Search Results

It was a busy week for child-centered policy in the Ohio Statehouse. Representatives introduced five house bills that would support child care access in the state. They are: HB 570: Provides publicly funded child care benefits to child care staff members. Introduced by Reps. Dani Isaacsohn (D-Cincinnati) and Bride Rose Sweeney (D-Westlake). HB 576: Authorizes nonrefundable tax credits for certain employer-provided child care expenditures. Introduced by Reps. Andrea White (R-Kettering) and Cindy Abrams (R-Harrison). HB 577: Authorizes a refundable income tax credit for certain child care expenses. Introduced by Rep. Andrea White (R-Kettering). HB 578: Authorizes a nonrefundable income tax credit for contributions to certain child care programs. Introduced by Rep. Andrea White (R-Kettering). HB 580: Makes foster caregivers and kinship caregivers eligible for publicly funded child care. Introduced by Reps. Andrea White (R-Kettering) and Sharon Ray (R-Wadsworth). These bills come at a crucial time for children and their families. Child care costs around the nation continue to rise. At the same time, the numbers of licensed child care centers and licensed family child care homes are still below pre-pandemic levels. Groundwork Ohio appreciates the policymakers from both sides of the aisle who are stepping up and offering real solutions to these challenges. Follow us on social media for more legislative updates.

By Caitlin Feldman, Statewide Coordinator, Ohio Infant-Toddler Court Team Follow Caitlin on LinkedIn Caitlin Feldman, Groundwork Ohio’s Statewide Coordinator of the Ohio Infant-Toddler Court Team, recently attended the 11th annual Trauma Informed Care Summit: A Time to Reflect, Adapt, and Innovate. Hosted by the Ohio Departments of Mental Health and Addiction Services, Developmental Disabilities, Health, and Youth Services, the Summit’s purpose is to move our systems beyond being trauma-informed to providing trauma-responsive and competent care. Caitlin attended to learn more about the Ohio state agencies’ trauma-informed care priorities and to hear from experts around the state who are leading the implementation of trauma-informed policies and practices. During the two-day summit, there were 30 presentations from experts representing a variety of industries, from state agencies to direct client services organizations around the state. From trauma competent leadership to the impact of trauma on classrooms and developmental outcomes, this summit offered an opportunity to deepen skills and understanding of how to prevent and respond to trauma in young children. Trauma is defined as exposure to an incident or series of events that are emotionally disturbing or life-threatening. While only 6.8 percent of U.S. adults meet criteria for a post-traumatic stress diagnosis (PTSD), 75 percent of Americans have experienced trauma that can impact their well-being in a myriad of ways. The word “trauma” can deflate the interest of general audiences who may believe these conversations are confined to the authority of trained mental health professionals; however it is important to consider the communities, clients, colleagues, and staff we serve are highly likely to be affected by trauma. Given its broad definition and pervasiveness in society, we all share a responsibility to be trauma competent as leaders, professionals, community members, and individuals. According to the Substance Abuse and Mental Health Services Administration (SAMHSA), trauma-informed care is defined as: A program, organization, or system that . . . realizes the widespread impact of trauma and understands potential paths for recovery; recognizes the signs and symptoms of trauma in clients, families, staff, and others involved with the system; and responds by fully integrating knowledge about trauma into policies, procedures, and practices, and seeks to actively resist re-traumatization. Using these four assumptions, trauma competency can be systemic or granular, from organizational structures, policies, and procedures to hiring practices, individual and organizational goal-setting, and how we respond to those around us. In the words of Natalie Smith, Vice President of Clinical Services at Ravenwood Health, “trauma-informed care is no longer a buzzword—it is here to stay.” As the host of the statewide coordination for the Safe Babies approach to infant-toddler court teams, Groundwork Ohio is committed to advocating for trauma responsive and competent systems that serve young children and families. Trauma-informed approaches are one pathway to support healthy development in early childhood and promote positive outcomes in health and well-being throughout a child's life. Safe Babies aims to bring a trauma-informed, holistic approach to child welfare practice that reinforces individual and family strengths and resiliency. Our vision to create a future where all families have the capacities, resources, and supports to care for and nurture their children would not be possible without a dedication to comprehensive, trauma-informed support. As Ohio’s state departments diligently work to integrate trauma competency throughout their systems, Groundwork Ohio looks forward to further advocacy on this crucial matter. Trauma-informed care must become standard practice. Our aim is to broaden the availability of trauma-informed approaches to our systems of care across all sectors, particularly within those systems that serve our state’s most vulnerable young children and families. More information about the Infant-Toddler Court Team is available online.

