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By Troy Hunter, Director of Research, Evaluation, and Performance, Groundwork Ohio Follow Troy on LinkedIn In a world inundated with data and statistics, it's often the power of a compelling story that truly captivates our hearts and minds. Stories have the unique ability to provide context to facts and figures, connecting with our emotions and inspiring us to take action. Groundwork Ohio understands the transformative potential of storytelling in the realm of early childhood advocacy. This past Saturday, a group of dedicated fellows gathered for a storytelling workshop led by LORE, a storytelling organization committed to helping professionals use narratives to drive meaningful change. Storytelling and narratives are imperative to advancing early childhood advocacy and how these skills can prepare fellows to be change-makers in this vital space. The Early Childhood Leadership Fellowship Groundwork Ohio's Early Childhood Leadership Fellowship is an initiative that brings together leaders from various corners of the state, all united by a shared commitment to champion early childhood issues in policy. This fellowship program seeks to inspire change through a well-crafted curriculum that includes keynote speakers, online learning experiences, discussions with policymakers, networking opportunities, technical assistance, and small group projects. The goal is to equip these fellows with the knowledge and skills necessary to advocate effectively for infants, toddlers, families, and communities. The Power of Stories in Advocacy Advocacy is about more than just presenting data and making logical arguments. It's about creating a connection with your audience, moving them on an emotional level, and inspiring them to take action. This is where storytelling comes into play. Stories have the ability to humanize complex issues, making them relatable and accessible to a wider audience. When facts and figures fail to resonate, a well-told story can break down barriers. Stories can also provide context and depth to policy discussions. They offer real-life examples of the challenges and triumphs within the early childhood space, making it easier for policymakers and stakeholders to understand the impact of their decisions. As the saying goes, "People don't buy what you do; they buy why you do it." Stories help convey the "why" behind early childhood advocacy, making it more compelling and persuasive. The Expertise of LORE At the heart of Groundwork Ohio's storytelling workshop is LORE led by Bridget Flaherty. Bridget's background in information technology and business process may seem unconventional for a storytelling expert, but it's this unique combination that makes her exceptionally qualified to teach storytelling for business and advocacy. Bridget's journey into storytelling began when she stepped onto a stage and won a storytelling competition. She recognized that captivating stories could impact business success through effective leadership, marketing, increased sales, and clarified company culture. LORE, under Bridget's guidance, offers workshops, small group sessions, and one-on-one coaching for business professionals looking to harness the power of storytelling. Her curriculum is tailored to the needs of business and advocacy professionals, making storytelling a tangible and practical tool for driving change. Bringing Storytelling into the Fellowship Groundwork Ohio's Early Childhood Leadership Fellowship understands the importance of storytelling in advancing early childhood advocacy. The collaboration with LORE and Bridget Flaherty highlights the commitment to providing fellows with the best tools available to champion high-quality early learning and healthy development for Ohio's children and families. Xiara, a 2022 fellow, demonstrates the power of a story here: Hearing the stories of our leadership fellows was captivating. Hearing the “Why” behind what they do is inspiring. Our fellows are motivated by influential family members who went before them, Parents who fought for what their child needs, and resilient children that deserve more than what Ohio has provided them. Fellows will use the power of these stories to be catalysts for change in our states. Groundwork Ohio is committed to providing data-informed policy initiatives and it is stories like these that breathe life into the facts. Over the next few months, fellows will continue fine-tuning their stories, preparing their personal narratives for wherever they might be used, be it the stage, their workplaces, or policymakers’ offices. We have no doubt they’ll be ready.

