Trish Dauer’s path to nursing and home visiting wasn’t a straightforward one. With a natural inclination toward the human-centered aspects of healthcare, her journey was defined by exploration, adaptability, and a deep passion for connecting with people during critical moments in their lives.

The Shift to Public Health and Home Visiting

Originally thinking she might want to be a labor and delivery nurse, one uninspiring instructor quickly changed that plan for Trish. “I realized what I loved most was the deep conversations—the moments when people really opened up.” That led her to adolescent psychiatric nursing. “My first job at an adolescent psychiatric facility was intense—I was barely 23 and suddenly in charge of a unit. But it was also where I learned how to truly listen. I have always been that person who friends came to and talked to about their problems, and I really like teenagers (a lot of people don’t!)” During an internship at Spokane’s Sacred Heart Hospital in the Adolescent Psychiatry unit before nursing school, Trish shared that her natural ability to talk with people about really hard things came easily, and the tough conversations became her strength.

Following nursing school and her first role in a private adolescent psychiatric facility, Trish knew she wanted something more structured. “I wanted somewhere I could grow. I flirted with the idea of emergency medicine but ended up in public health in Snohomish,” where an early supervisor recognized Trish’s ability to engage with people and encouraged her to start conducting home health visits. “Those first home visits were eye-opening. I drove into neighborhoods I’d never been to, stepped into homes where families were just trying to survive, and realized quickly—there’s no script for this job. Every visit was different, every situation unpredictable. I had no background in maternal-child health, but I knew how to talk to people, and that made all the difference. I found myself having some of the hardest but most meaningful conversations of my career—about postpartum depression, domestic struggles, and the weight of new motherhood. It was messy, but it felt like exactly where I was meant to be.”

Despite having no formal maternal-child health experience, she leaned into her strengths, supporting young parents and learning everything else along the way. That’s when she heard about NFP training and the structure and reasons behind home visiting practices seemed to make sense.

Finding Her Calling in Nurse-Family Partnership (NFP)

A year into public health, Trish found Nurse-Family Partnership (NFP) and knew she had found her niche. The structured, evidence-based approach felt like the perfect balance of science and human connection. “The training was intense, but I was confident in my ability to connect with young moms and help them navigate their challenges,” Trish reflected. ”Parents can work through their personal struggles while still being present for their babies. We can hold space for both.”

The Evolution of Home Visiting and Leadership

After years as a home visitor, Trish now leads the Nurse Family Partnership model for Washington state. “Leadership in home visiting isn’t easy. Funding is always precarious, and I’ve spent more time than I ever expected fighting to prove the value of this work.” Trish recently testified before Washington’s Senate Ways and Means Committee in support of home visiting and preservation of recent budget adjustments to provide more equitable funding for home visiting rates. “Home visiting is one of the best investments in preventive healthcare, but it’s still an uphill battle for recognition and stable funding. I’ve seen firsthand how early support changes lives, and I’ll keep fighting for that. This work isn’t about fixing people, it’s about showing them they already have the strength and resources to succeed. Sometimes, all they need is someone to remind them of that.

Home visiting is a powerful tool for supporting families and communities, and the Washington State Home Visiting Core Competencies are an essential tool to support home visitors. The translation of Washington’s Home Visiting Core Competencies into Spanish, Chinese, Somali, and Arabic is a significant step in ensuring that the competencies are accessible to home visitors in the languages they use and prefer.

A Living, Evolving Resource

These core competencies were never meant to be static documents. “They weren’t intended to sit on a shelf and gather dust,” Cassie notes. “They are for use by the people who created them.” Home visitors are encouraged to annotate them, add notes, and continuously reflect on how these competencies apply to their daily work. The process of refining and updating them is intended to be ongoing by design, informed by feedback from the field. Understanding how the competencies are being used will shape future revisions, with the ultimate goal being to ensure that they remain relevant and actionable, supporting home visitors in their mission to strengthen families and communities.

