How nurses and investment can help people rise from poverty

By Lois Capps, Special to CALmatters

As I campaigned in 1997 for the congressional seat previously held by my husband, who had died in office, a letter about my decision to run was posted in the local newspaper that asked, “What does she think she’s doing running for Congress? She’s just a nurse.”

“Just” a nurse. And yet, being a nurse is what solidified my decision to run for office in the first place. I won and represented the people of Santa Barbara for the next 19 years.

As a registered nurse, I had worked for my local school district, and learned firsthand the power that quality healthcare and education can have to positively transform families.

During my time in Congress, I sponsored numerous bills to address the nation’s chronic nursing shortage, support public health systems, and ensure federal funding for school-based health clinics.

One of my proudest accomplishments was the passage of legislation to expand the Maternal, Infant and Early Childhood Home Visiting program. That expansion of evidenced-based, home visiting programs helps change outcomes for families in poverty.

One of these programs, Nurse-Family Partnership, uses specially trained nurses to provide advice, support, and resources for first-time low-income mothers from pregnancy until her baby turns 2.

Other home visiting programs use paraprofessionals who serve families with multiple children, reaching them during later preschool years. Evidence shows that families that participate in home visiting programs have healthier outcomes and greater economic self-sufficiency.

As a nurse, mother, and former policymaker, I’m excited that Gov. Gavin Newsom’s revised budget calls for an expansion of home visiting programs with $89 million for the CalWORKs Home Visiting Initiative and $45.9 million for the California Department of Public Health home visiting programs.

These investments, part of the administration’s early childhood agenda, demonstrate California’s commitment to spending wisely on programs proven to transform lives and ultimately, save the state money.

A 2018 analysis found that out of all the states in the country, California has the highest number and percentage of children living in poverty. Many of our children face health complications from lack of maternal prenatal care and persistent poverty.

That impedes their ability to learn, contributes to social, emotional, and behavioral problems, and puts them at risk for poor physical and mental health. Research also tells us that an infant’s earliest experiences play a key role in life-long emotional and other competencies. Children born into a cycle of poverty are more likely to live below the poverty line, drop out of school, and become single teen parents themselves.

These challenges are not unsurmountable.

For a lasting impact to happen, we need to ensure we invest in programs that work. Over 40 years of evidence shows that Nurse-Family Partnership reduces preterm birth, improves child health and school readiness, and reduces child abuse and juvenile crime. In addition, there are cost savings on medical care, child welfare, special education, and criminal justice.

The availability of these programs falls far short of its full potential. Nurse-Family Partnership, for example, currently only operates in 22 of our 58 counties.

The Legislature can fulfill its commitment to transforming the lives of California families living in poverty by passing a budget that includes full funding to expand evidence-based home visiting programs, as included in the Governor’s May revision.

By investing in proven services, legislators will play a pivotal role in what we nurses already know. By being pro-family and partnering with parents to achieve healthier outcomes, we create stronger communities for California’s future.


Lois Capps represented the Santa Barbara region in U.S. Congress from 1998 to 2017, [email protected]. She wrote this commentary for CALmatters.

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