Los Angeles County's experience, write Christina Altmayer and Barbara Andrade DuBransky, shows how a universal offer of assistance can establish a foundation on which public and private agencies can plan meaningful systemic reform—and spark incentives for greater, more effective investments in services directed to vulnerable families. The county's vision for a universal, voluntary, integrated system of home visiting offered in 14 targeted communities builds on Welcome Baby, a universal home visiting program that provides as many as nine contacts to pregnant women and new parents until a child's ninth month. Piloted in one hospital in 2009, Welcome Baby is now available to new parents delivering in 14 hospitals throughout the county, reaching approximately one-third of all births in the county annually. As of June 2018, the program had reached more than 59,000 families.
Welcome Baby and other related investments are part of a broader story unfolding in LA County. The authors describe an important policy shift that's moving both public and private providers toward an integrated system of universal and targeted home visiting. The county's action plan calls for significant investments in new parent support and responsiveness from multiple county-level agencies, as well as the development and expansion of multiple home visiting models to meet the needs of the county's diverse population.
As the initiative continues to grow, Altmayer and Andrade DuBransky write, the county is aiming to streamline referral pathways to ensure maximum participation; fill service gaps for high-risk populations; increase access to voluntary home visiting for families at high risk for involvement in the child welfare system; create a common data collection system to improve outcome reporting; maximize the use of current resources while generating new revenue; and ensure that the home visiting system is deeply embedded in larger systems serving children and families.