By: Lynanne Gutierrez, President, Groundwork Ohio Follow Lynanne on Twitter and LinkedIn At Groundwork Ohio, advocacy isn't just a mission; it's a commitment to empowering the voices that matter most—those of Ohio's parents and families. As part of our ongoing efforts to ensure that families have a seat at the table in decisions affecting their children's futures, we're thrilled to introduce the Family Voice Workbook, a powerful tool designed to amplify the voices of families across the state. Developed as a companion to the "Amplifying Family Voice to Advance Equitable Outcomes for Young Children" report, the Family Voice Workbook is a comprehensive guide for community-based organizations and leaders. Drawing from Groundwork's extensive research and experience, this workbook invites users to embark on a similar journey of authentic family engagement in their mission-driven work, particularly focused on early childhood advocacy. You can access a fillable digital workbook here: How to use the workbook Whether you're shaping organizational missions or launching program initiatives, the Family Voice Workbook provides practical tools and activities to guide your actions. From identifying the next steps to cultivating family engagement to exploring opportunities for deeper involvement, this workbook is your roadmap to empowering families in decision-making processes that impact their lives. Join the Learning Community Groundwork Ohio is committed to supporting organizations in their journey towards greater family engagement. We invite you to share your experiences, learnings, and progress as you use the Family Voice Workbook. Together, we can create a vibrant learning community where peers can exchange insights, strategies, and best practices. This community is dependent on your willingness to engage and create it together. Reach out to us to get involved and learn more about the workbook. Get Started Today Are you ready to elevate family voices in your work? Download the Family Voice Workbook and embark on a transformative journey towards equitable outcomes for Ohio's children and families. For facilitated training or further support, don't hesitate to reach out to the Groundwork team—we're here to help you every step of the way. The Family Voice Workbook isn't just a tool—it's a catalyst for change. By embracing family voices, we can create a more inclusive and equitable future for Ohio's children. Join us in this vital mission and let's make a difference together.

By Brittany Boulton, Managing Director of Advocacy and Engagement, Groundwork Ohio Follow Brittany on Twitter and LinkedIn There was plenty of legislative activity related to young children and families at the Ohio Statehouse this week. In the Ohio House Finance Committee, Representatives Andrea White (R-Kettering) and Bill Roemer (R-Richfield) jointly provided sponsor testimony during the first hearing of House Bill 484, which would establish child care grant programs to incentivize employers to expand child care facilities for Ohio’s workforce. Employers could retrofit or equip child care facilities, build new facilities, or partner with existing providers in their community to expand child care capacity if the bill is passed. House Bill 352, a bill that would establish an Adverse Childhood Experiences (ACEs) study commission, passed out of Ohio House Behavioral Health Committee this week and will next move to the Ohio House floor, if provided the opportunity by the Speaker. Jointly introduced by Representatives Rachel Baker (D-Cincinnati) and Sara Carruthers (R-Hamilton), HB 352 would create a study commission that would convene professional experts and individuals with lived experience to recommend legislative strategies for addressing the prevalence and long-term effects of ACEs. Our team provided proponent testimony on April 23rd, which you can read here. Finally, House Concurrent Resolution 16 received its first hearing in the Ohio House Behavioral Health Committee earlier this week. The resolution, sponsored by Representatives Sharon Ray (R-Wadsworth) and Dr. Anita Somani (D-Dublin), would recognize the importance of perinatal mental health if passed. This resolution was introduced directly after Mental Health America’s perinatal mental health advocacy day last week, in which the Groundwork team participated. Groundwork Ohio will update our network when there is an opportunity to provide additional testimony on any of these bills.

By Troy Hunter, Director of Research, Evaluation, and Performance, Groundwork Ohio Follow Troy on Twitter and LinkedIn The Ohio Department of Developmental Disabilities proposed a new rule that would go into effect on July 1, 2024, and would expand eligibility for Part C Early Intervention services to newborns with extreme prematurity born at or before 28 weeks. A public hearing for this rule was on May 3rd. Groundwork Ohio submitted the following comments in support of the new rule. Groundwork Ohio is a committed, nonpartisan public-policy research and advocacy organization formed in 2004 that focuses on the prenatal period to age 5. We advance quality early childhood systems in Ohio by engaging, educating, and mobilizing diverse stakeholders and strategic partners to promote data-driven and evidence-based early childhood policies. As an organization dedicated to championing high-quality early learning and healthy development strategies for Ohio's youngest, we appreciate the proposed changes to the Early Intervention program. The timing of the rule renewal aligns with the Ohio Department of Children and Youth’s application to become the lead agency for the state's Part C Early Intervention program, replacing the Ohio Department of Developmental Disabilities. We are optimistic that this change will better integrate Early Intervention with other child-serving programs under the new department. We have faith that this transition will be seamless and will increase collaboration between Early Intervention with relevant agencies and other child-serving programs. The proposed changes to the Early Intervention rules by the Ohio Department of Developmental Disabilities are a significant step forward in ensuring that children and families receive the support they need. Expanding eligibility criteria to include newborns born before 28 weeks without an additional diagnosis and increasing the number of units of Early Intervention services available to parents will help ensure that more children and families can access