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.”[1] 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”.[2] 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.[3] 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)”. [4] 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. [1] https://www.columbus.gov/celebrate-one/Healthy-Beginnings-At-Home-Policy-Brief/ [2] https://www.columbus.gov/celebrate-one/Healthy-Beginnings-At-Home-Policy-Brief/#:~:text=Housing%20instability%20during%20pregnancy%20increases,acute%20and%20chronic%20health%20conditions. [3] 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 [4] Ibid., 4

By Troy Hunter, Director of Research, Evaluation, and Performance, Groundwork Ohio Follow Troy on LinkedIn Quality preschool education in a child's early years shapes their future success. However, in Ohio, there's still a pressing need to improve access to high-quality preschool programs. The state of preschool in Ohio shows that despite some progress, many children in the state lack the enriching experiences that quality preschool education provides. Inattentiveness to the importance of preschool could jeopardize opportunities for thousands of vulnerable children, emphasizing the need for continued advocacy and support. Inequities in access persist among different communities and it is Ohio’s most vulnerable children that are disproportionately impacted. Public-private preschool partnerships provide potential solutions to champion quality preschool experiences. The State of Preschool in Ohio While there have been significant strides, there remains a pressing need for improved access to high-quality preschool programs. Many children across the state still lack the opportunity to benefit from the enriching experiences that quality preschool education provides. Only 37.9 percent of students in 2021-2022 demonstrated kindergarten readiness. Ohio also saw a decrease in children on track for literacy. Recent developments in Ohio include the expansion of existing early childhood education grants. This expansion signifies a step in the right direction, as it opens more spots to serve preschool-aged children, helping them gain the foundation they need to thrive academically and socially. Barriers for Preschoolers However, as we celebrate increased investment, we must also address the threats gathering at the national level. Proposed cuts to Head Start and Early Head Start programs threaten to strip Ohio of thousands of slots for vulnerable children. This potential loss highlights the need for continued advocacy and support to protect these vital programs. In Cuyahoga County, hiring challenges have led to the heartbreaking closure of 23 Head Start classrooms. This serves as a reminder that we are far from achieving equitable access across the state. More than 500 children lost access to quality early childhood experiences that impact long-term outcomes and opportunities. With a national attack on Head Start and Early Head Start through proposed budget cuts of $750 million in FY24, it is important that we strengthen the infrastructure supporting our youngest learners. If Ohio does not invest, then it is children of color and children living in poverty that will be the most impacted. Access and Equity Disparities in preschool access persist in Ohio, reinforcing the need to emphasize that every child, regardless of their background, deserves an equal opportunity to excel. It is important that we talk about equity when looking at preschool across the state, as partnerships can play a critical role in elevating the issue and address the barriers where populations of children have limited access. As we discuss how to support all preschoolers in Ohio, we must emphasize the ALL. “Strategic partnerships are important to ensure there is equitable access to preschool. Using an equity lens matters in the ongoing work to provide a solid foundation for all preschoolers. A commitment to equity is essential to building partnerships that bring early childhood education to the forefront and provide access for all preschoolers.” -Chara Fisher Jackson, Cincinnati Preschool Promise Public-Private Preschool Partnerships As we confront these challenges head-on, public-private preschool partnerships emerge as a promising avenue for progress. Successful partnerships have a positive impact on preschool education. Collaborative efforts between public and private entities can help ensure that more children benefit from quality preschool experiences. “Our country is behind in its investment in early childhood education. We are extremely fortunate in Montgomery County to have private foundations that have invested for many years, as well as public leaders who put a stake in the ground by dedicating public dollars to make sure our children can attend high-quality preschool. The combination of private and public dollars has funded our early childhood initiative since the beginning, and it continues to help us address the needs of families and early childhood providers. The local funding allows us to fill in gaps where public funding falls short.” -Robyn Lightcap, Preschool Promise The state of preschool education in Ohio is a mix of progress and persistent challenges. Our children's futures are at stake, and the earlier we act the higher the return on investment we see, which benefits both Ohio’s children and its economy. If you would like to learn more about how public-private preschool partnerships are helping to bridge the gap to serve children, Groundwork Ohio is hosting a free webinar Wednesday, September 13th from 2:30-3:30 pm. This webinar will feature innovative initiatives from across the state working to increase access and support preschoolers, with a special update from the Ohio Department of Education. Join Preschool Promise, Cincinnati Preschool Promise, PRE4CLE, Invest in Children, and Hope Toledo as they discuss ways we can use partnerships in Ohio to address barriers and increase accessibility. Take action today and register for this webinar. Let's ensure that every child in Ohio has equitable access to quality preschool education, setting them on a path to lifelong success. Our children deserve nothing less, and they are counting on us to secure an opportunistic future.

