For Midori, her home visitor’s advice on breastfeeding her newborn was crucial in deciding to keep nursing him. For Lidia, her stress and fears were allayed by reassurance from her home visitor that her son, born five weeks early, was developing normally. For Helen, who was living without family support in a sober living home when she gave birth, her home visitor provided a much-needed friend.
“She boosted my self-confidence. Honestly, it’s better than going to therapy,” Helen said to laughter as she jiggled Diane, her curly-haired baby daughter, on her lap.
The mothers were relating their experiences with Los Angeles County’s home visiting program at the annual LA Best Babies Network Family Strengthening Summit, co-sponsored by First 5 LA, which funds 45 percent of home visiting through partner agencies.
The daylong summit in Los Angeles was attended by some 580 representatives from 40 stakeholder agencies, including home visitors, nurses, hospital liaisons, staff, supervisors and researchers, as well as First 5 LA staff and executives, to celebrate the power of home visiting, share research and hear directly from parents.
“Home visitors are amazing leaders,” said Kim Belshé, executive director of First 5 LA. “Because of your commitment and inroads, our county is recognized — in California and across the nation — as an innovator in home visiting.”
Home visiting, which is free and voluntary, provides families with a trusted partner who comes regularly to the home to offer information and support about child-rearing, as well as referrals to other programs the family may benefit from, such as charitable services and health insurance. Such visits, delivered to newborns through the Welcome Baby program and to children up to 5 under the Healthy Families America and Parents as Teachers programs, have been proven to strengthen parental capacity, enhance child development and increase child safety.
In 2018, home visiting in Los Angeles County underwent a major expansion when the service became available throughout the county, thanks to funds from the county Department of Public Health. It had previously been offered in just 28 percent of the county, namely in high-needs areas.
Data presented at the summit showed that most families enroll in Welcome Baby after learning about it from hospital staff when giving birth. Hospital enrollment increased from 8,756 in 2014–15 to 13,950 in 2018–19.
Dr. Jonathan E. Sherin, director of the L.A. County Department of Mental Health and a First 5 LA commissioner, lauded the expansion, saying home visits are a key component in identifying and fortifying “social determinants” that improve mental health outcomes, such as relationships and community connections.
Deborah Daro, a senior research fellow at the University of Chicago and a national leader in child abuse prevention and home visiting research, told the summit that L.A. County is considered a national leader in home visiting. “In this country we wait to help families until they fail, then CPS [Child Protective Services] is called in,” she said. “You are real innovators and pioneers.”
Daro said systems need to be created that assess the capacity of all parents, with the goal of providing support and intervention to keep all children safe. Making home visiting available all over the county is the first step toward doing that, she noted.
Home visiting may soon get a statewide boost. Gov. Gavin Newsom has earmarked $133.6 million in the 2019–20 state budget to implement home visiting throughout the state, via multiple sources including Medi-Cal and CalWORKs. “We have a governor who gets it, who understands investing in the earliest moments of childhood possible,” Belshé said.
However, more needs to be done to ensure that home visiting is offered to all expecting mothers, Belshé said. “Far too few families have access to these programs and supports,” she said.
Latino families formed the vast majority of participants — 76 percent — in L.A. County’s home visiting programs. According to data shared at the summit, only 10 percent of participants were black, while white and Asian American families comprised 5 and 4 percent of participants, respectively.
Reasons for low participation by black mothers are unclear, said Diana Careaga, senior program officer at First 5 LA, adding that a work group is currently examining ways to boost enrollment among this group.
The Welcome Baby program could benefit from more widespread promotion, such as referrals from doctors’ offices, said Midori, one of the mothers, noting that she found out about the program while taking a tour of the Dignity Health Northridge Hospital Medical Center when she was due to give birth. “People don’t know about the program,” she said.
Other speakers at the summit included Dr. Shawn Ginwright, a leading expert on black youth development, who spoke about addressing the root causes of trauma in the environment, and Nkem Ndefo, who advised the audience on ways to alleviate stress and avoid burnout.
Home visiting has proven extremely popular. In a client satisfaction survey, Welcome Baby received a rating of 4.9 stars out of 5 and, following the program, clients rated their confidence in their own parenting skills at 4.8 stars out of 5.
Mothers said the home visits benefited their whole families. Lidia said her relationship with her husband improved after he too learned about child growth and development. She added that after her home visitor brought art materials for all three of her children, coloring and drawing became a family activity.
Luz, another mother, said her home visitor also helped with her three older children as she coped with a new baby. Said Luz, “She was like an angel coming into my home. It was priceless.”