Budget Oversight Hearing for the DC Department of Healthcare Finance 

DC City Council, Committee on Health

June 5, 2025

 

Testimony of Chioma Oruh, Ph.D.

Health Justice Project Director

Advocates for Justice and Education, Inc.

 

Good afternoon Chairperson Henderson and members of the Committee on Health.

My name is Chioma, and I am a first-generation Washingtonian and Nigerian-American, a mother of two autistic sons, a disability self-advocate, and a Ward 5 resident. I am also here today as the Health Justice Project Director of Advocates for Justice and Education (AJE), DC’s federally designated Parent Training and Information Center and the Family to Family Health Information Center. AJE is also a proud Title V grantee of the DC Department of Health (DC Health) and work collaboratively with public and private healthcare partners, including the DC Department of Healthcare Finance (DHCF)and the DC Department on Disability Services (DDS) via our Community Health Advisory Panel. We work every day to empower families of children and youth with disabilities and special health care needs (CYSHCN) as they navigate complex systems — including education, healthcare, and social services — with a particular focus on those most marginalized by race, income, disability, and immigration status.

We come before you today with deep concern about the Mayor’s proposed FY26 budget and its impact on DHCF, particularly as it affects low-income children, youth, and families who rely on Medicaid, SNAP, housing supports, and special education services. While we appreciate the stated intent to “Grow DC” by investing in housing and opportunity, the reality is that the proposed cuts and policy shifts risk shrinking equity and access — particularly for disabled and medically complex children.

Medicaid Access & CYSHCN

DC’s Medicaid program, administered by DHCF, is a critical lifeline for CYSHCN. It ensures access to medical equipment, therapies, behavioral health care, and case management services that enable children to thrive in school and at home. Any budgetary reductions or service disruptions in this program disproportionately harm children who already face structural barriers to equitable health and education outcomes.

Children with disabilities often depend on Medicaid not just for clinical care, but also for school-based services like occupational therapy or counseling delivered via their Individualized Education Program (IEP) or Section 504 Plan. AJE is increasingly hearing from families reporting service delays, eligibility issues, and provider shortages — issues that will only be exacerbated if funding is not strengthened.

To receive equitable health care, the city needs to actively implement and refine a holistic approach that addresses  the social determinants of health. 

Recent research published in Pediatrics (2021) underscores the urgent need for sustained and increased investment in food security programs. Approximately 14.8% of US households with children experienced food insecurity in 2019, affecting millions of children’s well-being.  Children living in food-insecure households have higher rates of developmental delays, chronic health conditions such as asthma, and behavioral problems compared to food-secure peers.

Given these findings, the DC Department of Healthcare Finance’s budget must prioritize funding for nutrition assistance programs, school meal expansions, and integrated healthcare-food support interventions to improve child health outcomes and reduce costly healthcare utilization in our community.

Concerns About DC Healthcare Alliance and Exclusionary Policies

We are particularly troubled by the Mayor’s proposed restrictions to the DC Healthcare Alliance, which would reinstate quarterly in-person recertification requirements, a move the Washington Post rightly noted would place disproportionate burdens on low-income immigrant families. As the DC Fiscal Policy Institute also pointed out, this budget does not adequately account for the reality of DC’s economic inequality and racial wealth gap.

Many of the families we serve include mixed-status households, caregivers with disabilities, or relatives informally raising children. These families already face enough systemic barriers without having to navigate punitive bureaucratic processes to maintain essential healthcare coverage. When children’s caregivers are unhealthy, destabilized, or denied care, children suffer. When entire households are uninsured, children with disabilities face increased risk of neglect, medical trauma, and school absenteeism.

Austerity Budgets Are Not Healing-Centered

As a Title V grantee working at the intersection of health equity, disability justice, and healing justice, AJE cannot support a budget that relies on austerity for the most vulnerable while maintaining tax breaks and funding for carceral infrastructure. Our families tell us every day: access to housing, food, and healthcare are not optional — they are part of a care continuum that supports their child’s ability to learn, grow, and participate in community life.

The FY26 budget arrives at a time when federal uncertainties — including potential threats to the U.S. Department of Education — already cast a long shadow over children receiving special education services. DC must do everything it can to buffer these children from further harm, not compound it through policy choices that cut safety nets.

Our Recommendations

We urge the Council to:

1. Reject proposed in-person recertification requirements for the DC Healthcare Alliance.

2. Protect and expand Medicaid-funded services for CYSHCN, including Early Periodic Screening, Diagnosis, and Treatment (EPSDT).

3. Ensure stable funding for school-based healthcare coordination, including behavioral health integration and case management.

4. Invest in multilingual, culturally responsive navigation services for families of children with complex needs.

5. Collaborate with the DC Health, DHCF, and OSSE to improve interagency alignment on eligibility, care coordination, and equitable access to services.

There is no positive growth trajectory for this great city without considering the needs of all children — especially those with disabilities and complex health needs — are growing with us. Now is not the time for retrenchment or capitulation to pressures not aligned with DC values.. It is a time for bold investment in healthcare access for our most vulnerable residents, community well-being, and a functional and forward-thinking care infrastructure that uplifts every DC child and family. Thank you for your time and commitment to health equity. I am happy to answer any questions.