Congress should rescue federal programs that actually work
“Evidence-based policy” is a wonky catchphrase built on common sense: Evaluate to find which social programs work. Grow what’s effective. Improve or stop what isn’t. Starting late in the George W. Bush administration (in which one of us served), and continuing with vigor in the Obama administration (in which the other served), the federal government incorporated this approach into a series of new initiatives. Unlike many social programs, these programs do not allocate money based simply on formulas or promised results. Organizations usually must show that their approach has achieved notable results in a careful evaluation. A small amount of funding is reserved for promising programs that agree to be carefully evaluated.
No surprise, evidence-based programs are having a tough time in Washington today. On a bipartisan basis, Congress killed the Social Innovation Fund, which had funded some successful anti-poverty initiatives and was creating evidence about others. The Trump administration acted unilaterally to pull the plug on 81 teenage pregnancy projects that already had strong supporting evidence. On a brighter note, for an evidence-based program recently revamped by the Republican Congress, the U.S. Department of Education made what appears to be a pragmatic first round of grants.
{mosads}Now comes the biggest test. The most critical evidence-based program, the federal home visiting initiative, recently expired. Congress needs to come to its senses and reauthorize the program now. Home visiting addresses what is perhaps America’s greatest challenge today, which is the calcification of social class, the increasing likelihood that the rich remain rich, the poor remain poor, and the American dream becomes a memory.
While economic tools such as tax policies have important effects on opportunity, other key drivers of life outcomes are in the home, in the family, affecting children from the moment they are born, and even before. Highly educated parents know what they need to do: Bring babies to the doctor regularly, feed them properly, read to them, establish regular routines and expectations. Poor families are less likely both to know and to act. Quality home visiting programs close this gap in knowledge and practice, meeting parents where they are, without condescension.
Federal home visiting efforts began in the George W. Bush administration, which requested and received $10 million for programs proven to help at-risk children through voluntary coaching for parents. That program had been designed by experts at the Office of Management and Budget who were impressed by the Nurse Family Partnership, which demonstrated strikingly positive impacts on child well-being in three evaluations in three different locations.
In 2010, as part of health reform, Congress greatly expanded support for home visiting, providing up to $400 million per year. This new effort correctly supported programs far beyond the Nurse Family Partnership. Three-quarters of the money still had to be spent on model programs shown by a rigorous evaluation to produce impacts. The other 25 percent could be spent on promising approaches that were being evaluated. The U.S. Department of Health and Human Services invested in a national evaluation to study the impact of the four largest home visiting models.
While that impressive evaluation is ongoing, what we know at this point is promising. The four program models in which states have invested most have solid track records of improving child development and school performance. These positive effects reach the parents too, increasing employment and improving family stability. Cost-benefit analyses suggest that these programs save taxpayers money, mostly by reducing health care costs and use of public assistance. Analysis by Nobel Laureate James Heckman found that one Nurse Family Partnership site positively affected academic achievement of boys fully a decade after services ended.
Home visiting began as a bipartisan program in the 1980s and 1990s, with strong support from Republican governors like Mike Huckabee in Arkansas and Kit Bond in Missouri. While most of health reform has become bitterly ideological, the bipartisan support for home visiting remains. The program expired back in September, but the reauthorization is sponsored by Chuck Grassley (R-Iowa) and other Republicans in the Senate.
Even with $400 million per year, the expanded home visiting program still reaches only about four percent of eligible families facing serious challenges. While there’s a strong case for expansion, we don’t yet have a full evaluation of the expanded program. But precisely because we do not yet know the results, now would be the worst time possible to cut or kill this modest, smartly designed effort to sustain and expand America’s promise for the poor.
Robert Gordon is a senior fellow at Results for America. He served as acting deputy director and led evidence-based policy initiatives for the Office of Management and Budget during the Obama administration.
Ron Haskins is the Cabot family chair in economic studies and co-director of the Center on Children and Families at the Brookings Institution.
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