Date: 10/13/2009

Invest in Kids and Nurse-Family Partnership


Votes: View--> Action Taken:

09:41 AM -- Invest in Kids and Nurse-Family Partnership

Ms. Lisa Merlino, Executive Director, Invest in Kids, presented information on best practices related to the Nurse-Family Partnership, which is also known as the Nurse Home Visitor Program. She distributed a packet of information to the committee (Attachment A). She provided background information on the Nurse-Family Partnership. She discussed information related to child brain development and described the program's goals and its components. She noted the significance of using nurses and provided an overview of the home visit process.


09:47 AM

Ms. Merlino offered comments on evidence-based policy and provided detail on the outcomes that had been observed from the program trials. She discussed data related to: academic achievement; language development; days of hospitalization; months between births; months receiving welfare assistance; and months receiving food stamps.

09:54 AM

Ms. Merlino discussed the cost-effectiveness of the Nurse-Family Partnership. She identified the partners involved in the program and provided demographic characteristics related to the program's clientele. She provided data related to Colorado's outcomes, particularly outcomes concerning: full-term babies; immunization rates; breast feeding rates; cigarette and drug use; and education for mothers.

09:58 AM

Representative Summers asked for additional information related to areas without a program. Ms. Merlino noted that the program is voluntary for communities and for clients. She said that some communities have very few first-time births and programs are generally prioritized based on the population served. She discussed a loss of expansion money funding for the program.

10:01 AM

Senator Hudak asked for more detail related to the correlation between the communities with a program and the locations of early childhood councils. Ms. Merlino discussed the development of the program and its collaboration with the councils. Representative Kagan asked for information concerning the use of statistics related to program data and how those statistics may be influenced by the voluntary nature of program participation. Ms. Merlino discussed the randomization of the program trials and noted the importance of voluntary participation and the difficulties involved in keeping women engaged in the program over time. She agreed that women in the program were open to change, but stated that the voluntary nature of the program is an important aspect of its focus on self-empowerment. Representative Kagan expressed his concern that the evidence for the efficacy of the program is skewed because the population consists of women who have already volunteered to be a better mother. Ms. Merlino indicated that she would pose the question to Dr. David Olds, the founder of the Nurse-Family Partnership, who would be able to provide additional information. She noted that the women weren't necessarily seeking these services out on their own, but may find out about the program due to their participation in other programs or clinics.

10:07 AM

Representative Waller asked for information on the retention rate of the program. Ms. Merlino said that women participate in the program for an average of 20 months. She stated that 60 percent of the participants drop out of the program before their child is two years old. She noted that most of Colorado's attrition is due to moving out of a service area. She discussed how the attrition rate affects the trial outcomes. Discussion continued between Ms. Merlino and Representative Waller.

10:11 AM

Representative Kefalas asked if the Nurse Home Visitor Program would have the ability to analyze the population of eligible women not receiving services and conduct an economic model of the impact on Colorado's economy and poverty rate if those women were enrolled in the program. Ms. Merlino provided initial information, but noted that the program is voluntary, and an analysis of the program relies on a formula to predict how many women would volunteer. She noted that data from Pennsylvania provides some information, and partners in Colorado have discussed the possibility of a retroactive analysis. Discussion continued.