Thank you, Councilmember Gray and the members of the Committee on Health, for the opportunity to speak today. My name is Dr. Melissa Delia, and I am a pediatric resident in DC. Throughout my training, I have worked in a variety of settings, including newborn care, inpatient medicine and critical care, and general outpatient clinics. In these settings, I care for children and young adults either hospitalized or seeking medical care. Today, I am testifying in support of DC Health’s home visiting programs to provide much needed support to our most vulnerable families.
Those of us who practice in the DC area come across families from numerous backgrounds; we see different languages, races, ethnicities, literacy levels, sexual and gender orientations, and differing levels of impairment. We’re taught to be culturally competent physicians in order to provide the best care we can for our patients, but that doesn’t always work out. We know that non-English speaking patients have higher risks of adverse events while in the hospital and report lower satisfaction with their providers. Patients from different backgrounds than their providers may feel distrust, and sometimes these differences between patient and provider can lead to miscommunications, non-adherence, and patients may be less likely to seek medical care in the future.
One evening, I saw a little girl and her family in the emergency room after she had a seizure. After chart review, I found that she had a few episodes previously, and was started on medication to stop the seizures. The patient and her family were recent immigrants to this country from a Latin American country and did not speak English. When speaking with the family with an interpreter, they reported that they had stopped medication when the bottle ran out. They did not understand that this will be a long-term problem, so they did not refill the medication. This misunderstanding was likely fueled by both language and cultural barriers, and unfortunately led to this little girl being harmed.
This is where ancillary services – such as diverse home visiting programs – can intervene. DC Health’s home visiting programs aim to provide culturally relevant care to our families to make the provision of healthcare, education, food, and many other services equitable. Home visitors are able to support the family by navigating many different systems, including healthcare, education, and social services, while being a friendly, welcoming presence. Their home visiting programs aim to increase trust, tear down barriers to care, and address the family’s specific needs. When people feel heard and understood, they are more likely to engage and follow recommendations, in addition to reaching out when they are in need.
They can connect families with head start or early intervention, diaper supplies or food distribution, or even additional healthcare or mental health services to address the social inequities we see every day. For these reasons and many others, I am in support of DC Health’s home visiting budget to adequately support these essential staff members and provide programs with additional resources they may need. Thank you for your time, and I welcome any questions you may have.