Each month, Groundwork Ohio reads the latest and greatest resources on early education and health from a wide variety of sources. Below is a compilation of the most important articles we have read throughout August 2023. OHIO NEWS Gov. DeWine launches ReadOhio initiative to improve literacy Governor DeWine Announces More Ohio Children Will Have Access to High-Quality Preschool Education High infant mortality rates in Franklin County bringing more focus to racial disparities Life worrisome at the edge of Ohio's benefit cliff Most Franklin County children aren't ready for kindergarten. What needs to change? New Cuyahoga County, city of Cleveland task force combats youth mental health care shortage New federal rule could cut child care costs, boost access for low-income Ohio families: Rethinking Child Care Ohio child care providers press Intel to help families thrive Risk of death related to pregnancy and childbirth more than doubled between 1999 and 2019 in the US Staffing shortage has child care centers turning away families What impact are racial disparities having on Ohio economy? NATIONAL NEWS CNBC Majority of parents spend 20% or more of household income on child care, report finds CNN America’s child care crisis is about to get a lot worse Early Learning Nation Child Care is Now Free for Some Families–Which Raises Some Questions! EdSurge ‘God Forbid I Have to Move Again’: One Home-Based Child Care Provider’s Experience With Housing FFYF Bipartisan Bill Seeks to Leverage Existing Tax Credits to Support Working Parents and Employers in Accessing Child Care Forbes Why The Child Care Crisis Is Actually An Economic Crisis NPR The FDA approves the first pill specifically intended to treat postpartum depression NWLC Early Educators’ Wage Growth Lagged Behind Other Low-Paid Occupations, Jeopardizing the Supply of Child Care As Relief Dollars Expire Politico ‘A crying need for kids’: Federal child care aid dwindles The 19th Child care has been silently crushing women farmers for generations. That may change soon. Wall Street Journal Why Child-Care Prices Are Rising at Nearly Twice the Overall Inflation Rate Yahoo News Working moms feel the summer strain. Why a lack of child care options hit women hard

By Fawn Gadel, Ohio START Director During National Recovery Month in September, we take time to recognize people who successfully found recovery from substance use disorder (SUD), promote promising recovery practices, and ask others to join us in our recovery work. At Ohio START (Sobriety, Treatment and Reducing Trauma), our teams celebrate recovery all year long through our tireless work with parents struggling with SUD and child maltreatment. Ohio START has assisted more than one thousand families in their journey toward recovery during the last six years, and there is still so much work to do! While you may not have heard as much about it lately, the addiction epidemic is still plaguing Ohio, with overdose deaths continuing to be too high; we are especially concerned with the sharp rise in overdose deaths of African Americans. Implementing START The Public Children Services Association of Ohio (PCSAO) partnered with the State of Ohio in 2017 to implement Ohio START. We began in 17 counties and have since expanded to 53, with the intent of spreading the model statewide. The START model, which originated in Cuyahoga County in the 1990s, provides wraparound services to families who come to the attention of children services due to parental substance use. Ohio START teams work closely with all members of the family to help parents quickly get into treatment to achieve long-term recovery, ensure child safety and well-being, connect all family members with services to help them heal from past trauma, and work tirelessly to keep the family together when it is safe to do so. That means keeping young children at home with family rather than placing them in foster care. We approach substance use disorders with compassion, understanding, and hope for recovery. Ohio START is one of five child welfare prevention services being implemented to prevent Ohio children from entering foster care, aiming to keep kids in their homes or with kin. The START model is approved as a prevention service for families who have at least one child under age 6 in the home. Focusing on families with young children allows the START teams to engage early in the child’s life so that parents can fully and actively participate in the child’s upbringing. We have witnessed many families who previously lost permanent custody of older children achieve recovery through START and go on to parent a newly born child safely and successfully. In Kentucky, evaluators found mothers who participated in START achieved sobriety at nearly twice the rate of mothers treated without START (66% vs. 37%*). Children in families served by START were half as likely to be placed in state custody compared to children in a matched control group (21% vs. 42%). Ohio expects to see similar results through our ongoing evaluation conducted by The Ohio State University School of Social Work. Family Peer Mentors One key member of the Ohio START team is the family peer mentor, a person in long-term recovery with personal experience with children services. Peers partner with START caseworkers to jointly serve START families. Peers help connect parents to recovery services, introduce them to sober living resources, and most importantly serve as an example that recovery and a happy, healthy life are possible after SUD. START family peer mentors serve as a living example that recovery is possible, not only for other families but for children service caseworkers and the community at large. One of the biggest benefits communities experience with START is a reduction in stigma around SUD, and our peers are responsible for a large part of that. Seeing our peers out in the community – in court with their clients, accompanying parents to doctor appointments, sponsoring recovery events – shows everyone that success and second chances are possible. It also helps the public understand that SUD is a brain disease and that people who suffer from SUD should be treated the same as people who suffer from other diseases. Especially in small communities where people have known their peers from childhood, they demonstrate that it is never too late to seek recovery -- and we should never give up on our loved ones. We have come a long way in reducing the stigma around SUD and in changing attitudes around parenting while in recovery. As one START parent stated, “My experience, it was amazing. It was a blessing. I never realized how many people was in my corner until I actually started this program. … They really, really saved my life in a lot of ways.” This month, I hope we all take time to find ways to support people in recovery from SUD, believe that recovery is possible, and work to save as many lives as possible. To learn more about Ohio START, visit us online or reach out via email. *Huebner, R. A., Willauer, T., & Posze, L. (2012). The impact of sobriety treatment and recovery teams (START) on family outcomes. Families in Society: The Journal of Contemporary Social Services, 93(3), 196-203.

