Oregon is considering taking the idea of “nanny state” to a new level with a program that would send government-sanctioned health care workers to the homes of new parents to make sure newborns are getting proper care and screening.
The Oregon Senate Committee on Health is evaluating Senate Bill 526, which would direct the Oregon Health Authority (OHA) to study the effects of in-home care provided by licensed health care professionals. Oregon Sens. Elizabeth Steiner Hayward (D-Portland) and Bill Hansell (R-Athena) and Reps. Sheri Schouten (D-Beaverton) and Duane Stark (R-Grants Pass) are sponsoring the bill. The lawmakers gave the bill “emergency” status, requiring the OHA to submit findings and recommendations to an “interim” legislative health care committee by the end of the year.
Gov. Kate Brown made government-sanctioned home visits and supplemental health screenings a key initiative in her campaign in 2017. Brown says the policy will improve children’s school readiness and health outcomes. Brown’s proposal is included in the 2019-2021 budget but does not have a designated amount of funding attached.
OHA Director Patrick Allen told The Beaverton Valley Timeshe favors the plan, which he says would probably consist of two or three visits to every new parent in the state by a licensed health care practitioner who would provide screenings, contacts for primary care physicians, and planning for preventative care.
Expects Public Pushback
John Charles, president of the Cascade Policy Institute, says a study of in-home visitation is a long way from launching a feasible program.
“It’s possible this bill was introduced to have a token hearing,” said Charles. “Lots of bills are introduced to satisfy someone’s curiosity or their constituents.”
Charles says he expects the public to express a strong, negative reaction to the bill.
“It will generate a lot of pushback, because I don’t think many parents would welcome someone investigating how things are going with their newborn without a warrant,” Charles said.
Oregon has other, higher priorities, says Charles.
“The state has no particular expertise in this area, and it’s unclear what, specifically, they are trying to solve when they have so many other problems going on,” said Charles. “Parenting is highly subjective, and people are suspicious of anyone coming in, telling them what to do with their kids,” he added.
Raises Constitutional Issues
The bill does not say what the state would do with the information it gathers from the visits. Government employees entering private residences raises Fourth Amendment issues, as was the case in Michigan in 2013 when tax assessors in Davidson Township attempted to enter homes to make sure properties had been assessed correctly. Residents could refuse, but that would have put them at risk of having an assessment rise because an assessor could claim there was a lack of information. Property owners balked, and the local government backed down.
Paula Bolyard, coauthor of Homeschooling: Fighting for My Children’s Future, sees similarities between newborn visits and problems she witnessed in her 20 years in the homeschooling movement.
“As a general rule, I don’t think the government ought to be involved in health care or social work unless there is evidence of abuse or neglect,” said Bolyard. “If they want to give names of providers to parents, fine. But I think parents know what’s best for their own children and can do a far better job of taking care of them than some government agency.”
Children in Oregon’s foster care system are abused at twice the national rate, says Bolyard, and that alone should give legislators pause.
“One wonders how a state that can’t handle the children currently in its care could possibly manage to surveil an additional 40,000 children per year, let alone pay for such a program,” said Bolyard.
There is also concern about how the state would administer such a program, Bolyard says.
“The state may run into trouble providing contacts to new parents for primary care,” said Bolyard. “The state would have to determine what providers would be on that list.”
North Carolina’s Experience
In 2018, North Carolina conducted a pilot program for a similar service, targeting communities with poor access to pediatric care. The Oregon bill would establish a universal program throughout the state.
The state of Washington is also considering universal newborn home visits. In a news release, Gov. Jay Inslee says he wants to set aside $173 million for the next two years to “provide universal newborn screening assessments and home visiting services, expand and improve preschool opportunities, create a statewide referral system to connect families with early learning services and build more early learning facilities,” according to his office’s press release on the proposal.
Bolyard says there has been an enormous outcry over the idea nationwide.
“So lawmakers may be a bit more cautious about making the home visits universal right now,” Bolyard said. “Still, I think the threat remains. Lawmakers and health authorities keep using the word ‘universal’ to describe the effort, so what else could that mean except that they want every newborn child to be enrolled in the program?”
Brandon Best([email protected]) writes from Cedarville, Ohio
Oregon Senate Bill 526
Oregon state Sen. Elizabeth Steiner Hayward: https://www.oregonlegislature.gov/steinerhayward
Oregon state Sen. Bill Hansel: https://www.oregonlegislature.gov/hansell
Oregon state Rep. Sheri Schouten: https://www.oregonlegislature.gov/schouten
Oregon state Rep. Duane Stark: https://www.oregonlegislature.gov/stark
Oregon Gov. Kate Brown: https://www.oregonlegislature.gov/stark