Budget Hearing Testimony of Nisa Hussain, Program Manager of Early Childhood, before the Committee on Facilities and Family Services

April 11, 2023
Person Testifying: Nisa Hussain
Title: Program Manager of Early Childhood, Child and Family Services Agency
Testimony Heard By: Chairwoman Lewis George
Type of Hearing: Budget Hearing
Topic of Testimony: DC Council Committee on Facilities and Family Services: Budget Oversight Hearing

Good morning, Chairwoman Lewis George, and members of the Committee on Facilities and Family Services. Thank you for the opportunity to address the Council as it conducts this budget oversight hearing for the Child and Family Services Agency. My name is Nisa Hussain and I am the Early Childhood Program Manager for DC Action, Chair of the DC Home Visiting Council, member of the Under 3 DC Coalition, member of the Fair Budget Coalition, and Ward 1 resident.

DC Action uses research, data, and a racial equity lens to break down barriers that stand in the way of all kids reaching their full potential. Our collaborative advocacy initiatives bring the power of young people and all residents to raise their voices to create change. Through our signature coalitions, Under 3 DC and the DC Home Visiting Council, we empower families and communities. We are also the home of DC KIDS COUNT, an online resource that tracks key indicators of child and youth well-being.

Today, my remarks will focus on the critical role of CFSA’s early childhood home visiting programs and the need for increased funding so that programs can operate as effectively as they can for the families who want and need these services.

For context, CFSA funds the Parent Support and Home Visitation program at Community Family Life Services, the Father-Child Attachment program at Mary’s Center, and the HIPPY program at The Family Place. Additionally, CFSA provides intra-district funds to DC Health to administer Mary’s Center’s Parents as Teachers program.

We are asking this Committee to consider the importance of home visiting programs in the FY24 proposed budget and ask for an increase of $300,000 to the current home visiting grants at CFSA. This modest investment will allow programs to raise home visitor salaries and better meet the needs of families.

We are grateful for Chairperson Lewis George’s and the rest of DC Council’s support of home visiting programs over the years. We are also grateful for CFSA’s participation on the Home Visiting Council. We hope that the DC Council, the Mayor’s administration, and the agencies can all work together to ensure home visiting programs receive sufficient funding to continue upholding these critical programs that support families in the District.

Home visiting is a preventative, two-generation early childhood strategy. 

Home visiting is an evidence-based service delivery strategy that supports expectant parents, new parents, and families with young children. The service pairs a family with a trained professional or home visitor to assess the family’s needs, guide them towards their goals, and offer educational and health resources. These services use a two-generation model and a holistic, public health approach to support the entire family and ultimately, the rest of the family’s community. Research has shown home visiting to reduce child abuse and neglect, improve maternal and child health outcomes, increase school readiness, and improve family economic self-sufficency.

A key component of home visiting is the timing. These services focus on expectant parents and families with young children under 5 years old, both of which are critical windows of time for a child’s foundation and future trajectories. During these early years, a child’s brain develops rapidly and absorbs experiences that can create lasting effects on their cognitive, emotional, and physical development. Home visiting works to minimize negative experiences that can turn into adverse childhood experiences (ACEs), enhance the protective factors, and teach parents how to maintain a safe and stable environment for their children to grow up in. This is an important strategy to ensure children have the opportunity to thrive, support families in communities facing difficult scenarios, and to minimize stressors in order to reduce child abuse and neglect.

Home visiting programs in DC focus on families with low-incomes and many participants also face several risk factors. In particular, CFSA home visiting programs serve populations with specific challenges. Mary’s Center’s Father-Child Attachment program supports fathers and masculine caregivers with children under 5 years old. Community Family Life Services’ Parenting Support and Home Visitation program works with parents experiencing homelessness, domestic violence, or previous incarceration and seeking to reunify with their children. The Family Place’s HIPPY program focuses on Spanish-speaking families with children ages 3-5 who are low-literacy or from marginalized communities. In 2022, these three programs served 173 families.