By Caitlin Feasby, Statewide Coordinator, Ohio Infant-Toddler Court Team Follow Caitlin on LinkedIn In recognition of September being Child Welfare Workforce Development Month, hosted by the National Child Welfare Workforce Institute (NCWWI), we’re recognizing the achievements of child welfare professionals in acknowledgment of their professional expertise. Throughout the month, we will be sharing information and resources to raise awareness of the needs of the child welfare workforce and amplify appreciation for their service. Ohio’s child welfare system is not a single entity, but encompasses a myriad of professionals and services whose top priority is to strengthen families and keep children safe. Many families first interact with the child welfare system following a report of suspected child abuse or neglect. While this is often the extent of the general public’s understanding of the child welfare system, the system more accurately represents a wide continuum of services including resource provision, prevention services, support programming, and service coordination to name a few. Taking a Moment to Recognize a Highly Skilled Workforce in Crisis This service continuum is staffed by professionals whose work is often under-recognized. According to the National Association of Social Workers, child welfare workers are often subject to: low salaries, high caseloads, limited supervision, insufficient training, heavy administrative burden, and physical and psychological safety risks. Together, these factors create the foundation for a highly complex landscape that makes a difficult job even more challenging. The nature of child welfare work demands an intricate balance of critical thinking skills, sound judgement, and rapid yet calculated responses to endless high-stress situations. This level of demand is difficult to maintain long-term, and nearly impossible without adequate support. According to research done by The Ohio State University/PCSAO and the Quality Improvement Center for Workforce Development: 63% of case workers and agency staff report feeling moderate-to-high levels of work stress. 53% of Ohio’s children’s services workforce experience levels of secondary traumatic stress (STS) that meet the threshold for a formal PTSD diagnosis. 61% of ongoing caseworkers have caseloads exceeding the recommended level, forcing many to work overtime. These statistics represent a tenuous relationship between child welfare work, personal well-being, and work/life balance. The challenges noted above fuel the child welfare workforce crisis by prompting a revolving door of workforce turnover. In 2018, the median employment tenure for CPS workers was 1.8 years, and just 2 years for the child welfare workforce overall. The numbers tell the story. Turnover points to the stability of a workforce and the health of the system housing it. Unbridled turnover in the child welfare sector has severe financial consequences, as the continuous recruitment and replacement of personnel costs between $10,000 - $50,000 per vacancy. With each new vacancy, the workload becomes heavier for those who remain, as workers absorb additional cases and responsibilities to maintain the service continuum. Greater demand leads to elevated rates of burnout and compassion fatigue, further spurring turnover. Most importantly, an endless cycle of empty desks and new workers minimizes the child welfare workforce’s ability to conduct successful, family-centered services. In the context of child safety and family support, there is no margin for error caused by systemic deficiencies. Taking a Moment to Recognize the Impact This ripple effect has tangible, life-altering consequences. Families bear the most significant burden of the concerns plaguing the child welfare workforce. Research indicates that workforce instability results in poorer outcomes for child safety and permanency, results in fewer family visits, and lessens the likelihood of reunification. Placement instability and sporadic family visits are linked to numerous negative implications on a child’s well-being, including disruptions in physical, cognitive, and social development, increased probability of attachment disorders, and negative effects on behavioral well-being across the lifespan. Workforce issues do not exist in a vacuum. The very children we aim to protect are harmed by the structural shortcomings of the child welfare system. Supporting the Workforce In January 2023, Governor DeWine said: “Our future is bright - but that future will be defined by how well we educate all our children and how we tear down the barriers to their success. . . . [This] budget … focuses on our people, on our families, and on our children, for they are Ohio’s greatest asset.” At Groundwork Ohio, we fervently hold this same belief. This month, we uplift those on the frontlines who work every day to support Ohio families and keep children safe, recognizing the effort and care provided by the child welfare workforce, despite inherent challenges. How will you take a moment? Resources The Workforce Development Framework Workforce County Toolkit Five Steps to a Stronger Child Welfare Workforce

By Beth Hess, Managing Director, Policy Follow Beth on Twitter and LinkedIn The federal government is attempting to respond to the child care crisis impacting families in Ohio and across the country. The Federal Administration for Children and Families announced in July a proposed rule designed to lower child care costs, increase families’ child care options, improve child care provider payment rates and practices, and make enrollment easier and faster. The proposed rule offers many improvements to the publicly funded child care system including: Capping co-payments for families at 7%. Providing more flexibility to states in waiving co-payments for families meeting certain criteria. Requiring states to provide more responsive consumer education. Presuming family eligibility for three months. Building child care supply through requiring states to guarantee child care slots in selected programs using grants and contracts. Allowing child care providers to collect the full state payment rate, regardless of what they can charge private pay families. Aligning state payment processes to the private pay market (for example, paying providers on enrollment instead of by attendance). The policy improvements included in the proposed rule reflect positive steps forward that child care advocates have been vocal about for many years. These policy improvements also align with several of the recommendations of the final report from Ohio’s Legislative Study Committee on Publicly Funded Child Care and Step Up to Quality. In response to the Notice of Proposed Rulemaking, Groundwork Ohio partnered with child care stakeholders to offer insights into how the proposed rules will benefit Ohio. Additionally, Groundwork’s comments addressed the financial hurdles Ohio will face to implement these new rules, requesting additional funds to meet the new expectations. Read Groundwork’s full public comment here.

