The Board of Supervisors Lifts Home Visiting to the County Level

By Michaela Ferrari, MPH, Policy Director at LA Best Babies Network and Coordinator of the Los Angeles County Perinatal and Early Childhood Home Visitation Consortium

[related: Los Angeles County Leaves Money on the Table for Home Visiting – But Not for Long]

“Although 65 percent of California’s children ages birth to three have one or more risk factors indicating that they could greatly benefit from home visitation, home visiting programs reach only 3 percent of all families with young children.”

In their motion to the Los Angeles County Board of Supervisors, Supervisors Sheila Kuehl and Janice Hahn cite this statistic as an indication of the need to provide better support for home visiting programs in LA County. They also note the lack of state funding for home visiting, and the patchwork of home visiting programs and funding streams used across the County that seek to meet the needs of young children, families, and pregnant women.

The LA County Perinatal and Early Childhood Home Visitation Consortium (“the Consortium”) estimates that 92% of LA County families that need home visiting services don’t receive them.

The motion, which passed unanimously on December 20, 2016, tasks the Department of Public Health to work with other County agencies and organizations, including the Consortium, and develop a County-wide plan for home visiting within 180 days. Specifically, the plan is to include:

  • National home visiting models and best practices for creating regional early childhood systems
  • A coordinated, (preferably electronic), referral system, that may include a single point of entry into a variety of home visiting programs
  • Identification of high-risk populations in the County and service gaps
  • Strategies to increase families’ access to home visiting programs
  • A plan to collect and share data from all home visiting programs across the County
  • Identification of new funding streams and ways to leverage existing ones so that services may be expanded

For many of the organizations and agencies named in the motion, developing a County-wide plan for home visiting has been a long time coming. In response to the tragic death of an 8-year-old boy due to abuse and neglect in 2013, the Board of Supervisors created the Blue Ribbon Commission on Child Protection. The Commission’s final report led to the creation of the Office of Child Protection, one of the agencies named in the motion, tasked with developing a County-wide prevention plan for child abuse and neglect. In its five-year strategic plan, the Office of Child Protection identified home visiting as a proven strategy to prevent child abuse and neglect.

First 5 LA, another party named in the motion, is the largest funder of home visiting programs in the County, including its own model, Welcome Baby. The Department of Public Health also administers a home visiting program, a national, evidence-based model called Nurse-Family Partnership.

Finally, the Consortium, a network of approximately 50 home visiting programs, County agencies, maternal and child nonprofits and other organizations, was established to support, advocate for, and expand home visiting programs in LA County. Its strategic goals overlap closely with the motion’s plan, including efforts to collect County-wide data, improve the referral systems into home visiting programs, and increase sustainable funding sources. As Christina Altmayer, the Vice President of Programs at First 5 LA, has noted, this motion is like adding “rocket fuel” to the work that these and other organizations throughout the County are doing to support home visiting.

In addition to adding fuel, the motion provides an opportunity to work collaboratively across County systems and programs to create a more streamlined, comprehensive early childhood system. The long-term goal is to better serve children in families throughout LA County, beginning with universal access to voluntary home visiting programs and connecting to other resources that support children through kindergarten and beyond.

In an uncertain federal funding landscape with talk of repealing the Affordable Care Act and restricting Medicaid (both of which provide funding for home visiting), building a strong and well-functioning early childhood system at the local level is more important than ever.

To learn more about the Consortium and to access its many online resources, visit

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