the support they need. We appreciate the updated list of physical and mental conditions with a high probability of resulting in a developmental delay as outlined in Appendix C. Preterm birth can result in developmental delays. Currently, many of Ohio’s babies and young children born preterm, who are at higher risk for developmental delays are not getting the early intervention services they may need. Increasing eligibility to include newborns who are under 28 weeks will increase access to services that will support their development. We hope that with the expansion of eligibility established by the new rule that there will be an increased investment in the Early Intervention program to sustain the influx of children that would become eligible for services. Expanding the number of units of Early Intervention services available to parents from 55 to 100 per year is a significant step towards improving access to essential services for families in Ohio. This increase allows for more comprehensive support to children with developmental needs and their families. By doubling the number of visits, parents will have access to more support and guidance in navigating their child's development. These additional visits provide opportunities for Early Intervention providers to offer tailored interventions, monitor progress more closely, and collaborate with other stakeholders — such as child care programs — to support the child's development and inclusion in various settings. However, it's essential to consider the potential consequences of this rule change. In counties where there is already a high demand for Early Intervention services, increasing the number of visits without additional resources could strain existing programs. This strain may lead to longer wait times for services, decreased quality of care, and increased stress on providers. In counties with limited Early Intervention providers, the increased demand for services could exacerbate existing challenges in service delivery. Without sufficient funding and support, these providers may struggle to meet the needs of all families, hindering the effectiveness of Early Intervention services in those areas. While the rule change is undoubtedly beneficial for children and families, it is essential to accompany it with additional funding and resources to support the Early Intervention system adequately. Investing in workforce development, expanding provider networks, and increasing funding for Early Intervention programs are important steps to ensure that all children in Ohio have access to high-quality early intervention services. While we appreciate the positive intent behind these rule changes and recognize their potential to enhance access to services for families, we must emphasize the importance of accompanying these changes with substantial investment in the Early Intervention system. Without adequate support for providers, the increased workload resulting from these rule changes could undermine the quality and effectiveness of services, ultimately impacting the well-being of Ohio's children and families. It is essential to recognize that these changes must be accompanied by significant investment to ensure their effectiveness. Without adequate support for providers and resources to meet the increased demand for services, the quality and accessibility of Early Intervention services may be compromised, ultimately impacting the well-being of Ohio's children and families. Groundwork Ohio urges the Ohio Department of Developmental Disabilities to consider the importance of accompanying these rule changes with substantial investment in the EI system. We appreciate the opportunity to provide feedback on these proposed rule changes and encourage the Department to carefully consider our concerns. By investing in Early Intervention, we can ensure that all children in Ohio can thrive and reach their full potential.

By: Kezia Ofosu Atta, Policy Manager, Groundwork Ohio Follow Kezia on LinkedIn The Prevalence of Smoking and its Effects on Ohio’s Mothers and Children While the percentage of mothers who smoked cigarettes during pregnancy has fallen over the past decade from 16.9% to 9.4%, this rate is still nearly twice the national average. Smoking cigarettes while pregnant has been associated with a range of adverse health outcomes for both mothers and their children. These include certain types of birth defects, prematurity, and linked to sudden infant death syndrome (SIDS) and congenital defects. The smoking rate is even higher for pregnant women who are enrolled in Medicaid.  In Calendar Year2020,19.3% of Ohio mothers with Medicaid coverage smoked during pregnancy, compared to 2.2% of mothers not enrolled in Medicaid. To help states better understand how Medicaid can be used to address this preventable health risk, the Centers for Medicare and Medicaid Services (CMS) has released an informational bulletin on Strategies to Improve the Delivery of Tobacco Cessation Services. CMS notes that most adults who smoke want to quit, but individuals enrolled in Medicaid are less likely to be successful in this quest. This suggests that Medicaid beneficiaries could benefit from increased access to and use of cessation counseling and medications. CMS has recommended five strategies that states can use to improve the delivery of tobacco cessation programs and increase quit rates: standardize and communicate covered cessation benefits across fee-for-service and managed care delivery systems reduce barriers that make it difficult for specific populations, such as people with mental health or substance use disorders and pregnant women to access cessation services use managed care contracts and quality improvement activities to improve the delivery of tobacco cessation services partner with tobacco cessation quit lines and providers such as pharmacists to increase access to cessation treatments establish partnerships to promote coverage and encourage utilization of covered cessation services Ohio Medicaid provides access to cessation services and the state funds some targeted smoking cessation initiatives through the Department of Health. The strategies promoted by CMS offer a more comprehensive approach to addressing the issue of smoking within the Medicaid population and come with federal matching funds to help Ohio dollars go farther. To improve birth outcomes, Groundwork Ohio encourages the state to adopt these strategies to further reduce smoking among pregnant women.

