- The Washington Times - Tuesday, January 12, 2010

It’s a scenario repeated thousands of times in the past 30 years: A young, poor, pregnant woman agrees to have a nurse visit her in her home.

The nurse talks about good nutrition, giving up cigarettes and preparing for childbirth.

After the baby is born and for two more years, the nurse visits once or twice a month to help the young mother cope with the daily demands of a growing child.

This maternal home-visit service is on its way to becoming a massive federal program, thanks to President Obama and his administration’s push for health care reform.

But, as with any grass-roots approach that burgeons into a federal program, criticisms emerge. Concerns with this home-visit program range from its likely $1 billion price tag to the idea of Uncle Sam doing “in-home family planning” in poor neighborhoods.

As a candidate, Mr. Obama touted the Nurse-Family Partnership (NFP), founded in the late 1970s by psychologist David Olds.

“This program saves money,” Mr. Obama said in 2007. “It raises healthy babies and creates better parents. It reduced childhood injuries and unintended pregnancies, increased father involvement and women’s employment, reduced use of welfare and food stamps, and increased children’s school readiness. And it produced more than $28,000 in net savings for every high-risk family enrolled in the program.

“I will expand the Nurse-Family Partnership to provide at-home nurse visits for up to 570,000 first-time mothers each year,” Mr. Obama promised. “We can do this. Our God is big enough for that.”

The Obama administration kept its word. Its first budget called for a home-visitation program for new mothers costing $8.6 billion over 10 years. The home-visit program is now embedded in health care reform, costing $750 million over five years in the House bill and $1.5 billion in the Senate bill. The bills are being merged.

The Denver-based NFP has many supporters, including nine major foundations. Twenty-eight states use NFP, with almost 20,000 families enrolled.

However, the home visit program is viewed with suspicion in some quarters.

The House Republican Conference initially derided the House provision for its “billions for babysitters,” but seems to have backed off that claim, reportedly because of some Republicans’ support for NFP.

Other critics are animated by the specter of a “nanny state” and displacement of parental rights.

The program could increase “matriarchal dominance” in poor neighborhoods already awash with absent-father homes, said Gordon E. Finley, a psychology professor at Florida International University who writes on gender roles.

Most nurses are women, he said, so it would mean more women advising women, without necessarily considering the fathers. And because nursing is a female-dominated sector, the program means more jobs for women, but not men.

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