By Kezia Ofosu Atta, Policy Assistant, Groundwork Ohio
Follow Kezia on LinkedIn
Imagine being a pregnant woman or new mom from a low-income family who must deal with balancing the burden of providing housing while supporting their family. This is the story of many expectant parents to babies and toddlers who have difficulties accessing affordable, stable, and safe housing. Situations like this pose a significant threat to the health and lives of mothers and infants.
Across the state of Ohio, “67% of extremely low-income households are severely cost-burdened, as there are only 44 affordable housing units for every 100 extremely low-income households and the number of infants who access homelessness assistance programs increased by 53% from 2012- 2017 at 2,943 infants.” As a state, we must do more to secure access to affordable housing for infants and mothers, and we cannot let them down.
Representatives White and Humphrey introduced House Bill 7 (HB7), known as the Strong Foundations Act, on February 15, 2023, to support strong foundations for Ohio mothers and babies in their first one thousand days to address maternal and infant mortality. One of the provisions within this bill would increase funding to Healthy Beginnings at Home, a program focused on providing stable housing for pregnant mothers and improving maternal and infant health outcomes. Many mothers and infants in Ohio could possibly face death if they do not receive affordable housing services. According to research findings by the City of Columbus, “housing instability and homelessness increase the likelihood of pre-term birth, infant mortality, and acute health conditions”. Despite a decrease in Ohio’s infant mortality from “7.2 per 1,000 live births in 2017 to 6.7 in 2020”, housing stability, described by Jason Reece in his research on Housing for Urban Maternal and Infant Health as a “social determinant of health can address health disparities” that could lead to death. Housing stability serves as a major tenet of growth and healthy living for infants and mothers. Without this, many mothers and children will be at risk of losing their lives or facing detrimental health outcomes.
What is Healthy Beginnings at Home?
Healthy Beginnings at Home was launched in 2018 as a housing stabilization project. The program targeted pregnant women 18 or older in their first or second trimester in Franklin County at income levels of 30% or less than Franklin County’s median income. It provided them with a CareSource Medicaid managed care plan and a 2-year housing intervention along with rental assistance.
In the pilot program, 100 families were randomly assigned to two groups: the housing intervention and the usual care group, which only received the Care Source Health Insurance plan. By the end of the pilot program, within the group of 100 expectant mothers, there were four fetal deaths in the usual care group and none in the housing intervention group. This result further established the need for stable housing as the group that received usual care was less likely to take their infants to be admitted to the Neonatal Intensive Care Unit.
Once housing is secure, people are more likely to seek health care, as “infants from the housing intervention group were more likely to be admitted to the Neonatal Intensive Care Unit (NICU)”.  Over time, there have been many reiterations of the program, and it has proved itself to be successful.
What does House Bill 7 do?
One of the core goals of House Bill 7 is to expand access to stable housing for mothers and infants through Healthy Beginnings at Home and other programs across the state. House Bill 7 would appropriate $15 million in Fiscal Year 2024 to fund the Healthy Beginnings at Home program. In addition to this, HB7 appropriates $1 million to fund Move to Prosper, a Central Ohio-based program that assists families of low incomes in moving to neighborhoods with quality housing, better schools, and a safe environment.
What Happened in the 2023 Budget?
Funding support for Healthy Beginnings at Home was included as one of the provisions in the FY 24-25 Ohio Biennial Budget, which passed on July 4, 2023. Gov. DeWine and the Ohio House had initially proposed $16 million in their versions of the budget to expand the program to more areas outside of Franklin County. However, the Senate reduced the funding to $3 million, an 81% cut, which would be insufficient to expand the program to other areas of Ohio such as Dayton, Akron, Cincinnati, and Cleveland. Given this reduction in the investment to Healthy Beginnings at Home, there is more work that needs to be done to sufficiently fund the growth and impact of the program.
What can you do?
Fortunately, as we shared, House Bill 7 includes crucial additional investments in this life-saving program. The House Families & Aging Committee recently passed the bill out of Committee earlier this summer. It is likely that House Bill 7 will be brought to the floor of the Ohio House of Representatives for deliberation and a vote this fall.
As the potential floor vote draws near, it is vital that you contact your State Representative, informing them about the importance of this provision and how it can benefit thousands of Ohio’s families and prevent maternal and infant mortality. Stay connected with Groundwork’s Center for Maternal & Young Child Health to continue to receive updates about how to get engaged on this bill and other important legislation for Ohio’s pregnant women and babies. You can sign up for the Center’s monthly newsletter here.
 https://www.columbus.gov/celebrate-one/Healthy-Beginnings-At-Home-Policy-Brief/  https://www.columbus.gov/celebrate-one/Healthy-Beginnings-At-Home-Policy-Brief/#:~:text=Housing%20instability%20during%20pregnancy%20increases,acute%20and%20chronic%20health%20conditions.  https://odh.ohio.gov/wps/wcm/connect/gov/f972e9db-91c1-4b31-99c6-3d12ab095ddb/Infant+Mortality+Annual+Report+2020+Final.pdf?MOD=AJPERES&CONVERT_TO=url&CACHEID=ROOTWORKSPACE.Z18_M1HGGIK0N0JO00QO9DDDDM3000-f972e9db-91c1-4b31-99c6-3d12ab095ddb-oaDGMx0  Ibid., 4