Considerations for Supporting the Home Visiting Workforce Under MIECHV Reauthorization

Home visiting leaders, including representatives from the Association of State and Tribal Home Visiting Initiatives (ASTHVI), have identified maintaining a robust and well-trained workforce as both a key challenge and a top priority for the field. Prior to the COVID-19 pandemic, local and national studies indicated that 12 to 18 percent of home visitors planned to leave their positions in one to two years, and that average 12-month turnover rates ranged from 15 to 40 percent. ASTHVI indicates that these rates have likely increased since the start of the pandemic, jeopardizing programs’ investments in home visitor training and disrupting participating families. For example, changing home visitors has been shown to negatively impact families’ length of enrollment and visit frequency, while alignment on goals between families and home visitors has been shown to extend enrollment length. Inadequate pay and benefits are often cited as a key driver of home visitor turnover.

Even prior to reauthorization, MIECHV awardees had begun implementing innovative strategies to address workforce challenges using a range of funding sources. We spoke with home visiting leaders in three states to learn more about their efforts to strengthen the workforce, including efforts to increase home visitors’ compensation and provide additional supports for their professional and personal well-being. In this brief, we present an overview of these efforts—in the form of “snapshots” highlighting efforts from the three states—and offer considerations for MIECHV awardees as they plan for the future of their home visiting programs.

State Snapshots

Considerations for MIECHV Awardees

MIECHV reauthorization presents an exciting opportunity for awardees to better support children and families by both expanding access to home visiting services for families and investing in the well-being of their home visiting workforce. As awardees continue to determine how to best support the home visiting workforce with these funds, we offer the following considerations based on the experiences of Alabama, Colorado, and Iowa:

MIECHV awardees should consult with interested parties when planning and implementing new policies and programs to ensure that solutions are responsive to their needs and interests. Interested parties might include LIA leaders and staff, home visitors, families, other stakeholders in the early childhood field. Strategies for data collection and consultation include advisory groups, task forces, and surveys to gain insight from the workforce.

MIECHV awardees should increase home visitor compensation to advance home visitors’ well-being, improve retention, and advance equity. However, while a necessary strategy, increasing compensation may cause disruption and inequities at the LIA level, given that LIAs often also employ staff who are not home visitors. Awardees should think about how to mitigate these potential negative outcomes when designing programs and policies and provide clear guidance to LIAs on navigating these challenges. For example, MIECHV program directors could provide outreach to LIA leadership to engage in conversations on how to best address potential inequities.

MIECHV awardees should consider providing workforce supports that promote professional development and well-being in addition to compensation. Such supports might include access to trainings and conferences, which build home visitors’ skills and foster a sense of camaraderie; mental health supports, including mental health consultation; career pathways; and opportunities for greater workplace flexibility and autonomy. States may face fewer barriers to providing these supports relative to increasing compensation.

Acknowledgments

The authors would like to thank Maggie Enlow, Joyce Johnson, Angela Ben-Zerky, Aaron Miller, Kelly Schulte, and Claire Carlson for sharing information on their states’ approaches to supporting the home visiting workforce. The authors would also like to thank ASTHVI for their partnership and support in identifying MIECHV awardees to feature. Lastly, the authors would like to thank our Child Trends colleagues, Kristen Harper, Jessica Conway, and Silvana Esposito Hackett for their review of this work.