Home visiting programs in the U.S. grew from three major approaches that first became prominent in the 1960s: visits by public health nurses to promote infant and child health in disadvantaged families, Head Start home visiting to promote school readiness in hard-to-reach families, and home-based family support to promote positive parenting and prevent child abuse in high risk families. All of these approaches sought to foster early childhood health and development by intervening in the home to support and improve socialization, health, and education practices. Today, home visiting is seen as a particularly important strategy for high risk families who may be difficult to engage in other services. A study by the PEW Center on the States found that in fiscal year 2009-2010, states spent more than $500 million to fund home visiting programs, with additional programs funded by local governments and private foundations.
On March 23, 2010, the President signed into law the Patient Protection and Affordable Care Act (ACA) of 2010. Through a provision that authorizes the creation of the Maternal, Infant, and Early Childhood Home Visiting Program (MIECHV), the Act greatly expands federal funding of evidence-based home visiting programs. According to a Supplemental Information Request (SIR) released by the Health Resources and Services Administration (HRSA) in February 2011, “this program is designed: (1) to strengthen and improve the programs and activities carried out under Title V; (2) to improve coordination of services for at-risk communities; and (3) to identify and provide comprehensive services to improve outcomes for families who reside in at-risk communities.”