HealthySteps

Because most young children visit the pediatrician, child wellness visits are an important opportunity to connect with families and ensure that they have the appropriate resources to address their child’s needs. Physicians, however, may not always have the time or ability to address all concerns that families have. A HealthySteps specialist that participates in regular wellness visits can help families during and between these visits to address concerns outside the physician’s capabilities, such as feeding, behavior, sleep, and attachment. Parents can also receive support for themselves, including help addressing postpartum anxiety and depression.

Parents often have questions and concerns about developmental milestones, behavior, discipline, breastfeeding, and nutrition that aren’t always addressed during a visit to the pediatrician. Without prior knowledge of early childhood development, parents may not know what to ask or even that they can ask for help with issues that aren’t strictly medical. They may worry that additional help may be unaffordable. Guidance and support from an early childhood specialist can improve children’s health, safety, and social-emotional development, as well as provide early intervention that can be life-changing and allow for cost savings for families.

HealthySteps has demonstrated positive social-emotional results for participating children whose mothers experienced childhood trauma, compared to children who did not participate in the program.

Studies show that HealthySteps may yield positive outcomes in:

• Child social-emotional development
• Duration of breastfeeding
• Reducing postpartum depression
•  Improving key social determinants of health (i.e., reducing risk factors such as food insecurity, housing instability or homelessness, utility needs, transportation needs, interpersonal safety, substance misuse, tobacco use)
• Parent-child relationships
• Greater adherence to regular well-child visits and continuity of preventive care
• Vaccination rates
• Use of positive parenting approaches
• Child safety practices
• Decreased use of severe discipline
• Parental satisfaction with care

Full, sustainable funding for HealthySteps is key to ensuring this program can continue to address issues that prove costly to families and the health care system over time. More importantly, the accessible, expert, and comprehensive care provided by HealthySteps improves the lifelong health and well-being of children and families, preventing significant health, social-emotional, academic, and behavioral problems down the road, and promotes a brighter future for DC’s kids.

HealthySteps specialists are primarily embedded in pediatric primary care practices where the majority of current patients are enrolled in Medicaid.3 Across the District, there are ten HealthySteps sites in wards 1, 3, 4, 7, and 8. Of these ten sites, six are locally funded by DC Health and four are privately funded. The six locally funded sites are in wards 7 and 8 at Children’s National Hospital, Unity Health Care, and MedStar Georgetown. In FY22, Children’s National Hospital served 777 residents (356 were newly enrolled) and Unity Health Care served 336 residents.

Providing this kind of critical support to families with young children requires funding for specialists’ training and compensation. DC Health funds five Federally Qualified Health Centers in wards 5, 7, and 8 that utilize the HealthySteps model.5 Once fully phased in, HealthySteps will require $1.5 million in ongoing annual investments.6 The 2024 fiscal year DC budget provides $1.35 million for the six locally funded HealthySteps sites mentioned above.7 Importantly, the FY24 budget maintained funding for six locally funded sites and provided the sites the opportunity to continue expansion. FY24 will be the first full fiscal year for the sixth and newest locally funded HealthySteps site with MedStar Georgetown.