Home Visiting

A Promising Early Intervention Strategy for At-Risk Families Gao ID: HRD-90-83 July 11, 1990

Pursuant to a congressional request, GAO reviewed home visiting, focusing on: (1) the nature and scope of home-visiting programs in the United States and Europe; (2) its effectiveness; (3) strategies critical to the design of programs that use home visiting; and (4) federal options in using home visiting.

GAO found that: (1) some programs using home visiting improved the health and well being of families and children; (2) home visiting reduced the need for more costly services, but minimal research has compared its cost-effectiveness to other early intervention strategies; (3) some programs using home visiting failed to meet their objectives, primarily due to fundamental program design and operation problems; (4) successful programs usually combined home visiting with center-based and other community services adapted to their target group's needs; (5) the Department of Health and Human Services (HHS) and the Department of Education support home visiting through both one-time demonstration projects and ongoing funding sources, but are not coordinating and focusing their efforts; (6) Congress focused its home-visiting interest on maternal and child health initiatives, and considered legislation amending Medicaid to explicitly service pregnant women and infants, but did not pass the proposed legislation; (7) the legislation would have caused additional Medicaid costs, ranging from $95 million for optional home-visiting services to $625 million for mandatory services from fiscal years 1990 through 1994; and (8) the federal government could strengthen program design and operation for home visiting by communicating the knowledge developed at the federal, state, and local levels.


Our recommendations from this work are listed below with a Contact for more information. Status will change from "In process" to "Open," "Closed - implemented," or "Closed - not implemented" based on our follow up work.

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