*This report was replaced in its entirety by Early Impact Virginia on July 22, 2024.

The past year proved to be another of change and growth for Virginia’s home visiting system. With rapidly changing family and workforce needs at the forefront, local providers and leaders have worked to address immediate challenges while simultaneously adapting to major environmental shifts. As pandemic disruptions have leveled off, providers worked to rebuild relationships with community partners and regain footing in significantly changed landscapes. Throughout, local programs have maintained a steadfast commitment to being present with and for families as they navigate the parenting journey. And while much has changed, many things have not.

Fundamentally, new parents still want and need the same things for themselves and their children — good health, nurturing relationships, safe homes and communities and above all else joy — joy in parenting, joy in childhood and joy in life. What has changed is our collective understanding of the extent to which many of our systems have remained unresponsive to the needs of pregnant women and families with young children resulting in preventable trauma that carries lifelong consequences, including death. Rising rates of maternal mortality and morbidity and preventable infant deaths are now being prioritized and addressed. And, we are finally reckoning with the disparate treatment, access and outcomes endured by persons of color, especially black and brown women.

These issues are not new and have been well-known and reported for years by maternal and child health champions, including home visiting. Over the last couple of years, Virginia has made great strides improving access to perinatal supports, raising public awareness and educating providers to address racial bias and inequity in our healthcare and social support systems. Concrete changes in targeted services to support pregnant persons of color and those at the greatest risk, like Medicaid supports for Community Doulas, expanded postpartum coverage and expanded access to high quality early care and education are having a very real impact.

For home visiting, these changes are welcome, but come with challenges as we work to ensure all local programs understand what is changing and are able to support families to access community resources while navigating rapidly changing systems and expectations. Development of new services and supports without systemic approaches leaves communities and families to figure it out on their own. As a holistic service, home visiting works in collaboration with community partners across maternal, infant and early childhood systems. As new services are introduced, local providers must be careful to maintain a familycentered approach and not unintentionally seed competition or confusion among partnering organizations. This offers opportunity to build responsive systems in communities but also continues to contribute to fragmentation and inequitable access.

While addressing these systemic challenges is beyond our reach and capacity, Early Impact Virginia is committed to working with state partners to develop systemic solutions while prioritizing work to stabilize the home visiting system by addressing the following key strategic objectives: 

• Building the home visitor pipeline to support workforce recruitment and retention.
• Ensuring continuous quality improvement that prioritizes family voice.
• Collecting real-time data for decision making and equity analysis.
• Supporting community readiness for innovative, effective service delivery.
• Creating sustainable funding strategies to enhance program stability and targeted growth.

Early Impact Virginia is pleased to present the following report highlighting the current state of home visiting in Virginia and the ways in which we are leading efforts to address the Commonwealth’s key priorities for families and young children.

/s/ Laurel Aparicio
Executive Director