Testimony of Rachel Metz, Research and Data Manager, before the Committee on Health

February 23, 2022
Person Testifying: Rachel Metz
Title: Research and Data Manager, DC Action
Testimony Heard By: Committee on Health

Hello, Councilmember Gray and members of the Committee on Health. Thank you for the opportunity to address the DC Council as it reviews the Fiscal Year 2022 performance of the Department of Health. I am Rachel Metz, Research and Data Manager of DC Action.

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.

Chair Gray, we want to thank you, the Health Committee and DC Health for funding to conduct outreach to enroll eligible District residents in the Women, Infants, and Children (WIC) program this past year, as well as DC Health’s flexibility in continuing to provide telehealth services. In the District, WIC is one tool among many to combat food insecurity and help counter racial inequities. While levels of food insecurity have fluctuated over the course of the pandemic, from December 29, 2021 to January 10, 2022 – nearly one in five District households with children said that they sometimes or often didn’t have enough to eat. Due to the legacy of discrimination and racism, Black and Latinx families are far more likely to have to contend with food insecurity, with the negligible rate for white families driving down the District’s average rates.

Even worse, according to the most recent pre-pandemic publicly available data, less than half of eligible residents are enrolled in WIC (44.6% in 2018), which is a lower share than in neighboring Maryland and Virginia and than the national average, meaning that families who could benefit from WIC may not be participating in the program. There are policies and strategies the District could employ to enhance the ability to reach and retain District families with low incomes and link them to much needed assistance. Below are a few strategies that the District could try to broaden its reach to eligible families.

  1. Prevent stigma

WIC is in the process of transitioning to electronic benefits cards (EBT), which simplify WIC transactions in the checkout line, eliminate the stigma of paying with paper vouchers, enable stronger agency program management and oversight and, during the COVID-19 pandemic in particular, allow for online purchases. DC WIC has committed to piloting eWIC this spring and fully implementing it this calendar year. That is long overdue, and while we know how much hard work is going into the transition we truly hope this is the last year we have to ask that it be completed this year.

  1. Simplify enrollment across programs

Once an infant turns one, many participants drop out of WIC. The participation rates for children ages one to four is lower each year children age, while nutritional needs remain. Understanding the reasons for the decline can help government officials develop strategies to keep those eligible infants and children on the program past their first birthdays. One option for the District, as part of the development of the new Early Childhood Integrated Data System (ECIDS), is to create linkages and partnerships between programs that support families (e.g. WIC, SNAP, child care subsidy, TANF) so that enrollment in any one of these programs simplifies the application process for all others for which they are eligible.

  1. Continue to offer additional  flexibility that was instituted due to the pandemic

In national surveys and focus groups, WIC participants’ biggest complaints were about the in-office requirement for nutrition education and that the nutrition education material was not helpful. During the COVID-19 pandemic, the nutrition education component has been waived for participants, and telemedicine and virtual video-conferencing appointments have been successful. Once COVID-19 case counts allow a potential return to in-person programming we recommend a hybrid approach so that families can choose the option (in person vs. remote) that poses the fewest hurdles for them.