BUILD Initiative Blog | NCIT State Spotlight: Ohio
Strong Foundations For Our Youngest Children

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This State Spotlight features Ready, Set, Soar through an interview with Lynanne Gutierrez (Wolf), Esq., Policy Director & Legal Counsel from Groundwork Ohio.

The Capacity-Building Hub, an effort of the National Collaborative for Infants & Toddlers (NCIT), offers consultation and support to assist Pritzker Children’s Initiative-funded state and community leaders and their coalitions to make the provision of PN-3 opportunities and services more equitable. The goal, by 2023, is to help states and communities reduce by 25 percent the gap between the children and families served by high-quality programs and the children and families who want the services but don’t have access to them. The Hub aims, by 2025, to help states and communities decrease the gap by 50 percent. The Hub will progressively grow its efforts to increase the knowledge of all state and community leaders by sharing promising strategies and resources other states are successfully using to improve maternal health, birth outcomes, and infant-toddler well-being. 

The State and Community Spotlight is an ongoing opportunity to share the work happening at the state or community level and foster connections between grantees.


BUILD: What big prenatal-to-three goals are you focused on in Ohio?

Lynanne: 
I think that you would find us to be aligned with the Pritzker Children's Initiative in terms of our policy focus. We’ve defined three buckets of policy through our initial planning which occurred in the first six months of 2019. This consensus agenda has been adopted by our growing PN-3 coalition-drive effort, Ready, Set, Soar Ohio. Our “Countdown to Success for Kids” ensures that kids are “Ready to Thrive”—which includes access to timely and comprehensive prenatal care; high-quality healthcare through Medicaid and CHIP programs for pregnant women, infants and toddlers; early identification and treatment including developmental screenings and early intervention services; reducing the incidence and impact of trauma among infants and toddlers; and protecting infants and toddlers from lead hazards where they live and learn. Our Countdown also is focuses on “Setting Families Up For Success”—this includes empowering parents of infants and toddlers by increasing access to voluntary evidence-based home visiting services; stabilizing families so that there are fewer infants and toddlers engaged in the foster care system; and fostering economic stability for families with infants and toddlers. Our Countdown’s third focus is “Soaring to Kindergarten—and Beyond”—this includes expanding access to quality child care for infants and toddlers through expanded eligibility; ensuring access to high-quality learning environments; expanding access to high-quality preschool for three-year- olds; and supporting a quality early education workforce to support the development of infants and toddlers. 

BUILD: Has there been any adjustment or change to these goals in relation to the pandemic?


Lynanne: 
Yes, of course. Since March, we had really been responding day to day or week to week, trying to do the next right thing for young children and families. As I understand many of the states have experienced, child care has occupied so much of the early childhood advocacy soundtrack during this time. While we have embraced that, especially since it’s the largest child-serving program in our state other than Medicaid, we have to continue to challenge that and ourselves to ask “where are the babies and what is their experience?” As we have pivoted to a recovery mindset over the summer, or rather a normalizing of the chaos of both state policy development and our workload, we have laid out a process to update our policy agenda goals. This has included re-engaging our planning committee, our broader coalition of over 90 coalition members and a broad scan to ensure that our policy agenda reflects the needs of pregnant women, infants, and toddlers both in light of the pandemic and as we engage in the racial justice movement and act on integrating equity deeper into our work. We are identifying both new barriers and opportunities to innovate. I anticipate that upon a re-launch of Ready, Set, Soar Ohio this September, our public-facing priorities will not change dramatically, certainly the way we measure success and the tactics we engage to push progress will need to adapt.

BUILD: What about challenges? What are your primary challenges in achieving any of the goals that you've mentioned?


Lynanne: 
COVID-19 has challenged every system serving pregnant women, infants, and toddlers. Before COVD-19, we were challenged with defining the unique PN-3 space, as opposed to our organization’s broader focus on prenatal to five, and making that specific case for our youngest children. But where the attention is stretched across every system serving all people, I think it becomes increasingly difficult to single out pregnant women, infants, and toddlers. 

For example, looking at child care as a system that has gotten a relative amount of advocacy attention, even in the midst of this pandemic, we're struggling to get age-specific data to understand capacity loss at large, but also capacity loss specific to infants and toddlers. So that is certainly a challenge to even begin to disaggregate data in this moment to quantify the impact of the pandemic and understand what's happening for babies that may be different for older children. Layering race and ethnicity on top of age is that much more difficult.