By Christina Rodriguez, Executive Director, Mom’s House of Toledo Mom's House strives to break the cycles of poverty and welfare. It is our mission to guide at-risk single parents through the process of achieving educational goals and provide tools and resources needed to become effective parents. Mom’s House serves young, low-income, at-risk, single parents and their children by helping to build strong generations in the Toledo area. With intervention and support, the young parents have set and attained lifetime educational goals and the ability to break the cycle of poverty for themselves and their children. Some clients are the first in their families to graduate from high school or the first to even consider going to college. Mom’s House offers a Family Wellness Education Program and Early Childhood Education Program, which includes an array of different services. Mom’s House Family Wellness Education Program The Mom’s House Family Wellness Education Program is a critical component to breaking the cycle of poverty, at-risk behaviors, and cycles of abuse in the lives of our young families through addressing the root causes of poverty. By providing an exemplary model of individualized family support services and education, clients are empowered to become self-sufficient and less likely to have a repeat unplanned pregnancy and continued dependence on the welfare system. Mom’s House stands out because of one essential component: the HEARTWORK. It is essential to provide additional supportive services to at-risk, single parents and their families that ultimately work to reduce statistics and change mindsets. Early Childhood Education Program The Mom’s House Early Childhood Education Program has been awarded Five Stars, the highest recognition by the State of Ohio’s Step Up to Quality Initiative. Lucas County statistics show that children who come from broken or at-risk families who lack the funds, support, and understanding necessary to provide proper care and education development for their child, so critical in the early stages of development, remain at-risk for the rest of their lives. The children of young mothers are less prepared to enter the school system and score lower on measures of school readiness compared to the children of older mothers. In fact, the children of teen mothers score lower on assessments of cognition, knowledge, and language development compared to the children of older mothers. The goal of the Early Childhood Education Program is to help the children develop to their fullest capability, setting them on a path for long-term success. Mom’s House proudly brags that 96% of children leaving their program are Kindergarten-ready. The comprehensive program not only offers formal early childhood support in the classroom, but also helps educate the moms so that learning can extend into the home environment as well. Unfortunately, Mom’s House continues to have a waiting list. The need for these services is at an all-time high as the board of directors continues to strive for growth. The two-generation program has shattered statistics and broken barriers for hundreds of families in Toledo. Learn more about Mom’s House.

By: Kezia Ofosu Atta, Policy Assistant, Groundwork Ohio Follow Kezia on LinkedIn August marks National Breastfeeding Month, an aspect of parenting that has occurred for centuries. Many factors prevalent through society and time have contributed to families meeting the nutritional needs of their children in various other ways, including dealing with physical health barriers, workforce issues, and other challenges out of their control. Thus, breastfeeding has become a privilege for a lot of mothers and children. It is important for us to advocate for breastfeeding and put systems in place to make things better while also highlighting different types of barriers to breastfeeding and raise awareness that breastfeeding is a choice. Benefits of Breastfeeding for Mothers and Children Breastfeeding is a natural and nourishing experience that helps parents and children bond. On its face, babies receive many benefits from breastfeeding such as nutritional nourishment that leads to brain and body development, secure attachment to the mother that positively influences the child’s mental health, and important cognitive and emotional development that results from the bond of breastfeeding. It is important to highlight that if a parent does not breastfeed, that does not mean their child will not be set up to succeed or face negative outcomes. In Positive Effect of Breastfeeding on Child Development, Anxiety, and Postpartum Depression, researchers found that “Postpartum mothers with low risk of Postpartum depression breastfed their children more often than mothers with a mild or severe risk of perinatal depression.” Breastfeeding can be considered a “protective factor for postpartum mood swings,” contributing to the health benefits for the mother and child. Health and Social Difficulties that Discourage Breastfeeding Many women face societal pressure regarding how they decide to feed their children. Some women are plagued with external pressure for either breastfeeding too long into their child’s development or too little into their child’s development. Researchers found that “breastfeeding and non-breastfeeding women may experience judgment and condemnation in interactions with health professionals as well as within community contexts, leading to feelings of failure, inadequacy, and isolation.” Although breastfeeding is a natural act, mothers have been socialized to see it as a brave act, often negatively affecting mothers who face actual health issues that prevent them from being able to breastfeed. Children can thrive whether breastfed or formula-fed. Systems should be put in place that encourage women to breastfeed if they can, but women should not be forced to breastfeed if it places a heavy burden on their health, career, and wellness. Breastfeeding in the Workplace Returning to work and various levels of work flexibility and policy can have a tremendous impact on breastfeeding. In a study conducted on 715 employed mothers, 90.1% of mothers who were on maternity leave from shift work breastfed. This remarkable percentage decreased to 21.5% after returning to work for one-to-six months and further decreased to 17.9% after more than six months in the workforce. Additionally, workers with non-traditional hours breastfed at a rate of 87.6% during maternity leave, 24.1% for the first six months after returning to work, then actually increased to 34.6% after six months of returning to work. Systems in place at workplaces can affect a working mother’s ability to breastfeed. In a recent study conducted at a female labor-intensive electronics manufacturing firm in Taiwan, researchers found that when workplaces establish a dedicated breastfeeding room, it “encourages and increases the rate of continued breastfeeding.” Recent developments have also been made in labor laws. One is the PUMP Act, signed by President Biden in December of 2022. This act enables “more nursing employees the right to receive break time to pump and a private place to pump at work.” It is also an improvement to the already amended provision in the Fair Labor Standards Act, which permits “employers to provide a reasonable break time for an employee to express breastmilk for their nursing child for one year after the child’s birth each time such employee need to express milk.” Although the breastfeeding provision in the Fair Labor Standards Act and the PUMP Act are both vast legal improvements, they do not guarantee milk expression at the workplace for women who choose to breastfeed their children past a year. Even when difficulties are met in workplaces, women still face barriers to breastfeeding outside their homes and when feeding in public places. Women are often criticized for openly breastfeeding in public places as the act has been sexualized and mothers are forced to cater to people’s feelings about public breastfeeding to make others comfortable. In Shame if you do-shame if you don’t: women’s experiences of infant feeding, researchers recounted stories of women’s experiences with breastfeeding where one woman said, “I didn’t do it (public breastfeeding). I was more concerned with people looking and thinking why is she doing that in public she shouldn’t be there, she should be doing that somewhere behind doors, inside in privacy.” Various health challenges can also decrease or prevent breastfeeding. These include mastitis, trauma, traumatic birth, PCOS, and hypoplastic breast tissue. It should be widely acknowledged in breastfeeding advocacy that some mothers may be unable to breastfeed due to health and other socio-emotional reasons, and they should not be pressured. Looking Forward Although various improvements have taken place including an increase in available public and workplace breastfeeding areas, more advocacy for open breastfeeding, and an increase in breastfeeding educational opportunities and resources, more work must be done. We hope that in the coming years, breastfeeding and its awareness will be available for all women and expectant individuals, leading to knowledge, comfortability, and a sense of pride when people make decisions about their choice to breastfeed.

