Federal Goals, State Realities: What Home Visiting Evidence Reveals About State Variation in Family Outcomes

Session Submission Type: Panel

Abstract

Early childhood home visiting offers a uniquely informative lens on the interplay between federal and state policies: the Maternal, Infant, and Early Childhood Home Visiting (MIECHV) Program is a congressionally authorized national policy and funding mechanism with substantial state discretion in program design, funding mixes, implementation intensity, and scale (Duggan et al., 2018). Additionally, states also have jurisdiction over their own investments in home visiting, adding to the complexity and variation in how home visiting services are delivered to families (National Home Visiting Resource Center Yearbook, 2025). This panel brings together complementary evidence from national and state-level evaluations to examine how variation across states—and across models operating within states—translates into differences in family and child well-being. Panel participants bring diverse perspectives to this discussion as the papers are intentionally sequenced to move from national evidence to state-specific implementation and outcomes. By presenting findings from a national evaluation and two model-specific evaluations, the panel moves beyond asking whether home visiting works to examining how state choices shape observed impacts. These insights are especially salient as states assume greater responsibility for sustaining and strengthening family support systems within a shared federal policy framework.

The first paper presents findings from the Mother and Infant Home Visiting Program Evaluation (MIHOPE), a longitudinal investigation into the effectiveness of the MIECHV Program, which established a national benchmark for understanding patterns of impacts across a large, congressionally authorized funding mechanism for early childhood home visiting programs. In addition, the presentation will showcase the MIECHV Outcomes Dashboard and demonstrate how it translates federal benchmarks into state-level performance trends over time, revealing substantial variation in baseline outcomes and improvement trajectories across states. Presenting this information together on the panel permits an examination of how specific states that participated in MIHOPE have continued their investment and progress on the MIECHV performance measures, and how the MIECHV Outcomes Dashboard can be used alongside rigorous evaluations of home visiting programs. 

The final two papers focus on state-level implementation of two evidence-based home visiting models and highlight a shared mechanism that cuts across models and contexts: sustained family engagement. The second paper presents findings from a state-mandated evaluation of the Parents as Teachers model in South Carolina, leveraging administrative data to examine how variation in dosage and length of engagement is associated with outcomes including chronic absenteeism, kindergarten readiness, and child welfare involvement. The third paper draws on a multi-state randomized evaluation of the Child First model in Colorado, Connecticut, and North Carolina, which serves families facing complex risks and requires intensive, ongoing engagement to achieve impacts. Together, these state-level findings provide important context for interpreting the national patterns observed in MIHOPE, illustrating how differences in implementation and engagement within states may help explain variation in impacts across sites in a congressionally authorized program.

Policy Area

• Family and Child Policy

Chair

• Dana Thomson, RAND Corporation

Discussant

• Erin Bumgarner, MEF Associates

Organizer

• Ximena A Portilla, MDRC

Individual Presentations

• MIHOPE Across the Years: Insights from Evaluating the MIECHV Program - Presenting Author: Ximena A Portilla, MDRC

• Evaluation of South Carolina First Steps Parents as Teachers FY 2020-2024 - Presenting Author: Sarah Crowne, Child Trends, Inc

• Effects of the Child First Home Visiting Program Implemented in Three States - Presenting Author: Kristen Faucetta, MDRC