Home Visiting as a Tool for Equity

At its heart, home visiting exists to create trusting relationships between home visitors and parents. One of the clearest ways to achieve this mission is by hiring and supporting trusted professionals from within the communities being served. “What is synonymous with quality in home visiting is DEIB (Diversity, Equity, Inclusion, and Belonging),” Cassie states. “You can’t really pull those things apart.” The translation of the competencies is a direct reflection of this understanding—ensuring that home visitors from diverse backgrounds have the tools they need in the languages they are most comfortable with.

Bringing Core Competencies to Life

With the core competencies now available in multiple languages, the hope is that home visiting teams will actively engage with them. “I absolutely want home visiting programs to take them up, have discussions about them within their teams, and talk about the ideas represented there,” shares Cassie. “If they feel as if the ideas are important, I want home visitors and their supervisors to talk about how they are turning those ideas into action.”

By making the Washington Home Visiting Core Competencies accessible in Spanish, Chinese, Somali, and Arabic, we are not just translating words—we are reinforcing the values of equity, inclusivity, and community-centered care. These competencies are meant to be dynamic, evolving, and, most importantly, used by the very people who shaped them. The more they are discussed, applied, and adapted, the stronger the home visiting field will be in achieving its ultimate mission: empowering families and communities through trusted, culturally responsive support.

As parents juggle professional responsibilities and family life, the pressure to find reliable, high-quality child care can be overwhelming. Liv Woodstrom, Start Early Washington Director of Programs reflects on the challenges faced by working families, the impact of child care costs, and the barriers faced by working families across the United States.

The Numbers Don’t Lie

The Elusive Balance

Limited Options

Geographic limitations compound the problem. While some families have only one viable child care option within driving distance, others find themselves in child care deserts – areas with insufficient access to quality providers. Families resort to less conventional solutions, relying on family, friends, and neighbors to patch together care. And these child care challenges aren’t necessarily uniform. Liv herself lives in what’s known as a child care desert in South King County, and she knows the added stress this can have for families. For her, the reality of trying to address access and affordability for two children under age four has meant having her parents move in with her for the past two years and paying them in place of paying for traditional out-of-home care.

Strategies for Support

There are some bright spots and places where progress is forging a path forward. “Increasing child care subsidies eases the financial burden for more families, and we must also ensure that assistance reaches those who need it most”, shares Liv. This includes focusing on the child care and early learning workforce, who provide critical support for working families and are essential to the growth and well-being of young children. In addition, paid parental leave in Washington has allowed more parents to bond with newborns and reduce the strain on working families during those critical early months. For many families, parental leave provides an opportunity for several months of initial care by a parent. But then what?

A Call for Change

As someone who has worked in family support for over two decades, Liv understands the uphill battle. “We know our current system isn’t working for many families and we know we deserve better. Families deserve more support, and child care providers deserve more recognition and sustainable and thriving wages. When we come together to advocate for change, we can ensure that every child has access to affordable, high-quality care.” Her message to parents is to remember, you’re not alone in this journey. Many families share your struggles, and collectively, we can do better.

Learn more about Start Early’s parental leave program and commitment to policies that support time for parents and caregivers to bond with and care for their children without jeopardizing their ability to afford basic needs.

Start Early Washington is fortunate to work with committed partners like Perigee Fund who believe in the power of healthy relationships with caregivers to give babies and toddlers the best start in life. Learn more about how Perigee Fund prioritizes investment in infant and maternal mental health in our recent conversation with Perigee team members Becca Graves and Kim Gilsdorf.

Building for the Future

What would the biggest impact or change you would like to see over the next 10-15 years because of Perigee’s intentional investments?

Kim: I’d like to see policy makers have a greater understanding of the fundamental importance of early relationships. That mental model shift is part of creating policies that make mental health support more equitable and more accessible for families with very young children.

Becca: We need to value and embed support for families in the places where they are. Certainly, there are many ways that families support themselves and communities support families that don’t require additional resourcing, but they do require us to respect and value the importance of family relationships and community relationships and not get in the way. And there is a lot that we should be doing differently with our public policy and with the ways that we think about community-based models of care.

