Testimony of Alyssa Noth At the Budget Oversight Hearing for the Committee on Health

Chairperson Gray members and staff of the committee, thank you for the opportunity to submit testimony. My name is Alyssa Noth and I am a Policy Analyst at the DC Fiscal Policy Institute (DCFPI). DCFPI is a non-profit organization that promotes budget choices to address DC’s economic and racial inequities and to build widespread prosperity through independent research and policy recommendations.

My testimony focuses on how the DC Council can improve the Mayor’s proposed Department of Health (DOH) budget to:

  • Restore and preserve level funding for critical Birth-to-Three for All DC health programs;
  • Preserve and expand school based mental health services; and,
  • Reverse devastating cuts to the Department of Behavioral Health’s (DBH) budget.

The Mayor’s Budget Proposal Underfunds Critical Programs of Birth-to-Three for All Law

Thank you, Chairman Gray, for your continued commitment to invest in health programs that support early childhood development. Mental health, physical health and nutritional health supports are essential in the earliest years of a child’s life. The Mayor’s proposed budget for the 2021 fiscal year (FY) maintains level funding for some, but not all of these critical programs.

Help Me Grow

The Mayor’s proposal does not appear to provide any additional investments for Help Me Grow, which connects expecting parents and families to resources they need to encourage positive maternal and child health. The program also helps families locate services such as prenatal and child developmental screenings and links families to community-based support services. This service is critical as one in three children ages 4 months to 5 years old in DC are at risk of developmental delays.

Home Visiting

We are thankful the Mayor held the DOH home visiting funding level for FY 2021. Home visiting effectively supports expectant parents and the families of young children right where they are: in their home or another comfortable place. Home visitors come to families to help parents navigate stressors and challenges, which have been exacerbated by the COVID-19 pandemic. These programs are incredibly flexible and transcend the limitations of services centralized in a physical space and can continue over virtual platforms.

Healthy Steps

The Mayor’s proposed FY 2021 budget appears to remove $300,000 from HealthySteps, but it is unclear at this time whether the cut can be absorbed without leading to reduced services. HealthySteps embeds an early childhood specialist within primary care, and it is proven to improve the health and well-being of DC children and families, preventing significant academic, social, health, and behavioral problems down the road. It is critical the cuts do not result in a material impact to the program.

The Mayor Fails to Make Much Needed Investments in Student Mental Health

DCFPI calls on the Council to provide at least $4 million to adequately support the expansion of the DBH School Mental Health Program.

The pandemic has significantly disrupted students’ lives, compounding existing mental health challenges and ushering in newfound stressors, trauma, and anxiety. In addition, ongoing protests demanding an end to police brutality against Black Americans have forced us to confront the legacy of our nation’s ugly history of brutalizing and dehumanizing Black minds, bodies, and spirits. For these reasons, DCFPI is deeply concerned that the Mayor’s proposal underfunds DBH’s school mental health program.

Strong mental health and positive social-emotional skills can help reduce behavioral challenges and help students feel safe and excited about learning.[1] Yet, the Mayor’s proposal only provides an additional $1.5 million for the District’s school mental health program, $2.5 million below advocates’ ask. The proposed funding would come from the District’s Governor’s Emergency Education Relief allocation and would only be one-time funding, requiring policymakers to renew these funds in local dollars in future fiscal years to sufficiently continue the expansion of the program.

If the Council fails to provide adequate funding for the program and DBH continues the program’s expansion to the next cohort of 60 additional schools, students with the highest needs—particularly low-income students and Black and Latinx students—may experience reductions in the quality and quantity of mental health care they receive.[2] These students and their families are already shouldering the devastating health, social, and economic burdens of the pandemic. And, at a time when racism and injustice is being thrusted into the forefront of our children and families’ minds, city leaders must do everything they can to ensure these students have the mental health resources they need to be resilient during and after such stressful times.

We urge this Committee to take up this call to action and ensure that the school based mental health expansion is fully funded with an additional $4 million for FY 2021.

The Council Must Reverse Devastating Behavioral Health Spending Cuts

Robust behavioral and mental health supports are critical to DC residents bouncing back from the pandemic, resulting economic downturn, and ongoing public displays of state-sanctioned and vigilante violence against Black people. DCFPI strongly urges the Council to reverse the Mayor’s proposed budget cuts to community-based behavioral health services. The proposed FY 2021 budget would cut funding for these services in DBH’s budget by almost 19 percent, totaling $21.1 million. This reduction would devastate behavioral health providers as they already operate on razor thin margins and have taken a financial hit from the pandemic. Consequently, the Mayor’s proposed cut would likely result providers being forced to lay off staff or shutter their doors permanently—a harm that would slow our economy’s recovery and more importantly, rob deserving patients of quality care.

A Just Recovery Requires a Smart Revenue Strategy

Through a mix of cost-saving strategies (including the misguided decision to freeze COLAs for city workers), the Mayor balanced her budget proposal without making deep budget cuts to essential programs and social services. Yet, more investments are needed to ensure children and families have the resources they need as the city reopens and our economy begins to recover.

The DC Council should enact a common-sense revenue strategy, including making wealthy residents pay more of their fair share in taxes. Currently, a teacher making $60,000 in taxable income in DC pays the same tax rate as someone earning $350,000. Millionaires in DC pay a tax rate that is less than half a percent higher. Targeted tax increases on the wealthiest residents would allow the city to generate much needed revenue to stabilize the childcare industry, for instance, which is needed to get families back to work and reboot our economy. The Council should also repeal or eliminate ineffective tax breaks—such as the Qualified High Tech Company and Qualified Supermarket Tax breaks—and redirect the revenue to much needed food, cash, or housing assistance programs.[3]

[1] Shannon M. Suldo et al., The Impact of School Mental Health on Student and School-Level Academic Outcomes: Current Status of the Research and Future Directions, School Mental Health, 6(2), 84-98, 2014.

[2] Currently, the school mental health program serves two cohorts that include schools DBH identified as being in greatest need. Should DBH decide to expand the program to the third cohort of schools without more funding, DBH will be unable to award contracts to community-based organizations that sufficiently enable the CBOs to hire adequate staff. Other aspects of the program are at-risk due to no new funding including the Community of Practice and evaluation program, and the DCPS and OSSE staff positions that support the implementation of the program.

[3] Amy Lieber, Revenue Revealed: It’s Time to Amend DC’s Tax Expenditure Programs, DC Fiscal Policy Institute, March 26, 2019.

[4] Fair Budget Coalition, “Tax Revenue Recommendations FY21,” May 28, 2020, http://fairbudget.org/blog.html.