Maternal, Infant, and Early Childhood Home Visiting (MIECHV) Program Hearing

the committee will come to order wanna welcome everyone to our work in welfare subcommittee hearing on maternal infant and early childhood home visiting program known as MCV um and early support lifelong impact is the title of today so wanna welcome everybody for being here today um and look forward to a fruitful hearing um and obviously wanna thank our witnesses for being here today and i particularly wanna reference one of my constituents miss mendy smith from bright point in bloomington illinois on today's panel mendy thank you for being here today i'm congressman darren la hood proud to chair the work in welfare subcommittee uh with my counterpart uh danny davis and uh my district covers much of central and northwestern illinois and um i'm very very um proud to have the members here today for this important hearing. MCV provides voluntary evidence-based home visiting services to expectant and parenting families that are at risk for adverse outcomes. Federal funding for home visiting services was first proposed by President George W. Bush in two thousand eight and was later authorized by Congress as the MCV program in twenty ten. According to the Health Resources and Services Administration, in fiscal year twenty twenty five nearly, seventy nine thousand households were served with more than one million home visits. In my district, in twenty twenty five, Brightpoint provided McVie home visiting services to more than five hundred families across seventeen counties, many of them rural. By supporting families prenatally until age five, a critical period for early childhood development, McVie is a preventative program. MCV is a program that gets results. The program builds upon decades of research, improves home visits, um, improves home visits by a nurse, social worker, or other trained professional during pregnancy, and in the first years of the child's life, help prevent child abuse and neglect. Support, obviously, positive parenting, improve maternal and child health, and promote child development and school readiness. What makes MCV unique is that funding is tied to evidence. Unlike most federal programs, we know what outcomes taxpayers can expect from our investments. For a home visiting model to earn taxpayer support, an evaluation must prove the program has demonstrated significant positive outcomes on targeted measures of family well-being. Furthermore, support for the program has had broad bipartisan support including during reauthorizations in twenty eighteen in twenty twenty two our late friend and former colleague then ranking member of the work in welfare subcommittee Jackie Walorski of Indiana was a steadfast champion for children and the MCV program through the leadership of my friend and ranking member Danny Davis and Jackie Walorski congress passed the Jackie Walorski maternal and child home visiting reauthorization act in twenty twenty two this act reauthorized MCV for fiscal year twenty twenty three through twenty twenty seven and increased federal investments in the program, including establishment of state match requirement. Since passage of that act, the percentage of families receiving services and screenings has increased, and there has been continued improvement in key outcome areas. For instance, eighty one percent of mothers received depression screenings within three months of giving birth, up from seventy five percent, in twenty twenty in twenty seventeen. Seventy seven percent of children with developmental delays received timely services up from sixty nine percent in twenty seventeen. McVey's authorization expires in October of twenty twenty seven, and congressional action will be required to continue the program. At today's hearing, we hope to hear more from the perspective of parents, home visitors, tribal communities, local agencies, and state administrators about implementation of that twenty twenty-two reauthorization. I hope to continue building bipartisan support for this program and better understand how we can strengthen MCV's impact on families. But make no mistake about it, the evidence is clear. MCV's MCV MCV provides early support and lifelong impact for families and children. Unlike other welfare programs, MCV is grounded in rigorous evaluations, And American taxpayers can expect measurable outcomes with these federal investments. I look forward to our hearing today with our expert witnesses. And uh, at this time I will yield to ranking member Danny Davis for his opening statement.

Thank you, Mister Chairman, and I thank you for holding this hearing about the Maternal Infant and Early Childhood Home Visiting Program, or MIC-V, which is one of our most important tools to strengthen families and help babies and children. When talking about home visiting, I often invoke Frederick Douglass who said, and I quote, "it is easier to build strong children than to repair broken men", end of quotation. Home visiting has a kind of magic in helping children thrive. In particular, participants cite the powerful partnership fostered by the way home visitors respect parents and guide them with resources and tools to raise healthy, happy children. Home visiting has a special place in my heart. I introduced my first bill to provide dedicated support for home visiting with senator kitt Bunn and representatives tom osborne and todd platts in two thousand five later both senator Bunn and representative platts helped enact macv in the one hundred and seventeenth congress i had the honor of partnering with representative jackie walorski craft a historic five year expansion of home visiting. The good news that our witnesses bring today is an important part of my legacy and that of my friend Jackie who was taken from us far too soon. Thanks to this committee's action in twenty twenty two more parents are chosen home visiting and make the improves outcomes for them while also making children safer, healthier and ready to start school. We're now halfway to our goal of doubling funding for home visiting and will reach it in twenty twenty seven. Already, evidence-based home visiting has spread to more than half of US counties. with the majority of these counties supported by MACV funding. In addition to directly helping families, MACV funding has improved broader state home visiting efforts, driving other home visiting sites to coordinate intake, shift to evidence-based approaches, and more rigorously track outcomes. MCV now funds fourteen different models, so states can choose the right approach for their families and communities. And we've already doubled the number of tribal MCV grants, with more to come over the next year. I'd like to ask unanimous consent to insert an article into the record on the role home visiting can play in addressing developmental delays in tribal communities which was co-authored by doctor paulist and as into the hearing record

without objection

thank you mister chairman the chairman and i are fortunate that our home state of illinois has led the way in serving mothers and fathers mcvee helps our state provide home visiting to a thousand addition of families, including vulnerable populations, like expectant and parenting foster youth. It makes it easier and easier for families to connect with home visiting programs. Our state has used new funding provided in the reorganization to expand and you will pardon me a second there. MCV helps our state provide home visiting to a thousand additional families, including vulnerable populations like expectant and parent and foster youth, makes it easier and easier for families to connect with home visiting programs. Our state has used new funding provided in the reauthorization to expand services and increase wages for home visitors. and our program outcomes consistently exceed megabee's targets. As funding to states and tribes grow over the next two years, so will the number of Illinois families able to give their children the best possible start. Home visiting's magic doesn't happen on its own. It takes dedicated home visitors and administrators, like the people on our panel today. It takes parents who love their children and who embrace the resources and developmental knowledge shared by home visitors. And it takes all of us on the Ways and Means Committee working together and fighting to get parents and evidence-based home visiting programs in our communities the support that they need. Today's stories reflect the successes that grew out of our work in twenty twenty two and i look forward to watching how members of this committee will build on strong foundation in the next reauthorization so i thank you mister chairman and you're back to balance of my time

thank you mister davis for your opening statement uh with that i'm pleased to recognize and welcome our full committee chairman jason smith uh the gentleman from missouri and he is recognized for an opening statement