Supporting the Field

This is hard work and it’s not as easily measured as “can your child read by third grade.” Perigee has been such a champion in helping to advance our Neuroscience, Epigenetics, Adverse Childhood Experiences, Resilience (NEAR@Home) trauma-informed training to support home visitors in building a hope-focused approach when talking with families about trauma. It is also some of the most promising work we have for infant and maternal mental health. Can you tell us about why you chose to support NEAR?

Kim: NEAR does something with grace that is both important and difficult. It helps families and providers navigate difficult conversations about trauma, slowly and with compassion. Conversations about early childhood trauma can be very challenging for all involved, which is part of why many infant mental health professionals are invested in ongoing learning and reflective supervision. NEAR makes it possible to integrate some of that skill building and support into the job of being a home visitor. Regardless of their degree or education, all home visiting professionals trained in NEAR get the support they need to navigate hard topics with families and to do so with kindness and love. It is incredible!

Learn more about Perigee Fund’s priorities for Infant and Early Childhood Mental Health.

For more than a decade, Lula M. Ford has served on Start Early’s Board of Directors, contributing to the organization’s growth and impact on families with young children across the country. While Ford joined the Start Early leadership team in 2009, her impact on and experience in the field of early education spans decades, particularly playing a monumental role in expanding opportunities for children and families throughout Chicagoland.

As for the next 40 years, Ford knows there’s more work to be done to ensure equitable opportunities for our youngest learners.

“Let’s continue to be a diverse staff, that is so important,” Ford said when asked about her vision for Start Early in the next four decades. “We’re on the right track, and we have an outstanding leader in Diana Rauner, and I can’t wait to see what we do.”

Brenda Smith has taught at Educare Chicago, a program of Start Early, for 13 years. In that time, she’s seen first-hand how providing for the needs of families can uplift not only her students, but the communities in which they live.

The team at Educare Chicago worked to identify the family’s needs and address them as much as possible. Start Early’s quality early childhood programs often help families access community services that they might otherwise not be aware of or are otherwise unable to use because of systemic barriers.

“We made sure that she was able to get him here,” Brenda explains. “We provided her with carfare. We gave her gift cards to get things that she might’ve needed, that she wouldn’t have been able to receive if she wasn’t here.”

Mental health consultants and family support specialists on staff also worked with the student’s mom, connecting her to a wide range of supportive services.

“We had wonderful mental health consultants that took care of her, mentally and emotionally, in ways that us, the teachers, couldn’t,” adds Brenda.

After her son graduated from the program, the mother continued to occasionally visit Educare Chicago’s campus and provide the team with updates on her life.

“She has her own apartment now, and she has a job now,” says Brenda. “We provide our parents with so much information and so much family support.”

Partnering with parents and connecting them with services and resources to help understand their children’s developmental needs is a core component of Educare Chicago’s approach to ensure students grow up healthy, supported by their families and ready to learn.

“We have a program that links parents up with other organizations,” Brenda says. “These organizations help them if they want to go to school, if they have loans that are overwhelming them, if they need a car, if they need somewhere to live, if they need furniture… They provide that kind of help for our parents.”

The focus on providing for parents and families at Educare Chicago is indicative of the support that well-resourced early childhood learning programs can provide. Brenda, who worked at several daycare centers prior to her work with Educare Chicago, says that this approach makes a significant difference in the educational and social outcomes of its students.

“I’ve been in this field for a long time, and I have never been at a center that cared as much and had the same amount of compassion for its parents and families as Educare Chicago,” she says.

When a young student began drawing pictures using only black crayons, it caught the attention of veteran early childhood educator Alyia Dixon.

“Kids always gravitate to the brighter colors,” Alyia says. “But when she was scribbling, she scribbled her pictures all in black… Sometimes all black, all the way to the edge of the pages.”

Alyia, who has been teaching at Educare Chicago, a program of Start Early, for 23 years, shared her observations and concerns with the school’s family support specialists, and together, they arranged a visit to the student’s home. These sorts of discussions are critical for providing families with a multi-perspective and multi-expertise support system. This holistic approach is a core component of high-quality early childhood programs. It provides valuable support for students and can help connect their families to important resources.

