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Universally Offered Home Visiting

Evidence shows that when a home visitor can assess family needs and connect families to services that best address those needs, the health of the family improves. Current programs are not designed to reach all families which makes it difficult to make population-level change on health outcomes such as low birth weight or postpartum depression.

Universally offered home visiting is a voluntary, opt-in program. No families are required to participate.


Universally offered home visiting is a system of communication, connection and coordination available to every family with a newborn. Universally offered home visiting supports family health. The birth of a child is a big change for any family. A new family member changes a family’s social, emotional, financial and physical environment. While the needs of each family differ, most families report they welcome support as they move through this transition.

A safe and healthy environment during early childhood forms the foundation for a lifetime of physical and mental well-being and healthy relationships, and each family had unique strengths and constraints that need to be considered.

Building on Oregon’s current home visiting programs, an evidence-based, universally offered, 1 to 3 visit nurse home-visiting program would create a home visiting system in Oregon that connects all families with the services they need.

  • A universally offered model would not replace more intensive targeted home visiting programs. It would identify what families need and want from local resources and provide an individualized, non-stigmatizing entry into a community system of care, including referrals to other more intensive home visiting programs and social supports.
  • In collaboration with hospitals and birth attendants a provider would engage every Oregon mother (and father) of a newborn shortly after birth, ideally face-to-face postdelivery to schedule a home visit. If families choose to accept this service, they then receive 1 to 3 visits in their home to help them get off to a good start and get connected to services they need and want.
  • Participation is voluntary for families.
  • Implementation of universally offered home visiting system in Oregon will roll out over the three biennia using a phased-in approach, beginning with communities of readiness.
  • Oregon’s universal home visiting system would leverage federal Medicaid funding and engage commercial health plans to offer evidence-based home visits for all Oregon families of newborns, regardless of income status.


  • Universally offered home visiting is voluntary. All families would be offered this service.
  • Evidence shows about 70% of families choose to participate.
  • Evaluation of Family Connects, an evidence-based, universal, 1 to 3 visit nurse home visiting program has shown that families have:
    • More connections to community resources at 6 months.
    • More positive parenting behaviors with their infant (e.g., nurturing touch, reading) at 6 months
    • 28% less clinical anxiety reported by mothers at 6 month.
    • Higher quality home environments (e.g., safety, books, toys, and learning materials) at 6 months.
  • Specifically, the Family Connects evaluation has shown reduced emergency medical care (hospital overnights, emergency department and emergency doctor visits) for infants at 6 months, 12 months, and 24 months.
  • The Family Connects model estimates that for every dollar invested in the program, there is a $3.02 savings, primarily from reduced infant emergency medical care.

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