thank you chairman lehood ranking member davis um for hosting today's hearing the maternal infant and early childhood home visiting program provides critical evidence-based services to parents and kids to improve the health and well-being as important as the services offered in this manner in which mcv delivers them by meeting families where they live where they are raising their kids, it can ensure a more successful, more accountable program, and one that can reach more people in need. MCV has a long history, long history of strong bipartisan support, including the twenty twenty-two reauthorization of the program that was named in honor of our late colleague, Miss Jackie Wilarski. Jackie was a truly compassionate, and tireless advocate on behalf of our most vulnerable families. Her tremendous leadership ensured that we made improvements to the MCV program that have had a clear and sizable impact. The reforms that were made, made to make our state partners more engaged in the success of the program and more accountable has led to an increase in the number of families served. including a twenty percent increase in those in rural communities. Again, this is about reaching folks where they live and where they most need our help. I also wanna thank our colleagues, Representative Yackem and Davis, who have led the charge to further incorporate the MCV program into the historic effort this committee has embarked on to enact reforms to our foster youth program. Policies they have championed were included in the Fostering the Future Act that was recently approved by the house with unanimous support alongside the leadership of the first lady, Melania Trump. They will help connect expectant and parenting foster youth with the maternal and early childhood services provided by MICVI. Representative Yaakum, is building directly upon the great work of his predecessor, Representative Walarski, leveraging existing programs and resources to help young adults aging out of foster care build healthier, more stable family families of their own. As my colleagues know, this is the essence here. This program is only authorized only authorized through the fiscal year twenty twenty seven. And should Congress fail to reauthorize it, these services do not just continue on autopilot, our current funding levers levels. They stop. That is why we have to act. And that is why we're doing the work now to be prepared for the expiration next year next Congress, families who need our help will lose access to support that has a track record of success in improving lives. I'm hopeful, given the bipartisan nature of this program, that we can act to make meaningful reforms and reauthorize MCV in a very timely manner. To that end, I wanna thank each and every one of the witnesses, um, for being here today, taking time out of your busy schedule and talking to a a bunch of politicians so uh we appreciate you you being here it does make an impact and a huge difference um strong families make strong communities this is about helping the individual mom and that young child have a more positive environment in which to live and grow but it is also about helping our communities including our rural, underserved, and hard to reach communities. See the benefits of a healthier, more thriving, citizenry. I wanna thank you again, Chairman LeHood, Ranking Member Davis, and I yield back the balance of my time.

Thank you, Chairman Smith, for your statement there. Uh, now we'll move to introduce uh our witnesses on the panel today, and we'll start from my left to right here. first is miss mendie smith who is the vice president of early childhood services at bright point based in bloomington illinois next we have shemya wilson uh who is the parent ambassador at changeit based in columbus ohio next we have sean lagoria is the program director for parents as teachers at community health core based in longview texas next miss p j west is the mcvee program director for the state of iowa department of health and human services based in kettleton iowa and lastly paula sorel suniz is the director at the department of dying education for navajo nation growing beauty based in the navajo nation welcome to all of you uh i'll i'll first turn to you miss smith uh you're now recognized for your opening statement of five minutes

thank you Um, Chairman LeHood, Ranking Member Davis, and distinguished members of the subcommittee, thank you for holding today's hearing on the Maternal, Infant, and Early Childhood Home Visiting Program, or MCV. On behalf of Bright Point and the families we serve across Illinois, thank you for the opportunity to testify about this critical bipartisan program. My name is Mindy Smith, and I serve as the Vice President of Early Childhood Services at Bright Point. Over my twenty-seven years at Bright Point, I have served as a home visitor, a program manager for healthy families and parents as teachers, and a leader of programs focused on doula services, early childhood programs, parent support, and fatherhood engagement. Brightpoint is a community-based child and family service organization serving more than thirty seven thousand children and families annually, annually across seventy Illinois counties. We work in rural, suburban, and urban communities, each with different needs and access challenges. Home visiting is the cornerstone of our prevention approach. I'm inspired by mothers like Sierra, who lives in my hometown of Bloomington, Illinois. Three years ago, Sierra gave birth to twins, while she was already raising a one and nine year old. She was recently a single mother without child care or family support experiencing severe postpartum depression. She described the emotional weight at the time as unbearable. Home visiting was the life-changing for her and for her children. As Sierra recently told us, we stood out, what stood out most to me was that my home visitor never treated us like a case number, or a financial obligation. She treated us like family. And when you're going through a season where you feel completely alone, this kind of support is indescribable. Through home visiting, families receive voluntary relationship-based services right there in their homes. Home visitors help parents understand that child's development provide education, connect families to healthcare and community resources. At Brightpoint we use two primary home visiting models, Healthy Families America and parents as teachers, which serve families with children from birth to five and birth to three years old. These models focus on strengthening that parent-child relationship, preventing child maltreatment, and increasing school readiness. Across these models, the relationship between the home visitor and the family is central. Families are more likely to stay engaged and make progress when they have that same trusted person walking alongside them over time. I began my career as a home visitor. and I remember what the feel looked like before MCV. Home visiting existed, but there was never enough of it and it was more fragmented. Programs were doing important work, but there was not the same shared framework of quality, benchmarking, and coordination that we're gonna talk about today. MCV helped change that. Coordinated intake is a perfect example. In Illinois, MCV fund funding supports coordinated intake systems that connect families to an appropriate home visiting program while with available capacity. Instead of families having to connect multiple programs on their own, Coordinated Intake determines the family needs, identifies the appropriate model, and makes a direct connection to services. This helps families access support more quickly, and helps providers use available home visiting slots more effectively. MCV has fostered innovation for families with more complex needs. In two thousand sixteen Brightpoint helped establish the Illinois Pregnant and Parenting Youth and Care home visiting project, a coordinated intake system that connects pregnant and parenting youth in foster care, to home visiting services right there in their communities. Research shows that foster care involvement can be intergenerational. Children's who parents were in foster care have a substantially higher likelihood. Estimates range, depending on the study and region, from thirty to fifty percent of entering foster care themselves. For these young parents, home visiting can provide a trusted adult that helps them navigate parenting as well as their own transition into adulthood. MCV has also supported the integration of doula services with home visiting. creating a more complete continuum of support from pregnancy through early childhood. Doulas provides support during pregnancy, birth, the postpartum period, and newborn care, while home visitors provide the longer term support in parenting, child development, family goals, and resource navigation. Through my own career, I have seen the difference it makes when a parent has someone in their corner, during pregnancy, birth, and through the early years of a child's life. Parents let us into their home. They love their children. and they do the work. Continued reauthorization and investment in MCV are necessary to preserve this progress, reach more families with this effective tool, especially in those rural communities, underserved areas, and families involved with the child welfare system. Congress should also continue supporting the home visitors and staff, who build the trusted relationships with families and make this work possible every day. Brightpoint looks forward to working with Congress to strengthen and reauthorize MCV expand access to underserved families, and ensure that more children and parents have the support they need to thrive. Thank you and I look forward to your questions.

Thank you, Miss Smith. Now recognize Miss Wilson for your opening statement.

