Home Visiting Programs: Texas
The Texas Health and Human Services Commission (HHSC) received funding through the Maternal, Infant, and Early Childhood Home Visiting Program (MIECHV) to develop the state’s Texas Home Visiting program (THV)—a multi-layer approach to home visiting that includes both provision of evidence-based home visiting services and the development or expansion of community coalitions that build ECCS. THV aims to ensure that Texas children ages zero to five are healthy and prepared for school by promoting a seamless delivery of health and human services in high-need communities.
To achieve these goals, Texas is implementing four evidence-based home visiting programs in 13 communities across the state. The communities include both rural and metropolitan, and several communities that did not have home visiting programs prior to THV.
To best meet their localized needs, each community implements a unique combination of the four home visiting program models: Nurse Family Partnership (NFP), Parents as Teachers (PAT), Home Instruction for Parents of Preschool Youngsters (HIPPY), and Early Head Start-Home Based (EHS-HB). HHSC selected the program models because of the programs’ strong national and state level infrastructures, and because the programs cumulatively serve children ages prenatal through five.
In addition to implementing home visiting programs, each community (click for THV map by county) has developed or expanded an early childhood coalition to identify community-level needs, develop an ECCS that addresses community needs including both service coordination and system-level strategies, and build relationships with key stakeholders to create a foundation for long-term sustainability.
Texas is monitoring improvement among families who participate in home visiting across the six benchmark areas determined by the U.S. Health Resources and Services Administration (HRSA). The benchmarks are intended to serve as guidelines to monitor the implementation processes of the home visiting programs and to evaluate whether the home visiting programs are reaching expected outcomes. The six benchmark areas are:
- Maternal and newborn health;
- Child injury and maltreatment;
- School readiness and achievement;
- Domestic violence;
- Family self-sufficiency; and
- Coordination and referrals for other community resources and supports.
CFRP is conducting an ongoing program implementation evaluation (PIE) study of THV. CFRP completed its evaluation of communities’ engagement of fathers in home visiting services in December 2014, and is currently evaluating the factors related to family retention in home visiting programs and the factors that indicate success in communities’ efforts at systems-level change in separate evaluation studies.
Each of the evaluations provides Texas with greater understanding of how the THV components are associated with better outcomes for families, and will provide valuable information to other states that are interested in implementing a program like THV.
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