As part of our “Get to Know Groundwork” series, we've been spotlighting members of our amazing team. This week, we’re getting to know Margo Arnold, who joined Groundwork Ohio in August of 2023 as part of the Center for Family Voice team. In this role, Margo will coordinate for the Center to elevate the voices of families with young children in early childhood policy and advocacy to achieve programmatic, policy, and practice changes at local, regional, and state levels. Prior to joining Groundwork Ohio, Margo spent the past decade working in civic and community engagement at various Central Ohio non-profits including Mental Health America of Ohio, New Salem Baptist Church, and Asian American Community Services. Margo is a proud graduate of Columbus City Schools, as well as The Ohio State University, where she earned a Bachelor of Arts in Public Affairs with a specialization in Community Organization and Civic Engagement. Margo is an AmeriCorps Alumna and most recently managed the AmeriCorps Seniors, a Senior Companion Program through Catholic Social Services. Check out our Q&A with Margo to learn more about why she’s a passionate advocate for young children and families in Ohio. Q: What drew you to early childhood policy research and advocacy? Tell us more about your “why." A: Throughout my life, making a difference has always been an important value. With ever-increasing disparities in the world, there is a present need to make a difference in the lives of society's most vulnerable. In many cases, education is the barrier to progress. So, the journey of educating and empowering families through the Center for Family Voice is vital in bringing about community transformation. Q: What’s the best piece of advice you’ve received or a lesson learned that has helped you in this work? A: The power of persistence is one lesson that I’ve carried throughout my career. Whether it is a lack of capacity or budgetary constraints, nonprofits and families face many barriers that hinder progress. Yet, often these obstacles shrink in the face of collaboration. Through unity and collaboration, we can gain the courage to persist and ultimately to overcome. Q: What is a motivating word for you in 2023? A: My word for 2023 is FREEDOM. Our freedom helps us to free others, so I am intentional about addressing whatever doesn’t allow me to live freely. Q: When you aren’t advocating on behalf of young children and families, what do you enjoy doing? A: On an intentionally lazy Saturday, you’ll find me napping, journaling at the park, or trying out new recipes or restaurants. Q: Describe a scene from your vision of the future for Ohio’s youngest children and their caregivers. A: My future vision is simply for adequate resources for those who need it. I envision ongoing wraparound support for parents before and after they birth children in hospitals or their homes. I see consistent support for families who homeschool or send their children out to school, as well as clarity for families to know which resources and leaders to connect with for their individual and community needs. Connect with Margo on LinkedIn or by Email.