Thank you. Good afternoon, Chairman LeHood, Ranking Member Davis, and members of the subcommittee. Thank you for the opportunity to testify testify about my experience with nurse-family partnership and evidence-based home visiting b model. Funded by Maternal Infant and Early Childhood Home Visiting Program, or MCV. My name is Shemaiah Wilson. I am a licensed social worker, community advocate, and a proud mother from Columbus, Ohio. I am here today because MCV did more than help me deliver a healthy baby. It changed the trajectory of my life. To understand the impact of MCV, you need to understand the generational cycle. i was trying to break i am the oldest of seventeen children growing up my family navigated homelessness a devastating house fire and a life in unsafe neighborhoods my mother became a mom at fourteen when she was pregnant with me and was absent by the time i turned thirteen when my father was incarcerated my young brothers were left alone to fight hunger and abandonment and i had to step in as a caregiver once they moved in in my neighborhood poverty and trauma trapped families in cycles of instability forcing children to take on adult responsibilities while many adults worked endlessly to survive and turn to drugs and alcohol to cope i watched members of my family struggle with poverty trauma violence and instability my sister became a teen mother with little support one of my one of my brothers survived a gunshot wound while a cousin died beside him another brother was later murdered but i was determined to build a different life i became the first in my generation to graduate college but when i became a parent or pregnant in twenty twenty two the trauma of my past caught up to me i entered the nurse family partnership program during my first trimester overwhelmed by fear and anxiety After a previous miscarriage. And she and hearing from family members throughout my life that I was only meant to be an aunt. And never a mother myself, I was convinced something would go wrong. I experienced frequent panic attacks and questioned whether I could become a mother. That I wanted to be. But everything changed when my nurse walked through my door. My nurse became a trusted partner during the most vulnerable period of my life. She provided medical guidance, emotional. and practical tools that helped me navigate pregnancy and parenting with confidence. I was terrified of Sudden Infant Death Syndrome, or SIDS. But my nurse helped me learn a safe sleep practice and trust and to trust myself as a parent. When I wanted to breastfeed but doubted whether I could, she taught me to advocate for myself in the hospital and helped me to reach my goal. She didn't tell me what to do. She taught me how to speak up. and make informed decisions for me and my baby. My nurse also taught me how to access the right medical care at the right time, reducing unnecessary emergency room visits and saving both my family and the healthcare system money. In twenty twenty three, my brother was murdered in front of his children. The grief was overwhelming. I completely broke down and I wanted to drop out of my master's program. But my nurse met me where I was. She came to my home and sat with me as I sat in a dark, paralyzed. She gently reminded me that continuing my education wasn't about me. It was about creating opportunities for my son. Because of her continuous emotional coaching during my home visits, I earned my master's in social work. Later, when I faced financial challenges during a career transition, my nurse connected me to short-term resources that helped me stay on track professionally. Today I work full time as a therapist, helping others navigate trauma and adversity, while raising a thriving son who's excelling in preschool. I also lead mentorship programs in my community, since every woman deserves the support that helped me change my life. The NFP nurses who supported me continue to live inside of me and shape how I parent, serve as a therapist, and advocate. and being mindful of joy in the chaos. We grow through pain, learning to hold multiple emotions at once. It is a vulnerable and honest way to live. My story is a reminder that resilience alone is not enough. Families possess incredible strength, determination, and love for their children. What they need is stable foundations that allow those strengths to flourish. McVie and everyone who supported this life-changing program gave me the resources to turn my so from an anxious traumatized pregnant woman into a licensed professional, community advocate and thriving mother. The investment made in me, my son, my family and my community will continue to pay dividends. That is the power of MCV. I urge Congress to please continue to provide robust funding for home visiting and reauthorize MCV well before its expiration by investing in parents during one of the most important periods of our lives You are investing in healthier children, stronger families, communities, and brighter futures. I am living proof that this investment works. Thank you for the opportunity to share my story.

Thank you, Miss Wilson. Appreciate that. Uh, we'll next recognize Miss Longoria for your five minutes.

Good afternoon, Chairman LeHood, Ranking Member Davis, and members of the subcommittee. My name is Shaw Longoria. I'm the Parents as Teachers Program Director of Community Health Corps. in Longview, Texas, where I have worked over twenty years. Community Health Corps provides mental, emotional, behavioral health services to residents in twenty-three counties across East Texas. Our professionals deliver treatment, prevention, and outreach to more than sixteen thousand individuals each year. We help children build resilience, adults live independently, and families grow healthier. Community Health Corps received one of the first MCV grants. that brought parents as teachers to Gregg County in two thousand twelve. I oversaw that program's start-up and development, and have since expanded to Harrison, Smith, and Bowie counties. We currently employ twelve parent educators who can partner with two hundred and forty families across the four counties. This number will expand to two hundred and sixty when we hire for our current vacancy. Prior to the availability of the MCV's supported services, East Texas families had no access to this type of evidence-based support. It's exciting to report in twenty twenty six that our Parents as Teachers program, along with two other MCV home visiting programs, work collaboratively to ensure families are connected to the model that best supports their needs. We selected the Parents as Teachers model for East Texas because it serves a broad population of families. Eligibility is linked to families having a child, prenatal through kindergarten entry, that can enroll at any point during that age span. Our parent educators partner with and support primary caregivers and welcome other family members to participate. We find there is no typical family. We have worked with mothers, fathers, step-parents, grandparents, foster parents, and more. Ideally, our goal is to partner with a family for at least two years. The PAT model has four interrelated parts. First, personal visits from parent educators, focus on supporting child development and family interactions, which are designed to strengthen resilience, identify stressors, and find community resources if needed. Second, health and developmental screenings. Provide an opportunity for families to get real-time data about their child development including strengths areas for growth and any specific concerns. Third, resource referrals. Connect families, community organizations, and other programs. In East Texas, it can these can include food banks, shelter, mental health services, early intervention services for children with disabilities, veteran services, and more. Fourth, group connections, which is help which helps families to connect with each other and build, expand, and strengthen their social supports in the community. An example of how these interrelate is a mother we enrolled who was living in one room of somebody else's house with her two children. She had no job, no car, and no driver's license. What she did have was resilience. She was biking her children in a cart to daycare, so she could go bike around and look for a job. When she enrolled with us, we learned that she was a veteran and we connected her to our veteran services and other resources. Armed with these, she moved forward in her goals. By the time she completed her program, she had a driver's license, a car, a stable job, her own apartment, and her children were kindergarten ready. The mom knew what she wanted, she just needed support and direction. We served as her compass. This is the program at its core. We build on family strengths to support their abilities to serve their own children and achieve their own goals. I'd like to share one more example to highlight how the model serves all types of families. We connected with a family who received news that their new baby was born with a brain malformation. They were told not to expect the child to live past six months. We enrolled them in starting provided and started providing services as we knew the family would need support regardless of the outcome. We connected them with our early childhood intervention program and other resources. This child not only survived past the six month mark, but she met milestones her parents were told she would never meet. She will celebrate her eighth birthday this summer. In her last parent satisfaction survey, mom wrote, "This program has been a unique experience for our family. My child has grown and developed her skills, even though she's a little girl with a brain condition." Despite her limitations, she has blossomed with the help of PAT. Thank you for everything you did for our family. We love you all, and we're going to be forever grateful we found you. In conclusion, I hope my testimony has demonstrated that MCV is a game-changer for families and children in East Texas. When families enroll in the program, parents and other caregivers strengthen their parenting skills, foster closer bonds with their children, and achieve tangible life goals. Their children are ha- healthier and stronger developmentally, less likely to experience abuse and neglect, and are ready for kindergarten. If there's anything I would ask Congress, it is keep this vital program going. I want to leave you with a parent comment from a recent parent survey that embodies PAT. My parent age educator is such a joy to work with. She makes you feel special as a parent. She gives you the confidence to conquer the world. Thank you again for inviting me to speak before you. I look forward to your questions.

Thank you, Miss Longoria. Next, we'll recognize Miss West for five minutes.

Chairman LeHood, Ranking Member Davis, and all members of the subcommittee, thank you for the opportunity to speak to you today. My name is PJ West and I serve as the MICVI Program Director for the Iowa Department of Health and Human Services. I oversee Iowa's portfolio, including statewide workforce initiatives and quality supports that strengthen home visiting services across our state. I've worked in home visiting for nearly thirty years. beginning as a home visitor myself. I will never forget walking up to a family's door, knocking, and having them let me into their home. Those early years, sitting with families in their living rooms, on the floor with their children, shaped everything I understand about this work. Those experiences, combined with my current role supporting programs statewide, have given me a full view of what families need and what home visiting makes possible. Before MCV was created, Iowa had committed family support programs, but that system lacked stability, statewide training, and strong evidence-based models. MCV changed that. It provided the funding, the structure, and the accountability needed to build a modern, cohesive home visiting system in Iowa. Today, MCV funded programs serve families and the communities with the highest needs. Last year, they served more than eight hundred and fifty households and provided over twelve thousand home visits. Over ninety percent of the families we serve are low income and may face multiple risk factors affecting health, development, and long-term well-being. MCV reaches families who otherwise struggle to access consistent supports. But I want to focus today on something just as important as those outcomes, Iowa's innovations, many of them made possible only because of MCV. First, the PAYS program, Performance and Education Yield Success. PAYS is an educational-based salary supplement program for in-home family support professionals. It provides a quarterly award based on education and performance benchmarks. It improves data accuracy, strengthens reflective practice, and supports retention without penalizing staff. In pay sites, we're seeing higher data quality and lower staff turnover. It is one of Iowa's most effective tools for building a stable, skilled home visiting workforce. Second, Iowa has made major investments in comprehensive workforce supports. Through MIC-V, we helped create and fully use the institute's for the advancement of family support professionals. A resource providing free professional development, a national competency framework, and certification pathways. We also invest in reflective supervision, mental health consultation for family support professionals, peer support, crisis supports, and the teach family support initiative. A supported workforce means better supported families. Third, Iowa is working to reduce administrative burden for local agencies through streamlined reporting and fewer duplicative requirements. Home visitors spend more time with families and less time on paperwork. This directly improves job satisfaction and family engagement. Finally, Iowa strengthened guidance on virtual visits by requiring that most visits occur in the family's home. This maintains quality while still supporting rural families and those facing transportation or health barriers. We closely monitor visit types to ensure quality stays high. These innovations, pays, workforce investments, and reduced administrative burden show how Iowa has used MIECHV not just to maintain programs but to elevate them. As someone who has walked alongside families, supervised home visitors, and now oversees the system at a statewide level, I can say with confidence, MICV works. It changes trajectories. And it is irreplaceable for Iowa's families. Thank you for the opportunity to share Iowa's experience and innovations. I look forward to answering your questions and working with you to ensure this critical program continues to provide stability, health, and opportunity for families across Iowa.