More than two dozen early childhood professionals from across the state will meet annually Columbus, OH: Groundwork Ohio is thrilled to announce the Class of 2025 Early Childhood Fellowship, a network of early childhood professionals throughout the state who will spend the next year receiving training and support to enhance their leadership skills and advocacy outreach. The Fellowship utilizes a unique curriculum consisting of keynote speakers, online learning experiences, discussions with policymakers, networking opportunities, technical assistance, and small group projects. Upon completion of the program, Fellows will have a better understanding of how to be successful advocates for themselves, infants and toddlers, families, and their community. “We have an exuberant group of Fellows this year who are ready to hit the ground running toward the goal of making Ohio the best place to be a young child,” said Troy Hunter, Director of Research, Performance, and Evaluation for Groundwork Ohio. “We are excited to offer a revised program for Fellows including more than 35 hours of professional development. Our Fellowship is mission-critical. We elevate early childhood professionals as unique experts and emerging advocates to champion early childhood policies. We are building an advocacy army by giving the early childhood workforce the opportunity to grow in their advocacy and leadership skills." This year’s class includes passionate early childhood professionals from in-home and center-based providers, home visitors, child development specialists, child welfare professionals, early childhood mental health providers, preschool educators, maternal, infant, early childhood health professionals, and higher education professionals. The class will meet in a series of virtual and in-person conversations and prepare for Groundwork Ohio’s Advocacy Day on March 12, 2025, where they’ll have a chance to interact with their state policymakers. Since the inception of the Fellowship, 109 early childhood educators have taken part in the program, representing 31 counties in the state, 48 out of 99 Ohio House of Representatives Districts, 26 out of 33 Ohio Senate Districts, and 14 out of 16 U.S. House of Representatives Districts. Class of 2025 Fellows Chris Acock, Early Learning Policy Analyst, Franklin County Minister Jauneece Adams-Mitchell, Consultant, Angel Heart Foundation Shaun Barrett, Senior Behavior Support Specialist, The Ohio State University Nisonger Center Bonnie Berg-Simmons, Librarian, Twinsburg Public Library Monica Cardenas, Professional Development & Support Specialist, HOPE Toledo Holly Conroy, Prevention & Inclusion Programs Specialist, Starting Point, Cuyahoga County Emily Cresswell, Early Childhood Education Coach, Miami Valley Child Development Center Simone Ellerson, Early Childhood Mental Health Consultant, Nationwide Children’s Hospital Samantha Forsythe, Education Systems Coordinator, Child Development Council of Franklin County Emily Gessner, Early Childhood Educator, Mom’s House Toledo Margeric Gonzalez, Early Education Program Specialist, Starting Point Dr. Linda Hicks, ECE Career Navigator, 4C for Children Delaney Jones, Social Worker, Educational Service Center of North East Ohio Tonya Kelly, M.Ed, Principal, Bridge Gate Community School Angela Martin, Early Head Start Home Visitor, The Ohio University Early Head Start Keshia McCahill, Executive Assistant, Child Development Council of Franklin County Brittney McCarey, Early childhood education student Laura McFalls, Early Childhood Specialist, Akron-Summit County Public Library Jennifer McNellie, Educator, Starting Point, Cleveland Courtney Nerad, Executive Director, St. Peter’s Child Care Center Inc., Lakewood Katy Philpot, Teacher, Dayton Public Schools Jennifer Rigano, Early Intervention Specialist, Union County Board of Developmental Disabilities Dr. Allison Riggle, Project Manager, Nationwide Children’s Hospital Meghan Scott, Early Education Program Specialist, Starting Point Michelle Shelton, Administrator, the Learning Grove Emilee Stahl, Trainer/EI Service Coordinator, Franklin County Family & Children’s First Council Mary Taylor, Nurse, Franklin County Public Health Joy Welch-Bey, Program Manager, Cuyahoga County Office of Early Childhood Samantha Whatley, Site Administrator, Step Forward, Cleveland Sarah Zang, Program Coordinator, Action for Children More information about the Fellowship can be found online and in our recently published Early Childhood Fellowship Report.

Guest blog by Lisa Golden, Implementation Consultant, Triple P As April is National Child Abuse Prevention Month, it’s a great time to highlight Ohio’s efforts to reach all parents with evidence-based parenting support through the well-researched Positive Parenting Program (Triple P). This program is supported by the Ohio Department of Children and Youth and the Ohio Children’s Trust Fund. Historically, parenting programs have been developed and disseminated for targeted groups of parents, often associated with various identified risk profiles, or requiring eligibility based on limiting criteria.[i],[ii] This approach neglects the reality that all parents can benefit from: evidence-based strategies proven to lower parent stress an improved parent-child relationship a reduction in the emotional and behavioral challenges for their children Who Can Benefit from Triple P A population-level approach to reach everyone helps parents develop skills to cope with difficult circumstances in a healthy and nurturing way. It also avoids expensive population screening, ensures that parents and caregivers receive the support they seek, and enables parents to enter, re-enter, and exit the program depending on their changing needs as their children develop.[iii] When only targeting more vulnerable families, the majority of parents experiencing difficulties with parenting are not reached and such approaches make it more difficult to impact the prevalence rates of child maltreatment. Additionally, it can stigmatize the targeted families. A population-level approach creates an environment in which parents do not feel shame in accessing resources, thereby increasing the number of parents seeking these supports. Triple P has been proven to reduce rates of child maltreatment both in the US[iv] and internationally.