By Caitlin Feasby, Statewide Coordinator, Ohio Infant-Toddler Court Team Follow Caitlin on LinkedIn Ohio ranks 46th in the nation for children having three or more Adverse Childhood Experiences (ACEs). Although common, ACEs are not inevitable. As one of a three-part policy brief and resource page, the Health Policy Institute of Ohio’s (HPIO) most recent publication offers insight into the ways state policymakers and local-level partners can strategically reduce the long-term individual and societal impact of ACEs in Ohio. Our proactive response promotes healthier and happier children while drastically improving outcomes across their lifespan, helping Ohio become the best place to be a child and raise a family. The Impact of ACEs in Ohio Early life experiences associated with safe and stable housing, and responsive, nurturing caregivers help an infant to form strong attachments and develop a sense of safety and belonging. As a baby matures into childhood, those strong foundations carve a path for healthy development in domains such as physical health, cognitive and social skills, language, and literacy. For children without a strong foundation or for those exposed to certain traumas during vital developmental years, negative impacts on physical health, mental health, and poorer educational outcomes emerge as barriers throughout childhood and into adulthood. A well-balanced structure between an infant’s environment, consistent caregivers, and enriching experiences is the ideal, but not the reality for many of Ohio’s children. ACEs are potentially traumatic events that occur between the ages of 0-17. Using a simple questionnaire, adverse experiences fall under four primary categories (included in the picture to the left) in which exposure to an adverse experience equates to one point. A score of 4+ on a scale of 0-10 is considered clinically significant with greater risk of negative outcomes throughout the lifespan of a child. By age 5, nearly 1 in 5 Ohio children have been exposed to two or more ACEs. The scope of this issue is enormous. While some individual factors can influence ACE scores, more complex issues such as poverty, poor educational outcomes, and social/environmental factors are the most blatant contributors and point to colossal systemic barriers outside individual control. Deep racial inequities in housing access, poverty, and the gross over-representation of Black and other POC in child welfare and criminal justice systems substantially increase the likelihood of ACEs in children of color. Groundwork Ohio published a factsheet noting that while 40% of white children have at least one ACE, 51% of Hispanic children and 61% of Black children have at least one ACE. What happens in childhood has immense authority over the course of our lives. A 2017 meta-analysis shows higher ACE scores can translate to increased problem behaviors across the lifespan, including excessive alcohol consumption, drug use, and violence victimization or perpetration. ACEs have physical health implications as well, and a high ACE score is strongly associated with cardiovascular disease, diabetes, cancer, and respiratory and liver diseases, and are closely associated with poor mental health outcomes including increased rates of depression, anxiety, and higher risk of suicide. The data is clear: ACEs result in lower life satisfaction scores and shorter life expectancies. They have a deleterious impact on individual, community, and state levels and come at a significant cost to state infrastructure and individual out-of-pocket expenses. If exposure to ACEs were eliminated, an estimated $10 billion in annual healthcare spending could be avoided along with more than $4.5 billion in annual spending to treat depression attributed to ACEs exposure. A Systematic Approach to Change Although this data is alarming, there is a corrective path forward and many meaningful solutions are already available throughout Ohio. HPIO recommends 12 key strategies to prevent and mitigate the impacts of ACEs, ranging from trauma-informed care to family income supports. While some strategies are costly to implement, the individuals and communities most at risk of ACEs exposure are worthy of our investment. Using a cost-benefit ratio, HPIO explains the up-front cost of financial investment in these strategies is outweighed by substantial social benefit returns. Any strategy with an estimated cost-benefit greater than $1 demonstrates meaningful social benefit. For example, by expanding the Ohio Earned Income Tax Credit to 30%, the cost-benefit ratio is $1.75. Comparatively, Dating Matters, a comprehensive teen dating violence prevention program, has a cost-benefit ratio of $34.90. For more information on the cost-benefit analysis of HPIO’s 12 key strategies, click here. Building Skills and Strengthening Connections to Caring Adults HPIO’s most recent brief expands on strategies that build skills and strengthen connections to caring adults. By focusing on skills enhancement, parents and youth are better able to manage stress in the face of everyday challenges. These skills training programs offer a benefit to children and their caregivers by strengthening relationships, increasing caregivers’ understanding of child development, and promoting healthy behavioral management. Skills training has been shown to effectively reduce the cycle of generational trauma, promoting healthier relationships across the lifespan, and lessening ACEs exposure. School-based Violence, Bullying, and Intimate Partner Violence Prevention Programs Online and school-based bullying, sexual dating violence, and physical fights impact millions of children each year. School-based intimate partner violence prevention programs aim to curb exposure to violence by promoting healthy relationship development through education and skills training. Dating Matters is one such program available in Ohio and has illustrated effectiveness in promoting healthy relationships while enhancing awareness of unhealthy relationships. Evidence shows Dating Matters is successful in reducing incidents of sexual violence perpetration and victimization, bullying, cyberbullying, and physical violence. School-based Social and Emotional Instruction These programs focus on teaching life skills and emotional and behavioral management to navigate challenging situations. Skills such as cultivating healthy relationships, understanding and managing stress, and making good decisions are shown to increase positive social interactions and demonstrate positive results in education performance, employment outcomes, and overall life satisfaction. While Ohio law does not require teaching these skills in K-12 education, funding is available to Ohio schools to invest in a variety of wellness activities, which can include teaching life skills and emotional and behavioral management, early childhood mental health initiatives, and substance use prevention to name a few. Although not required, 81% of Ohio schools offered prevention-focused programming during the 2020-2021 school year. Mentoring Programs Finally, mentoring programs are designed to match youth with volunteers to develop supportive relationships and promote the child’s personal growth. Mentoring relationships have been shown to reduce delinquent behavior, aggression, and drug use for youth who are at risk. An array of mentoring programs are available in Ohio, including Big Brothers Big Sisters of America and MENTOR. Although there is no state funding available for mentoring programs, federal grant funding is available to expand these services and increase accessibility to mentorship. A Challenge Worth Taking Each of these strategies comes with a unique set of strengths and challenges. For example, Dating Matters is most effective when the curriculum is tailored to the needs of individual communities while making the program engaging and personal for students. HPIO notes funding constraints are an implementation barrier for parents and caregivers to receive family skills training, school-based social and emotional instruction programs, and mentoring programs. Workforce shortages create an additional barrier for all but volunteer mentoring programs. Exciting efforts to expand Ohio’s capacity to provide improved care are happening every day. In addition to the programs and strategies outlined by the HPIO’s ACEs series, Groundwork Ohio is also dedicated to ACEs reduction strategies and is housing the statewide expansion of the Safe Babies approach for Ohio Infant-Toddler Court Teams. The Safe Babies approach is designed to improve child welfare outcomes for children ages 0-3 and their families by employing a holistic and family-centered approach. By enhancing oversight and interdisciplinary problem-solving, expediting effective services, providing trauma-responsive support, and prioritizing continuous quality improvement, Safe Babies is a revolutionary approach to child welfare for system-involved children and families who rely on our state systems to work well. To continue following these conversations: Stay informed on the HPIO’s continued work on ACEs prevention strategies and learn how you can advocate to policymakers. Read more about the Safe Babies approach Follow Groundwork Ohio for developing information on the Safe Babies approach and its expansion in Ohio.