Thank you, Miss West. Now recognize Doctor Sinise.

Good afternoon, Chairman. Ranking member Davis and members of the subcommittee. Thank you for this opportunity and greetings on behalf of the Navajo Nation. My name is Paulus Relsinas, and I just recognize a strong extended family who I represent. For twenty years, I have worked to support Navajo children and families, including developing our program on the Navajo Nation, called Hojongo. or Growing a Beauty home visiting program. Growing a Beauty serves hard to reach parts of Arizona, New Mexico, and Utah. The Navajo Nation or Nikit, the Nebekaya, spans over twenty-seven thousand square miles. Of the ten thousand seven hundred miles of roadway, roughly eighty-five percent are dirt roads and fifteen percent are paved. Our home visitors drive hundreds of miles per week to visit families and provide them with early childhood education, activities, and support. we build on successes with families like the Begay family and their three children ages three four and one upon enrollment and developing a parent relationship with with the mrs. Begay um she expressed significant concerns about her toddler's tantrums and speech delays she felt overwhelmed balancing the needs of all three children With their home visitor, the Begay family planned daily routines with engaging developmentally appropriate learning activities. It wasn't easy, but over six months of effort and support, things have improved for the entire family. The children experience fewer tantrums. They are thriving and eager to help with with daily activities and chores. They count in the Navajo language and can identify several um animals in their community in in the Navajo language. They are beginning to speak in complete sentences and enjoy singing songs and rhythms and rhyming activities in the Navajo language. Our community carries the weight of historical trauma and poverty. Designated as a medically underserved area, the people's life expectancy is five point five years shorter than the US average and our infant mortality rate is thirty percent higher. Compared to the rest of Arizona, twice as many Navajos Navajo third graders fall far below the state learning standards. Growing in beauty helps secure the health and well-being of our people by delivering home visiting using the evidence-based model parents as teachers. Activities integrate enhance um activities from the diner culture the Navajo culture and customs that support family strengths and builds resil resilience. Home visitors help to build parental knowledge, prevent child abuse and neglect, and increase school readiness and success. Children and caregivers are screened for health, dental, vision, and hearing, as well as developmental delays, maternal depression, and s- and substance use. And families are connected to the services that they need. as a result of growing in beauty between two thousand sixteen and two thousand twenty three seventy four percent of enrolled children had documented well child visits with primary care twenty four percent of enrolled children were identified with risk for delay seventy three percent were referred to early intervention thirty four percent of caregivers were identified as having risk for depression domestic violent substance use and or the need for general social services. Home visiting is making a difference. But some families still don't receive the support that they need to thrive. The Navajo Nation is a is proud to be a tribal MCV grantee and thanks you for helping to expand home visiting to more tribal nations. In the last reauthorization you quadrupled tribal home visiting funds. today there are fifty three tribal macvee grantees up from twenty three in fiscal year twenty twenty two by the end of fiscal year twenty twenty seven approximately eleven percent of eligible eligible tribes will receive tribal macvee macvee to serve native american and alaska native families as the navajo nation does thank you again for being champions of home visiting and macvee And I look forward to answering any questions you may have.

Thank you, Doctor Sinise, for that, and let me just thank all of our witnesses uh for your valuable and insightful testimony here today. We will now turn to the question and answer session with the members of Congress and I'll begin by recognizing myself. Miss Smith, um we're blessed to have Brightpoint um in Illinois and covering much of my district and obviously the program has supported hundreds of families. across uh my district in central Illinois, particularly in rural communities, um through the parents as teachers and healthy families America home visiting services. Um you talked a little bit about this in your testimony, but can you describe some of the outcomes and impacts on families who's who who you serve um who voluntarily receive McVey services?

Yes, thank you. Um for for us, I mean, the hardest part about serving rural families is getting there. And so, find and informing them about what home visiting is. So what McVie allowed us to do is to get to those those communities, hire staff from those communities, actually knowing who and where things are t- so that we can get the outcomes that we're gonna talk about today. We've seen increases in breastfeeding initiation, in domestic violence screenings, in connecting families to resources for jobs and housing, that um and creating those partnerships through community partners was how we got there. the home visitors are just the connector the families are the ones that are doing the work i wanna um give one example of a family that i get to work with that um that i did get to work with back in the day and um she talked about she was so excited to show me the first home that she ever put her name on a on a lease and i i got to go there with her and she walked to every room wanted to show me every single thing there and i got back to the living room and on the wall there was a picture of her and her child and a picture of a piece of paper and a frame of something that she completed in her home visiting time And she said, "That's the first thing that I've ever completed in my life. Home visiting did that for me." And I just thought about, we we use Xerox copies, we give these to families, we talk about these things, and how proud she was to show that. And I'm even more happy to say, two years after when she graduated, that wall was full of not only pictures but accomplishments. She lived in a very rural community, had no idea that she could ever finish high school, ever have her name on a lease, ever be able to be a mother to her child, to find quality child care. And the home visitors that worked with her were able to provide that.

Excellent. Thank you, Miss Smith. I'll now turn to you, Miss Wilson. Um, first of all, let me just acknowledge your, um, your story. Thank you for sharing that here today. Uh, remarkable. Uh, uh, w- describing where you came from with your family and what you've achieved. And just how commendable your resilience and determination on getting your degree and being here today as an advocate, we're really grateful to have you here today. and have you share that. Um, you talked about in your testimony how the nurse home visitor taught you how to advocate for yourself, and gave you confidence to pursue your goals. Can you describe what a typical home visit was like and the role you you have seen, um, home visiting services play in your son's developmental journey?

Yes.

Yes, thank you. Um, so, when the nurse first came to visit she came in and she had like a bunch of blood pressure cups and like weighing scales and she had a lot it looked like a doctor's office in my house and that's when i was pregnant and she did that again as he was growing as well um and she would test his weight every week so that was pretty nice but the other thing that they would do um the other thing that she would do when she came is she would screen like provide screenings for him um that tested his child development as well as like give us family goals that we have for ourself that we have for our child and then provide referrals one of those referrals um after i mentioned him having a speech delay was to a program that was a early intervention program um that early intervention program that she referred us to had evaluated him and noticed that he did qualify for the program they stayed with us for three years and when he turned three he was able to get evaluated again and he received an iep and went to preschool at the age of three after only six months my son is doing so much better with his speech i mean he has this creative way of telling me to mind my own business like telling me mommy go take shower and sometimes he tells me he's busy too he'll just tell me mommy i'm busy so mmm he's definitely has achieved so much of that language and is feeling really confident to speak his mind and be emotionally safe in speaking for himself. So he even tells me when he's angry and happy.

