Investing in Home Visitors is Investing in the Nation’s Children and Families
October 5, 2026
Dear Colleagues:
As part of the Trump Administration’s commitment to Make America Healthy Again, the Health Resources and Services Administration (HRSA) supports evidence-based home visiting services through the Maternal, Infant, and Early Childhood Home Visiting (MIECHV) Program. Parents are a child’s first and most important teacher, and by giving them the tools and support they need, we’re creating a strong foundation for families to thrive.
In 2025, MIECHV delivered over one million home visits and reached more than 158,000 parents and children in all 50 states, the District of Columbia, and five U.S. territories. Families enrolled in MIECHV services routinely outperform national comparisons on key child and family health and development outcomes.
Home visitors make this work possible. They build trusted relationships with families, provide education and support to parents, promote healthy child development, and connect families to critical health and community resources. The effectiveness of home visiting programs depends on a skilled, stable, and well-supported workforce.
Replacing a single home visitor costs a local program an average of $60,000, more than the average home visitor’s annual salary, and these losses are increasing.1 More than half of home visiting programs experience at least one staff departure each year, and an estimated 20% to 29% of home visitors leave the field annually.2 Home visitors are often compensated well below professionals with comparable education, credentials, and responsibilities, and this gap remains one of the most significant drivers of workforce instability in the field.3 The strain is already visible in recruitment; there is currently only one home visitor for every 315 households eligible for MIECHV services, and more than half of programs report recruitment challenges.4 Beyond the financial toll, every departure disrupts the trusted relationships between home visitors and families, reduces program capacity, and undermines efforts to reach the communities with the greatest need.
To address this, HRSA partnered with the Institute for Home Visiting Workforce Development to launch the National Strategy for the Home Visiting Workforce. This is a roadmap, shaped by home visitors and state and local leaders, for building a sustainable, well-supported workforce through fair compensation, strong supervision, and clear career pathways.
HRSA is calling on the home visiting field — MIECHV awardees, state partners, local implementing agencies, model developers, health care providers, institutions of higher education, workforce development organizations, community partners, and public and private funders — to take action.
Specifically, we’re asking you to assess current workforce investments and prioritize:
• Competitive compensation for home visitors and supervisors, including reviewing salary structures and identifying opportunities to raise wages to fair, competitive levels that align with local labor markets.
• Retention of experienced staff through a range of strategies, such as salary progression, recognition programs, mentoring, and opportunities for advancement.
• Recruitment efforts by improving hiring processes, expanding local recruitment partnerships, and targeting outreach to match community context.
• Benefits and workforce supports, including health insurance, paid leave, retirement benefits, mileage reimbursement, technology resources, safety supports, and flexible scheduling.
• Workforce well-being through high-quality reflective supervision, manageable workloads, employee wellness resources, and workplace practices that reduce burnout.
• Expanded career pathways by creating opportunities for paid apprenticeships, professional development, skill-building, and career ladders.
• Braided funding strategies across federal, state, local, and philanthropic funders to promote field-wide advances in home visiting workforce supports.
Investing in home visitors is investing in the Nation’s children and families. HRSA remains committed to supporting these efforts through technical assistance, workforce resources, and ongoing consultation. Home visiting programs across the country can access tools and resources.
Thank you for your continued leadership and commitment to advancing home visiting and supporting the workforce that makes this work possible.
Sincerely,
/s/
Thomas J. Engels Administrator
“Home visitors make this work possible. They build trusted relationships with families, provide education and support to parents, promote healthy child development, and connect families to critical health and community resources. The effectiveness of home visiting programs depends on a skilled, stable, and well-supported workforce. ”
1 Institute for Home Visiting Workforce Development (2026). Recruiting, Supporting, and Retaining a Qualified Home Visiting Workforce: State of the Field and Current Trends. https://hvworkforce.org/wp-content/uploads/Recruiting-Supporting-and-Retaining-a-Qualified-Home-Visiting-Workforce_State-of-the-Field-and-Current-Trends_Report.pdf
2 Institute for Home Visiting Workforce Development (2026).
3 Ibid.
4 Ibid.