Chair Kennedy, Chair Livingstone, and distinguished members of the Committee – thank you for the opportunity to testify today. My name is Charlotte Bruce, and I am the Director of Policy for Children’s HealthWatch – a network of pediatricians and child health researchers headquartered at Boston Medical Center.
I am here to express our strong support for H.215, An Act supporting the development of children experiencing homelessness. This bill, filed by Representative Decker, would codify eligibility for children experiencing homelessness to automatically receive child care vouchers and qualify for early intervention screenings upon shelter entry.
As pediatricians and researchers, we see every day how foundational the earliest years of life are. From birth to age 5, the brain develops more rapidly than at any other time. These early years shape physical health, social-emotional development and long-term well-being. The experience of homelessness during this window places young children at profound risk.
Our research at Children’s HealthWatch has shown that homelessness during pregnancy is itself a unique risk factor for poor birth outcomes. Even when birth outcomes are controlled for, the stress of prenatal and postnatal homelessness increases the likelihood of adverse outcomes.
Our research also shows that homelessness in early childhood is associated with higher rates of hospitalizations, fair or poor child health, and developmental delays. The stress of instability during this sensitive period can disrupt the developing brain’s architecture in ways that can persist for decades, including higher levels of stress-related chronic disease later in life.
This reality is unfolding here in Massachusetts. Nearly 30,000 people in our Commonwealth experience homelessness on any given night. According to the National Alliance to End Homelessness, three-quarters of them in families, and 40% are children. These numbers almost certainly underestimate the real scale – many families experiencing homelessness stay with friends, couch surf, or adopt other strategies to avoid entering shelter or sleeping on the street.
Childhood homelessness is also on the rise. 12,000 children live in emergency shelters across the state – an 82% increase since 2017.
The scale of this problem is significant and demands policy solutions that stabilize young families quickly and effectively.
One powerful tool we have to improve health outcomes and mitigate the consequences of homelessness is access to early childhood development programs. These are proven to buffer the effects of early adversity – including homelessness and housing instability. Yet parents in shelter face enormous barriers: Massachusetts has some of the highest early education costs in the country – around $20,000 annually – and the voucher application process is complex and underfunded. In April, the Globe reported that nearly 32,000 children sit on a frozen waitlist for child care assistance. Even with voucher prioritization, only 9% of infants and toddlers experiencing homelessness in Massachusetts are enrolled in child care programs.
Barriers similarly exist in accessing and identifying the need for early intervention services. These include lack of knowledge and training of shelter staff on the signs of developmental delays, language barriers, and poor coordination between EI agencies and shelters.
H.215 takes an important step to address these barriers by codifying automatic child care voucher eligibility and early intervention screenings for children experiencing homelessness upon shelter entry. This is a commonsense and evidence-based policy.
Young children experiencing homelessness are among the Commonwealth’s most vulnerable, and they need an early childhood system capable of meeting their needs. H.215 strengthens the infrastructure that supports them and we urge you to swiftly report the bill out favorably – alongside continued investment to ensure access is real, and not just theoretical.
Thank you for your commitment to Massachusetts children and families, and for the opportunity to testify.
Charlotte Bruce, MPH
Director of Policy, Children’s HealthWatch