Great. Thank you for sharing that. Uh, Miss Longoria, in your testimony you discussed how Parents as Teachers helps families build group connections and and contribute to the family's social capital. You also highlighted how the model brings bridges to other resources such as local organizations and faith-based communities. Can you provide an example of a group connection activity and explain how this has strengthened the outcomes of families who participate in?

Thank you for your question. Um, an example of a group connection that we have had was uh partnering with our local library. Um, so families were able to participate during story time. Um, they were able to go to the library and um participate during that time also learn about the programs that the library had to offer that were free to them um they learned about getting a library card they walked about uh the library so they knew the structure and they also were able to uh make social connections with the library staff and also the other families that attended

excellent thank you for that uh miss west as part of the jackie Walorski maternal and child home visiting reauthorization act of twenty twenty two Congress increased the the federal investments in MCV program as we've talked about, and added a state match requirement. And in fiscal year twenty twenty seven, states will see the largest amount of MCV funding uh in its history. How has the increased federal investment from the twenty twenty two reauthorization act strengthened the quality of MCV services in the state of Iowa?

Excellent question. Thank you. In Iowa, the increased federal investment from the the last reauthorization have funded new matching grants encouraging state contribution and dramatically strengthening program quality through enhanced coordination workforce development and data systems these additional resources have really enabled strategic initiatives like PAYS that I mentioned earlier reflective supervision certification through the institute for the advancement of family support professionals all in which help us uh improve retention, skill and consistency among among home visitors. So truly supporting home visitors and in the work that they do. The funding also allowed for Iowa to streamline those recording reporting requirements, freeing up home visitors to fully engage families and improve that service delivery. Uh, we also bolstered guidance and funding for virtual home visits. um which ensures quality and access uh particularly beneficial for rural uh areas of iowa in which i live uh while maintaining fidelity to that evidence-based model

thank you for that and lastly uh doctor sinise um in your testimony you discussed challenges in serving remote tribal communities such as the lower rate of referrals to community resources due to long waiting lists and extreme distances that must be traveled to receive these services um what strategies have home visitors deployed to overcome some of these challenges in tribal communities and what can be done to reduce these barriers

thank you for that question the um as i mentioned earlier there's uh unpaved roads within on the navajo nation uh very few um passable roads so our home visitors do travel directly to um the homes to address the developmental needs um where families don't have necessarily reliable transportation and they connect um they they are the bridge to providing the direct services for the physical divide of bridging developmental screening um health education and parent resources directly to the families um it also we also address the gap that parents have the inability to access valuable resources by developing a a broad base um resource mapping that collects the data for resources for families where we can connect families to those resources as well so we also connect uh uh service resources to those families thank you for that question

thank you

that concludes my questions i recognize mister davis for his questions

thank you mr. chairman and let me thank each one of you for your very impactful testimonies. As a matter of fact, you reinforce for me having taken a job in nineteen seventy, working with the Visiting Nurses Association at a community health center in Chicago, where I first learned some of the principles and practices of what home visiting really is about. Doctor Snez, you were instrumental in bringing home visiting to the Navajo Nation and adopting the parents and teachers model to incorporate it into the Navajo culture. Could you tell us more about some of the gaps that that home visiting field for this population group?

thank you for that question um as i mentioned um earlier we do provide the direct uh visits to the families so that definitely fills the gap of families not having to come to us for services the um incorporating um the navajo culture and language into our program also um builds that child family relationship we've adapted the parents um parents as teachers model to incorporate navajo culture and values which is allowed in the parents as teachers model so that fills that gap of developing a curriculum and and services directly for the family's needs um we work with families to um connect them to resources such as um home insecurity i'm sorry food insecurity resources and other resources for developmental screenings, we connect them to early intervention. um children are often identified through our early intervention program um and referred for home visiting to provide the direct services for for the families.

thank you thank you very much um miss smith i was very interested in the comments that you made relative to work with males in the program. Could you share with us a bit about that work?

Of course. Um, what we try to do is we're engaging fathers from every, every stage of home visiting. If it's during recruitment, during um enrollment and throughout the service um um with a with a home visitor. We're engaging them to be invited in the in the service, in the home visited home visiting actually you know um their their sessions, as well as um having parent support groups just for dads. What we have found is um, i talked to a um a father a couple of weeks ago that was going through a graduation ceremony and he stated that this was the first program that first invited him to participate engaged him to participate had resources that were geared more towards dads and also provided a peer support group of dads that are able to talk like dads he said i finally was respected as a father someone actually listened. And so, you know, being in human service a long time, we know that not everything um has been set up to do that. So I think partnering with fathers, hearing how they like to be engaged, how they like to um show up is really important. In Brightpoint we spend a lot of time talking to dads to get that input. So it's it's a partnership and um the children um have loved it. Um we have found in our doula program if we get fathers involved in the prenatal program they're more likely to stay throughout the the time of the program. and what you know research shows that if a father's involved in the prenatal time they're more likely to stay in the child's life long-term whether or not the you know um the parents stay together so it's really important

thank you and miss miss wilson i'm very familiar with the type of communities that you described in your testimony i've lived in those kind of communities i've been a part of those kind of communities how how how helpful was the inspiration that you received from your case worker or your worker

thank you for that question um she was very helpful i mean even going back to what you were talking about about you know involving fathers uh my fiance he is now my fiance um but at the time he was my boyfriend and we had our child together and one of the things that she would do is definitely involve him in the parenting process of it and it wasn't hard because he's always been very very much involved in it but even just teaching him some of the tools and making sure that he's a part of the conversations that we were having um when i had questions about sleepovers or you know letting him go over people's houses and you know how to fight the how to create those boundaries with where he can go and where cannot she was very helpful in helping me like realize that i'm allowed to have those boundaries and how to safely establish those and that i didn't have to be mean about it but just keeping him close and it made me feel really good um and confident about raising him knowing that i had the option to say you know i don't feel sorry for my son here he has to stay there um when i was showing her to places that i wanted to move to um we came up with a gated community so i was really excited about that

mmm

um she provided safety just when she came and visited the home making sure that um she didn't make us feel unsafe i know for me i was always scrabbling around and trying to clean up before she got there but she just stepped in and she's like it's fine it's fine so it's like that confidence that allows you to feel ok in your house it's hard to open those doors to people and feel like you might be judged so

thank you thank you very much and uh you're back chelman

Thank you, Mr. Davis, recognize Mr. Carey of Ohio.

Well I thank you, Chairman LeHood, and I thank the ranking member uh Davis for covering this hearing today. And uh I wanna thank all the witnesses for being here, but obviously Miss Wilson is from the Buckeye State, so most of my questions gonna be spent on you. Um and you know and and that description of having that person come over to the house and trying to clean up real quickly before they got there and you know that kinda reminds me when My wife's out and I've got the two kids at the house. I try to do the same thing every time she's gone. But um I noticed from your testimony you you went to Youngstown State. Am I correct with that?

Yes, that's correct.

Now, you from the Mohoening Valley originally or did you go to school there? How did you how did you wind up in Youngstown?

So I actually am from Columbus, Ohio.

Uh-huh.

Um I was going to go to Akron University. It was really hard to make that decision to go to Youngstown State University cuz I knew I would be leaving my siblings wherever I went. But um, I was talking to someone at my school from the I know I can uh organization,

Mm-hmm.

and I did my FAFSA all the way wrong. And so she had helped me go through it. And she is like, my son's going to Youngstown, have you considered that? And I'm like, no. So

Well, the only reason I asked is I looked at your, I looked at your resume and one of our former colleagues,

Mm.

uh, Bill Johnson is the president of Youngstown State, so I sent him your resume.

