June 24, 2018
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Cutting home visits for families harms us all

By Mark S. Brown, Special to the BDN

Time is running out for the Legislature to reinstate Maine Families Home Visiting into the state budget for the next two years. I recently read Dr. T. Berry Brazelton’s letter to Maine’s legislators, commissioners and the community. I was reminded that an important part of a pediatrician’s love of their work with children includes the duty to speak up for families — repeatedly.

Dr. Brazelton has been in pediatrics for over 50 years. He is a renowned pediatrician and author known worldwide for his contributions to parents and the science of raising emotionally and physically healthy children. He is professor of pediatrics emeritus at Harvard Medical School and founder of the Brazelton Touchpoints Center.

He has been to Maine on a number of occasions and has personally been involved with Maine Families Home Visiting in instructing and coaching the home visitors about how to actively listen and work with the families they interact with using the Touchpoints techniques. Each home visitor has had this instruction as part of their training.

It was significant to have Dr. Brazelton speak up about the importance of keeping the Maine Families Home Visiting program. In his letter he wrote about his Maine experience: “For the past four and a half years, we have worked intensely with state and community based providers in your state so that over 100 Home Visitors from the Maine Families Program can enhance their practice and provide the kind of support and information that parents crave. When parents have the opportunity to develop a relationship with a caring professional and understand the individual roadmap which their child is following, then everyone wins.”

Dr. Brazelton’s letter continued: “The Maine Families Home Visitation Program has become a crucial component of the home visiting continuum of services in Maine, addressing the social and developmental needs of new parents and their children. Independent evaluation of the Maine Families Program demonstrates the effectiveness of the program to reduce preventable injury and illness and assist families to reach financial independence.

“Across the country states are struggling to balance their budgets. When making decisions, legislators and governors must consider the evidence for cost saving that is behind programs like Maine Families as well as the vital role that your home visiting program has in the system of care that is required to support and care for our pediatric population, especially those at highest risk. I know from long experience that healthy, well-cared for children present our nation’s best bet for a productive future. Hence, I hope that Maine people and their legislators will lead the way again and continue to make this prudent investment in the future of your children,” Dr. Brazelton concluded.

More than 30 years ago, home visiting was demonstrated by David Olds to help young women take better care of themselves and their babies. It is the most efficient and effective way to work with families around parenting, risk reduction and building healthier children. I have personally worked with Maine Families with a particular focus on the high-risk families whose infants are born after prenatal opiate exposure.

The prescription opiate abuse epidemic in Maine is a reality we all face and so is caring for these families and their children. We have built a comprehensive program around the in-patient care for these infants and families and have begun to undertake the challenge of creating a system of care in the community for keeping these families engaged after discharge of the infant from the hospital. Our thinking is that if we can “get it right” for these infants and families, then there will be a system of care in place for other infants who are high-risk, whether the risk factor is prematurity, disability, poverty or opiate exposure. Again, the pivotal role that home visitors play is underscored as we move these infants and families into a receptive system of care and keep them engaged.

Eliminating the funding for Maine Families is counterintuitive to improving the health of our next generation in Maine. Unfortunately, if funding is taken away it will have a long-lasting and profoundly negative effect. Maine Families is a cost-effective way for keeping high-risk, disadvantaged families and their infants engaged in a system of health care.

Mark S. Brown is the chief of the Department of Pediatrics and director of nurseries at Eastern Maine Medical Center.

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