[v]  This suggests that all parents experience difficulties and challenges raising their children from time to time, that confronting and dealing with these challenges is normal and healthy, and that there is value in learning skills and strategies to help children thrive.[ii] How the Program Works Universal access to parenting supports, such as Triple P, targets multiple risk and protective factors across childhood and adolescence at scale. Such universal approaches compound the benefits for individuals, families, and systems as access to resource-efficient and cost-effective solutions promote early intervention and may reduce the likelihood of intensive parenting support needed later. Triple P programs are based on the principle of minimal sufficiency, that is, providing “just enough” help to solve a problem. This approach recognizes that most people will benefit from low-intensity parenting programs that avoid over-serving families. Furthermore, these programs are also cost-efficient to deliver at a population level.[iii] Providing some level of support for all families promotes ownership and empowerment for parents to engage in the level of intervention that meets their family’s needs. This approach is public health-friendly, supporting parents without relying on professional intervention. Parenting support that is perceived as time efficient, relevant, flexible, self-paced, and resource-light allows for the greatest potential for program reach and engagement as it encourages participation from parents facing multiple time or resource stressors, and/or from more vulnerable families who may initially refuse more intensive support. [vi] Triple P is designed as a system of support with the idea of having flexible support for families at the right time, the right place, and in the right amount. It can be delivered in group settings or one-on-one by a range of different providers across lots of different settings where families naturally gather.  In Ohio, Triple P is delivered in libraries, early childhood centers, schools, primary care clinics, and by trained providers in area agencies that provide support to families. Triple P is parent-led and parent-driven. Parents are introduced to a range of strategies proven to be effective across many diverse parenting contexts and can select their own goals for support. They then try only the strategies they consider to be relevant for them. The program has content for children ages birth to 12, helping parents lower stress with transition times like bedtime or morning routines, offering parents strategies for teaching and encouraging the behavior they want to see with their children. Additionally, the program also has content to help parents learn strategies to respond well to tweens’ and teens’ changing emotions, further reducing family conflict. Ohio’s investment in the Triple P model supports a universal access approach to parenting support and is making an impact statewide.  Over the past 18 months, with funding from the Department of Children and Youth and the Ohio Children’s Trust Fund: A successful marketing campaign has resulted in over 20,000 parents and caregivers registering for Triple P Online, representing parents from every Ohio county, including many counties where access to other professional supports may be limited by available workforce or limitations due to eligibility. Additionally, many parents indicate a preference for online parenting support.[vii] The following heat map represents the count of parents and caregivers who have registered for the Triple P Online (TPOL) parenting program in Ohio: Testimonials from parents who have taken the Triple P Online course include: Others to consider… “It's been helpful to see real life examples of ways to communicate better with my children. I have implemented and already seen an improvement in both my kids reactions and my feelings during difficult moments.” – parent, Greene County “…I definitely was trying to find just decent resources to help me with the children because they are a wide variety of ages. And more so for my youngest, my son, the four-year-old who's on the Autism spectrum. I'm always trying to find tools and strategies that fit with that.” For more information, check out the Ohio Triple P website. The Ohio Children’s Trust Fund’s (OCTF) mission is to prevent child abuse and neglect through investing in strong communities, healthy families, and safe children. Since its creation in 1984, OCTF has funded primary and secondary prevention strategies conducted at the local level in all 88 Ohio counties, in addition to initiatives and projects of statewide significance, all of which are designed to strengthen families and prevent child abuse and neglect. [i] Sanders, M., Higgins, D., & Prinz. R. (2018). A population approach to the prevention of child maltreatment. Family Matters, 100. Australian Institute of Family Studies. https://aifs.gov.au/sites/default/files/8_a_population_approach_to_the_prevention_of_child_maltreatment_0.p [ii] Prinz, R. (2019). A population approach to parenting support and prevention: The Triple P System. https://files.eric.ed.gov/fulltext/EJ1220068.pdf [iii] Doyle, F. L., Morawska, A., Higgins, D. J., Havighurst, S. S., Mazzucchelli, T. G., Toumbourou, J. W., ... & Sanders, M. R. (2022). Policies are needed to increase the reach and impact of evidence-based parenting supports: A call for a population-based approach to supporting parents, children, and families. Child Psychiatry & Human Development, 1-14. https://doi.org/10.1007/s10578-021-01309-0 [iv] Prinz, R. J., Sanders, M. R., Shapiro, C. J., Whitaker, D. J., & Lutzker, J. R. (2009). Population-based prevention of child maltreatment: The U.S. Triple P System population trial. Prevention Science, 10(1), 1-12.https://doi.org/10.1007/s11121-009-0123-3 [v] Sanders, M. R., Clague, D., Zajac, T., Baxter, J., Western, M., Chainey, C., Morawska, A., Tomazewski, W., Prinz, R. J., & Burke, K. (2024). Parenting, child maltreatment, and social disadvantage: A population-based implementation and evaluation of the Triple P system of evidence-based parenting support. manuscript submitted for publication. [vi] Wymbs, F. A., Cunningham, C. E., Chen, Y., Rimas, H. M., Deal, K., Waschbusch, D. A., & Pelham Jr, W. E. (2016). Examining parents’ preferences for group and individual parent training for children with ADHD symptoms. Journal of Clinical Child & Adolescent Psychology, 45(5), 614-631. https://doi.org/10.1080/15374416.2015.1004678 [vii] Metzler, C. W., Sanders, M. R., Rusby, J. C., & Crowley, R. N. (2012). Using consumer preference information to increase the reach and impact of media-based parenting interventions in a public health approach to parenting support. Behavior Therapy, 43(2), 257-270. https://doi.org/10.1016/j.beth.2011.05.004