Wow.

And I said, is there anything you want me to say, cuz one of your graduates is testifying before the Ways and Means Committee, and he said, say, go, Gwen's.

Yes.

Okay, so I I I just had to do that. Um,

A proud penguin.

my That's right. And and my time is a little bit, and you're on the east side of Columbus, so for those of you who don't know Columbus, I I always define myself as the member from Columbus who is not Joyce Beaty. Okay, and anybody who knows Joyce knows why I'm saying that. But uh Joyce and I have a very good relationship and I know you're one of her constituents and you're well represented by Joyce.

Mm-hmm.

But I just wanna take a few uh a few minutes I and I don't have a lot of time. But one of the things that I I was looking through this and I because your experience talking about you know coming from were you from the east side originally of town?

I've lived all over Columbus.

Yeah.

Um I believe that I was born maybe on the south side and but I spent a lot of time on the north side.

South side? Okay. Okay.

And spent the rest of my teen years on the east side and in between that,

So.

the west side.

OK, so you you've been all over central Ohio.

Yes.

But so I just wanted to just kind of, you know, because I know there's gonna be a lot of people in our region,

Mm-hmm.

you know, um, that are that are gonna be watching this. And so can you kind of explain for others that maybe in the same situation that you were, how uh Franklin County, um, how the Nurse-Family Partnership model specifically and

So I actually got the information from attending a um event that we had at my job at the time. And my boss, she told me, go over there and talk to them, you're pregnant. So

Mm.

I went over there and I talked to them. It was another program and they said I was over income. So after that, they told me that they would still refer me to another program, which was the Nurse-Family Partnership program. Um, so that was one way that I got connected personally, was that they gave them my information. Um, there are other programs that can send referrals. I know that there is a website called Rise for mothers who have their children or, uh, families that have their children's in child care. And that website also provides referral services if they need them as well. So there, it's basically a referral program. Um, you can also get onto the website, change it and access it there. Um, it'll take you straight to our state and you can email the person, um, and let them know that you're interested in the program.

And and you're an ambassador for that program now, am I correct with that?

Yes, I am a parent ambassador for change it.

And how and how does that work? What do you what do you do in that role? What do you advocate for? How do you do it? We don't have a lot of time, but.

Um, so real quick, uh, parent ambassador is probably one of the best situations I could get myself into. um it's amazing um what this program does is provide us the tools to be able to do exactly what i'm here doing today and that's advocating for not only myself but the people in the program and it also supports us in other ways with our professional development in helping us network and find opportunities with others and the things that we're most interested in so if you're a nurse um you can do that too and they have also something that is called um i don't know the name right now it's not clicking to me but when you're a person that graduates, you have access to this program and it provides career building skills too. So it's doesn't just stop at Nurse-Family Partnership.

Miss Wilson, my time is out, but as a Buckeye, I have to say, OH.

I O.

There we go. With that, Mister Chairman, I yield.

Great.

I like that.

Uh.

Thank you, Mister Kerry. I will now uh turn to Miss Chu of California.

Well, I wanna thank all of the witnesses for sharing your experiences and doing such a great job at it. Um, the evidence could not be clearer that home visiting delivers such strong positive outcomes for children and families. Four years ago, I was proud that this committee worked in a bipartisan matter manner to pass a Mc- McVie uh reauthorization bill named after our incredible colleague, Jackie Walorski. In that law, we doubled overal- overall McVie funding and also doubled the set-aside for tribal home visiting. As a result, Ms. Sinas, you testified that by the end of twenty twenty seven we expected to have as many as seventy tribes receive MCV grants which is about triple the number that we had in twenty twenty two but even with that dramatic increase seventy would have still represented only about eleven percent of all eligible tribes. You also mentioned that tribes have to compete against one another for grants, while states get mandatory funding. Can you talk about the challenges tribes face when competing for funding? How would tribal home visiting programs and the families they serve be impacted if Congress were to increase funding for tribal make these so that tribes don't have to compete for such limited funds?

Thank you for that question. There are challenges in competing for the funds and um because of the high competitiveness of these grants uh can can provide some challenges. Um oftentimes tribes are um being operated by small administrative staff um where the a single employee may um like myself wear different hats um to to so there are administrative and capacity um constraints when applying for a highly competitive federal grant. Also some tribes may not know that the evidence-based models that are here today are being able to be adapted. Um and so oftentimes um while these models are important um they have not been evaluated um or validated in some um American Indian and Alaska Native community. So um being able to uh look at those uh adaptations are important when a tribe is applying for for funding. Um so shifting the competitive um scarcity of funding uh shifting it to more equitable sustainable um funding that respects tribal sovereignty and fulfills the responsibility for ensuring that native american children do receive the home visiting supports that they need um expanding the funding for home visiting would definitely increase the services in tribal communities especially in alaska native uh villages where they have to um they can't get two homes without you know um boat flight or um and so it would definitely increase the um number of families being served in tribal communities thank you for that question

thank you and i'd like to address this question to both uh miss longoria and uh doctor sinis and it's about the uh fact that there is a big challenge that we've heard about recruitment and retention for the workforce due to issues like low pay and overwhelming caseloads. So, um, Miss Longoria, you were a former, uh, home visitor, now supervisor. What challenges do you see with those issues? And Doctor Sinis, can you talk about the unique challenges that tribal programs face in hiring and retaining home visitors?

Thank you for that question. Um, I could tell you reflective supervision, uh, provides an immense support, um, to our home visitors, which is a integrated part of the pat model um it provides them a safe space to feel supported heard and and uh be able to reflect which is what they provide to families so um thank you for asking about the investments we need um i spent time maneuvering budget to making decision for staff um resources everyday my first recommendation is to uh do all you can to increase MCFI funding i mentioned in my written testimony we struggle to pay parent educators what they're really worth

yeah

we have uh we are having a difficulty hiring for our vacant parent educator position as applicants are declining due to low salary

yeah sorry i wanna make sure that doctor has a chance to respond to

she thank you for that question um our home visitors are um members of tribal communities so oftentimes they're approached at grocery stores and other functions and so they're never off the clock so this may mean also burnout when they have to serve their communities so reflective supervision does provide a lot of that support in addition um we um pay his is another example of of what what we are challenged with and finally um to to find professionals with qualifications and a deep cultural and language backgrounds, it is necessary to increase the pay and um really support these home visitors through reflective supervision. Thank you for that question.

Now recognize Miss Yackem, Mr. Yackem of Indiana, please.

