Estimating Cost and Benefits of Early Childhood Visiting Service

Early Childhood Visiting Program

The early childhood visiting service begins during the prenatal phase for high-risk families. After delivery, child welfare and public health workers initiate the service. This human service continues until age three to four years, when the child receives child care. Providing intensive intervention for a child, from prenatal to three years old, in families that face multiple risks, was shown to provide good outcomes. Familial challenges and circumstances make parenting and optimal child development difficult. Clinical research established that optimal development of the neonatal brain requires specific stimulation and, when it occurs, management of trauma. These are the elements of good early childhood parenting.

Early childhood home visiting promotes (a) parent-infant attachment, (b) family health and well-being, (c) parenting skills, (d) cognitive, emotional, and behavioral skills of children, and (e) linkage to healthcare, social service, and education resources.

The program enlisted potential first-time parents from the county's hospitals, public health, and social service agencies. The program assesses the risk factors, which, aided by the score on a parental aptitude tool, determines the vulnerable parent's eligibility for the healthy family program.

Multiple counties in the Minneapolis-St. Paul metropolitan area organized a healthy family pilot program. More than 60 public health nurses, social workers, and family support staff delivered home visiting services. These home visitors received training based on the Growing Great Kids (GGK) curriculum. Home visits start during the mother and child's prenatal or postpartum stage and occur weekly over the program's first 9-18 months.Visits decrease until the child reaches age four, when the program ends for the child.

At specific points in the planned timeline, the visitor conducted a Scale of Parenting and Life Functioning assessment to track the progress of the parent and child in the program. All evaluation data were collected and managed in a database by one of the counties participating in the pilot.

Four hundred fifty-three first-time at-risk parents were enrolled in an intensive home visiting program and followed for 22 months. During this period, 42, or 9.3%, were investigated for child maltreatment. In 5 out of these 42 families, 1.1% experienced maltreatment, a significant improvement from the 9.2% in a similar control group.

Cost-Benefit Analysis

This type of analysis creates a structure to gain approval from a county's board of directors to offer early childhood visiting services to needy residents. Available studies on a good return on investment from early intervention with high-risk families influenced the approach to measuring costs and benefits. Research on the Head Start program focused on preparing the child for school and other aspects of parenting. Wilder’s research in the State of Michigan demonstrated that investing in school preparedness reduced the need for government welfare programs and resulted in positive outcomes for K-12 and higher education.

Covering a similarly extended scope, the Minneapolis Federal Reserve Bank examined the cost-benefit of investments in the child. [1] Net benefits were projected based on differences in potential income and government assistance over an average lifetime, using data from the study of a control group. Costs and benefits were adjusted to present value using a 3% discount rate, as utilized in the Minneapolis Federal Reserve Bank study. Their analysis estimated the internal rate of return on early childhood investments at 16%.

From the data of the pilot program in the Minneapolis-St. Paul metropolitan area, a member county, conducted a cost-benefit analysis of the home visiting service. [3] The study demonstrated, in 2005 dollars, that while a home visiting service may cost $6,200 per target family, avoidance of the cost of

investigating and prosecuting a single case of abuse in the child protection system may cost $26,000 per case.

The studies mentioned above guided the cost-benefit analysis flow. The chart traces the benefits that will accrue to a program participant from birth to a retirement age of 65. Human services investment expended during infancy and childhood makes the participant more likely to absorb training and complete higher education. This investment also mitigates the chances of involvement in criminal tendencies. It will be a potential for higher income employment and the avoidance of the societal cost of incarceration.

A computer simulation model was developed to streamline the cost-benefit analysis process. The program cost estimation relied on county financial data for operation planning requirements. [2][4] The computer model decides the complement of home visiting staff in full-time equivalents (FTE). A planner inputs a proportion of public health nurses relative to social workers with their average salaries and benefits from the county's financial data. The calculated staffing cost forms the basis of administrative and other cost. Added to these costs is the average financial assistance, as determined by the number of active families in the program. Other parameters required to run the computer model were calculated based on data from the pilot program.

The cost-benefit analysis facilitated by computer model simulation showed the effectiveness of early childhood home visits, leading to the county's board of directors' approval of the proposal to provide visiting services.

By Mgmtlaboratory.com staff. 2024

References

1. Early Childhood Development: Economic Development with a High Public Return. A. J. Rolnick, R. Grunewald.Federal Reserve Bank of Minneapolis. March 1, 2003

2. Examining Organizational Functioning Through the Lens of Complexity Theory Using System Dynamics Modeling. Fitch, D. and Jagolino, N. C. Journal of Social Service Research. 2012.

3. Minnesota Visiting Programs. https://www.health.state.mn.us/communities/fhv /index.html.

4. A Dynamic Model of Child Physical Development. www.mgmtlaboratory.com.August 2018.