These are programs that allocate time, attention, and care for families that are navigating challenge after challenge. Much of that success comes from the trusted, long standing relationships that home visitors build with the families.

Home visiting programs face the risk of losing a dedicated workforce of home visitors. 

Home visitors are highly educated–over 80% have a bachelor’s degree or higher–and many have a background in social work, child development, or public health. The majority of the workforce is made up of women and people of color. The workforce is dedicated and works hard to balance their time building relationships with families, delivering the home visiting model curriculum during visits, responding to family participant emergencies, and completing administrative requirements of the program. Home visitors are committed to the families they work with and have built trust with over time.

However, home visitors in DC have been leaving the workforce for higher paying jobs and as a result, services to those families are disrupted.

The average salary for DC home visitors is $44,000. This low range of pay prevents many home visitors from being able to afford to live in the communities where they work. Some home visitors are forced to take on a second job.

When home visitors are forced to quit their roles to find higher-paying jobs to support their own families, the meaningful relationships they build with participants are cut short. And when a home visitor leaves, the program is often left with an overburdened, understaffed team and cannot operate at peak capacity. This can impact the quality of visits to families and the reach to families who may benefit from these services.

Home visiting programs need more funding to increase home visitor salaries and address turnover. Home visitors deserve the recognition and compensation. Without them, the District will lose a talented and invaluable team that are committed to supporting specific populations facing complex challenges in a way that other health and social supports cannot.

Long-term investments will stabilize the home visiting field and allow programs to sustainably support families over time 

Home visiting is one of several key strategies to support the District’s efforts to produce positive health and family outcomes. While home visiting may not be the one single solution for every family, it can be one of many effective approaches within a robust system of care to support families during the perinatal, postpartum, and early childhood period of time. Families, especially families dealing with compounded challenges and risk factors, deserve the option to choose from support that meets them where they are at. Home visiting is uniquely positioned to support families in a holistic and individualized way. And due to the trusted relationships that home visitors build with the families, they are able to successfully connect these families to other vital health services and community-based supports the District offers.

However, home visiting programs cannot continue to provide the highest quality care and reach as many families as they need to if they are underfunded, short-staffed, and underinvested in.

Home visiting programs need more funding to address the risk of losing valuable staff and lowering participant retention. Home visitors deserve higher wages to be able to continue working in the roles they love to do without needing a second job. Families deserve uninterrupted, quality home visiting services. Additionally, home visiting grants have historically remained at flat funding and need to be adjusted for inflation, which has risen exponentially in recent years. Programs have been working hard since the start of the pandemic to meet the needs and resources of families who have been hit hard over the past three years. An increase of $300,000 would enable programs to raise home visitor salaries and catch up with inflation rates. This increase will stabilize the local home visiting programs and allow them to address these current workforce challenges.

Beyond CFSA’s portfolio, we have been seeking a $1.2 million increase to DC Health-funded early childhood home visiting programs and exploring an option to leverage Medicaid to fund evidence-based home visiting programs. With deeper investments in the FY24 budget for all home visiting programs overall, DC has the ability to stabilize the home visiting field and create a stronger, more sustainable funding structure.

Home visiting offers clear, evidence-backed benefits and based on the inspiring experiences that you will hear from witnesses later in this hearing, home visiting supports DC families in a holistic way that few services can. However, year after year, we continue to ask our dedicated home visiting teams and families to appear at public hearings to describe the value of home visiting for very modest funding increases. We are hopeful that this budget season, the District will recognize home visiting as a critical fixture within the early childhood system of care.

We ask the DC Council to invest in families and their communities for the long-term by increasing CFSA home visiting funding by $300,000 in the FY24 budget. We are confident that this modest investment will make all the difference in stabilizing the workforce and ensuring families continue to receive the support they deserve in their parenting journey.

Thank you for the opportunity to testify and I welcome any questions.

Nisa Hussain, nhussain@dckids.org