Testimony of Nisa Hussain Program Manager, Early Childhood before the Committee on Health

June 11, 2021
Person Testifying: Nisa Hussain
Title: Early Childhood at DC Action , DC Action
Testimony Heard By: Before the Committee on Health
Type of Hearing: Agency Budget Hearing - Fiscal Year 2022

Good morning, Councilmember Gray and members of the Committee on Health. Thank you for the opportunity to address the Council as it conducts this budget oversight hearing for the Department of Health. I am Nisa Hussain, Early Childhood Program Manager for DC Action, coordinator 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. Through our signature coalitions, Under 3 DC and the DC Home Visiting Council, we organize families , educators, and communities. We are also the home of DC KIDS COUNT, an online resource that tracks key indicators of child and youth well-being.

Chairperson Gray, thank you for championing home visiting programs and early childhood efforts over the years. We are also grateful for the DC Council’s ongoing support of the early childhood space as well as DC Health’s active leadership and partnership on the Home Visiting Council.

I am here today to ask for maintained level funding for home visiting programs and Help Me Grow, as well as an increase to the HealthySteps program, in the FY22 budget through DC Health.

My testimony today will focus primarily on DC Health-funded home visiting programs and the agency’s work to support and strengthen families through the strategy of home visiting. DC Health funds Georgetown University’s Parenting Support Program, Community of Hope’s Parents as Teachers program, Mary’s Center’s Healthy Families America and Parents as Teachers programs, and Mamatoto Village’s Mothers Rising program. Each of these programs serves a unique and specific population of families using the program model that is most appropriate for those families.

DC is home to 45,040 children under age 5, of whom 27,196 are under age 3. Nearly half of the District’s under 5 population is Black, 17% are Latinx, and 27% are white. Unfortunately, about 1 in 5 DC children under age 6 is in a family that lives below the federal poverty line.

Home visiting is a powerful strategy that supports DC families to work towards self-sufficiency

Home visiting is an evidence-based strategy for comprehensively supporting families from pregnancy through the first few critical years of a child’s life. Home visitors meet the family in a comfortable setting, in the home or virtually, and guide them to achieve their developmental goals for their children or themselves. Studies show that some home visiting models can lead to improvements in school readiness, birth outcomes, and family economic security. Broadly, home visiting programs support parents to work towards self-sufficiency. Families that enroll in home visiting programs have the ability and desire to aid their child’s development. They work with home visitors to handle challenges and earn the extra confidence and skills to carry out their parenting journey.

Home visiting is a unique and invaluable service due to its relationship-based approach. Whereas medical interactions can be concise, brief encounters, home visitors have an established relationship with families and frequent opportunities to discuss goals, challenges, and solutions at length. This built trust and open communication allows families more opportunities to receive referrals to the other services or resources they may need.

DC Health-funded programs are built to support a wide range of family needs and types, including specific populations who may need this extra support the most. Home visiting programs in the District primarily serve Black and brown families who may be dealing with the consequences of systemic racism and the barriers it creates in accessing health care, affordable housing, and more. These programs offer meaningful support for families to navigate these unjust barriers successfully. Georgetown University’s Parenting Support Program is the primary home visiting program that supports caretakers with intellectual or associated disabilities. The programs administered by Community of Hope, Mamatoto Village, and Mary’s Center focus on expectant parents or families with children under 3 and are all able to provide individualized support based on the family’s circumstance.

Home visiting programs showed up for families during COVID-19 and will continue to support families during the District’s recovery.

The District is still reeling from a difficult year navigating the COVID-19 pandemic. Many families faced physical, emotional, mental, and financial challenges and losses for over a year in lockdown. Expectant parents grappled with the limitations and unexpected changes to their pregnancy and birthing plans. Families of young children struggled with child care, virtual learning, and the uncertain impacts of social isolation on the child’s development.

Fortunately, home visiting programs have been a critical support for families through this pandemic. Home visitors are trained to manage crises and walk families through intense periods of stress and instability. Home visitors have virtually supported families, helping them access the District’s food and relief services, referring them to mental health services, and coaching parents to navigate and cope with emotional stressors. Stressors can place young children at greater risk for child abuse and negelct. Research shows some home visiting models can play a preventative role and mitigate child abuse and neglect. These programs have truly helped keep families safe and afloat during a difficult and uncertain time.

While the District’s gradual reopening and a renewed sense of hope around the pandemic’s unwinding is certainly welcomed, a true recovery for all DC families is not in clear sight yet. Black and brown households have been disproportionately overburdened by the impacts of COVID-19 and the economic fallout of the pandemic. Some of our youngest residents are still unable to receive the life-saving vaccines, keeping some families still at risk. Families are still navigating stressors around child care, school reopenings, and stable housing.

Home visiting programs are built to support families dealing with these types of challenges and should be allowed to continue supporting them through this transitional period of time. Any cuts to the funding of these programs would be detrimental to the well-being of DC’s families facing the greatest barriers. Interrupting these critical early childhood services during an ongoing pandemic and a difficult recovery will have lasting negative impacts on the families who need extra support the most.

Home visiting is an effective early childhood strategy the District can utilize alongside other health programs like Help Me Grow and Healthy Steps.

Home visiting is just one strategy that sits within the District’s early childhood system. Every family has their own set of needs and goals, many of them complex needs. To address every need, home visiting works alongside other health programs, such as Help Me Grow and Healthy Steps, to reach families at every angle.

Help Me Grow connects expecting parents and families to health resources through a free information and referral helpline. The program helps families locate services such as prenatal and child developmental screenings and links families to community-based support services. The parental support services provided by Help Me Grow’s phone line are COVID-safe ways to promote healthy child development, making Help Me Grow an especially valuable tool for supporting DC families as they navigate the anxieties caused by the pandemic. We are asking to maintain the $581,000 funding for the Help Me Grow program in FY22.

We are thankful for DC Health’s partnership with the Home Visiting Council to develop a coordinated, centralized intake system for home visiting through Help Me Grow. This collaboration has brought together two important services and contributes to strengthening the broader early childhood system. We look forward to continuing this partnership.

HealthySteps is another well-positioned program, included in the Birth-to-Three law, that can support the many needs of babies and parents living in low-income households. Healthy Steps integrates early childhood specialists into pediatricians’ offices to ensure families receive a wide range of additional supports during their regular doctor visits. These supports include: child development and postpartum depression screenings and referrals; support improving infant sleep, attachment, and nutrition; lactation consultations; assistance connecting with government benefits and services; and more. By enhancing the HealthySteps program budget by $300,000 to create an additional HealthySteps site in Wards 5, 7, or 8, more low income families will gain access to essential child development and social services embedded in their pediatric wellness visits. Our understanding is that this program may have lost $450,000 in the Mayor’s proposed budget. If this is the case we also ask you to restore these funds so that families can continue receiving HealthySteps’ important support.

Home visiting, Help Me Grow, and HealthySteps are all built to support expectant parents and families with young children navigate critical services for their own success.

We’re also glad to see that this year’s budget includes $103,000 for the Lactation Certification Preparatory Program authorized through the Birth-to-Three Law. Last year, while those funds were included in the budget, they did not reach the lactation program. We hope you will work with DC Health to ensure that those funds pay for the important work of LCPP.

As you deliberate the final FY22 budget, we urge you to maintain level funding for home visiting programs and Help Me Grow, as they are currently funded in the proposed budget, as well as restore and enhance HealthySteps in the FY22 budget to a total of $1,050,000.

As families recover from an incredibly difficult year, we must be sure they have the support that these important programs provide.