What Is The Cost of a Home Visit?

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Home visits by the government are apparently the new thing across state legislatures in the U.S. See below for a list of bills and why these could pose a risk to your family’s privacy.

Before you put out the welcome mat and  assume ‘Home Visits are great; it is helping kids’…  Please consider this:  What is the trade off?  Services for newborns, pregnant mothers and children already exist without Home Visits to tell you about them.

Home visits should not be a required, forced prerequisite to receive services.

If you must hand over your citizenship status, your family’s personal medical and mental health information, marital status, income, race,  answer questions about depression, family interactions, tobacco use, infant’s gestation, birth order, developmental delays, immunizations, etc. in order to receive services or information about services, this is coercive.

If in doubt about the data collected, take a look at this document entitled, Maternal, Infant, and Early Childhood Home Visiting Program Performance Indicators and Systems Outcomes Data Collection & Reporting Manual from the U.S. Department of Health and Human Services; be sure to review the lists of personal data elements collected and how they are used as performance indicators.  Many (all?) of these Home Visit programs leverage federal Medicaid monies to pay for services. If you are unfamiliar with the questions asked on a Medicaid form, see this Colorado Medicaid form which families must complete to receive mental health services. As you can see from proposed state legislation below, Home Visits can be forced,  sometimes without your permission. Forced data collection is invasive, especially when we know data can be used against you, can be used to profile and deny services.

Information about family, early childhood services is already readily available.

Information about services for families is readily available, often (as in the case of Washington) directly mailed to families, is already posted on websites, in hospitals, doctor’s offices and clinics, at food banks, libraries, phone books and schools.  Are Home Visits really about informing parents about available services?

Home Visits & leveraging your personal information.

If data collection isn’t the main focus of Home Visit programs, ask WHY, in states like Washington, amendments (below) to protect personal information, make data collection and sharing voluntary and transparent, have been killed.  With every state bill posted below, we wonder if bill sponsors would consider adding opt-in CONSENT and transparency before personal information is collected and shared. 

Is personal data the price of a home visit?

Wrench in the Gears recently wrote about this, brilliantly documenting how Home Visit legislation sweeping the nation is a well connected, well funded Moneyball scheme based on data collection.  (See MEWs prior piece on Moneyball for Kids and see who are the All Star Moneyball for Government Players in your state.)  Home Visits are disguised as charity but are actually a profit based invasive data grab, turning people and personal information into human capital and predictive numbers. Wrench in the Gears writes:

Home Visit Legislation: A Sales Pitch For Family Surveillance?  “It tells the tale of a sweeping program of “collective impact” cultivated by consultancies like Third Sector Capital PartnersFSG, and the Nonprofit Finance Fund. Strive Together, a non-profit program incubated in Cincinnati, OH under the wing of Gates Foundation-funded Knowledgeworks (promoter of learning ecosystems), will carry out the program.”–Read this Wrench in the Gears piece. Look at the maps. Follow the money.

A List of State ‘Home Visit’ bills for 2019.

Below are a few states with current Home Visit legislation.  If you don’t see your state, click this NCSL bill tracker and check back often, to see if your state has already passed Home Visits, Early Childhood Visits, mandated Universal Mental Health Screenings.

Colorado has SB102 bill which permits a public school to include in its innovation plan that it will operate as a community school. Community schools are tied to the federal law, ESSA.  Community Schools require Home Visits and mandatory community, parent, child surveys.  Colorado’s Governor appointed an Education Leadership Council who has recently  released this report to guide the state’s future education strategies. The report cites Marc Tucker’s work on lifelong work based learning and K-12 education as a building block for a workforce databadges aka, credentials. The Colorado report has been lauded as a Culture Shift in Education in which many Colorado education bills (including this Community Schools Bill) will be generated.  (See powerpoint presentation and listen to testimony by  Representative Bob Rankin at the Colorado State Board Februrary 14, 2019.)

Illinois has introduced a bill, HB3560, that says if you want to home school, you will be visited by the Child Protective Services.   Yikes.

Iowa has S111Medicaid Managed Care Newborn Visitation Services.  The bills says the department of human services shall contractually require a Medicaid managed care organization to provide at least one evidence-based home visit for every newborn.

