Home visit law would be cash wisely spent
The 2019 Oregon Legislature will debate legislation that, if passed, would create a program of voluntary, universal home visits by nurses or other medical professionals for the families of every newborn baby.
Oregon would be the first to offer universal home visits.
And this, to our thinking, is about the smartest money ever spent by the Legislature.
They'd be "voluntary" in that families could opt out, but "universal" in that they eventually would be offered to every family with a newborn child.
As outlined by Gov. Kate Brown, by the Oregon Health Authority, and by Sen. Elizabeth Steiner Hayward of Beaverton, the program would offer three visits to homes when babies are a few days old, two weeks old and two months old. The medical professionals could look for several things:
n Evidence of any childhood illnesses.
n Potential concerns about the home situation — is there a safe place for the baby to sleep and bathe?
n The well-being of the parents — Do you know how to nurse? Are you experiencing postpartum depression?
Parents would be able to opt out if they don't want the service, according to Steiner Hayward, who co-chairs the Legislature's budget-writing body, Ways & Means, and who also is a physician.
The Oregon Health Authority is seeking $4 million to begin a pilot program for an estimated 10,000 families on Medicaid; money that would draw matching federal funds.
Steiner Hayward said it would be up to the Legislature to find the funding for all other Oregon families: urban, suburban and rural, from Portland to Pendleton to Prineville.
One reason this is such a smart idea is it would save money. Duke University ran a similar pilot program in North Carolina and found that for each $1 in program costs, the Durham Connects program yielded $3.02 in savings in emergency health care costs (families not having to go to emergency rooms for basic health care for their infants). Their findings are available at familyconnects.org.
Duke researchers estimate that for cities like Durham, which averages about 3,187 births per year, an annual investment of $2.2 million in nurse home visits would result in a community health care cost savings of about $7 million in the first two years of a child's life.
This is hardly an isolated example of spending early money to save money later. Every dollar spent on childhood vaccinations saves more than $5 in direct costs and about $11 in additional taxpayer costs by avoiding illnesses before they manifest.
And the U.S. Centers for Disease Control and Prevention has, for years, cited a study stating that strong smoking-prevention programs have demonstrated achievement of a $55-to-$1 savings, by getting people to quit smoking or to stop them from even starting in the first place.
When it comes to health care, it's been known for decades that spending money before an illness is just smart policy.
We also applaud the universal nature of the proposed program: This isn't just aimed at underserved families, or low-income families, but everyone. Having a baby is stressful and harrowing. It doesn't matter who you are.
Finally, we may be in boom times now, but the next recession is coming, maybe in 2020, maybe this calendar year. Any funding mechanism now that saves money later is the equivalent of adding to the rainy-day fund.
This is sane, simple, smart legislation that likely will draw bipartisan support. It's exactly where the Legislature ought to be investing our money.
We hope the bills come to fruition and become law. Because some cliches reflect reality, we note that an ounce of prevention really is worth a pound of cure.
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