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

February 24, 2023
Person Testifying: Nisa Hussain
Title: Program Manager of Early Childhood, DC Action
Testimony Heard By: Child and Family Services Agency
Type of Hearing: Oversight Hearing

Good afternoon, Councilmember Lewis George and members of the Committee on Facilities and Human Services. Thank you for the opportunity to address the Council as it reviews the Child and Family Services Agency’s performance, and thank you Chairperson Lewis George for your ongoing support for DC families. I am Nisa Hussain, Early Childhood Program Manager for DC Action, chair of the DC Home Visiting Council, and member of the Under 3 DC Coalition.

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. 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 to these services, so that programs can perform at their optimal level for families.

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.

Home visiting is an effective early childhood strategy that supports the healthy development of children and families. 

Home visiting is a valuable, evidence-based strategy that has long been used by states to improve the health and well-being of young children under 5, expectant parents, and families, especially families with lower incomes or multiple risk factors. Home visiting programs deliver social, health, and educational services and connect families to other medical or social services they may benefit from.

Studies have shown home visiting can lead to positive maternal and child health outcomes like improvements in school readiness, healthy birth outcomes, reductions in child maltreatment, and family economic security1.

These services also support families during an extremely critical time, since their participants are expectant parents and families with children 5 and under. A child’s brain develops rapidly during the first five years of life. The early years are critical for making brain connections that will determine cognitive, emotional, and physical development. This is a window of time where experiences can create a lasting effect on a child’s trajectory in life as an adult2. Positive experiences, such as engaging and nurturing parenting or basic activities like talking and playing, can stimulate growth and protect a child’s brain from toxic stress.  Negative experiences, like exposure to violence, unstable housing, or accumulated family hardships, can take a toll on an individual’s development and their future physical and mental health. Home visiting is a preventative public health approach that works to enhance protective factors and minimize these negative ones, such as adverse childhood experiences (ACEs), in a child’s life, strengthening the family and community overall. Home visiting can help parents cope with stressors, navigate a parent’s own history of trauma, and ultimately work towards reducing child abuse and neglect.

Home visiting distinctly relies on a home visitor’s long standing and trusted relationship with the family to achieve success. This connection allows the home visitor to coach parents to succeed in providing their children a stable environment and in caring for their children with confidence. When parents feel confident in their role as an empowered caregiver, their children can receive the care they need to meet their highest potential.

This extra support to caregivers who are working to create a safe and secure environment for their child to thrive in is demonstrated well in CFSA’s home visiting programs. For example, Mary’s Center’s Father-Child Attachment program works with fathers and masculine caregivers to build positive relationships with their children and families. Community Family Life Services’ Parent Support and Home Visitation program works with parents experiencing homelessness, domestic violence, or formerly incarcerated citizens 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 programs are uniquely positioned to serve special populations and primarily Black and brown households, who may face additional barriers and have been disproportionately overburdened by the impacts of COVID-19 for the last several years.

While home visiting continues to play a critical role in the District’s early childhood strategy, home visiting programs face several challenges that can be addressed with increased investment. Our primary challenges include the low pay that is driving home visitors out of the workforce and the stagnant funding that hasn’t increased in years. We are seeking a $300,000 increase to local home visiting grants in FY24 to resolve these current issues.

We recommend increasing home visitor salaries to reduce turnover, avoid interrupted services to families, and lessen the burden on programs operating without full staff. 

Home visitors are educated, committed, and passionate about the role they play in families’ lives. Similar to child care teachers, home visitors are some of the most dedicated, yet underpaid, professionals working with DC’s families and children. As highlighted in the Voices from the Field Report, home visitors also report an emotional toll dealing with difficult scenarios with families and face a heavy workload. Despite this important role they play in the community and the challenges that come with it, home visitors’ salaries do not reflect this valuable work and as a result, are leaving the workforce in pursuit of higher paying jobs. In 2021, the Home Visiting Council’s survey data revealed the average salary for a DC home visitor was around $44,000. In 2022, the majority of programs reported experiencing challenges retaining and hiring staff. Not only is it a glaring issue that some home visitors cannot afford to live in the DC communities they work in, but it also has real impacts on the families they work with. As mentioned, home visiting relies on their long-term relationships with families to achieve success. When a home visitor leaves their role, this disrupts the services for the families they work with and have built trust with over time. This also leads to a stressful scenario for the remaining home visitors in the program to fill in the gaps of care to families in the meantime as they wait for those roles to be filled after the hiring and training process. Increasing investments so programs can increase home visitor compensation will preserve the workforce and avoid these consequential challenges for the workers and the families alike. The Home Visiting Council released a Policy Recommendations Brief that further outlines several approaches to raise wages for the workforce.

We also recommend an overall increase to local home visiting programs to adjust for inflation and stagnant grant amounts, enabling programs to support the higher demand for services and supplies from families during this pandemic and economic recovery.

The COVID-19 pandemic continues to impact families. Despite the District’s focus on adjusting to this new normal after nearly three difficult years, home visiting programs have seen a consistent increase in families’ demand and urgency for services, supplies, and resources. In the recent Home Visiting Council’s Annual Report, programs observed more families seeking mental health and domestic violence resources, asking for basic supplies like diapers and food, and requesting rental assistance. This is during a time where all families, excluding the highest-earning District residents, are feeling the financial squeeze of rising costs of living, groceries, and basic supplies with high rates of inflation. Family supports, like home visiting, as well as HealthySteps and Healthy Futures, are available at little to no cost for families and can be a critical lifeline for them to cope with the stressors of surviving an economic crisis.

Despite all of the challenges that come with rising inflation and impacts of the pandemic, home visiting grants have remained flat for several years. We were grateful to win a modest 15% increase to CFSA home visiting funding in this past year’s budget. However, home visiting programs need deeper and sustained investments to adjust for the higher urgency for resources and for the rising expenses. More funding will enable programs to serve families with adequate resources and ensure families are receiving the support necessary to manage these challenging times.

Without consistent and enhanced funding for home visiting programs to pay their home visitors adequately and retain their workforce, the District will interrupt care to our most vulnerable families and threaten the trusted relationships home visitors have built with their communities over time. As we’ve seen this year and since 2020, programs have used extra time, resources, and creativity to meet the heightened needs of families during this public health emergency without any funding increases. To accommodate for the rise in inflation and help home visitors better meet the evolving needs of families, increased investment is needed to reflect this important work.

To address this low pay, inflation, and flat funding of grants, we are seeking a $1 million increase to local home visiting grants in FY24. This is specifically a $300,000 increase to CFSA funding for home visiting programs.

In recent years, home visiting investments with CFSA have included:

  • $150,000 for the Parent Support and Home Visitation program for parents who have experienced homelessness, are survivors of domestic violence, or are returning citizens
  • $160,000 for the Father-Child Attachment program at Mary’s Center to help fathers and masculine caregivers build and maintain healthy relationships with their children.
  • $160,000 to DC Health as part of an MOU in which DC Health provides Mary’s Center’s Parents as Teachers home visiting services for pregnant or parenting teens who are in or exiting foster care to support CFSA’s Family First Program.
  • $50,000 to The Family Place’s HIPPY Program, which is a subgrantee of Collaborative Solutions for Communities (CSC)

We implore the DC Council to prioritize home visiting as a valuable early childhood investment that will fulfill CFSA’s goal of preventing child abuse and neglect and strengthening the District’s families.

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

Nisa Hussain