Home Visiting Nurses

WM, Worker and Family Support:  Improving Family Outcomes through Home Visiting, March 16, 2022

This program should be available to all families, whether they are in “the system” or not. When this Congress or the next adds a public option to the Affordable Care Act, this should be included. It should also be featured in any Medicare plan used by the disabled. If pre-existing condition protection is repealed, the end of private insurance is inevitable, turning the public option into a single-payer program. If, on the other hand, we find single payer through Medicare for All, this program is a must-have.

In short, home visits for expectant and new mothers should be included in all plans, including those where employers hire their own nursing staff. 

When my daughter was born, we could have used this. While my wife and I could get to services needed, if I had not been available, we may not have been able to go to services rather than have them come to us (from lactation consulting to depression screening). Indeed, lactation consulting is best handled in the home, where a more intimate setting would be helpful.

Looking at the title alone, one could get the impression that it was talking about welfare visitation or housing inspection - which could be punitive in both cases. Even those visits should not be punitive. Paid remedial and job training should be available to one and two parent households with no qualification process required. Anyone over 16 with less than an associates degree or vocational certificate must be made eligible. 

Working toward literacy and seeking a decent level of education should be compensated at the minimum wage - and not the current level. The Minority countered the Fight for $15 with a $10 counter-offer. The appropriate response should be yes - but also  immediately. The wage should transition to $12 per hour, or $11 with a 32 hour work week, with the child tax credit increased to the level received by families at the median income. $1,000 per month is a good number.

The (refundable) Child Tax Credit and minimum wage must both be indexed to inflation. The CTC should be included with other government benefits, from Unemployment to paid education to Social Security. An adequate CTC would allow discontinuing orphan benefits and most child support arrangements, as well as SNAP for families.

In certain circumstances, unemployment compensation should be available on a no-fault basis. Better still, employees should be allowed to voluntarily leave firms with a history of quickly dismissing employees without penalty. There should be no expendable jobs or workers. 

Working parents should receive their CTC through wages (the full amount). This can be accomplished in one of two ways: employers could deduct CTC payments included with wages from their quarterly payments to the IRS - or even receive a rebate. 

An employer-paid subtraction VAT paid by all employers would take this scheme to the next level as part of more comprehensive tax reform. We believe that such reform is necessary to break the log jam on providing adequate support to all families. Our most recent tax reform proposals are included in the attachment.

An adequate CTC and minimum wage are pro-life issues and must be scored as such. This is the best way to make these provisions bipartisan. Republican legislators should be made very uncomfortable voting against this and pro-life clergy should be made very uncomfortable for not insisting that these matters be put at the top of the anti-abortion agenda.

Such benefit improvements will put the free market for housing back in play for many families - although equal housing opportunity enforcement must be beefed up. Criminal penalties for violating fair housing rights should be enacted as well. Do these things, and the only home inspection required for any family would be home nursing visits.

Thank you for highlighting this worthy program, which again, should be available to all households - especially as we consolidate toward some form of Public Option, Medicare for All or other form of Single Payer insurance.

Attachment: Tax Reform