Testimony of Nisa Hussain Program Manager of Early Childhood before the Committee on Human Services

Testimony of Nisa Hussain

Program Manager of Early Childhood, DC Action

Child and Family Services Agency 

Committee on Human Services: Budget Oversight Hearing

Fiscal Year 2023

Council of the District of Columbia

Good morning Councilmember Nadeau and members of the Committee on Human Services. Thank you for the opportunity to address the Council as it conducts this budget oversight hearing for the Child and Family Services Agency. My name is Nisa Hussain and I am the Early Childhood Program Manager for DC Action and Chair of the DC Home Visiting Council.  

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. Through our signature coalitions, Under 3 DC and the DC Home Visiting Council, we empower families and communities. We are also the home of DC KIDS COUNT, an online resource that tracks key indicators of child and youth well-being. 

Today, my remarks will focus on CFSA’s early childhood home visiting programs, which the agency both funds directly and supports in partnership with the DC Department of Health. In particular, CFSA administers the Father-Child Attachment program at Mary’s Center, the Parent Support and Home Visitation program at Community Family Life Services, the Parents as Teachers program at Mary’s Center, and the Home Instruction for the Parents of Preschool Youngsters (HIPPY) program at The Family Place. 

DC Action appreciates the Council’s past support of home visiting programs, but it is necessary to provide home visiting programs with adequate, recurring funding so programs can strengthen and sustain the long-term relationships that make them so effective. I would like to focus my testimony today on the importance of increasing investments in home visiting programs in the FY23 proposed budget to continue supporting DC’s families. 

To address the home visiting workforce shortages and the rising inflation rates, we are asking for a 15% increase to the current home visiting grants at CFSA and DC Health to enable programs to adapt to the increased demands on their workforce and resources to support families during this pandemic. We are also asking to ensure the one-time $310,000 funding for CFSA home visiting programs become recurring investments in the FY23 budget. 

Home visiting supports the healthy development of children and families

Home visiting is a powerful, evidence-based strategy that supports the healthy development and well-being of children, expectant parents, and families. The service connects families with a trained home visiting professional, who builds trusted relationships over time to address family and child needs including kindergarten readiness; healthy birth outcomes; maternal and child social, emotional, and physical health; and family economic security

Home visiting services coach parents to address their challenges to better meet their goals and succeed in caring for their young children with confidence and positive parenting practices. When parents are empowered and engaged with the support of a trusted home visitor, their children can receive the care they need to meet their highest potential. 

This extra support for caregivers has been especially important for the special populations served by CFSA-funded home visiting programs. Mary’s Center’s Father-Child Attachment program works with fathers and masculine caregivers to build positive relationships with their children and families. Community Family Life Services’ Parent Support and Home Visitation program works with parents experiencing homelessness, domestic violence, or formerly incarcerated citizens seeking to reunify with their children. These are programs that are uniquely positioned to offer individualized, tailored support to these specific populations, who are often facing multiple family risk factors. As highlighted in the recent Home Visiting Annual Report, these two programs were able to serve 175 families in 2021. 

Mary’s Center’s Parents as Teachers program, which is funded through CFSA’s Family First dollars in partnership with DC Health, also provides valuable home visiting services to families with young children and expectant parents who are often facing higher risks. Some home visiting models, such as this Parents as Teachers model, have strong evidence behind preventing child abuse and neglect by offering a holisitic approach to strengthening families. These programs aim to stabilize the family, support a parent’s ability to cope with toxic stress, and help strengthen protective factors to prevent child maltreatment. 

Home visiting programs continue to support families during COVID-19 

During the past two years of the COVID-19 pandemic, DC families have been working hard to overcome endless challenges around job losses, child care shortages, and anxieties around the constant changes to our world. These challenges have compounded upon existing hardships that many home visiting families were already experiencing.  

As a result, home visitors became a lifeline to families during this pandemic.  They adapted quickly to continue serving families, while adjusting to safety guidelines. 100% of programs pivoted to a virtual setting and found new ways to maintain these trusted relationships with families. Most commonly, home visitors found themselves delivering basic supplies to houses or centers, utilizing video or phone calls to conduct their regular visits, and directing participants to relevant resources or services that the District provided for COVID-19 relief. The adaptability of programs allowed an uninterrupted continuity of care to the families who needed it the most. 

As reported to the Home Visiting Council, 55% of home visiting families experienced an increased need for mental health and domestic abuse resources in 2021. Programs also reported an increase in basic needs like rent assistance, supplies, and food. These combined challenges, plus the effects of social isolation, can all contribute to amplified levels of stress in the home, increasing the risk for child abuse and neglect. As mentioned, home visiting is an effective tool to prevent these outcomes since home visitors coach parents to cope with these negative stressors and continue positive parenting practices especially during crisis. 

While programs have effectively transitioned to a safer virtual setting, they are still facing challenges meeting the needs of families who have been hit disproportionately hard by this public health emergency. Programs reported a struggle to maintain consistent engagement and active participation from families, due to competing priorities. 87% of programs observed challenges around their participants’ experience and access to technology or WiFi during their virtual visits. Programs are also seeing families facing increasingly urgent needs and emergencies, so home visitors are spending more time and resources to address those needs before the usual home visiting curriculum. These new set of challenges for programs have weighed heavily on the home visiting workforce these past two years. More investment in these programs is needed to provide home visitors the support and any additional resources they may need to continue serving families in such a heightened state. 

Increase funding for CFSA programs to reflect their important work and make funds recurring

Families are strongly motivated to see their children grow to their fullest potential. They continue to work hard to provide a safe and healthy environment for their families, despite the constant challenges that they faced before the pandemic and even more so now during the pandemic. To ensure they continue receiving the extra support they need to carry out this parenting journey, home visiting programs need enhanced funding. 

A 15% increase to the home visiting program grants would align with the rising inflation rates and enable programs to adapt to the increased demands on their workforce to support families during this pandemic. Many of the home visiting programs have received flat funding since 2019 or earlier and have carried out this critical work without any adjustment for inflation. Programs have also used extra time, resources, and creativity to meet the heightened needs of families during this public health emergency without any funding increases. During this hearing, programs will continue to share their perspective on how valuable this additional funding could be to address these various issues, including reducing turnover by increasing staff salaries, covering the costs of pandemic-related expenses, and more. Programs have worked tirelessly to ensure families stay afloat during this pandemic and should have the adequate resources to continue to do so.

Additionally, we ask that the home visiting funds are made recurring. The CFSA-funded programs spend year after year imploring DC policymakers to restore their one-time funding. We ask for a more sustainable solution to allow these programs to continue their valuable work supporting families by ensuring this funding -which is modest relative to its impact - remains in the budget and remains a priority for this agency. Without consistent and recurring funding for home visiting programs, the District will interrupt care to our most vulnerable families and threaten the trusted relationships home visitors have built with this population over time. 

To accomodate for the rise in inflation since these grants were initially awarded and help home visitors better meet the evolving needs of families, increased and recurring investment is needed to reflect this important work. 

In recent years, home visiting investments with CFSA have included: 

• $160,000 for the Parent Support and Home Visitation program for parents who have experienced homelessness, are survivors of domestic violence, or are returning citizens
• $150,000 for the Father-Child Attachment program to help fathers build and maintain healthy relationships with their children. 
• $160,000 to DC Health as part of an MOU in which DC Health provides Parents as Teachers home visiting services for pregnant or parenting teens who are in or exiting foster care.

We implore the Council to find recurring funds to sustain these critical programs. This investment goes a long way to fulfill CFSA’s ultimate goal to prevent abuse and neglect. Therefore, we ask that this funding be maintained on a recurring basis.