure technology for families, including data plans or devices, that can be used for visits. They can also be used to secure and safely deliver household necessities such as formula, diapers, and other supplies to maintain basic hygiene and health.
  • Allow virtual visits to be considered home visits. To safely preserve the critical relationships at the core of home visiting, Congress should allow virtual home visits to serve families while maintaining physical-distancing requirements. Doing so will allow programs to continue their important work and not penalize them for choosing families’ health and safety over funding that is currently tied to in-person visits.
  • Preserve the existing home visiting infrastructure and maintain all staffing levels and funding for MIECHV programs. Due to temporary reductions in enrollment caused by the COVID-19 pandemic and physical-distancing recommendations, programs may be forced to cut staff and disinvest from other parts of home visiting infrastructure such as family outreach and training. Without a reliable, consistent funding source, experienced home visiting staff will find themselves with little choice but to look for work elsewhere.

Although there is an immediate need to secure the flexible funding necessary for serving families through virtual visits now, families will continue to need longer-term support from home visiting well after the pandemic’s peak has passed and physical-distancing requirements are relaxed. Despite broad bipartisan appeal, the MIECHV program has received flat funding for the past seven years, which means the United States only serves 3 percent of eligible families that could benefit from the program. To preserve services to families, states cut training and other important activities. The MIECHV system has matured, and the time is ripe for expansion both in terms of system capacity and the need for services. To this end, Congress should double MIECHV funding by 2022 and double the funding set aside to tribal programs, a provision included in the Elijah E. Cummings Lower Drugs Costs Now Act.

Conclusion

As the current coronavirus wave spreads across the country, it appears that children may largely be spared from its most devastating physical health impacts. However, without proper support to their families, children will undoubtedly experience the emotional distress and trauma of the pandemic’s social and economic aftermath. This wave will overwhelm children and families unless Congress acts quickly to support families throughout and beyond the crisis. Increasing funding for home visiting in the short and longer term is a crucial step Congress must take now.

Cristina Novoa is a senior policy analyst for Early Childhood Policy at the Center for American Progress.

The author would like to thank Catriona Macdonald, executive director of the Association of State and Tribal Home Visiting Initiatives, and CAP’s Executive, Health, and Art and Editorial teams for their contributions to this column.

To find the latest CAP resources on the coronavirus, visit our coronavirus resource page.