By Caitlin Feasby, Statewide Coordinator, Ohio Infant-Toddler Court Team Follow Caitlin on LinkedIn Note: This statement, written by Caitlin Feasby, was read by Susan Ackerman before the Ohio House Behavioral Health Committee on Tuesday, April 23, 2024. A recording of this testimony may be viewed here. Chairwoman Pavliga, Vice Chair White, Ranking Member Brewer and members of the committee, my name is Caitlin Feasby and I am the Ohio Infant-Toddler Court Team and Policy Coordinator for Groundwork Ohio. As a master’s level social worker (MSW), trained mental health professional, and policy advocate on behalf of young children, I am pleased to have the opportunity to provide proponent testimony on House Bill 352 (HB352) to create a study committee on Adverse Childhood Experiences or ACEs. Groundwork Ohio is a statewide, nonpartisan advocacy organization that champions high-quality early learning and healthy development strategies from the prenatal period to age five that lay a strong foundation for Ohio kids, families, and communities. Our vision is to make Ohio the best place to be a young child so that all children have the opportunity to reach their full potential. Evidence is clear that the first few years of life are some of the most important for determining lifelong outcomes, as the most rapid period of brain development happens in the earliest years of life. With 80 percent of brain growth taking place by age 3 and 90 percent by age 5, a baby’s brain is forming more than a million neural connections every second. The development of Ohio’s youngest children is highly susceptible to influence from caregiving and environmental factors, where negative experiences can have just as much impact as positive ones. This creates an imperative that must be addressed. What happens in childhood has immense authority over the course of our lives. Children who grow up in safe and loving environments may experience advantages in physical health outcomes, cognitive and social skills, language and literacy, setting the stage for academic, social, emotional and cognitive success. Unfortunately, we know that not all children grow up under positive circumstances. Children exposed to adversity without the advantage of a safe, stable, and loving home are more likely to experience negative long-term effects. Adverse Childhood Experiences (ACEs) are potentially traumatic events that occur between the ages of 0-17 with potential to cause long-lasting negative effects. Exposure to ACEs can translate to increased problem behaviors across the lifespan, including excessive alcohol consumption, drug use, and violence victimization or perpetration. ACEs have health implications as well, including strong association with increased rates of cardiovascular disease, diabetes, cancer, and respiratory and liver diseases, and poorer mental health outcomes including increased rates of depression, anxiety, and higher risk of suicide. Children in Ohio are experiencing adversity at an alarming rate, as Ohio ranks near the bottom of all 50 states and D.C. for children having two or more adverse childhood experiences. Using a scale of 0-10 where exposure to an adverse event equates to 1-point, a score of 4 or more is considered clinically significant with greater risk of negative outcomes throughout the lifespan. By age 5, nearly 1 in 5 Ohio children have been exposed to two or more ACEs. While almost half of all children in the United States have experienced at least one ACE, a 2019 Ohio Medicaid Assessment Survey included in Groundwork Ohio’s Early Childhood Dashboard indicates nearly one in five Black and Hispanic/Latino children ages 0-5 were exposed to two or more ACEs, compared to one in six white children. This data tells us that some children are more likely to be left behind than others, and evidence suggests adversity differentially impacts vulnerable, marginalized, underrepresented, and at-risk people experiencing poverty, systemic racism, and other social factors. In 2018, our Early Childhood Race & Rural Equity Report illustrated how the color of your skin and where you live determine where you start in life, and often where you stay—children who start behind, stay behind. We must consider the broad range of environmental and systemic factors that prevent young children and families from succeeding by addressing issues like ACEs from a place of equity. The Health Policy Institute of Ohio’s 2021 Health Value Dashboard notes key findings that if ACEs were eliminated, more than $10 billion a year in healthcare spending could be saved in Ohio and $319 million in lost wages could be eliminated each year in our state. In addition to this: 36% of depression diagnosis are potentially preventable Smoking could be reduced by 33% The inability to afford care could be reduced by 25% Asthma could be 24% more preventable COPD could be 20% more preventable Heavy drinking could be reduced by 19% We know that no single solution or intervention is sufficient to meet the needs and challenges faced by young children and families that lead to adverse childhood experiences. We furthermore acknowledge that even among our state systems serving some of Ohio’s most vulnerable children, there is room for improvement. Children engaged in the child welfare system are experiencing significant trauma, and those engaged in this system during the earliest years of life are particularly vulnerable. In Ohio, 0-3 year olds make up 29% of all children