Safe Babies and the Power of Prevention: What We Protect, We Support

By Dominique Johnson, Policy Associate

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Too many children enter the child welfare system not because they’re unloved, but because their families weren’t supported soon enough. While it’s critical to protect children from harm, we must also recognize that removal from the family home can be deeply traumatic. Infants and toddlers, who make up more than 33% of all child maltreatment victims, are especially vulnerable. Separating them from their parents, even for safety, can cause emotional and developmental harm that lasts a lifetime.  

Groundwork Ohio has worked with other state partners to implement and scale Safe Babies, a program designed by ZERO TO THREE. Too often after a removal takes place, parents don’t get their children back simply because they don’t understand the system or can’t access what is needed to comply with case plans. Since its inception in the 1990s, ZERO TO THREE’s Safe Babies approach has enabled participating communities to partner with local child welfare agencies and court systems to support families after separation, supporting faster reunification, reduced foster placements for young children, and more frequent court hearings and family interactions. 

Ohio has worked with ZERO TO THREE’s  Safe Babies Approach in Lucas, Scioto, and Cuyahoga counties since 2020. Challenges in local communities, such as change in Judicial leadership or challenges collaborating with local child welfare agencies, necessitated that Ohio’s Safe Babies programs relocate from the local juvenile court systems into local communities instead. While the former iteration of Safe Babies was more focused on reaction after a removal had taken place, the Ohio Safe Babies team has worked collectively to build new partnerships, think outside the box, and implement the philosophy of Safe Babies in new ways, focused more on prevention. 

 The goal: keep families together from the start.  

Ohio's Cuyahoga County Safe Babies program was the first in the nation to pursue implementation upstream of the court system.  This change sparked a national conversation and broadened the Safe Babies program nationally, giving states and sites more options for implementation with a focus on prevention.  

A couple of weeks ago, I joined Safe Babies leaders, state partners, and families from across the country in Pittsburgh to reimagine how we support families, before removal takes place. By investing in family supports, we can keep more families together safely and spare more children from the trauma of separation. Every time we choose support over punishment, we choose healing, stability, and hope. And we give families a real chance to break cycles, not repeat them. 

One of the most inspiring examples was Pittsburgh’s Hello Baby program. Using data, they identify families who may be at risk of separation before age three and offer support right at birth. Their team provides warm referrals, accompanies families to appointments, and even supports grandparents and fathers to build a full circle of care. Families choose how often they meet and set their own goals, from weekly house cleaning to enrolling in trade school.

We heard powerful stories from parents who had lost and later regained custody of their children with the help of Safe Babies. Their journeys often started with something fixable: domestic violence, housing insecurity, substance use, or lack of support. And it reminded us, removal is often about circumstances, not uncaring caregivers. These are loving families who need help at the right time. 

On the final day, we went to work. In Ohio, we’re building upon what Cuyahoga has started and preparing other counties to launch their own prevention-first models. Other states are beginning their own journeys, planning how to bring prevention out of the courts and into the community. 

Key Takeaways

• Support fathers and help them stay involved 

• Bridge trust between hospitals and families 

• Empower families to build their village 

• Connect families to the full benefits of Medicaid 

Building on the insights from the convening, it’s clear that moving toward a prevention-oriented model requires acknowledging the well-documented link between early adversity and long-term outcomes for children. Adverse Childhood Experiences (ACEs), which include abuse, neglect, household challenges, and broader social stressors such as neighborhood violence, racism, or discrimination, have a profound and lasting impact on child development. Without early intervention, these experiences increase the risk of substance use in adulthood and limit long-term health, educational, and economic outcomes. A prevention approach means addressing these root causes early and comprehensively, to break the cycle of harm and create lasting pathways to stability and opportunity. 

 Here in Ohio, we’re still facing an uphill battle. Of all 50 states and D.C., we rank: 

• 44th for children experiencing food insecurity

• 40th for children under 5 living in poverty

• 51st for childcare subsidy eligibility

• 30th for infant maltreatment 

We can do better. And we must. 

Early childhood programs, like home visiting, childcare, and developmental screenings, can play a powerful role in preventing trauma. These supports build resilience, improve school readiness, language, and social skills. And most importantly, they can reduce the need for family separation in the first place. 

Prevention will look different across every state and community. Some may focus on preventing re-entry into child welfare while others may work with hospitals at birth. But the heart of the work stays the same: wrap around families before a crisis ever happens. 

That means investing in: 

• Home visiting programs- home visitors don’t just offer parenting tips; they listen, build trust, and help families navigate challenges before they grow into crises. These relationships can be a lifeline for families who feel isolated or overwhelmed, especially in the first critical years of life. 

• Early intervention services- when families are connected to evaluations, therapies, and support early, reduce stress and uncertainty and give children the tools they need to succeed socially, emotionally, and academically. 

• Safe and stable housing- Housing insecurity adds enormous stress and instability that affects the whole family. When families have a roof over their heads, they can begin to focus on long-term goals instead of short-term survival. 

• Reliable transportation- without a way to get around; families miss doctor’s appointments, therapy sessions, childcare drop-offs, and job opportunities.  

• Financial assistance-when families can cover basic needs, they’re better able to focus on parenting, healing, and long-term goals rather than surviving day to day. 

• High-quality childcare- parents deserve to work or go back to school knowing their child is safe, learning, and being cared for in a nurturing environment. 

“What you’re not doing, you’re choosing.” 

If we’re not choosing to support prevention, then we’re choosing the trauma removal. If we’re not investing in families, we’re investing in harm.