Jonae was nervous about becoming a parent. She only had the experience of being an aunt and wanted to make sure she was doing everything right.
Enter Julie Evans, a registered nurse who has visited Jonae at her apartment in Del City since she was 27 weeks pregnant. Now, her baby, Miracle, is 10 months old. The pair has grown a lot since then.
During one of the biweekly visits in November, Evans weighed Miracle in at 18 pounds and 11.5 ounces. She conducted a 10-month safety check, asking Jonae if she had a properly installed car seat and outlet covers at home. Jonae also shared Miracle is beginning to say words and always listens to her talk.
“That’s one of the first signs that they’re about to blossom with talking,” Evans said, smiling. “They really watch your mouth. They might watch you talk to dad, looking back and forth. They want to do what you’re doing.”
Evans is a provider for the Oklahoma City-County Health Department’s Children First program, one of the state’s three home-visiting services funded under the Maternal, Infant and Early Childhood Home Visiting Program (MIECHV).
Programs offer free, voluntary home visits from professionals — like nurses, social workers and family support specialists — to families from pregnancy to kindergarten. Their common goal is improving health outcomes, reducing child abuse and enhancing school readiness.
The U.S. Department of Health and Human Services is increasing funding for this program, and the state hopes to use those dollars to fill gaps in maternal and infant health care.
What is home visiting and MIECHV?
Home visiting began decades ago through state funds and was expanded through federal MIECHV funding in 2010 to serve low-income, high-need families. The Oklahoma State Department of Health (OSDH) has overseen it since its inception.
MIECHV used to reach more communities, like Kay, Muskogee and Garfield Counties. Juan Delara, the health department’s MIECHV grants manager, said in an email that funding reductions caused the health department to prioritize services in Comanche, Oklahoma and Tulsa Counties, where higher population densities and greater family needs are concentrated.
Oklahoma’s MIECHV covers three evidence-based home visiting services, which include:
- Children First: This program targets low-income mothers pregnant with their first child, and services continue through age two. It schedules biweekly home visits to provide health assessments, growth and development assessments, support in accessing resources and health education centered around family’s needs.
- Parents as Teachers: This program targets families in pregnancy up until kindergarten. It’s based on the idea that parents are their children’s first teachers and is designed to help families connect with their children’s early development and build a foundation for school readiness. It also works to prevent child abuse and neglect.
- SafeCare: This program can be delivered to families between birth and age five. It serves families with more stressors, like domestic violence, substance abuse and depression, through weekly home visits. SafeCare works to improve parents’ skills and prevent child abuse and neglect by addressing things like infant and child interaction, health care and home safety.
Eight organizations serve families under MIECHV, which reached 988 families in the last fiscal year.
Other counties rely on state funds to support the same home visiting programs but lack some MIECHV-provided perks, like additional material resources, training and support. Western Oklahoma’s Great Plains Youth & Family Services, for example, covers six counties under Parents as Teachers with two home visitors and one supervisor.
The nonprofit’s executive director, Kody Suanny, said the OSDH-funded home visiting program has worked to cut through funding and geographical barriers with some virtual visits, but their two home visitors still drive 400 to 600 miles every month to serve 40 families.
“There is a waiting list, unfortunately,” Suanny said “There's a lot of families in the six counties that we serve that want and need our services. But, because we're just a two-person team … we can only serve at the capacity we are currently serving.”
More funding is on the way for Oklahoma. The Biden Administration signed legislation in 2022 to increase MIECHV funding over five years. However, due to mandatory federal budget cuts, there was a decrease in the projected funding increases for home visiting programs’ base and matching dollars, according to OSDH.
OSDH received nearly $300,000 in additional funding during FY2024, which was used to sustain current services. It expects a notable increase in base funding through the 2027 federal fiscal year. Delara said the state department hopes to use future dollars to maintain current services and expand access.
“In rural Oklahoma, [there are] higher rates of poverty, higher rates of unemployment. We have generational poverty as well, increased use of substance abuse, alcohol abuse. And, so having a parent educator simply helping to stabilize that family has a huge benefit to everyone overall,” Suanny said. “Rural Oklahomans deserve that access to care.”