The supports available through our high-quality early childhood programs don’t just provide for the needs of students while they’re in the classroom; they also address challenges at home that could keep a student from thriving in pre-kindergarten and beyond.

“A lot of the circumstances we witness go way above and beyond the norms for what a teacher is supposed to encounter,” Alyia says.

That’s why high-quality early childhood programs often rely on experts that can help families connect with mental health resources, find safe housing and obtain food assistance. At Educare Chicago, family support specialists and mental health consultants work diligently with parents to ensure the needs of their entire family are being met.

Additionally, our programs connect parents of young children with their peers, creating supportive communities that benefit both adults and their kids.

“Our parents build relationships with other adults that they maintain outside of Educare Chicago. We’ve had a few parents that built relationships where they would take their kids on outings with each other,” Alyia says. “They’re building relationships and making connections that will outlast their child’s time in our program.”

In honor of Women’s History Month, we’re commemorating women’s vital impact and accomplishments on society.

Our Start Early staff members: Keneischia Jones, health coordinator, Early Head Start Network; Rio Romero-Jurado, policy manager, National Policy and Kayla Goldfarb, policy specialist, Illinois Policy shared how their womanhood has influenced their career journey, the crucial importance of pay equity in early childhood and the need for inclusion and continued progress for all women.

How has being a woman influenced your identity?

Keneischia Jones: Being a woman of color is my daily makeup. I get to wake up and change my hair and wear my afro today because that’s what I’m feeling. I’ve become the young Black woman that I wanted to be when I was younger and I wasn’t able to present like this. Now as a woman I have my bearings and I can show the world who I am at all times.

Rio Romero-Jurado: My identity in being a woman and a woman of color in particular has really shaped my values, social conscience and the kind of person I want to be and what I want to contribute to the world. I came to social work, policy and advocacy because I was naturally drawn to eliminating inequities in our society and empowering other women through social change and action.

That’s part of why I love what I do. Even in elementary school I really loved social studies. I recognized pretty early on that there was an underrepresentation, we all know, of women and people of color at our highest levels of government. I think that’s really further motivated me to embrace my identity as a woman and to be part of an organization to help ensure that women and the issues that matter to them and their families are prioritized in our society and in policy.

Kayla Goldfarb: There are so many things that have been shared that really resonated with me and are really energizing. Being a woman has influenced my identity in that I don’t feel limited in any way. But I also recognize how much of a privilege that is when you look at women globally and locally because that is not always the case. I’ve begun to understand the breadth of how people experience being a woman from a race, class, location and lived experience perspective. It’s been mind opening.

Each year, we celebrate Black History Month to recognize the contributions and influence of African Americans to the history, culture and achievements of the United States.

Our Start Early staff members: Erice Evans, senior financial analyst; Stuart Lassiter, early childhood practice consultant; Kristie Norwood, education manager for the Early Head Start and Head Start Network of Illinois shared how their heritage has shaped their identity and impacted their work, how they maintain their culture and why it’s important to recognize Black History Month.

How do you feel that your African American heritage has influenced your identity and what do you appreciate most about being Black?

Kristie Norwood: What I appreciate most about being Black is being Black. It is a heritage and legacy of strength and strong traditions of faith and family. I love that feeling of coming into a room and even if there’s only one other Black person there is an immediate connection of knowing each other.

Erice Evans: We come from a very rich background and history that I appreciate as I’m older now that I didn’t really know to appreciate growing up. I love the melanin and the different colors, characteristics, traits and everything that makes us a beautiful people from the outside to the inside. My [African American] heritage has made me who I am today.

Stuart Lassiter: Being Black is my identity and it’s how I’m recognized by others and also how I recognize myself. My family has always stressed what it means to be a Black male. The idea that I heard from my great grandfather, grandfather and uncles of being the best you can be because you have to work from a place of excellence to be seen as being good.