Thank you, uh, Chairman LeHood, and to our witnesses for all being here today. The Maternal Infant and Early Childhood Education Visiting Program or MICVI is a top priority for me. It has a long history in Indiana's second district, as my predecessor Jackie Walorski was a longtime champion. She worked tirelessly with her friend at the time and now mine, ranking member Davis, on the last reauthorization. And it was named in honor of her after her tragic passing. I'd like to give a special thanks to Chairman Smith, Chairman LaHood, and to my colleagues for recognizing Jackie and the great work that she did on behalf of this program. You know, my grandfather used to say, when you have children they don't come with an instruction manual. You just have to figure it out yourself. I'm a proud father of three kids over the age of ten, but I still remember preparing for the first arrival of our daughter, Elle. Those early days as a parent, uh certainly for any parent, can bring a lot of anxiety. I remember leaving the hospital and thinking, I can't believe they're letting me take this child home. Yeah, you agonize oftentimes over the the little things, you know, the cries. Is that a hungry cry? Is that a tired cry? Or is one of us on diaper duty? You just have to figure it out. You know, often your mind often wonders to the more existential questions, like how do I raise this child to be a good person and ensure they're a productive member of society? You're making it up as you go, and you learn from a lot of trial and error. But a strong support system of family and friends can lead, that can lend a hand or sometimes advice, is a difference maker. But unfortunately, not everyone has that. That's where a program like MICFI comes in. It brings trained professionals alongside at-risk families to coach parents on valuable skills, and lead to better child development, decreased instances of domestic violence and child neglect, and improved economic self-sufficiency. What sets MICVI apart from other programs is that it's evidence-based. That means that the methods and approaches have been researched and tested. That gives us confidence as legislatures that our taxpayer dollars are getting results, not just counting the numbers served. I wanna share the story of Catherine, a constituent who is facing pregnancy with twins as a single mother. I spoke with Catherine this morning, and she shared with me how she searched for resources and found the Nurse-Family Partnership or NFP through Goodwill Michiana. Her NFP nurse, Tasha, became a steady presence that helped her prepare for motherhood. It also provided vital resources and, more importantly, trusted support. During early motherhood, Tasha noticed that Catherine was struggling with severe postpartum depression. And Tasha connected her with a therapist to help her navigate and manage her depression. While talking with Catherine, she shared that the NFP saved her life and that she wouldn't be here without Tasha, because Tasha helped her take control of her postpartum depression. NFP gave Catherine important resources and supportive relationships to help her and her sons thrive. This is just one example of the incredible work that MIECHV programs do in our community, and across this country. Indiana is proud to have a strong MIECHV program that exceeds the national threshold for ten out of the nineteen performance measures. Since two thousand eleven nearly sixteen thousand Hoosiers have provided almost four hundred thousand home visits. Miss Smith, could you speak about the landscape of home visiting before and after the twenty twenty-two reauthorization of the MIECHV program, and why program outcome measures are so important?

Yeah, thank you. Um. Not just the doubling of slots which are, you know, were extremely important, the doubling the money for slots and and seeing more families, but that emphasis on the rural communities. I come from Illinois and the same type of how we get to families um was was was critical. That emphasis on spreading the these this critical resource that you talked about having that support system was was really important. The other piece was the training, the training component of the National Institute, um which some of my staff have have proudly been a part of and we've seen that that that increase of retention for staff, that um the quality increase in how they provide the home visits, and it also professionalized the the the job of a home visitor. People know what it is, what it does and why it's so important to pay the the to put in that development dollars and to pay uh um a a salary which we some of my colleagues were talking about today.

Thank you. Two of the main focuses of the last MCV reauthorization was to reduce the program's administrative burden and better support the home visiting workforce. To date, HRSA has reduced that burden by at least thirty-seven percent and developed the national strategy for the home visiting workforce. Miss West, in your experience, how has reduction administrative burden burden benefited home visitors while maintaining program quality?

That's an excellent question and something that we consider all of the time in Iowa. Uh, the reduction in administrative burden has been felt strongly at the state level and we felt really strongly about. assuring that that was passed down to our local implementing agencies. And in turn to our home visitors so that they could spend more time with families and less time on paperwork. Yes, the data is important. Uh, proving results is important, but we want our home visitors spending time with families and supporting them in all of the ways that you've heard here today. Uh, it is a priority of ours, not just through this reauthorization, but in the future. to try to maintain and keep those administrative burden levels down.

And thank you to all of our witnesses again for being here. Mister Chairman, I yield back.

Thank you, Mister Yackem. Now turn to Miss Moore of Wisconsin.

Thank you so much, Mister Chairman and ranking members, uh, I have listened uh with delight at all of the testimony that we've had here today from all of you and I've and instead of all the questions and inquiries from my colleagues causing me to say, all the questions have been answered, i got more questions, but i i've enjoyed this dialogue with all of you. i wanna start maybe with um with doctor sines. um i noticed that in the navajo community something like thirty six percent poverty rate. um I I guess that speaks volumes about our notions here that resilience is really an important tool to try to navigate things, but resilience is temporary and it it doesn't help if you don't actually get the support that you need. I think, Miss Wilson, that you mean you're just holding on by your fingernails until that help comes along. And so, um, you also talked, Doctor Sinez, about uh some of your navigators um seeing people working twenty four seven they see people in the grocery store they're never really off how we we have on this committee really come to some conclusion that poverty is not neglect and so so how do you how do you train people through mcv and these other programs when they do the home visiting to make a distinction between somebody who needs some resources and they're just poor uh and somebody who is neglecting their kids if you go in a house and there is no food is it that they're you know is it they're neglecting their kids or they just need food how do you how do you train for that

thank you for that question when we um hire our home visitors we definitely make sure that they are from the community because they are very familiar with the vast Navajo Nation

yeah

we make sure that they are they do come from those communities and um training them about parent-child interactions um and developing those relationships building trust and parents as teachers um through their curriculum has a a basic foundation or a very good foundation for building that trust so

i yeah yeah that's that's important miss wilson you know you really mentioned you know the fear of someone coming in and seeing your house dirty and judging you. I know my kids would have been taken from me a lot of times if that had been the standard of of care. Um, so cultural competence is important. And I mean, I'm so glad you're a real social worker, not just a case worker, but a real educated social, congratulations on your journey. We ought to clone you. Um, but Miss Wilson, Miss Smith, I want to ask you a question. related to what she is is saying. You you have uh you use doulas uh in your program to help people navigate uh up to what three years old or eighteen months old? What what is the time line that

So the yeah so the doula um usually comes in around the beginning of the third trimester and then stays about eight to twelve weeks after the child's born,

Yeah.

in partnering with the home visitor that would stay until three to five years.

got you how has do you can you give this committee some insight into how doulas uh have saved lives or prevented sins that miss wilson was terrified of or you know stop you know she sounded like she was terrified during her pregnancy i was too i i i had my first child at eighteen and

me too

um i just looked up the history of pampers which i couldn't afford in nineteen seventy anyway But the visiting nurse taught me how to put a diaper on after I stuck my baby several times. Um, how has, how have doulas changed the landscape for, for women and children and their outcomes?

Yeah, we have found when we are able to partner doulas and let them be the prenatal, prenatal experts, and let the home visitors do the longer term, the parenting, the, the life goals, that it provides a higher level of, of, of relief, of knowledge of what that's gonna be like and be able to advocate for your own birth understanding what what that that entails to be heard

how how important is cultural competence you know like miss wilson's like you're not

it's it's very critical

being judged or like doctor siena said not being judged by by someone uh you know

absolutely

it's important to recruit people who speak the language you you know if

to come from their neighborhood

you're a muslim they're not gonna fix you a pot of gumbo with shrimp and pork in it

exactly yes and we actually you know hire former participants as well

Yeah.

that actually can talk the, like you said, talk the talk and be able to really tell how this is going to feel and how they can support to advocate and support that family.

Mister Chairman, thank you so much. This has been a delightful hearing and I I do love this subcommittee.

Thank you, Miss Moore. We'll get you on the record for that. Thank you. We appreciate it. Um, we'll now recognize uh, Mister Bean from Florida.

