Home Visiting of Mecklenburg County Landscape Analysis - Executive Summary

EXECUTIVE SUMMARY of
Home Visiting of Mecklenburg County
LANDSCAPE ANALYSIS:
Opportunities for Growth, Expansion & Building Infrastructure

Executive Summary of
Home Visiting of Mecklenburg County Landscape Analysis:
Opportunities for Growth, Expansion & Building Infrastructure
Early-childhood home visiting is a voluntary program for
expectant parents and caregivers of young children,
aiming to enhance family health and well-being,
contributing to positive outcomes. This broad definition is
necessary because the various home-visiting models differ
from each other in their level of intensity, target population,
and mode of delivery. The two widely discussed subcategories
of early-childhood home-visiting programs are:
universal home visiting-designed to serve all families with
young children regardless of risk factors or circumstances,
and targeted home visiting- specifically designed to serve
families with identified risk factors or challenges that may
impact their child’s development or well-being.
This said, theoretical foundations of home-visiting models
are very similar. They prioritize prenatal and preventative
care, encourage secure parent-child attachments, linkages
to community resources and facilitate developmentally
appropriate practices through coaching—ultimately
supporting parents’ role as their children’s first and most
important teachers. The specific role of the coach might vary,
whether a registered nurse, a community health navigator, or
some other type of parent educator, what remains consistent
between models is the supportive relationship developed
between the home visitor and the family achieved by
providing services to suit the distinctive needs of each family.
Early-childhood home visiting is particularly important
for families living in communities experiencing inequities
in healthcare, education, and economic mobility. While
80% of White mothers receive prenatal care within the
first trimester of pregnancy, only 69% of Black mothers
and 57% of Hispanic mothers receive health care during
pregnancy. Statistics for low birth weights, infant mortality,
and child maltreatment tell a similar story. These disparities
demonstrate the need for proactive solutions that bridge the
gaps and dismantle barriers to accessing maternal and child
health care and other resources for family well-being.
In Charlotte-Mecklenburg, we’re fortunate to have several
qualified organizations 1 providing home-visiting services. In
2021, a collective total of 54,871 home visits were provided
to 6,430 families. However, data from seven reporting of
organizations 2 reveals just over 1,000 families are actively
receiving home visiting services. This accounts for just 7% of
the live births in Mecklenburg County although our existing
infrastructure (excluding Mecklenburg County Health
Department services e.g. CMARC), collectively has the
capacity to double the number of families they serve in their
current construct, effectively moving coverage from ~7% to
~14%.
Recognizing the need to invest more resources in home
visiting, Smart Start of Mecklenburg County is excited
to move home visiting to the next level thanks to a
generous $342,500 American Rescue Plan Act grant from
Mecklenburg County, which channeled federal dollars to
local communities dealing with the aftermath of Covid-19.
The partnership between Mecklenburg County and SSMC
makes sense given our relationship over the last three
decades. Since 1993, SSMC has worked to transform the
system of early care and education in our community. In
recent years, SSMC has helped the county respond to
upward mobility disparities through the administration
of the nationally recognized MECK Pre-K program. In
addition, in 2021 Mecklenburg County and SSMC leadership
convened an Early Childhood Executive Committee to
address prenatal-to-age 3 opportunities and challenges. This
led to a set of recommendations and action steps, including
the need to partner with local organizations and agencies to
expand access to high-quality home visiting.
To create a plan to expand home visiting, Smart Start
partnered with Dr. Paul Lanier, Associate Director of the
Jordan Institute for Families and Associate Professor at the
University of North Carolina’s School of Social Work. It is
important to note that this work was not done in isolation. A
cross-functional team of parents, funders, home visitors and
program leaders, as well as county staff contributed to the
drive forward of this work.
The result of this work—Home Visiting of Mecklenburg
County Landscape Analysis: Opportunities for Growth,
Expansion, & Building Infrastructure—is explained in more
detail in the full report. This study, was modeled on the
methods used in the 2018 seminal report, North Carolina
Early Home Visiting Landscape Analysis: Strengthening
Systems to Support Families, published by Dr. Paul Lanier,
Associate Director of the Jordan Institute for Families and
Associate Professor at the University of North Carolina’s
School of Social Work.
Building upon the state research study, SSMC’s landscape
analysis is comprised of several components, including group
model-building, an online survey conducted among local
organizations that provide home-visiting services, and input
from the Home Visiting Collaborative.
Footnote:
1
YMCA Parents As Teachers, YMCA Greater Charlotte, Parent Child+, Safe Journey
Parents As Teachers, Community In Schools, A Guided Journey, Care Ring in
partnership with Mecklenburg County Health, Nurse-Family Partnership, Care Ring,
Child First, Children’s Home Society, Early Head Start Home Based, Alliance Center for
Education
2
Seven home visiting providers were able to provide data on costs and number of
families served. They are as follows: Parents As Teachers, Child First, Early Head Start,
A Guided Journey, Nurse Family Partnership, Safe Journey, and ParentChild+

