Testimony of Katharine Kairys, Department of Health Budget Hearing, FY 2014


Testimony of Katharine Kairys, Policy Analyst
DC Action for Children

Agency Budget Hearing
Fiscal Year 2014

District of Columbia Department of Health
Testimony before the Committee on Health
Council of the District of Columbia

April 10, 2013

Thank you Chairwoman Alexander and members of the Committee on Health for the opportunity to testify to the Council as it reviews the budget for the Department of Health (DOH). My name is Kate Kairys, and I am a policy analyst with DC Action for Children and a DC resident.

DC Action for Children is an advocacy organization dedicated to ensuring that all children in the District of Columbia have the opportunity to reach their full potential.

DC Action for Children (“DC Action”) provides data-based analysis and policy leadership on critical issues facing DC children and youth. Our vision is of a District where children and youth who are most in need of health, education, safety and financial well-being are receiving competent and equitable services.

Today, with support from the Annie E. Casey Foundation to become the home of DC KIDS COUNT, DC Action is the primary source of data on conditions and outcomes for all children and youth in DC. We work closely with city agencies, the school system and providers to get the most accurate and timely data to present clear and accessible analysis. Our public policy agenda is based on this critical data.

Today, I will focus on the budget for the Department of Health Community Health Administration’s Home Visitation Programs for expectant mothers and families with young children. Home visitation is a strategy where trained professionals visit families at home to offer targeted services and information. These programs help to improve health and education outcomes for children, and research shows they have a significant return on investment. For example, a North Carolina study found that the reduction in infant emergency room visits alone created a $1.59 benefit per dollar spent on home visitation.  We know that smart investment in evidence-based home visitation not only saves money in the long run, but it also prevents education and health disparities before they start.

The young child population (under age five) in DC is increasing, so an investment in home visitation programs could not come at a better or more important time. More than 36,000 children under the age of five are growing up in DC, and the population of children under five has increased by 11 percent since 2000.  Today, the greatest numbers of young children currently live in Wards 4, 7 and 8 – and 4,700 young children live in Ward 7 alone. Strengthening home visitation will help more young children grow up healthy and ready to learn.

Funding for home visitation in the DOH budget comes from two federal sources – a formula grant from the Maternal, Infant and Early Childhood Home Visiting (MIECHV) Program and a separate grant that funds the Healthy Start program in DC. (DC also has a two-year competitive grant for home visitation, which I will discuss later in my testimony.) It is important to note that all funding for DC home visitation programs is federal.

As it is, home visitation programs are only able to serve a small number of families, far fewer than the number of families who could benefit. To make home visitation a central part of DC’s comprehensive early care and education system, we need to make sure the programs are supported locally and not just dependent on federal dollars. We urge the Council to invest local funds in home visiting, to make sure that these effective programs are sustainable in DC.

Home visitation is a strategy that helps new and expectant parents. These programs target at-risk families who are in poverty or face challenges for other reasons, such as disabilities or health concerns. Trained professionals visit families at home and provide on-going information about child development and parenting strategies. They also share information about school and child care options, stress the importance of immunizations, screen children for developmental delays, and more.  As part of their work with the families, they can also connect families with other services, such as medical care providers, early intervention services and nutrition programs.

Home visits are voluntary, and most evidence-based programs seek to empower parents to improve their child’s health and education beyond the confines of a home visit. Research shows that home visitation reduces infant mortality, improves identification of delays and disabilities and improves first grade school readiness.

DOH contracts with providers to provide home visitation services, concentrating on families in Wards 5, 7 and 8, where the need for services is greatest. Current providers include Mary’s Center and The Family Place, which implement evidence-based programs and serve approximately 230 families. The Perry School and DOH Healthy Start use parts of evidence-based models. These programs are seeing results, but they are only able to reach a small number of families that need their support.

Recently DC won a $4.5 million, two-year competitive grant for home visitation from the US Department of Health and Human Services. The grant would allow DOH to expand the number of organizations providing home visitation, support a centralized intake for enrolling families and boost professional development for home visitation staff, among other goals. However, this competitive grant is for a limited time. After the grant is ended and home visitation services have been expanded, we need to be able to sustain them.

Home visitation programs in DC are a vital service in our neighborhoods, and they need to be sustained and supported locally.

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