in state custody. Through a partnership including Groundwork Ohio, the Educational Service Center of Northeast Ohio (ESCNEO), Case Western Reserve University, and the Children’s Defense Fund of Ohio, we seek to expand the Safe Babies approach to Infant-Toddler Court Teams to prioritize a holistic, trauma-informed solution to child welfare practice for infants, toddlers, and their families involved in the child welfare system. Child welfare practice changes for families involved with the Safe Babies program have created a pathway to improve child welfare outcomes by decreasing time in care with increased rates of permanency placement or reunification and fewer foster care placements. Every baby served by this program inherently has at least once ACE score due to the trauma of removal, and we know from talking with their families and the professionals wrapping services around them that unmet needs remain, including lack of access to infant-early childhood mental health care, lack of affordable housing, challenges with service coordination, and timeliness of and access to substance use treatment. Groundwork Ohio seeks to unravel and rebuild systems to apply early childhood brain science to policy and ensure our policies and investments are trauma-informed regardless of agency, service, program, or funding stream. While the statistics surrounding early childhood adversity are both staggering and daunting, there are strategies that have demonstrated efficacy in addressing ACEs if we shift our state culture to prioritize prevention through actions such as this study committee. I want to acknowledge the inclusion of two individuals with lived experience and one mental health professional serving children up to age five recommended by Groundwork Ohio, as essential members of the Adverse Childhood Experiences Study Committee alongside other uniquely qualified professionals. This study committee offers a unique opportunity for policy makers to connect the latest research and interventions to public policy with experts who bring a vast knowledge base to the table. This will allow the tenants of research to be embedded in the creation of laws and state programs and will increase the public’s knowledge of conditions caused by ACEs and bring attention to how trauma impacts disparate communities. Groundwork Ohio looks forward to being a partner to the ACEs Study Commission, we are pleased to see support for this proactive legislation and we ask for your support of the bill.

By: Lynanne Gutierrez, President, Groundwork Ohio Follow Lynanne on Twitter and LinkedIn Are you a family who’s struggling to pay the exorbitant cost of child care? Have you quit your job or decided not to work outside the home because you don’t have reliable, affordable child care? Is your business struggling to hire and keep workers because employees can’t find child care? We all pay when children don’t get the priority they need and deserve from state government. The fallout is tremendous and lasting, overwhelming parents and holding back our economy. Child care costs are crushing Ohio families — when they can find it. Ohio workers, on average, spend nearly $10 of every hour worked on child care expenses – and Ohio’s median income is $29 per hour. Infant care averages $11,438 annually. This reality is why we see so many “Help Wanted” signs. It’s why big and small businesses can’t hire and keep people on the job. But failing to invest in high-quality child care and early learning that allows families to work isn’t the only way we’re shortchanging young children. Nearly 65% of all Ohio children start kindergarten behind. If they don’t catch up quickly, they’ll likely stay behind, with learning gaps compounding year over year. They need early educators who are well-trained and fairly compensated so those workers can afford to stay in the profession. On the health front, almost 4 in 10 babies and toddlers from low-income families aren’t getting the necessary preventative care at well-visits. If we don’t intervene early when children have a health issue, the consequences can be life-long and limiting to their potential. Groundwork Ohio is committed to driving up investment in children, especially now, in the wake of the pandemic, which exposed the fragility of systems that support children. We’re helping build a movement that pushes young children to the top of our state’s political agenda, one that holds our leaders accountable for lifting up children and investing in their futures. With the support of families, businesses, and community leaders, we can change things for children. This focus is paying off. Ohio Gov. Mike DeWine’s recent State of the State address was all about what Ohio must do better to ensure children grow up to become healthy, well-educated members of society. We are grateful that he’s using his bully pulpit to advocate for children whose needs too often are overlooked. One of the most important things we at Groundwork Ohio do is create opportunities for the voices of adults who represent children to be heard by policymakers. Children don’t attend town halls or testify before lawmakers. And many of the parents, caregivers, child care providers, health care workers, and small business owners who see the challenges young children face every day cannot participate in the policy process. But we can. And we are doing just that. Over the next 90 days, we’re going on the road for a Listening Tour. We’ll be in 14 communities across the state where we’re inviting families and leaders to come together to share the changes they want, so Ohio can truly and accurately be the best place to be a young child. We hope to see you at one of the upcoming events. Come make your voice and your experiences heard! Learn more and register to attend online. Supporting our youngest children is an investment in them and in Ohio. As Gov. DeWine said in his recent address, “Kids have only one chance to grow up. So, we must have a great sense of urgency, as every moment we waste is a moment they lose.” We owe our youngest our best. As adults, we must speak up for them because they can't speak for themselves. It’s time to take action and hold Ohio leaders accountable.