One thing I truly appreciate is our strength, perseverance and striving to always overcome. It’s amazing that we’ve come so far and still have so far to go.

Erice Evans: I love that you mention strength because it is part of our heritage. We were taught the skills to overcome anything. If you get knocked down get back up and keep fighting. We don’t stay down.

Nurturing others comes naturally for Victoria Barajas, who has found her true calling as a home visitor. After spending 10 years working at an early learning school, she was drawn to home visiting’s ability to create supports for the whole family that build a strong foundation for years to come.

The “Yes Moment”

Home visitors like Victoria help parents engage in their children’s education and get a better understanding of developmental milestones. “A lot of parents are not aware that what they bring to the table impacts their child’s development,” she shares. “As parents get more involved, they’ll tell me things like, ‘Wow, I didn’t know my child could do this. I thought they were too small,’ and it makes them more eager to be involved.”

This builds a strong foundation for future learning. “Having the parent involved shows the child that their parent took the time to be with them and interact with them, so they feel confident enough to detach and interact with other adults,” she explains. When the child gets older, they’re more receptive to what they’re learning, are better able to problem solve and have increased communication skills.

For Victoria, the “yes moment” comes when parents begin to follow their child’s curiosity and development. “We can’t choose their interests for them — if we don’t follow their curiosity, they won’t want to learn anything else,” she says. “I know it clicks when parents say, ‘Wait, I know we planned for this because that’s what they were interested in last week but they’re not interested in that anymore. Can we do this instead?’”

Meeting Families Where They’re At

As a Spanish-speaking Latina, Victoria knows being part of a diverse home visiting workforce is essential to fostering intimate relationships with her families.

“You need to be empathetic and meet parents and families where they are at. It’s beneficial that I can connect with families in their language. It’s where they feel more confident in speaking and interacting with me because that is how they’re communicating with their child,” Victoria explains.

It is important to consider each family’s home culture and how they interact with their child. “Even among Latinos, Mexicans speak different dialects and Ecuadorians have different vocabulary so you can’t go into the home assuming everyone speaks the same type of Spanish.”

By building relationships with every adult in the home, including grandparents, Victoria builds a foundation of professionalism, empathy and cultural sensitivity. “When you do that, the adults give you so much more to work with and are open to receiving whatever you bring to their home,” she shares.

Supporting the Whole Family

In addition to helping parents build strong relationships with their children, home visitors connect families to the resources and supports in the community they need to thrive. Particularly during times of high stress, a parent may feel unable to give their full self to supporting their child. That’s why home visiting provides comprehensive supports to families. It’s only when a parent feels 100% that they can be fully present.

“I tell families that I’m here to work with the family as a whole, not just the child,” she shares. “If parents are focused on what they’re going through financially or dealing with depression, I know only supporting children’s development isn’t going to help. Once we address families’ basic needs and supports, we start to see an increase in parent interaction.”

During the pandemic, Victoria helped her families access basic needs like diapers, baby wipes, formula, cleaning supplies and gift cards to purchase additional items. “All my families said they really appreciated it, especially those who lost their jobs. It kept them afloat,” she recalls.

One of the biggest challenges during COVID was helping families with technology needs. Victoria helped her families navigate a variety of issues, from lacking access to a laptop or tablet to not having enough data to download the new apps required for virtual meetings. When some of her parents struggled to download mobile apps because the instructions were in English, she shared screenshots and instructions in Spanish.

As the pandemic ebbs and Victoria is able to resume in-person visits, she continues to prioritize each family’s perspective and comfort zone. “There are some families that are very relaxed and open to visitors and others that are very cautious as to their interaction with the rest of the world. I work with each individual family and meet them where they are.”

The Impact of Her Work

Now nearly 20 years into the work, Victoria remains passionate about being able to make a difference in children’s lives and help their parents understand why it’s important for them to be a part of their children’s development. Her reward is the pictures and text messages she receives from parents sharing a video of a first step, a photo from a birthday party, or an update from school.

“I got into this work for personal reasons, but working with families so closely and seeing the impact of my work is incredibly meaningful.”