Home Visiting in Montana: Supporting Families from the Start

By Caili Lowney

As Montana continues to find ways to support families and young children, home visiting is an evidence-based service that the state can, and should, look to expand. Home visiting services match expectant parents and caregivers of young children with a designated support person, typically a trained nurse, social worker, or early childhood specialist, to support a family through the early stages of raising a child. These services typically begin during pregnancy or shortly after the birth of a child and continue through the child's early years.

Rather than expecting families to navigate complex systems on their own, home visitors meet parents where they are—both physically and emotionally. By visiting families in their homes, visitors build trust, reduce barriers to accessing services, and provide individualized support tailored to each family's unique needs.

Home Visiting in Montana

Montana’s home visiting program has been a success, but too few families are able to access the services. Healthy Montana Families (HMF), Montana's home visiting program, delivers services through local public health departments and nonprofit organizations. Other home visiting programs also operate throughout the state. In Montana, 975 families received services in 2025 across 16 counties and three Tribal communities, demonstrating both the reach and demand for these programs. Eligibility is intentionally broad. Many programs serve pregnant individuals and families with children under 5 who may be experiencing economic hardship, substance use challenges, developmental concerns, military service, or other factors that increase the need for additional support. While access to home visiting has expanded, the program continues to reach a small percentage of total families. More can be done to expand access.

Why It Matters

Conversations with Montana home visiting leaders consistently point to one theme: relationships and support matter. The strength of home visiting comes from meeting families and building trust over time. Instead of asking parents to travel to appointments or navigate multiple agencies, home visitors bring resources directly into the home. This individualized approach has produced some of the strongest evidence-based outcomes in early childhood intervention, helping improve child development, school readiness, and family well-being. Engagement with services has remained steady, showing that families continue to value this type of personalized support.

The Funding Challenge

While the benefits of home visiting are well established, maintaining and expanding these services depends on stable funding. The largest funding source is the federal Maternal, Infant, and Early Childhood Home Visiting (MIECHV) program, which provides base funding to states and offers additional matching funds for states that maintain their own investments. Advocates note that increasing the state’s investment could unlock additional federal MIECHV matching funds and strengthen long-term program sustainability. 

Montana also recently received a federal grant to pilot a universal home visiting program in seven sites, allowing every family to receive up to four visits regardless of eligibility requirements. That grant has ended, and organizations are now seeking new funding opportunities to continue offering those universal services. Montana is also utilizing some Medicaid funds to support home visiting through targeted case management; however, the eligible population is limited to individuals with serious disabling mental illness or substance use disorder. Currently, 28 states fund home visiting through Medicaid.

Another potential funding source is the Temporary Assistance for Needy Families (TANF) program. Although federal law allows states to use federal TANF funds or state matching funds for eligible home visiting services,

Montana currently does not use either funding source for this purpose. Nationally, 23 states report using federal TANF or state matching funds for home visiting programs. This includes Colorado, Nebraska, and Wyoming that have expanded their home visiting services through TANF investments. As of 2024, Montana had $83 million in unobligated TANF funds. Utilizing a portion of these funds to expand TANF support for home visiting could provide Montana with an additional funding stream while complementing existing MIECHV investments.

Looking Ahead

Home visiting is a relatively simple idea with a lasting impact: provide families with trusted support during one of the most important periods of a child's life. Montana policymakers should explore new funding opportunities for home visiting, including using TANF funds. When more families can access home visiting, families experience reduced barriers to care and can build a strong foundation for their children. Investing in home visiting is an investment in healthier children, stronger families, and more resilient communities.

Caili Lowney served as a Baucus Leader with Montana Budget & Policy Center in 2026 and is a student at the University of Montana.