Another clear example of this challenge in terms of putting attention on PN-3 policy in the COVID-19 context is that many of our state government partners, who typically are focused on young children or children of all ages, have been pulled away to assume other COVID-19 related work within their respective departments. They are all strapped for capacity and balancing different priorities.

For example, when we first talked to the Department of Medicaid, the Bureau Chief who's over all the child-serving policy initiatives in the Department of Medicaid, for the first couple of months of COVID, she really hadn't thought a lot about kids. Not because she's not interested or committed to children,  and not because it wasn't a priority of the Administration before but, quite frankly, they were all required to work on immediate nursing home, long-term care, hospital capacity, telehealth, etc. So, where you have institutional knowledge, they've sometimes been pulled for capacity to different issues that are more urgent in this pandemic. The same goes for the Department of Health. Our Maternal and Child Health Bureau Chief just moved into that position. But the staff who was overseeing all of our home visiting work, because she is such a great leader, has been pulled up to have a more direct COVID response role within our Department of Health.

So it's not extreme to the point that these programs are falling by the wayside, but we do have serious concern just about the capacity to focus on this specific population, given that so much of the attention has been pulled away from kids, because kids have, in many ways, been relegated to “spreaders” of the virus. The focus has been on adults and the behavior of adults. And early childhood advocates were always trying to fight against the presumption that we should make decisions based upon the adult's behavior versus what's in the best interest of children. And I think that that is a challenge now, more than ever.

BUILD: Of course, COVID has added even more challenges to the list than you already had. What pre-COVID challenges that continue to exist as well?


Lynnanne: 
I think from a policy perspective, we were positioned fairly well prior to COVID-19. We have a really strong governor in terms of his agenda for young children - in home visiting, child care, health, and infant mental health. Our legislature always posed a tough political puzzle to solve but the executive leadership we have is second to none considering Republican governors across the nation. We expect that to continue, but there is no denying COVID-19 will redefine what looks like for Governor DeWine’s kids agenda, just as it does ours.

I think the tactical challenge pre-COVID, and even more so now, is getting and holding the attention of outside stakeholders - folks who aren't early childhood experts, providers, or educators, or child advocates - to be for our agenda. And not just to be for it in principle, but to lend their voice to advance our agenda and to also experiment or invest their own resources in the agenda, whether it's as a local policymaker in their local communities, or as a business leader in their own business practices. It has been always a challenge to get these allies to understand why PN-3 policy investments are so critical to their work and to actually act on this understanding. This challenge has certainly become worse because now we are competing with the reality that every industry, every business, and local policy maker is struggling to wade through this pandemic. And everything, every system, is on fire. So even for those who view this as a priority, their capacity is spread thin by the present crisis.

BUILD: Tell us about your stakeholders. Who makes up your coalition, including at the leadership level?


Lynanne: 
I continue to learn how different states have organized their coalition-driven efforts, but here in Ohio, Groundwork Ohio is the Pritzker-funded entity and serves as the state lead and coalition manager. That is a role with which we are comfortable and for which we have a  strong track record of experience. In fact we had previous success in part due to the support of the Pritzker Family Foundation in our Vote for Ohio Kids gubernatorial-focused public-awareness initiative to ensure that, whoever was Ohio’s next governor as a result of the 2018 election, he or she had a platform for young children. That was a predecessor to our focused prenatal-to-three work. Our coalition membership includes early learning stakeholders from child care, home visiting, mental health, resource and referral, child welfare, including state associations, local collaboratives, and individual programs. We have health stakeholders including the Ohio AAP, the Ohio Children’s Hospital Association, and infant mortality collaboratives. Ohio has five major metro areas in addition to a 32-county rural Appalachian region. So it was important for us to have real geographic diversity in terms of our coalition partners. We have many local stakeholders that have a focus on early childhood, and some have a specific focus on birth to three. We also have coalition partners that reflect key target audiences, including local policymakers such as the County Commission Association of Ohio. In addition to partners in the rural region, we have broader health and human services partners including policy, advocacy, research organizations in addition to K-12 partners and associations. We currently have over 90 organizational partners as of our public launch of Ready, Set, Soar Ohio at the end of February. We look forward to a re-launch this fall where we hope to build deeper relationships with current partners and build out new partner relationships including those who have equity and racial justice at the forefront of their mission.

BUILD: What about parents?

