If it makes it through the legislature, Governor Andrew Cuomo's budget plan could wipe out state funding for one of New York's best-proven methods of preventing child abuse, neglect and long-term poverty, while also making the state ineligible for millions of federal dollars through the health care reform act. New York is home to two large-scale home visiting programs for low-income mothers whose babies are considered at risk of entering the child welfare system. Starting early in pregnancy, educators meet one-on-one with new moms, talking about everything from bonding with their babies and child brain development to filling out job applications and planning a budget. The idea is to build trusting relationships, teach concrete parenting skills, and help mothers navigate difficulties in their own lives that might interrupt bonding or lead to abusive or neglectful behavior later on.
In the sometimes numbers-fuzzy universe of social services, Nurse-Family Partnership (a national program administered here through the city's Department of Health and Mental Hygiene) has been the subject of a series of rigorous, controlled trials, with some pretty stunning statistical results. In one long-term study, rates of child abuse and neglect were 48 percent lower among families that received home visiting services than families in a control group.
By the time kids who'd been in the program turned 15, they were 59 percent less likely to have been arrested than kids in similar peer groups and 90 percent less likely to have been designated by a court as needing external supervision because of incorrigible behavior. The RAND Corporation estimates that taxpayers get a return of up to $5.70 for every dollar they invest in the program.
In a smaller-scale study published last fall, Healthy Families New York showed statistically meaningful results on improved birth weight, language delays, child maltreatment and the need for special education. The program serves about 5,500 families across the state.
Currently, the state spends $23 million for services through Healthy Families New York and $6.3 million on Nurse-Family Partnership. New York City also invests substantial funding in Nurse-Family Partnership, which operates at a budget of just over $14 million to serve more than 3000 families. (For more on the program's services targeting young mothers in foster care, see this article in the Center for New York City Affairs' latest edition of Child Welfare Watch.)
Both stand to be slashed out of the state budget come June of this year as part of a $50 million state cut to services designed to prevent involvement in the child welfare and juvenile justice systems. Under Cuomo's plan, home visiting would compete for funds with a long list of other programs, ranging from juvenile delinquency programs to shelters for homeless teenagers. Added together, all of these services currently receive $85 million from the state, according to an analysis by the Citizens' Committee for Children of New York. Once they are all lumped into the new funding stream, they'll battle for a total statewide pot of $35 million, a cut in overall funding of nearly 60 percent.
"These are programs making observable, measurable differences in children's lives," says Christine Deyss, executive director of the advocacy group Prevent Child Abuse New York. "By reaching them as early as these home visiting programs do, their whole lives are changed in ways you can't change them if you wait. Unfortunately we have some political leadership that doesn't seem to be concerned about saving money in five or ten years but cutting right now."
The Cuomo administration contends that combining preventive services into a single, competitive funding stream (called the Primary Prevention Incentive Program) will allow counties to make targeted decisions about which programs are most vital to their communities. "New York State is facing a severe and unprecedented fiscal crisis requiring deliberate choices be made prioritizing our limited funding opportunities," says Susan Steele, a spokesperson for the Office of Children and Family Services, which administers Healthy Families New York. "The Proposed Executive Budget includes a flexible Primary Prevention Incentive Program intended to give local discretion for those programs considered to be most effective. Healthy Families programs may be funded using this innovative funding stream, and those localities who choose to invest in the vital services that home visiting programs provide, may elect to use their flexible dollars in that regard."
Cutting the home visit funds may also mean the state will lose access to millions of federal dollars provided under the Affordable Care Act (the Obama Administration's healthcare reform initiative), according to advocates. The act includes an initiative to support home visiting programs, but states are eligible only if they demonstrate that they've maintained their own funding at the same level as when the act was passed in March 2010.
"There's just nothing about this that makes sense," says Meredith Wiley, state director of the advocacy group Fight Crime: Invest in Kids. "If we know so much about how to prevent abuse and neglect and we don't do it, what does that say about us as a state and people? This is the last thing we should cut; not the first."