Iowa also has a bill, HF 272, that mandates school district board of directors to conduct quarterly home visits to check on the health and safety of private home schooled children. The home visits shall take place in the child’s residence and an interview or observation of the child may be conducted.  Apparently, you can’t say no.

“If permission to enter the home to interview or observe the child is refused, the juvenile court or district court upon a showing of probable cause may authorize the person making the home visit to enter the home and interview or observe the child.”

Is it weird that they can come into your home, without your permission? What constitutes probable cause?  Simply because you home school? Or maybe if you are Black? White? Muslim? Christian?  Immigrant?  The 4th Amendment says probable cause means when you have reason to believe that a crime has been committed and that evidence of the crime will be found in the place to be searched.   Is home schooling a crime? 

Maine has H97 which appropriates funds for home visiting services to provide child development education and skills development for new parents.

Minnesota has S671, the GREAT START FOR ALL MINNESOTA CHILDREN ACT which creates funding and opportunities for children ages prenatal to three; home visiting prenatal to 3, public school/head start birth to 3 education, early childhood education, and child care assistance birth to 3 years for all MN infants and toddlers. This bill details the Great Start Fund in state treasury for birth to 3 education in the schools. Also, various grant programs will target primarily low income, ethnic, and high risk population. Home visit and birth to 3 education is offered to all families

New Hampshire has NH S 274, Newborn Home Visiting Program which declares that the Newborn Home Visiting Program shall be available to all Medicaid eligible families.

New Mexico has NM S 290 Medicaid Home Visiting Services and Council which requires the secretary of human services to establish Medicaid home visiting services.

Ohio has OH 7 Executive Order, that creates the Governor’s Advisory Council on Home Visitation looking at evidence based home visiting programs.

Oregon has OR S 526 Licensed Health Care Providers Study that directs state Health Authority to study home visiting by licensed health care providers, requires report to interim committee of Legislative Assembly related to health care and declares an emergency.

Washington (the home state of Microsoft) wants to be a leader in Home Visits and data collection; so we will highlight a few interesting points about Washington Home Visit legislation.  WA has an “emergency”  bill  WA H1771 / S5683 called “The Baby Act”, that says if you have a baby, you may be visited by “allied professionals” from the State government(A note on Emergency Clauses in bills, this basically means citizens have no recourse.)  The WA Baby Act creates a universal home visit program for newborns and creates a state run family linkage. Parents and privacy advocates are asking legislators to STOP the WA Baby Act.  Will they listen or are they too far down this home visit path?

According to this CCSSO publication,

“The Washington state legislature created the Home Visiting Services Account in 2010 to blend federal, state, and private dollars to efficiently and effectively serve families across the state with high-impact, home visiting services. Home visiting is part of the state’s commitment to early learning. A strong public-private partnership – inclusive of the Office of the Superintendent of Public Instruction, the Department of Early Learning, the Department of Health, the Department of Social Services, and Thrive Washington – guides implementation of the state’s Early Learning Plan and Birth to Three Plan.”

Watch February 5, 2019 testimony on this bill, HB1771.  Starting at about the 39 minute mark, you will hear a representative from Washington’s Governor Inslee state,

“I am excited to be here today, in support of this bill which is Governor Requested legislation…that will make Washington a national leader for statewide Home Visiting…“–Michelle Davis, Executive Director of WA Board of Health, Representing Governor Inslee [Emphasis added]

At the 44 minute mark, Representative Griffey asks a good question about protecting personal medical information. He states,“I’m a health care provider Emergency Medical Technician have been for thirty three years. I just want to make sure that we have a firm grasp on HIPAA and that medical information that we have is going to stay. I found that many bills that we’ve worked on here we don’t have the same HIPAA once you transfer information to a state agency the health care protect Health Care Information Protection Act doesn’t apply and I want to make sure that we have tight sideboards on this and could you talk to that please?” [Emphasis added]

Ms. Davis responds without answering the question. Instead she refers to prior testimony from Durham, SC  Home Visit Family Connects program, that Washington would like to model,

“So as you heard from the folks at Durham they’ve implemented this program across the country and so they do have expertise in help but they are medical professionals who have worked on this so we can provide you with more information about health privacy of the families who are receiving the services.”

If Home Visits are so wonderful, why must they be forced on citizens and why can’t parents consent to how their family’s data are shared?