RECOMMENDATIONS
Based on the findings from the online survey of local home-visiting programs, the group model-building sessions, and
the analysis of county-specific data collected from the statewide landscape study, SSMC has developed the following
recommendations:
Improve navigation
and referral processes
between home visiting
programs and other
services to efficiently
meet the needs of
families by connecting
them with appropriate
programs.
What this looks like:
• Explore the scale-up of current Mecklenburg
County Public Health programs to serve as
the backbone agency to provide assessment
screenings and utilize a centralized data system
or coordinated intake system to link families to
appropriate resources.
• Integrate county referral tools to support data
collection for home-visiting services and resources
to support family needs.
Increase funding for
current programs and
curate new funding
streams for program
addition, growth and
expansion.
What this looks like:
• Provide funding to enable programs to expand
their current capacity, moving from 7% to 14%
service coverage.
• Secure funding to fill gaps in services for families
that are underserved by current funding
mechanisms or programs.
• Explore the implementation of a new home-visiting
program to effectively reach and serve families
that are currently not being reached by existing
programs.
• Explore funding for an education-based, salarysupplement
program for in-home family support
professionals.

RECOMMENDATIONS
Build and support
a well-trained,
well-supported
home-visiting
workforce.
What this looks like:
• Ensure funding is directed towards raising the
compensation of home visitors across the county.
• Establish an ongoing process of assessing and
improving services and outcomes based on datadriven
feedback.
• Partner with local schools to increase sustainability
in the workforce through training and
apprenticeship opportunities.
• Develop and implement a workforce program that
provides ongoing training, support, and resources
for home-visiting and family-support professionals.
Increase opportunities
for parents to influence
program implementation
and development.
What this looks like:
• Increase awareness and opportunities for the
development of parent leadership to elevate the
voices of those directly affected by programming.
• Support capacity-building efforts of earlychildhood
collaborations seeking to increase
parent leadership and enhance engagement.
• Establish a resource center as a platform for
enhancing family well-being to promote change
through a human-delivery approach.
• Support sustainable growth and change within
home-visiting and family-support systems.

CONCLUSION
While we are proud of what we have accomplished to
date, our work is not done. Successful implementation
of the recommendations will require ongoing
monitoring and evaluation of progress. This is best
done through continuous convening efforts to update
models and frameworks, gather new data, and heighten
advocacy for home visiting.
Our research to date has uncovered a robust yet
disconnected infrastructure of home-visiting providers.
Therefore, one of the most important things SSMC
can do is serve as hub organization in partnership
with Mecklenburg County government. We aim to
take the lead in enhancing and broadening the local
home-visiting system through the collective efforts
of the Home Visiting Collaborative. Our objective is
to work in conjunction with Mecklenburg County and
our partners to eliminate gaps in services and reduce
fragmentation of the system. Collectively, we will need
to monitor our progress, keeping everyone informed
about successes and challenges as they relate to the
system of home visiting.
Our work will inevitably involve further research
and more connections with local and state programs.
Finally, and of utmost importance, we must fully
support the home-visiting workforce. This entails
intentional strategies to recruit, retain and reduce
stress within the field. Achieving these goals will
necessitate significant support from the community
and its leaders as we embark on the next phase of
our work.