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:

  1. Maternal and newborn health;
  2. Child injury and maltreatment;
  3. School readiness and achievement;
  4. Domestic violence;
  5. Family self-sufficiency; and
  6. 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.


Related Publications and Posts

Title Type Date
Family Retention in Home Visiting Powerpoint 2015 October
The Top 5 Benefits of Home Visiting Programs (English) Post 2015 June
The Top 5 Benefits of Home Visiting Programs (Spanish) Post 2015 June
Pre-K is Good for Kids and For Texas: Short-term Savings from Pre-K Estimated at Nearly $142 Million Annually Brief 2015 April
What Should be Expected When Taking Home Visiting Programs to Scale? Brief 2015 April
From Randomized Controlled Trials to Community-Level Change: What Should Be Expected When Taking Home Visiting Programs to Scale? Working Paper 2015 April
Reality Check: Can the Effects of Home Visiting Programs Found in RCTs Be Replicated in the Real World? Working Paper 2015 April
5 things you should know about Home Visiting in Texas: A Two-Generation Approach to Supporting Families Post 2014 December
Two-Generation Approaches to Breaking the Cycle of Poverty News Post 2014 November
Special Event: Toxic Stress and Early Childhood Event 2014 November
Home Visiting Programs in Texas: Working Toward Being a Better State for Children News Post 2014 July
Increasing Father Participation in Home Visiting: Lessons from Mothers Brief 2014 May
"Expectations of Outcomes" from Variation in Service Delivery and Family Outcomes across the Texas Home Visiting Program Report Excerpt 2014 March
Early Lessons Learned from Building Local Early Childhood Comprehensive Systems in Texas (Journal of Applied Research on Children) Publication  Volume 5 Issue 1 (2014)
Perspective from Texas: Investing in Home Visiting Programs Not Prisons News Post 2013 October
Implementation Not Evidence-Base is the Key to Home Visiting Program Success News Post 2013 October
"Lessons Learned" from Observations and Early Findings from the Evaluation of the First Year of the Texas Home Visiting Program Report Excerpt 2013 September
Maternal Depression and Home Visiting Programs News Post 2013 July
Early Childhood Education is Linked to Greater Success in School News Post 2013 May
How to Involve Fathers in Home Visiting Programs News Post 2013 May

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