Why did Washington legislators kill amendments that would protect privacy and would have guaranteed Home Visits as an opt-in program, and would have given parents transparency on how Home Visit data are used?

See these Proposed Amendments on Washington Baby Act: that were killed by Washington State legislators. Ask yourself why.

What if you refuse Home Visits? Will this turn into a big red flag that labels you as a risk? 

What if you really can’t say “No”? 

What if the WA Baby Act with Home Visits becomes mandatory, gets changed like another “voluntary” WA bill did? (In 2015, WA HB1491, The Early Start Act, was changed in the legislative process. The bill reads voluntary in some areas but also removed the word voluntary in another area. The bill states that if you receive state funding, you must participate in this Early Start program that collects longitudinal data: “EARLY ACHIEVERS, QUALITY RATING, AND IMPROVEMENT SYSTEM….The department, in collaboration with tribal governments and community and statewide partners, shall implement a ((voluntary)) quality rating and improvement system, called the early achievers program. Approved early childhood education and assistance program providers receiving state-funded support must participate in the early achievers program by the required deadlines.)

Washington also has an ACES bill, HB1925, that creates an ACES pilot to track Adverse Childhood Experiences (ACES).  Watch this February 13, 2019 testimony where HB1925 ACES is the first bill presented.

“…our Department of Health administers the child profile health promotion system a program that mails information [about services currently available] to parents of children up to the age of six; those materials include age specific reminders for parents about well child checkups immunizations and other information Adverse Childhood Experiences or Aces. [These] are indicators of severe childhood stressors and family dysfunction experienced before the age of eighteen that can negatively impact a person’s physical and behavioral health Ace’s indicators include child abuse and neglect alcohol or substance abuse in the home mental illness depression or suicidal behaviors in the home incarceration of a family member witnessing intimate partner violence and parent divorce or separation.”

If you aren’t familiar with ACES, and predictive profiling, I again direct you to Wrench in the Gearswho shares that “ACES will be a crucial pubic health concern, my fear is that ACE prevention and mitigation interventions will become vehicles for “innovative” finance and will expand profiling of vulnerable populations.”  Read more on ACES here.

Protecting children and preventing child abuse is good but predictive analytics can be wrong.

The data you provide can be shared, re-shared, and analyzed.

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With Home Visits, you will be scored.  Unless specific opt-in consent and transparency provisions are put in place, and are enforceable,  the data Home Visits collect can be analyzed, (profiled?), shared with researchers, businesses, nonprofits or any government agency.  You should be aware of a new federal law HR4174mandating “data interoperability”, data sharing across all agencies.

You should also be aware of a current U.S. Department of Homeland Defense biometric data collection programHomeland Advanced Recognition Technology, HART, tied to services and benefits of US. citizens, much like China’s Sesame Credit and India’s Aadhaar.

Personal Property, Personal Rights, and Personal Privacy

Your home is your property and should be protected against warrantless search and seizure. Your data should also be YOUR property.  Surveys collecting students’ personal beliefs on sensitive topics must have prior informed parent consent under federal law PPRA. Home Visits, mental health screening should be no different.

Don’t be so quick to put out the welcome mat for any Home Visit legislation unless it implicitly guarantees opt-in consent, and is not a condition of receiving services, and allows parents to see and choose how their family’s data is used or shared.


A few references as to why we are so focused on infants, toddlers (zero to three years old) and Early Learning data:  ROI and human capital. 

Zero to Three targets are:

  1. Early Learning Guidelines;
  2. Infant and early childhood mental health; and
  3. Connecting families to appropriate services.

This article, released in June 2014, discusses how the most recent ELC grantees (Georgia, Kentucky, Michigan, New Jersey, Pennsylvania, and Vermont) are targeting infants and toddlers. Additional resources and excerpts from the full article can be found here. The full article explores topics including:

  • Developing and Integrating Early Learning Guidelines for Infants and Toddlers
  • Professional Development of the Infant-Toddler Workforce
  • Expansion of Home Visiting
  • Building Capacity in High-Need Communities
  • Engaging and Supporting Families
  • Connecting Families to Appropriate Services
This has been cross posted here with the author’s permission.  It was initially posted on the Missouri Education Watchdog and then on Truth in American Education.  Much thanks to author Cheri Kiesecker as well as the informative work provided on Wrench in the Gears.
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