I'm in. Thank you so much, Mister Chairman, and a very good afternoon to you, to committee members, and especially our witnesses. Let me tell you one thing you'll always have for the rest of your life. You get to say that time I testified before Congress. How about that? Not everybody can say that. Uh, Mister Chairman, I know what you're thinking. You're thinking, um, I look way too young. to be a grandfather. How about that? Uh, but it is true. And, uh, I am blessed with the cutest, most intelligent little toddler grandbaby, uh, there is. Uh, we think up excuses to take dinner to, uh, to our kids just to see the grandbaby. We will, uh, help them with appointments and my staff knows that if it says, uh, uh, the congressman is babysitting, Uh, that cannot be overridden. I will uh, we will babysit any time that we get a chance. So the support that we give our kids and our grandchild is uh, is I think uh, we'll do anything we can for them. And you know what, it's what our parents did for us, I guess, when I had a kid and and uh, Rudy uh, explained he didn't know what he's doing, I didn't know what I was doing either. But there we are, uh, that we give that support. So I can't imagine when you don't have that level of uh of support. By the way, uh Pop Pop is my uh code name, Pop Pop and BB. That's uh, that's that's where we are. So not to have that support, but enter uh the MCV program, the Maternal, Infant, and Early Childhood Home Visiting program created in twenty ten, uh provides funding for lots of groups that can access this funding to provide evidence-based visits in the home, right where it needs to be uh to give uh parents who were facing an uphill battle, and we know if we don't help them they're most likely to get in trouble, health and whatever-wise uh to give there. In Northeast Florida, I'm gonna recognize the Magnolia Project and the Northeast Florida Healthy Start Coalition that have accessed this program. And I visited with them many times, I was in the state senate before and uh, we utilize this program and wanna continue it. I know, uh, it has a sunset feature, at least it's gonna, it's gonna run out unless Congress acts, so we need to act. So here's a toss-up question for the panel. What happens if this program goes away? Anybody wanna jump in? You gotta be short and brief, but, uh, d- d- what is it, uh, Miss Wilson, you, uh, you buzzed in first.

So, I would say what happens if this program does not continue, is that there will still be a whole lot of violence. Um, by having this program we decreased the violence in the neighborhoods, giving those parents those opportunities to really think about and have access to someone who can coach them through those emotions and those hard parts of parenting.

Nice, nice. No, Miss Wilson, well done. You're on the board. Anybody else wanna jump in? Miss West, you're recognized.

I I'll I'll go. Uh, if MIECHV funding went away, it would have a huge impact on Iowa.

Mm-hmm.

I know it's a two-year grant. period we spend all of our money in year one and if mcv went away over eight hundred families would go unserved and not have those supports and people to help them understand what parenting is like uh i oftentimes say we parent the way we are parented unless we learn a different way or

true

if we have a parent who helps us through that and that's home visiting

true so true miss west you're on the board too ok here we go we hear about this evidence-based uh evidence-based and for those that say this is just

Thank you. Um,

Mm.

well, I mean, the the the the point of like with the youth and and care that we're working with, for providing home visiting, you're looking at thirty to fifty percent chance of those children going into foster care. without this additional help of home visiting. So your first question, what happens if we get rid of home visiting, child welfare numbers will will will go up, child uh foster care as well as mental health service needs.

Thank you. Thank you so much. Let me uh say this, uh there's lots of headlines out there, don't hold your breath that the headline on whatever newspaper you wanna talk about, that Congress comes together and agrees that the MCV program should uh should continue. That's something that we both uh, uh both sides of the aisle agree with. So hopefully uh we can get it done, Mr. Chairman. I'm on board to make it happen as is I think everybody on the committee. So with that, pop pop yields back, Mr. Chairman.

Well, thank you, Mister beam. Uh, Bean, I'm not sure we actually needed to turn on your mike. I think you would have been fine on your own.

Yeah.

Um, our last uh member to ask questions today will be Mister Miller of Ohio. You're recognized.

Thank you, Mr. Chairman. It's uh it's gonna be really hard for me to compete with uh my colleague, Aaron. So but thank you for being here uh this afternoon. It is a pleasure and thank you to the chairman for doing this. I represent Northeast Ohio, a region home to thriving cities, small towns and rural communities, many of which face significant challenges accessing quality health care and family support services. That's why today's hearing matters so much to me and as you can hear to everyone, right, as well as the iris mcgary chairman of the hood as well as everyone on the other side um so in fiscal year twenty five ohio's make the program serve more than two thousand three hundred adults two thousand two hundred children and conducted nearly twenty four thousand home visits across twenty six counties sixteen of which are rural these are real families and real communities getting the support they need before a challenge becomes a crisis make-ve works because it meets families where they are literally train professionals go into homes build trust screen for development delays connect parents to resources and help families get on a path towards stability and the data backs this up since twenty seventeen the share of mothers receiving postpartum depression screenings has risen from seventy five to eighty one percent nationally children with developmental delays receiving timely services has risen from sixty nine to seventy seven percent these are not small numbers these are children's and families whose trajectories have been changed forever the twenty twenty two jackie wachowski reauthorization act expanded make these reached by fifteen percent nationwide including a twenty percent increase in the number of rural communities that it served that is meaningful progress and showcases the effectiveness of this preventative program i look forward to hearing from our witnesses today about what this program has meant for families and how it is working and once again thank you all for being here today it's a pleasure listening to you and hearing your stories i know i haven't been present but Thank you, many, for listening in the back. So, thank you very much. Miss Smith, Brightpoint serves families across Illinois using a coordinated intake system to connect them with the right home visiting program. Can you just walk us through how Brightpoint spreads the word about MICVI services and the communities you serve, and how coordinated intake process makes it easier for easier for families to get connected?

Absolutely. Um, being someone that's been in the field for three decades, I remember the days of just handing out flyers. agencies competing on trying to get slots filled so before and what Coordinated Intake has been able to do is to not only coordinate those services but to help navigate families through that there's one place where you can go what's home visiting and which one do I apply for it reduces time it gets families in home visiting earlier which is important sometimes for model for the model itself but also we know that the if we can get in that prenatal the earlier the better um it also has um increased just the quality of the referral they know what it is, they're engaged, they wanna participate. That voluntary nature in getting them involved is a critical uh component of home visiting. And we feel that Coordinated In-Kate does that in a way that that makes parents understand what they're signing up for before that knock at the door.

Yeah. Thank you very much.

Yeah.

Just like everything in life, and I know people say it all the time, but it's uh familiarizing yourself with the process or it w- whether it's education, one of the two however people would like to frame it or or talk about it, is incredibly important. And uh thank you and your organization and for getting that done and and educating those parents um so that they know miss wilson i i know you're from ohio i saw mr. carey go ohio so i need one as well ok so ohio

i oh

alright thank you it wasn't as good but i understand i'm i i'm piggybacking off so

yeah

your your testimony describes how your nurse family partnership has helped you work through real fears about your son's safety as a new mom including concerns about SIDS and i know you talked about it earlier little bit but can you share what support look like and how it gave you the confidence to care for your son and to get through those times

yeah so um in my history i have two siblings that passed away from SIDS um as early as like two or three months but so i have known all along about abc's and the risk of that like making sure that they're alone on their back in a crib but it's really different when you're a parent and all you can do is keep falling asleep because you know the oxytocin is releasing um but what my person what my nurse has done for me was letting me know the strains that i already had that was fighting against sid's and that was nursing um when you like that when you're nursing your child that can prevent sid's she also taught me um that i'm abstaining from drugs so that also keeps him alive as well as checking on the baby throughout the night and throughout the day and where he should not be sleeping and then also preventing

thank you for sharing that and i i truly believe it's important for people back home and all of our communities to hear your story and you know the things that americans go through and just thank you for staying strong and getting through the program and thank you for being who you are uh mr. chairman i yield back

Thank you, Mister Miller. Um, that concludes our questions and answers today. Um, and I just wanna, again in closing, wanna thank each and every one of you for taking the time and effort to be here, for contributing to this conversation, the dialogue, the discussion, helps all of us as we look at the reauthorization of MCV and suggestions and things that we oughta be thinking about but also thinking about how valuable the resources are in what they do in affecting children and families and people's lives on a daily basis so we commend all of you for the work you do back home we look forward to working with you along with all the colleagues here in a bipartisan way as we work towards a reauthorization of MCV with that please be advised that members have two weeks to submit written questions to be answered later in writing those questions and your answers will be made part of the formal hearing record and with that the committee stands adjourned thank you

I really appreciate it