The Great Plains providers said they believe that wholeheartedly — primarily as they work to prevent their fellow community members from getting involved in other systems.
“[This is] why our program is so important — and it just gives me that uplift whenever I start getting a little down or tired — it’s those children waiting at the door when you get there. Just waiting for you to get there to work with them,” said Emma Shandor, the nonprofit’s Parents as Teachers supervisor. “I just think that's amazing.”
The benefits of home visiting for providers and people
MIECHV has meant a lot to Patty DeMoraes-Huffine, the director of prevention programs at the Latino Community Development Agency in Oklahoma City. The agency began its home visiting program in 1994 using state funding and was part of research to test the feasibility of adapting SafeCare to serve Latino communities better.
It got MIECHV later on and currently operates Parents as Teachers and SafeCare. It used its funding to hire more providers, which serve 150 families under MIECHV, compared to 40 under state funding. The program still has a waiting list.
“Many of these families are isolated. And then think of the families that we serve that don't speak the language. If they have someone that looks like them, that speaks their language, that comes to [their] house — it’s like you are everything to the families,” DeMoraes-Huffine said.
The Oklahoma City Public Schools Parents as Teachers program used to receive state funding but now has services covered by the district and MIECHV. Stephanie Hinton, the district’s executive director of early childhood, said MIECHV helps pay for people’s salaries, benefits, training, materials and supplies to implement services.
Now, Hinton said she has the privilege of hearing about the program’s impacts from families once their kids make it to school, including one mom who showed off her son’s report card and attributed his success to the program.
“This is an investment in the future of our community, in the future of our citizenship,” Hinton said. “What kind of citizens do you want to see leading our community?”
State and federally funded home visiting services are making a difference in Oklahoma’s communities. An FY2023 report from the Oklahoma Partnership for School Readiness found those participating in Oklahoma’s three programs across 62 counties saw decreases in parental substance abuse, tobacco use, maternal depression and reported child maltreatment.
The partnership’s director of early childhood systems, Allison Loeffler, said there’s still room to grow in reaching more underserved populations, seeking families’ input and improving home visitor turnover rates.
“We know that this is effective. We know that this works. We have the research that tells us that, and so I think an increase of funding and being able to expand services [and] get more services in counties — especially rural Oklahoma — [is important],” Loeffler said.
Oklahoma’s home visiting programs have impacted families like Monica Rodriguez. She was one of DeMoraes-Huffine’s home-visiting clients from decades ago.
Rodriguez came from Mexico to the U.S. when she was 18 and had her son when she was 19. He was premature and spent over a month in the hospital. She didn’t speak English at the time.
She was referred to DeMoraes-Huffine and said they clicked immediately.
“I don't know how [we] ended up [together]. I think it was God, because I was really needing a friend,” Rodriguez said.
Rodriguez said she grew up with a father who yelled and was physically violent. She wanted something different for her family, and DeMoraes-Huffine taught her how to accomplish that.
She said she and DeMoraes-Huffine read with her son all the time, which he remembers to this day. She’s kept a folder of all his achievements over the years, ranging from a phonics award to a newspaper clip highlighting an outstanding senior award. He just graduated from OU’s College of Dentistry.
And, because of the program, Rodriguez also got connected to other services at the agency that helped her meet people, learn English and get her GED. She now owns a restaurant in Woodward called Ramiro’s Mexican Restaurant.
There, she said she talks about the program with anyone who will listen. She hopes through additional funding, more families will get to experience home visiting.
“Just to have a person that, yes, they come to your house, but they're not judging you. They're not going to report you with anybody. They will teach you, and they will take your family as their own. They will not make you feel like you're a bad parent. … It's worth it,” Rodriguez said. “Do it for you, for your family, for your kids and for a better future. It is possible.”
StateImpact Oklahoma is a partnership of Oklahoma’s public radio stations which relies on contributions from readers and listeners to fulfill its mission of public service to Oklahoma and beyond. Donate online.
