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F I S C A L I M P A C T R E P O R T

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ORIGINAL DATE

LAST UPDATED

1/18/08

HB 157

SHORT TITLE Statewide Home Visitation Program

SB

ANALYST Lucero

APPROPRIATION (dollars in thousands)

Appropriation

Recurring

or Non-Rec

Fund

Affected

FY08

FY09

$1,000.0

Recurring

General Fund

(Parenthesis ( ) Indicate Expenditure Decreases)

Relates to Appropriation in the General Appropriation Act: The LFC recommendation includes

a $1 million increase to expand home visitation services. The HAFC recommendation for HB2

includes the $1 million increase.

SOURCES OF INFORMATION

LFC Files

Responses Received From

Department of Health (DOH)

Children, Youth and Families Department (CYFD)

SUMMARY

Synopsis of Bill

House Bill 157 appropriates one million ($1,000,000) from the General Fund to Children, Youth

and Families for expenditure in fiscal year 2009 and subsequent fiscal years to fund a statewide

home visiting program.

FISCAL IMPLICATIONS

The appropriation of one million ($1,000,000) contained in this bill is a recurring expense to the

general fund. Any unexpended or unencumbered balance remaining at the end of a fiscal year

shall NOT revert to the general fund.

This bill would add to the existing funds received by CYFD and managed by ValueOptions New

Mexico.

This appropriation is not included in the executive recommendation.

House Bill 157 – Page

2

SIGNIFICANT ISSUES

This bill would expand statewide home visiting services and provide existing programs the

ability to serve additional new first time parents. Home visiting services help identify possible

developmental delays and ameliorate further developmental problems, identify maternal post

partum depression, provide developmental guidance to the parents so that they know what to

expect from the infant and or toddler in terms of development. Home visitors provide referrals

to community resources, assist the parent/caregiver in accessing or building formal and informal

networks that the parent/caregiver may or may not have. In addition, home visiting provides

information on nutrition, breast-feeding, and the consequences of prenatal drug use to the infant

and mother. Finally, home visiting provides supports to enhance the child-parent relationship in

order to create environments that positively impact the child’s social and emotional development

and prepare the child for a productive life.

The Home visiting program is targeted toward first time parents and provides services to prenatal

mothers and continuing through the third year of the child’s life. Funding appropriated in FY07

for home visiting services was $979.6. As of the first half of FY08, the nine current home

visiting programs conducted 6,222 visits.

Home visiting is a preventive strategy used to offer parents and families better pregnancy and

birth outcomes, increased time between pregnancies, improved child health and safety, parenting

skills, and improved economic well-being. Children receiving home visiting show improvements

in academic skills, are more likely to complete high school, less likely to abuse drugs, more

likely to be employed and less likely to be involved in the criminal justice system.

Mothers face a variety of obstacles including being teens, having less than a high school

education, being single, living at or below the poverty level, and health disparities. The latter

include, access to and use of prenatal care, smoking, alcohol and drug abuse, being overweight,

and family stressors such as homelessness or jail time. These disparities often disproportionately

affect racial and ethnic minorities. A statewide home visiting initiative would be able to address

these issues.

Access to voluntary home visiting is a priority of the Lieutenant Governor’s Early Childhood

Action Network (ECAN), a statewide, multi-agency, multidisciplinary working group that is

aimed at assuring that all newborns and their families are connected with essential services at the

local level. Home visiting is a prevention strategy used by states and communities to improve

the health and well being of infants and their families and to maximize each child’s potential and

readiness to succeed in life.

In New Mexico, home visiting services are fragmented, provided by several agencies and funded

through various mechanisms. HB168s proposes appropriating funds to develop a comprehensive,

long-range plan for a statewide system of universal voluntary home visiting. A coordinated plan

could help to assure that all home visiting programs or providers work together so that the

families of New Mexico receive services seamlessly.

In New Mexico, an estimated 10-11% of

all mothers received at least one home visit from 1997 to 2000, and an estimated 25% of first-

time or teen mothers receive at least one home visit

(

www.health.state.nm.us/phd/prams/home.html

). New Mexico has a wide range of home

visiting models that target needs, outcomes, and intensity of services. Some models provide

comprehensive services, while others are targeted with limited interventions.

House Bill 157 – Page

3

Research has shown that new families who receive intensive home visits starting during

pregnancy and continuing to age 3, have improved short-term outcomes including better

pregnancy and birth outcomes, increased pregnancy intervals, improved child health and safety,

reduction of emergency room use and improved preschool readiness. Parents in families

receiving home visiting have better parenting skills, improved economic well-being, and

enhanced maternal life courses. Children receiving home visiting show improvements in

academic skills, are more likely to complete high school, less likely to abuse drugs, more likely

to be employed and less likely to be involved with the criminal justice system. Investment in

evidence-based home visiting programs has demonstrated significant returns on investment

returning

from

$6,000

to

$17,200

per

youth

(

http://www.nursefamilypartnership.org;http://www.rand.org/

pubs/research_briefs/RB9145/index1.html)

In Washington State, Nurse Family Partnership

Home Visiting programs resulted in savings of $2.88 for every $1 invested. In New Mexico, an

estimated 10-11% of all mothers received at least one home visit in the years 1997-2000 and an

estimated 25% of first time or teen mothers receive at least one home visit

(

www.health.state.nm.us/phd/prams/home.html

).

PERFORMANCE IMPLICATIONS

HB168 is related to the Governor’s Performance and Accountability Contract, Goal 2: Improve

Health Outcomes and Family Support for New Mexicans; Task 2.5, Improve health, develop-

mental, and educational outcomes of newborns.

CYFD maintains several output and outcome measures related to home visiting focusing on the

number of visits, the early identification of possible developmental delays, and enhancing

positive parent/child interactions.

ADMINISTRATIVE IMPLICATIONS

CYFD states that adding new sites may require additional resources to manage the monitoring

and evaluation components of the program. The current web-based data collection system may

need to be upgraded in order to accommodate the additional data and analysis that would result

from program expansion.

CONFLICT, DUPLICATION, COMPANIONSHIP, RELATIONSHIP

Relates to the General Appropriation Act (GAA). HAFC has recommended a recurring $1

million increase for the home visiting program.

TECHNICAL ISSUES

None identified.

OTHER SUBSTANTIVE ISSUES

A Home Visiting Work Group was organized last year by the Children Youth and Families

Department to build a comprehensive plan for New Mexico. The plan promotes evidence-based

approaches to expand home visiting services in New Mexico. As currently written, HB 157 does

House Bill 157 – Page

4

not require that funded activities comply with the New Mexico Home Visiting Work Group’s

long range plan.

A statewide home visiting initiative would address disparities seen in mothers who are teens,

who have less than a high school education, who are single, and who live at or below the federal

poverty level. Health disparities frequently affect racial and ethnic minorities. Health disparities

include access to and use of prenatal care; smoking, alcohol or drug abuse; exposure to physical

abuse; high family stressors (loss of job, use of drugs, homelessness, and jail time); being

overweight and being at risk of diabetes. For families with children, health disparities indicators

include access to and use of recommended health care for the child, immunizations, intentional

and unintentional injuries, infant feeding practices, and a violence-free home.

ALTERNATIVES

None identified.

WHAT WILL BE THE CONSEQUENCES OF NOT ENACTING THIS BILL

Status quo.

POSSIBLE QUESTIONS

None at this time.

DL/bb