February 2020Vol. 21, No. 1Hello Baby: Expanding Primary Prevention in Allegheny County

Written by Marc Cherna, director, Allegheny County Department of Human Services

For more than 20 years, the Allegheny County (PA) Department of Human Services (DHS) has spent hundreds of millions of dollars on preventing child maltreatment through strategies such as family support centers; conferencing and teaming; the Allegheny Family Screening Tool; child care and early intervention; Head Start; home visiting; out-of-school programs; community and natural supports; and community collaboratives and joint endeavors, such as the behavioral health/child welfare community of practice. In Allegheny County (which includes Pittsburgh, PA) and other jurisdictions, however, infants and young children continue to be at the greatest risk of harm caused by serious abuse and neglect. Indeed, from 2009 through 2019, almost 80 percent of children in Allegheny County who suffered fatalities associated with child abuse and neglect were under the age of 3. Furthermore, in half of all events in which a child was seriously injured or died as a result of abuse and/or neglect, the child had not been identified as vulnerable and/or in need of protection by community members or professionals. Therefore, no allegation of maltreatment had ever been made to child protective services. Unfortunately, this means that there had been no opportunity to reach out to the family to intervene before the tragedy occurred.

In an effort to prevent serious abuse and neglect, DHS is set to launch Hello Baby, a tiered primary prevention strategy that combines universal, geographic, and intensive targeted strategies with the best of what we know about analytics to strengthen families; improve children's outcomes; and maximize child and family well-being, safety, and security. DHS will reach out to every Allegheny County family with a newborn to offer a variety of supports tailored to their varied needs and interests. In the first year, Hello Baby will be piloted in a limited geographic area.

Hello Baby's strategy is supported by the use of integrated data and a predictive risk model used to stratify families into the three tiers. Universal supports, the first tier, are available to all families, regardless of need, and include the Hello Baby warmline, available 24 hours a day, 7 days a week; the Hello Baby website (for information and to connect families directly to other services available in Allegheny County); and other available community resources for parents, such as NurturePA, a texting service staffed by trained volunteers who can answer questions related to parenting a baby.

The second tier, which connects families to family support centers (FSCs) and other services in their neighborhood, builds upon the findings of an evaluation conducted by the Center for State Child Welfare Data at Chapin Hall that indicate the presence of an FSC in a neighborhood is associated with lower maltreatment investigation rates. The key to this promising finding is getting the right families connected to the rich variety of services available at their nearest FSC. To that end, outreach workers will make home visits to families with new babies living near one of Allegheny County's 28 FSCs in an effort to engage them and encourage their continued involvement with the nearest FSC.

The third tier, intensive and targeted strategies, is available to families with higher and/or more complex needs, who will be offered the support of a team consisting of a family engagement specialist and a social worker. That team will work to engage families, learn about their needs, and work with them to develop an individual plan of wraparound services that they may utilize for up to 3 years. Examples of the types of assistance available include concrete goods (e.g., diapers, formula, food), transportation, eviction prevention, and connections to community resources (e.g., evidence-based parenting programs, behavioral health treatment, child care, emergency housing). To provide these services, DHS has partnered with Healthy Start Pittsburgh.

Hello Baby is a program of DHS's Office of Community Services and is not connected with child protective services. It is a voluntary program intended to build upon the robust set of services and supports that already exist for Allegheny County families. Hello Baby was developed through an extensive process that included research, community and stakeholder engagement, and two ethical analyses by experts in the field of child welfare and the use of data for decision-making. It builds upon DHS's earlier work in predictive analytics, developed in partnership with researchers at the Centre for Social Data Analytics at the Auckland University of Technology in New Zealand. Among the stakeholders involved in the development and review of the model were social workers; local, national, and international child development experts (including pediatricians, developmental psychologists, and academics); local service providers and peer-support agencies; families, including fathers, who are often underrepresented in family-strengthening efforts; judges and children's advocacy agencies; the Allegheny County Health Department; the United Way; local funders; and civil liberty, civil rights, and social justice advocacy organizations.

Hello Baby was developed and will be implemented and evaluated with support from the Children's Bureau (through a Community Collaborations to Strengthen and Preserve Families grant) as well as state and foundation funding. Through Hello Baby, DHS will reach more families who can benefit from support, better match families and babies to the right services, and ensure that the most vulnerable families and babies have access to the best supports Allegheny County can offer.