Agency Performance Oversight Hearing, Fiscal Year 2013-2014, Department of Health

Testimony of Bonnie O’Keefe, Senior Policy Analyst 

DC Action for Children

Agency Performance Oversight Hearing

Fiscal Year 2013-2014

Department of Health

Before the Committee on Health

Council of the District of Columbia

March 7, 2014

Good morning Committee Chair Alexander and members of the Committee on Health. Thank you for the opportunity to address the Council as it reviews the performance of the Department of Health (DOH). My name is Bonnie O’Keefe, and I am a senior policy analyst with DC Action for Children.   

DC Action for Children (“DC Action”) provides data-based analysis and policy leadership on critical issues facing DC children and youth, to promote policies and actions that optimize child and family well-being. 

DC Action is the home of DC KIDS COUNT, which tracks key indicators of child and youth well-being in the DC neighborhoods where children live, learn and grow. We work closely with city agencies, the school system and service providers to share the most accurate and timely data along with clear and accessible analysis. Our advocacy agenda is based on these data.

My testimony today will focus on the Department of Health Community Health Administration’s Home Visiting Programs for expectant mothers and families with young children. Home visiting programs are a key part of Mayor Gray’s Early Success Framework, as they serve families starting from the very beginning of children’s lives. These crucial programs deserve more attention and support from the entire DC community.

DC Action is a member of the DC Home Visiting Council (, which includes representatives from community agencies that provide home visiting services, advocacy groups such as DC Action, DOH staff and other DC agencies. The Home Visiting Council works to strengthen DC’s implementation of early childhood home visiting as a strategy to support children and families. 

As members of the Home Visiting Council, DC Action wants to sincerely thank the DOH staff from the Community Health Administration’s home visiting team for their hard work and their commitment to collaborating with members of the Home Visiting Council to spread the word about home visiting, ensure high-quality services and expand access to home visiting. 

Home Visiting Programs Serve Families in Need - and There is Room to Grow 

Early childhood home visiting programs in DC serve expectant mothers and families with young children at risk of adverse child outcomes due to circumstances like poverty, teen motherhood or substance abuse. There are over 38,000 children under age five in DC, many of whom live in poverty or have other risk factors that would qualify their families for home visiting services. According to estimates by the Home Visiting Council, approximately 3,500 children born in DC in recent years could benefit from home visiting, but currently programs sponsored by DOH and other DC agencies have the capacity to serve fewer than 1,000 total families. 

Trained Home Visitors Provide Support, Education and Connections to Resources

Early childhood home visitors provide many services to their clients in the comfort and convenience of their homes. Home visitors are specifically training to be culturally competent and familiar with families’ potential needs, and many home visitors come from the communities they serve. Services home visitors provide vary by the particular program model, but generally include:

Educating parents about their child’s development, healthy parenting practices, health care access and early care and education.

Screening for developmental, health or behavioral issues.

Referring families to mental health services, substance abuse treatment or anything else parents may need to improve their parenting.

Home Visiting Has Proven Positive Effects on Children and Families

Home visiting is a simple, cost-effective strategy for improving the health and well-being of DC children and families, because it intervenes with families early, during the most critical developmental period of children’s lives, in the home, where infants and young children spend most of their time. Home visiting prevents many potential health, abuse and neglect problems, and it empowers families to obtain services that will put their children on the path to better health and school readiness.

DOH Home Visiting Programs are Funded by At-Risk Federal Grants 

There are several early childhood home visiting programs currently serving DC communities. Those overseen by DOH are funded primarily by federal Maternal, Infant and Early Childhood Home Visiting (MIECHV) grants, which are authorized under the Affordable Care Act. DC’s MIECHV funding includes a formula grant and a competitive grant awarded to DC in 2012 and expiring in 2015. The formula grant funds two evidence-based program models serving families in Wards 5, 7 and 8, while the competitive grant will help expand home visiting services in all wards under an additional evidence-based model starting this year. 

Last year, DC Action testified to the committee that the funds for the time-limited competitive grant had been delayed, and this delay continued until January 2014, when applications were opened. After 14 months of delay, the application process was open for less than a week. We are glad that these resources will soon be put to use serving DC families, but we would like to hear more from DOH as to why the delay occurred and how such delays will be avoided in the future.

Both types of federal funding are time limited, and renewal is doubtful. To secure DC’s investment in the future of our young children, we cannot let the progress we have made toward expanding home visiting programs be lost. We hope to see DOH and this Committee take proactive steps to secure and sustain the future of early childhood home visiting after MIECHV funding potentially expires.

Looking Towards the Future with Help Me Grow

DC Action is committed to supporting high-quality implementation of evidenced-based home visiting in DC. We look forward to seeing these vital services reach more families in 2014, and we are especially excited to see home visiting programs integrated into Help Me Grow, a model to connect at-risk children and their families to community-based services via a single telephone access point, which is in the beginning stages in DC. Working with other DC agencies and community service providers will also be crucial to the future success of this program. 

Thank you for the opportunity to testify, I’m happy to answer any questions. 

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