On Wednesday, July 8, 2026, at 11:35 a.m., the Committee on Health, chaired by At-Large Councilmember Christina Henderson, held a public roundtable on the state of maternal and infant health in the District of Columbia. The meeting focused on the mayor's FY27 budget proposal, which included over $3 million in cuts to maternal and early childhood public health initiatives, and the most recent perinatal and infant mortality report from DC Health (2018–2024) showing concerning trends such as increases in severe maternal morbidity, marijuana use in pregnancy, and preterm birth rates. The committee heard from public witnesses, health professionals, and government officials.
All right. Good morning. Still morning. I'm calling this public round table to order. Today is Wednesday, July 8th, 2026. We're in room 123 of the John A. Wilson building. The time is 11:35 a.m. I'm at large council member Christina Henderson, Chair of the Committee on Health. Today we're holding a round table on the state of maternal and infant health in the district. The mayor's FY27 budget proposal included over 3 million of cuts to maternal and early childhood public health initiatives and interventions with no new proposed investments or strategies to improve maternal and infant health outcomes. This came even as the most recent perinatal and infant mortality report from the DC Health shows concerning trends for certain key maternal health metrics between 2018 and 2024, including an increase, including increases in severe maternal morbidity rates, marijuana use rates and pregnancy, and preterm birth rates. The district has a substantial role to play in perinatal health, as 43.4% of district births in 2025 were funded through Department of Health Care Finances Medicaid programs or alliance. The Committee on Health held a round table in December of 2023 on maternal and infant health, at which the executive highlighted efforts to improve health outcomes here in the district. Since that round table, the council has also passed several bills and made investments aimed to improve maternal and infant health. Today we will discuss how the executive and the council driven efforts have been rolled out through the district and what additional improvements must be made to meaningfully increase access to pre- and postnatal care. Uh, address the maternal mortality uh rates and ensure healthy outcomes for district residents who are birthing uh children. We will also hear from maternal health professionals, including doula's midwives, OBGYNs, and more about their experience on the ground ensuring safety and health of expecting parents and infants. Uh we haven't been joined by colleagues. Um, although I know some of them are in the building as there are other hearings that are going on, but we'll certainly welcome them if any of them join. We are going to turn to our public witness testimony. All of our public witnesses will have three minutes to testify. You're welcome to submit longer written testimony for the record. Uh, please be conscientious of your time. Uh, I'm gonna call the first uh in-person witnesses, and then we'll go to our virtual folks. So uh Crystal Jackson from a Queen Mommy uh Mama Doula Services, uh Leah Caslis from Children's Law Center, Rodrigo Stein, ah, there he is, uh, from La Clinica de Pueblo, and Dr. Kate Sugarman from Doctors for Camp Closure. Miss Jackson, when you're ready. Oh, you can. Good morning, Chair Person Henderson and members of the Committee on Health. Since first testifying before this committee in 2023, I've gone from identifying barriers in the Medicaid DULA benefit to helping implement it as a Medicaid provider and the district's doula equity consultant. There are four things I hope you remember today. One, the Medicaid dual benefit exists, but implementation is incomplete. There are challenges at every step that have not been corrected systemically since the benefit was released. Dual is continue to struggle with enrollment, credentialing, billing, and reimbursement. Two, uh, community-based organizations have been doing the implementation work through the Doula Learning and Action Collaborative and Interdisciplinary Group grown from the Ward 8 Health Council's Maternal Health Working Group. Approximately 60 doulas have been supported with technical assistance, peer learning, and systems navigation. This work has been funded through short-term grants rather than sustained public investment. Three, um, the Medicaid Doula Implementation Infrastructure is a maternal health investment. Creating a benefit was only the first step. If the district wants the Medicaid dual benefit to improve maternal and infant health outcomes, it must invest in the organizations that help providers successfully participate in the program. Three, nope, four. Um, I urge the council to invest in community-based DULA-led implementation organizations that have demonstrated the ability to build and sustain this workforce. We should not rely on temporary grants to support an essential part of the district's maternal health strategy. Policies are designed in government, but they succeed or fail in community. Don't forget your doulas in implementation. I'm submitting more detailed written testimony describing my experiences and expertise. Thank you for the opportunity to testify. I am Crystal Jackson, a member of the Ward 8 Health Council and co-chair of the Maternal Health Working Group, a DC Medicaid Doula provider, and the district's doula equity consultant, meaning I work at the intersections of Maternal Health, Workforce Development, and Medicaid Systems Transformation. Thank you.