By Troy Hunter, Director of Research, Evaluation, and Performance, Groundwork Ohio Follow Troy on Twitter and LinkedIn The RAPID Survey Project is a national initiative designed to gather information on the needs and well-being of children under six and the important adults in their lives. We're excited to collaborate with RAPID to implement an ongoing survey of families with young children right here in Ohio. We want to hear from you! If you have at least one child under the age of six, please take our brief, 15-minute survey here. Our objective with RAPID-Ohio is to provide actionable, relevant, and timely data about families' experiences to inform policymakers, advocates, the public, and participants themselves. Together, we will field surveys over the next two years to hear directly from parents on topics like economic security, early learning, maternal and child health, and child well-being, aiming to better understand and address their needs. We hope to engage at least 1,000 Ohio parents in the 15-minute survey available here. Each participant will receive a $5 gift card upon completing the survey, making it a rewarding experience for you as well. The survey will remain open through Thursday, May 2nd. Again, our goal is to reach 1,000 respondents, and we need your help!

By: Kezia Ofosu Atta, Policy Manager, Groundwork Ohio Follow Kezia on LinkedIn Too many Black moms and babies are dying from preventable causes Babies in Ohio bear a disproportionate burden of our failing care systems. In Ohio, infant mortality rates continue to be worse than the U.S. average at 6.9 infant deaths (under age 1) per 1,000 births. Mothers in Ohio also lack adequate access to prenatal care and support. This creates various maternal and infant health disparities across the state. Groundwork Ohio’s Early Childhood Dashboard showed Ohio’s maternal mortality rate in 2019 was 23.8 deaths per 100,000 births. In 2023, the March of Dimes’ Report Card for Ohio showed that 14.4% of birthing mothers in the state received care beginning in the fifth month or later or less than 50% of the appropriate number of visits for the infant’s gestational age. Additionally, nearly 1 in 4 pregnant moms don’t have access to prenatal care in their first trimester. These rates are worse for Black moms and children in Ohio. Black moms in Ohio deserve attention because of the health disparities they experience alongside their babies and families. Some examples: Racial disparities in infant and maternal mortality/morbidity persist regardless of maternal income or education level. Non-Hispanic Black women were more than 2.5 times as likely to die from pregnancy-related causes than non-Hispanic white women. From 2017-2018, excluding deaths due to overdose, the pregnancy-related mortality ratio for non-Hispanic Black individuals per 100,000 live births was 20.9 compared to 13.6 for non-Hispanic white women. Of all pregnancy-related deaths that occurred in Ohio from 2017-2018, 73% of deaths of non-Hispanic Black women were preventable. Ohio has a higher neonatal abstinence rate (11) than the U.S. average of 11 per 1,000 newborns. The infant mortality rate is 2.5 times greater for Black Ohioans than for white Ohioans. Key contributing factors that could have prevented maternal deaths include the provider, support person, or mother’s lack of knowledge or understanding of threats to the health of Black pregnant women. These threats include shortness of breath, which requires immediate care, or the impact of chronic stress due to racism. Raising awareness through Black Maternal Health Week In May 2023, Representatives Juanita Brent (D-Cleveland) and Andrea White (R-Kettering) introduced House Bill 190, which designates the week of April 11 to 17 as Black Maternal Health Week. The bill was created to raise awareness of Black maternal and infant care in Ohio. Since its passage in the Ohio House of Representatives in December 2023, more collaborations have been formed with agents of change to promote Black maternal and infant health. Sadly, HB 190 remains in the Ohio Senate Health Committee. Local communities up their efforts: Mama Certified Earlier this year in Southwest Ohio, Queens Village, Cradle Cincinnati, the Health Collaborative, Mercy Health, the Christ Hospital Health Network, TriHealth, and UC Health came together with bi3, Anthem, and CareSource to establish the Mama Certified website, a collective impact approach to maternal and infant health equity. This website provides visibility into the maternal and infant-related efforts of local hospital networks with a particular focus on better meeting the needs of Black and brown mothers. How it works Mama Certified places the choice of care in mothers' hands. On the website, moms can see rates of maternal, infant, staff, and community care of specific hospitals and whether the hospital is an ally, advocate, or leader in such care. Expectant mothers can also read equity-centered maternal care reports on each hospital which list their performance with a breakdown of their infant and maternal care rates. Each hospital certified by the website receives a grade level for each focus area through points earned from questions asked about their maternal and infant health initiatives. This unprecedented initiative brings inpatient voice into the care delivery process. It also ensures hospital staffs are better trained to support Black and brown mothers and committed to improving workforce diversity to better represent the patients they care for. Kiana Trabue, Vice President of Strategic Partnerships & Chief Program Officer for bi3 said: “Mama Certified is bringing competing health systems together, helping to build trust and transparency in the community by inspiring birthing health systems to work together. Mama Certified has the potential to put Greater Cincinnati at the forefront of positive maternal and infant health outcomes.” Cradle Cincinnati added: “Our local birthing hospitals’ commitment to transparency and their accountability to Black women is groundbreaking. We are deeply grateful for their willingness to work towards maternal health equity. In the end, we want women of all races and ethnicities to have joyful birthing experiences.” Furthermore, “looking back on those initial conversations with moms, it is incredible to see how that seed of an idea has grown into what Mama Certified is today.” The collective hopes that Mama Certified grows into a well-used resource across the state and that more hospitals join forces to meet their goals for Black mothers and infants in Ohio.