Help for new mothers proves more popular than state can handle

A recently expanded state program that connects new mothers to a personal nurse already has a waiting list in at least one of the South Dakota counties it serves.

The Department of Health’s Bright Start program grew from a handful of counties to near-statewide over the past year, thanks in part to an influx of federal funding. The program has proven more popular than the department was prepared for in terms of staffing.

First-time moms who qualify based on income guidelines can receive in-home visits from nurses who provide pre- and postnatal medical advice. It’s modeled in part on the work of a national nonprofit organization called Nurse-Family Partnership that aims to improve the health of mothers and children in multiple states. The nonprofit offers guidance to state and local governments on best practices in their own versions of the program.

The benefits of offering personal care and guidance to at-risk moms are typically measured in terms of maternal and child health, but some research has shown value for years down the line. Last year, the city council in Billings, Montana, voted to deposit public safety dollars from taxes generated by legal marijuana sales into its nurse-family partnership programs. The local school district superintendent argued for an expansion as an early bulwark against the kind of school-age misbehavior that can morph into criminal behavior as children grow. 

Bright Start nurses offer advice and guidance to pregnant women, and may continue visiting with new moms for up to two years following childbirth.

The state hired a Sioux Falls marketing firm last year to help with the rollout of the expanded program, but Department of Health Secretary Melissa Magstadt said her agency has pulled back on marketing because “we know we can’t absorb” all the families that want to sign up.

The program has drawn greater-than-expected interest, especially in Pennington and Beadle counties, she said.

In Huron, “we’re full, and there’s 61 more people who want in,” Magstadt said.

South Dakota lawmakers signed off on a $2.5 million Bright Start funding expansion during the 2022 legislative session, with around half the money coming from the federal government. At a January 2022 budget hearing, Health Department officials noted that Bright Start had about 600 annual participants statewide prior to expansion. The number was expected to grow to 1,150 during the expansion, at a total annual cost of $4.7 million. 

The department did not immediately respond to a request for information on current participation levels. 

Magstadt’s mention of the program came Tuesday during a meeting of the Legislature’s Government Operations and Audit Committee in Pierre. The committee heard from Magstadt on a host of Health Department performance measures, including infant mortality, vaccination, breastfeeding and obesity rates. 

Magstadt framed the waiting list situation for Bright Start as a positive, since the program can improve outcomes for families.

“I’m glad that people are using it,” Magstadt said. “Because at this point, all of the things that we’ve talked about are things that can be impacted by good prenatal care and access to health care.”

Even so, the interest in the program took the department aback. Sen. Reynold Nesiba, D-Sioux Falls, asked Magstadt how the department intends to address the backlog, but she said the only immediate step is scrambling to keep up until more money becomes available through the Legislature.

“We’ve got to take a really good problem to have and redirect some resources towards it,” Magstadt said. “So in the short term, I’m maneuvering around a little bit and trying to look a little more efficiently.”

The secretary said the agency is likely to see a shortfall in funding as a result, and encouraged lawmakers to fill the gap next session.