Federal Policy Agenda

Nurse-Family Partnership Program

Field of Work: Nurses visiting young, low-income pregnant women and first-time mothers to train them and deliver preventive health services.

Synopsis of the Work: In 1979, the Robert Wood Johnson Foundation supported a demonstration project in Elmira, N.Y., that used registered nurses to take preventive health services into the homes of young, low-income pregnant women and first-time mothers. Randomized controlled trials conducted in Elmira and subsequently Memphis, Tenn., and Denver showed the home visits yielded positive health and developmental outcomes for children and mothers. After two decades of research, David L. Olds, Ph.D., architect of the Nurse-Family Partnership Program (April 1999 to April 2008), initiated a national program to replicate the model across the country.

Federal legislation introduced in 2007 would have given states the option of covering 100 percent of home-visitation services under Medicaid and SCHIP—instead of the 10–50 percent coverage now possible, according to program staff.

In addition to increasing coverage, the legislation would clarify that nurse home visiting qualifies for reimbursement under federal Medicaid rules. That would be significant, according to program staff, because federal scrutiny of state Medicaid spending now leaves state officials reluctant to seek reimbursement.

Key Results: As of early 2008, neither the Senate nor House had acted on the legislation.

In 2007 the Bush administration proposed $10.2 million for a competitive grants program to encourage states to implement the program. Congress included the funding in its appropriations legislation for fiscal 2008.

President Bush's budget for fiscal 2009 proposed continuing the program at the $10.2 million level. The Nurse-Family Partnership planned to work to maintain the grant program and increase the funding for it in subsequent years.

Nurse-Family Partnership program's third priority at the federal level is a generic home-visiting bill that the organization supports as a member of a national coalition of home-visiting programs. Unlike the other two measures, it would not single out any one program.

Sponsors have introduced the bill a number of times without success.

Nurse-Family Partnership funds its policy work with earned revenues and eligible philanthropic giving. RWJF prohibits use of its grant money for lobbying activities.