By Stephanie Geneseo and Ashley Wellman, All Nestled Inn, Family Child Care Center An Initiative of All Nestled Inn, Family Child care Center, Chesapeake, Ohio What is the ANI Initiative and how did it begin? Advocating for the Need of Inclusion in Early Childhood Environments, or ANI, was born out of the recognition of the immediate need for placement not only for quality child care, but care in general for children of differing needs in southern Ohio. We had enrolled in and were accepted to represent the state of Ohio for the inaugural cohort of the National Association of Family Child Care's (NAFCC) Leaders Shaping Leaders initiative. This initiative is a dynamic in-person and virtual learning series that includes 30 sessions of interactive education and networking. It also included 15 teams of NAFCC leaders and emerging leaders who would participate in a year-long professional development journey uniquely designed for Family Child Care (FCC) providers to strengthen personal and civic leadership, advocacy skills, entrepreneurship, and business sustainability all grounded in NAFCC values and commitments. Within Leaders Shaping Leaders, we were encouraged to look for a civic need within our community and to build a community project to truly make change surrounding it. While other teams took to developing associations and podcasts, we knew of a locally established, well-qualified family child care center that chose not to reopen following the government shutdowns of the pandemic and who happened to be the only local FCC that openly qualified to work with children with special needs. We also felt this loss as we would accept phone calls daily from families looking for placement for their children. They would cry, as they would be so used to hearing "no" as soon as they volunteer the information that their child may have autism, an intellectual/developmental disability, or simply require interventions such as speech therapy, applied behavioral analysis, occupational therapy, physical therapy, or other services. Many of these families were simply exhausted, both physically and emotionally. We saw a need for this care in our community and designed the ANI initiative in a few phases: Establish All Nestled Inn FCC as a fully inclusive environment. This required an entire system of documentation to be developed, staff to be trained (continuously), and an invitation extended to all community partners (i.e., OT, PT, SP, IT...) into ANI to complete sessions within the inclusive environment. 2. Expand reach to teach other FCCs and child care centers to implement inclusive environments utilizing the ANI system of design. We have now seen our services expanded: Consultation services are now offered. A full training curriculum has been rendered. We’re taking part in speaking sessions at national conferences: At the 2022 NAFCC National Conference in San Francisco, we were able to introduce our initiative to the nation among partners, funders, peers, vendors, and attendees alike. At the 2023 NAFCC National Conference in Atlanta, we were able to partner with the National Parent Leadership Institute as a sponsor who asked us to present our curriculum and teach interactive session attendees the ANI system design, and emphasize Why Inclusion Matters, as well as how to make their environments truly inclusive. We offered the session bilingually and attendees from all over the nation, along with a few from Liberia and Mexico, attended our class. 4. Upcoming speaking sessions include the OAEYC Conference in Ohio in 2024 and the 2024 MFCN Conference in Montana. We at ANI believe no child should be considered optional when they had no option, and we will advocate as such. About the Authors Stephanie Geneseo has been in business for 30+ years and has degrees in Child Development and Organizational Leadership. Ashley Wellman, while newer to the field of child care, has brought a wealth of knowledge and experience to the field after spending eight years in adult intellectual/developmental disabilities and/or autism, and two years with children in sexual trauma as well as foster care. Ashley earned her M.Ed. in Counseling & Human Development, as well as her MBA. In addition, she has now worked with Stephanie at All Nestled Inn FCC formally for three years. About All Nestled Inn, FCC All Nestled Inn, FCC, now regularly holds at capacity, with a running waitlist, and is known in the community and abroad as the go-to for families who are interested in an inclusive environment for their children or need assistance with their child with differing abilities. The general demographic of All Nestled Inn is 4-6:13 who have some sort of differing ability or require a specialized service. For more information, please contact All Nestled Inn, FCC.