- Associated Press - Monday, March 12, 2018

ST. PAUL, Minn. (AP) - Like a lot of parents-to-be, when Zipora and KP Niowong were expecting their first child, they had a lot of questions.

But instead of just scouring books and the internet or getting advice from family members, the Niowongs had an expert to turn to - Michelle Thao, a nurse from Ramsey County.

“This is my first baby, and I wanted to learn more about how to take care of my baby,” Zipora Niowong said of her now-19-month-old son, Zeph. “It has helped a lot.”

The Niowongs participate in Ramsey County’s Healthy Families program that provides home visits from a nurse from pregnancy until a child is 3 years old. The program ensures that parents have the right skills and that children are developing properly so they’re ready for preschool and beyond.

The voluntary program, typically offered to new parents with low-incomes, also aims to strengthen family bonds and help new parents understand all the resources available to them.

“Part of the goal is to promote parent and child interaction,” Thao told the Pioneer Press . “That helps a child be successful more than anything.”

Ramsey County has been providing home visits from nurses for roughly three decades. In 2016, St. Paul-Ramsey County Public Health made 20,598 home visits to 1,139 families at a total cost of $7.3 million.

With $12 million in new funding for the Minnesota Department of Health to expand similar programs, state education officials are beginning to collect data to learn more about the impact of home visits. Health experts already believe the visits pay off with a 5-to-1 return on investment.

Brenda Cassellius, state education commissioner, received home visits from a nurse when she was a young mother. She said the program helped her understand the milestones her child needed to reach to be ready for school.

“It really is about the child and the whole family,” Cassellius said. “Making sure not only that the child has what they need for success, but that mom and dad do too.”

Under Gov. Mark Dayton, Minnesota has put considerable resources into programs that help young children. The state expanded funding for full-day kindergarten and has dramatically increased spending on preschool programs.

Minnesota spends about $250 million a year on early-learning and child care programs. We’ve committed all that money because state leaders believe children who are properly prepared for school will be more successful in life.

High-quality early learning is seen as a key tool in the work to address Minnesota’s persistent academic achievement gap between students who are poor or racial and ethnic minorities and their white and more affluent classmates.

Democratic lawmakers have pushed to have programs for young learners universally available to any family that wants them. Republicans have argued the state’s limited resources should be focused on children and families that are most at risk and struggling.

Nurse home visits bring the early-learning focus to even younger children, often before they are born. About 50 percent of a child’s brain development happens before they are 3, so what happens in the first years of life can have a big impact later on.

State health and education officials want to know more about what is going on in those early years. They’re interested in how much a family receiving home visits from a nurse can improve a child’s cognitive and social development.

The education department is using a $20,000 grant from the advocacy group Child Trends to gather data about home visits and connect that information to other statistics the state already collects about students.

“Then it will become an evidence-based practice,” Cassellius said, and lawmakers will be more likely to support increased funding for home visits.

Thao met with Zipora Niowong during her pregnancy to make sure she was healthy and answered all of her questions about being a first-time mom. After Zeph was born, Thao visited the Niowong family weekly to monitor his growth and development and ensure he was interacting properly with his parents.

As Zeph got older, the time between visits stretched to two weeks, but that can be different for other families. Thao was always there to answer any questions KP and Zipora Niowong had, like one time when Zeph wasn’t eating properly.

Mostly, Thao was there as support for the new parents.

“They were such naturals,” Thao said. “I didn’t have any concerns.”

For KP Niowong, who often works the night shift, the regular visits with Thao were much-valued family time.

“She’s been very helpful,” he said.

When Thao finished her nursing training in 2014, she decided that she didn’t want to work in a setting where she would be “churning out” patients every day. She wanted a more personal connection.

Unfortunately, Thao’s time with the Niowongs is coming to an end. She’ll soon be relocating out of state.

But Katie Mildon will step into Thao’s role and regularly visit Zeph and his parents, likely until the boy turns 3. Mildon worked in a neonatal intensive care unit, but was drawn to home visits for reasons similar to Thao.

“I love babies and working with mothers,” Mildon said. “I want to work with families where I can build a relationship.”

Anne Barry, director of St. Paul-Ramsey County Public Health, is glad state education officials are studying the outcomes of nurse home visits. She said there is plenty of evidence the visits are worthwhile from a public health standpoint, and she’s interested in what they mean for school readiness.

“Educators have a different lens they use when they look at child development,” Barry said. “We each bring our own perspective. When we work together with greater alignment is when we can help one another and learn from each other.”

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Information from: St. Paul Pioneer Press, http://www.twincities.com

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