Council Testimony: DC Health, Budget Oversight Hearing, FY 2020

Health Oversight Testimony

Testimony of Ruqiyyah Abu-Anbar

Director of Early Childhood Policy and Programs

DC Action for Children


Agency Budget Oversight Hearing

Fiscal Year 2020

Department of Health


Before the Committee on Health

Council of the District of Columbia


April 9, 2019


Good afternoon, Councilmember Gray and members of the Committee on Health. Thank you for the opportunity to address the Council as it reviews the Department of Health’s budget for FY 2020. My name is Ruqiyyah Abu-Anbar, and I am Director of Early Childhood Policy and Programs at DC Action for Children (DC Action).

DC Action provides data analysis and policy leadership on critical issues facing DC children and youth. We envision a District of Columbia where all children, regardless of their race/ethnicity, family’s income or zip code, have the opportunity to reach their full potential. We are also the home of DC KIDS COUNT, an online resource that tracks key indicators of child well-being in the District.

DC Action is part of the Birth-to-Three Policy Alliance which is committed to transforming how DC invests in infants, toddlers, and families starting prenatally through age three. Alongside our Policy Alliance partners, we applauded the Council’s unanimous passage of the Birth-to-Three for All Act last year and look forward to working with you to ensure full funding for that program.

DC Action for Children also serves on the DC Home Visiting Council with other advocates, community-based providers and agency leaders. This council works to strengthen home visiting in the District by building a cross-sector network of support for programs, advocating for resources and funding for their stability and growth and collaborating to address system-wide challenges to the implementation of home visiting services. We are grateful for the leadership and partnership of the Department of Health’s (DC Health) staff on the Home Visiting Council and their commitment to promoting maternal, child and family health through evidence-based home visiting services.

The need for birth-to-three is urgent.

There are over 45,000 children under age 5 living in the District.[1] Of these children, 71% are children of color[2] and  25% are in families living below the poverty line, a figure varying widely by ward. [3] As the population of young children continues to grow, it is critical that the city remains focused on increasing access to equitable and affordable services to help them meet their full potential, including quality early education, health, and behavioral health. Birth to Three for All DC, which we are thankful you introduced, Councilmember Gray, has the potential to lead the nation in developing a comprehensive early childhood system that addresses the needs of young children and their families. Birth to Three for All DC strengthens the District’s early childhood system by expanding and coordinating early childhood services and supports, with attention to equitable access to opportunity regardless of race, ethnicity or zip code.

Last summer, the DC Council demonstrated a commitment to young children and their families by unanimously passing the Birth-to-Three for All DC (B3 DC). We are grateful for the work the Councilmembers did to pass this law and to allocate a small amount of local revenue to support it in FY 2019. However, as currently drafted, we are concerned that the proposed FY2020 budget leaves out the District’s youngest residents and their families. In particular, this budget does not grow investment in B3 DC, leaving development of a comprehensive early childhood system largely unfunded. We hope that you and your Council colleagues will work identify ways to fund this incredible legislation in FY2020. Our children and families need these services as they also contribute to improving family outcomes and success.

Early childhood health programs need support

We believe the bold vision laid out through B3 DC is still the right path towards achieving better results for children and families across the District. Provisions within the legislation build on many of DC Health’s existing programs to expand the availability of important services that promise to improve outcomes for children and their families. In particular, if funded, B3 DC would invest in system supports for and an expansion of early childhood home visiting to set families of young children up for success and link them to other services. This legislation also expands Healthy Futures, a program that provides mental health consultation to early childhood educators to build their capacity to support young children’s social and emotional development, and the Lactation Certification Preparatory Program, which trains and supports aspiring lactation specialists.

This budget fails to appropriate the $4 million necessary to implement these important programs at the Department of Health in FY 2020. This is particularly concerning because, in recent years, overall home visiting funding in the District has decreased significantly, as federal funding priorities for child abuse and neglect prevention and other programs have changed, and as DC Health’s local home visiting dollars (aside from B3 DC funding) continue to be shared with other types of programs. Beyond federal cuts, in the proposed budget, DC’s traditional local home visiting funding amount of approximately $2 million is reduced to less than $1.8 million, shared with place-based and other programs. The benefits of home visiting are proven and DC families have voiced their desire for these programs year after year. We now that the Council is supportive of these programs and hope that you and your colleagues can find funds to support them in FY 2020.

The proposed FY2020 budget is a missed opportunity.

We think this budget presents a missed opportunity to create meaningful investments for long-term impact. While the Mayor’s proposed FY2020 budget includes some investments in early childhood supports, we are disappointed to see that the budget does not include sufficient funding to implement B3 DC, and especially leaves out early childhood health programs.

In the fall, a group of over 20 local organizations requested that the Mayor invest $30 million in B3 DC to support services that families need every day like high-quality early learning, mental health consultations, and home visiting. Instead, the mayor invested $5 million in early learning, which we feel is necessary, but not sufficient for us to achieve our goals for young children in the District. The additional $5 million to increase subsidy reimbursements for early educators is needed, and we are pleased to see $52 million in capital investments to create new slots for early education. However, without companion investments in health programs such those included in B3 DC, the District will struggle to meet the needs of young children in families who could benefit from additional support. It is imperative that this landmark legislation receives funding if we want to guarantee children a strong foundation for meeting their full potential. Additionally, we must ensure that the agencies have the necessary resources and personnel to manage programming and initiatives.

Moreover, this budget does not invest revenue from sports betting, as envisioned by the Council last year, into B3 DC. We are disappointed to see that the proposed Budget Support Act strikes language in the Sports Wagering Lottery Amendment Act of 2018 that directs revenue from taxation of sports wagering operators to B-3 for All DC and the NEAR Act. We hope that the Council will return these funds to these important laws aimed at supporting communities most impacted by structural racism. Furthermore, a larger pool of funds that the Council intended to be dedicated to B3 DC and the NEAR Act do not fund either law. The projected revenue that Councilmembers intended to dedicate B3 DC would have made significant strides in supporting development of a strong early childhood system unlike any other in the nation. We recognize that projected decreases in public revenue necessitate careful evaluation of funding priorities in FY 2020- however we believe that programs that address unmet needs of DC’s youngest residents are important and must be funded.

Finally, in reviewing the FY 2020 budget, we were pleased to see that the agency improved its performance or met its targets for a number of important benchmarks. However, we would like to hear from DC Health about why the “number of families/providers calls/referrals to Help Me Grow” measure is not available for FY 2018. We look forward to better understanding the context surrounding this measure.

We are grateful for the Council’s work to support young children in the District through unanimous passage of B3 DC. B3 DC will require a significant long-term investment, but our children can only meet their full potential if we invest in them.

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



[1] Data via DC KIDS COUNT; Child population by age group. Source: Population Division, U.S. Census Bureau. Retrieved from:,870,573,869,36,868/62,63,64,6,4693/419.

[2] Data via DC KIDS COUNT; Child population by race and age group. Source: Population Division, U.S. Census Bureau. Retrieved from:,870,573,869,36,868,867,133/68,69,67,12,70,66,71,13|62/17077,17078

[3] Data via DC KIDS COUNT; Children in Poverty by Age Group; Source: US Census Bureau. Accessed at:,870,573,869,36,868,867/17,18,36/12263,12264

April 10, 2019