New Democrat Update

BUILDING STRONGER FAMILIES

Imagine a way to help the first-time, vulnerable mother so that she and her child have a better chance in life. Imagine a trained, registered nurse as a guide for that young mother. Imagine a strong pre-natal and an ongoing mentoring relationship that builds parenting skills along with goal setting for the mother that leads to completing school and entering the workforce - and delivers an impressive return on investment for policymakers and taxpayers.

You might imagine that this would work in helping to break the cycle of poverty. In reality, there is proof that it does work. There is such a public health program with more than three decades of randomized, controlled trials that show significant results time and time again in the health, social and economic well-being of participating parents and their children. It's called the Nurse-Family Partnership (NFP) and its national headquarters are right here in Colorado.

NFP is an evidence-based, nurse home-visiting program that improves the health, well-being and self-sufficiency of low-income, first-time parents and their children. Today, it has approximately 14,300 of those eligible households enrolled each day in 25 states, including Colorado, and the program serves more than 22,000 first-time families annually. The need, however, is far greater. It's estimated that there are 650,000 eligible first-time mothers each year in the U.S. that would benefit from NFP.

In the 110th Congress, Senator Ken Salazar (D-CO) and Senator Arlen Specter (R-PA) introduced the Healthy Children and Families Act (S 1052), which would provide states with the option to offer evidence-based nurse home-visitation services under their respective Medicaid and State Children’s Health Insurance Programs. The bipartisan support doesn't end there; President Bush included funding for NFP in the administration's Fiscal Year 2008 Budget - the only new program of its type included.

On the presidential campaign trail, Senator Barack Obama speaks often of his desire to expand the program nationwide with additional new federal funding to serve many more eligible mothers. In the House of Representatives, legislation was introduced by Congresswoman Diana DeGette (D-CO), with original co-sponsors from both sides of the aisle including Representatives John Salazar (D-CO), Lois Capps (D-CA), and Timothy Murphy (R-PA). The bill has also received support from Representatives Mark Udall (D-CO), Ed Perlmutter (D-CO) and 12 other bipartisan House Members. The National Governors Association endorses NFP as a model program.

The bipartisan support has been strong at the national, state and local levels for a simple reason - political leaders have seen the proven results from three randomized, controlled trials conducted over three decades that are nothing short of extraordinary, including: 48% reduction in child abuse and neglect; 39% reduction in childhood injuries; 56% reduction in childhood emergency room visits for accidents and poisonings; 79% reduction in pre-term births among women who smoke; 67% reduction in childhood behavioral and intellectual problems; 50% reduction in childhood language delays; and 83% higher labor force participation by mothers by the child's fourth birthday.

NFP nurses and mothers begin their relationship during pregnancy (when the opportunity is greatest for positive behavioral changes) and continue until the child's second birthday. The majority of mothers served are teenagers who are ill-equipped to cope with being a parent without this help. Nurses help the mothers obtain pre-natal care, and learn about nutrition and child health and development. Nurses help these first-time moms develop parenting skills and coping methods, and they assist parents in getting and staying on track to complete their education and obtain employment to support their families.

"Objective studies have shown the Nurse-Family Partnership to be smart health care policy, highly cost-effective for taxpayers with real successes that can be seen in the tens of thousands of mothers and children who have better lives because of it," said Senator Salazar in a congressional news release.

"I am pleased to join Senator Salazar in his commitment to children's health," Senator Specter said in the joint news release. "The Nurse-Family Partnership empowers first-time mothers with the resources and knowledge to provide an environment in which children can reach their full potential."

Many outside of Congress agree. Not only is NFP a rare evidence-based program, it also delivers a strong return on investment.

RAND Corporation Senior Economist Lynn Karoly calls NFP "a wise choice" that generates favorable economic returns to communities of $5.70 for every public dollar spent on the program. The Washington State Institute for Public Policy ranked NFP highest among pre-kindergarten, child welfare, youth development, mentoring, youth substance abuse prevention and teen pregnancy prevention programs. Rob Grunwald, an associate economist at the Federal Reserve Bank of Minneapolis, calls NFP "a sound [community] investment that will yield public and private gains in both the long and short run." And based on the strong evidence of effectiveness, the Brookings Institution recommends a federal investment of $12.5 billion in NFP over five years to serve all eligible low-income mothers.

In the private sector, some of the most respected and well-known foundations are generously supporting NFP, including the Robert Wood Johnson Foundation, The Edna McConnell Clark Foundation, Bill and Melinda Gates Foundation, W.K. Kellogg Foundation, The Picower Foundation and The Kresge Foundation. This private support enables the non-profit Nurse-Family Partnership National Service Office in Denver to work with community agencies implementing the NFP program to ensure local fidelity to the proven model so that comparable results are achieved.

"I have long been a supporter of the Nurse-Family Partnership program because it is one of the most effective programs out there and has been proven to dramatically improve the lives of children," said Congresswoman DeGette (D-CO). "In Colorado, we are fortunate to have many NFP sites and have witnessed the profound public health and social impacts."

NFP’s Chairman of the Board Bob Hill was instrumental in working with Colorado state legislators to make NFP a statewide initiative, one of a handful of such initiatives in the country, and to raise the organization's profile among federal policymakers who will be instrumental in the growth of NFP. Hill's advocacy work with NFP CEO Tom Jenkins and staff is focused on ensuring public investment in NFP in Colorado and across the country is not only protected, but grows to meet the increasing demand in communities nationwide for NFP.

But to grow this evidence-based program that is helping to transform the lives of mothers and their children, a substantial increase in public funding is essential. Policymakers have a historic opportunity to fund a proven approach to improving outcomes for these vulnerable families, while creating long-lasting social and economic returns for communities.

"The success of the Nurse-Family Partnership is undeniable," said Salazar. "This program should be expanded to every community in this country, not just a select few."

With strong bipartisan political leadership in both houses and growing support across the country, the Nurse-Family Partnership is just beginning.