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Rural Health Information Hub

Taos First Steps Program

  • Need: Support for families that promotes early childhood development and the parent-child relationship.
  • Intervention: Home visits which provide information, support, and access to early childhood resources and tools for building relationships.
  • Results: Easily replicable program, even for rural areas, that results in growth in knowledge and self-sufficiency for families as they provide for and understand their child's earliest years.


A program of Holy Cross Hospital since 2007, Taos First Steps supports new families and promotes early childhood development and the parent-child relationship. New families are referred by various agencies, healthcare systems, or people can self-refer after hearing about the program themselves. A soon-to-be new family can enter First Steps as early as the mother's pregnancy and can continue up until the child reaches his/her third birthday.

Taos First Steps

At the heart of the program is supporting the parent-child relationship. Home Visitors are trained to provide education, information, and access to early childhood development and for building that parent-child relationship. Home Visitors can come as often as once a week and are committed to being responsive to a family's needs, priorities, and concerns. Working with the family to establish goals and then assisting with accomplishing them if appropriate are parts of Home Visitors' duties. After collaborating with family members and ascertaining needs, Home Visitors make referrals to various organizations, agencies, and classes.

Taos First Steps staff.

On an annual satisfaction survey, one Taos First Steps participant wrote, "My home visitor is so very helpful and provides alternatives to me when I am feeling most overwhelmed. She has been especially helpful as our family transitions and adapts to a new baby."

Funding for Taos First Steps comes solely through the New Mexico Children, Youth, and Families Department (CYFD). In 2019, the program will celebrate its 12th year of service. With the current funding, they are budgeted to serve 140 families each year.

Services offered

Taos First Steps provides the following services for participants:

Taos First Steps serves families of New Mexico.
  • Home visits provide information and support for developing the parent-child relationship.
  • Access to early childhood resources in the community
  • Preparation for parents coping with everyday stressors in order to build a strong family foundation
  • Classes to increase familial support and understanding of their children's needs: Love and Logic parenting classes, infant massage, Birth Art, nutrition, ESL for Parenting, Parenting with Emotional Intelligence, and Circle of Security for Parents.
  • Referrals to various agencies or organizations addressing healthcare needs, behavioral health, and breastfeeding education and support
  • Group events at community locations: swimming pool, play dates, story time
  • For families with low incomes, providing assistance with accessing programs such as Medicaid, TANF (Temporary Assistance for Needy Families), food stamps, WIC (Supplemental Nutrition Program for Women, Infants and Children), housing


In fiscal year 2017-2018, 284 families were served and 2,144 home visits were completed. Of these families, 64 were new to the Taos First Steps program. Most referrals come from the local OBGYN provider (The Women's Health Institute), The Holy Cross Medical Center's Labor & Delivery unit, and self-referrals.

Taos First Steps Home Visitors make service referrals to members of participating families. Of 804 service referrals, 1/5 were made to healthcare. The other prominent categories were comprised of behavioral health, breastfeeding, early intervention, childcare/early education, family/social support, and parenting classes.

On the 2017-2018 annual survey, 110 parents responded (99% of families surveyed). For the statement "My home visitor is responsive to my family's needs and culture," 95% of respondents indicated 'Strongly Agree' while the remaining 5% indicated 'Agree.'

Home Visitor Beth Enson and First Steps Program Manager Jaci Imberger were authors of the following publications:

Enson, B. (2017). Weaving Emotional Intelligence into a Home Visiting Model. ZERO TO THREE, 38(1). Article Abstract

Imberger, J. (2016). Using the FAN Approach to Deepen Trauma–Informed Care for Infants, Toddlers, and Families. ZERO TO THREE, 36(6). Article Abstract

Imberger, J. (2016). Strengthening Reflective Capacity in Skilled Home Visitors. ZERO TO THREE, 37(2). Article Abstract

This video introduces families that have benefited from the Taos First Steps program and the staff who serve them.


  • The lack of services to refer to, including child care, housing, behavioral health (particularly in Spanish), drug/addiction rehab, employment, and transportation
  • Consistently meeting the deliverables of the contract due to staff turnover
  • Providing consistent service to families
  • Providing ongoing education to community partners so they embrace the foundational aspects of the program


Partnering with local agencies, community partners, and supporters is key to a successful replication to this program. Referrals from participating agencies provide the majority of new families coming into the program and then also provide some of the services needed for these families.

Taos First Steps administrators are willing to contract out their services to other organizations that are considering the implementation of an early-childhood home visiting model in their community.

Staff presented a poster at the annual Zero to Three conference in November 2017 in San Diego. The poster outlined Beth Enson's article on the history of Taos First Steps and discussed program replication.

Contact Information

Jaci Imberger, RN, BSN, IMH-E® II, Program Manager
Holy Cross Medical Center
Taos First Steps

Benefit enrollment and application
Children and youth
Community health workers
Hispanic or Latino
Maternal health and prenatal care
Wellness, health promotion, and disease prevention

States served
New Mexico

Date added
January 22, 2007

Date updated or reviewed
May 8, 2019

Suggested citation: Rural Health Information Hub, 2019. Taos First Steps Program [online]. Rural Health Information Hub. Available at: [Accessed 6 February 2023]

Please contact the models and innovations contact directly for the most complete and current information about this program. Summaries of models and innovations are provided by RHIhub for your convenience. The programs described are not endorsed by RHIhub or by the Federal Office of Rural Health Policy. Each rural community should consider whether a particular project or approach is a good match for their community’s needs and capacity. While it is sometimes possible to adapt program components to match your resources, keep in mind that changes to the program design may impact results.