The Commercial Appeal

Home visits key to care for kids faced with traumatic experience

- Your Turn Guest columnist

As evidence of the impact of childhood trauma continues to permeate child-serving institutio­ns, teachers, social workers, pediatrici­ans and caregivers are changing the way they interact with children who have been subjected to Adverse Childhood Experience­s (ACEs).

Of the many techniques and programs developed to provide traumainfo­rmed care, home visiting is among the most studied and evidence-based approaches to mitigating or preventing childhood trauma.

Before the end of this legislativ­e session, our lawmakers have a chance to restore funding for home visiting through an amendment to Gov. Bill Haslam’s proposed budget.

In 2012, state budget restraints resulted in a 50 percent reduction in home visiting funding. Health Commission­er John Dreyzehner has been supportive of funding for home visiting, and Haslam’s team included recurring funding for home visiting in the state’s budget.

However, the proposed budget is still $1.4 million short of the pre-2012 level. State Rep. Ryan Williams (R-Cookeville) and state Sens. Becky Massey (R-Knoxville) and Steve Dickerson (RNashville) have proposed an amendment to the budget to restore $1.4 milprovide­s

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lion for a total home visiting budget of $3.4 million. This change requires votes by both the House and Senate Finance Committees.

There are several proven models targeted for different outcomes. The specific Tennessee model in need of restored funding is known as Healthy Start.

Partnering with new parents in the home, profession­als administer programs that provide and connect parents with a wide range of services focused on child health and developmen­t, promoting school readiness, and enhancing parenting skills. They are fundamenta­l to preventing child adversity and often abuse and neglect.

Most families that receive these services are living at or below the poverty level. As of 2017, our state is home to 118,580 children under the age of 5 who also live in poverty – which often creates conditions leading to toxic stress and childhood trauma.

At the current level of funding, Tennessee is able to provide home visiting services to only 1.7 percent of those children. And of the 95 counties in Tennessee, 45 counties have no home visiting services at all.

These grim statistics are even more disturbing when one considers that home visiting has a proven track record. Evidenced-based home visiting a return of $5.70 for every $1 invested.

Research on home visiting has demonstrat­ed impacts for children and families, such as infant and maternal health, education attainment and readiness, reduction of child abuse, and positive, supportive parenting practices.

Evidence-based home visiting models have shown positive long-term impacts on school readiness, reduced child abuse, and reduced lifetime arrests and conviction­s. Adding to the efficacy of home visiting, many states are now employing home visiting models specifical­ly to combat the opioid epidemic.

As the legislativ­e session winds down, members of the finance committees must consider hundreds of amendments to the proposed budget, many for worthwhile programs and initiative­s.

In weighing the needs of our state, I urge our leaders to give ample considerat­ion to the impact home visiting can have on families and children living in poverty and experienci­ng toxic stress and trauma.

While the proposed $1.4 million will not dramatical­ly increase the number of children served, it will change the lives of some, and more importantl­y signal a state commitment to changing the trajectory of children and families impacted by childhood trauma.

Lisa Wiltshire is policy director for Tennessean­s for Quality Early Education.

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Lisa Wiltshire

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