Lynanne: 
I can honestly say that we are not satisfied with our level of parent engagement, both as an organization and in terms of this coalition. This is an area of opportunity. We have many coalition partners who directly serve parents and engage parents in their decision-making process but because, in part, we don’t provide any direct care, we are naturally removed from parents. One of our main learnings from our focus on equity over the past couple of years has further confirmed our need to engage parents more deeply and center parents and families in our policy development and advocacy work. We don't have a cohesive infrastructure of parental engagement, either for policy development or advocacy, in the state. We are currently working with another funder to help leverage all our policy and advocacy initiatives, including our Ready, Set, Soar Ohio campaign, and our ongoing equity work to build out organizational capacity and our state capacity for parent engagement in policy and advocacy development. We have accelerated this work because of the COVID-19 crisis.

There is a common recognition among state and community early childhood advocates, leaders, and even those in state government that, despite the deeply personal work we do, we have failed to seriously commit the time and capacity to building out a parental engagement infrastructure. Given the devastation of the pandemic, the economic recession is impacting all public and private systems and industries simultaneously. While it will continue to be critically important, we cannot continue to only move forward with current advocacy strategy focused on community stakeholders, early childhood providers, business leaders, and local policymakers to influence statewide policy. In fact, in consideration of our child care system as an example at this time, and the natural position of the industry versus child advocates, even with deeper relationships with providers, we cannot build an objective and strong demand for quality child care without parent and family voices. 
Perhaps most obvious, beyond the rational need to elevate statewide early childhood advocacy, is the hypocrisy of continuing a genuine commitment to equity without listening more intently to the voices and experience of families, especially black families. Upon further reflection of the current racial justice movement, we are resolved to serve as an ally to families of color who are too often excluded form vital conversation that impact their own health, education, and well-being.


While we anticipated parent-focused work in Groundwork’s future, specifically in building a parent cohort to our existing 
Early Childhood Leadership Fellowship, we are intentionally accelerating this commitment as we have identified why parent voice is important now more than ever. We cannot continue to tolerate the failure to do so or the excuse to delay because of the inherent challenges in the work. We must begin to invest and experiment in a statewide infrastructure of family voice for early childhood in consideration of Ohio’s unique political and geographic landscape. If we never begin, we will never get there.

BUILD: How are you supporting families of infants and toddlers and pregnant women who face significant barriers to supports and services?

Lynanne: 
I shared that our Vote for Ohio Kids initiative was the predecessor to us leading the Ready, Set, Soar coalition and being engaged in this specific prenatal-to-three work. Another critical body of work that ran in tandem with that initiative was a very intentional commitment to advancing a conversation about early childhood equity. What started as a “project” has really begun to be integrated into everything we do and we're building upon our progress. The work began with the publishing of the Ohio Early Childhood Race and Rural Equity Report which included 26 metrics across the life span from prenatal care to postsecondary attainment disaggregated by race and geography. Our goal was to tell a more complete story of what it meant to be a young child in Ohio and how both race and geography impact or determine this story. 

So I guess my first answer to your question is that this report and body of work was a genuine recognition of disparities or inequities in our PN-3 systems and a commitment to measuring these disparities and advancing an equity dialogue with state policymakers. We discovered very quickly, based on our data requests, that race and geography were not something that state agencies and other stakeholders were considering and, for far too long, our state and many advocates were comfortable using poverty as a proxy for race. Since the report was published, we have taken the better part of two years traveling the state and getting feedback from local communities, stakeholders, and policymakers. We are excited to share our learnings in a follow-up report, Drafting a New Blueprint for Success, to be released at the beginning of September 2020, with key recommendations and commitments that our organization is making as a result of our learnings. One of those is to focus our policy and advocacy on PN-3 work—to start earlier and close gaps where they begin. Equity is a guiding principle of our Ready, Set, Soar Ohio coalition-driven effort and we continue to challenge ourselves to practice and act on this principle often and invite our coalition members to challenge each other to do the same.

I already shared about our renewed or accelerated commitment to engaging parents and centering parents and families in our policy and advocacy work. And, we have committed to disaggregating data, through the Pritzker-funded work, to measure success for populations of infants and toddlers and pregnant women based on race, but also on geography. For example, one of the things we did when we launched our coalition was to release state- and county-specific baseline data on key PN-3 metrics. In the past we have just been able to regionalize data. More specificity with data is another commitment we have made in recognition of the barriers that Ohio’s pregnant women, infants, and toddlers face.

As part of our policy agenda evaluation and re-launch planning, we have been engaging our partners on how we can be even more intentional with our commitment to equity. We've done internal training among our advisory team and invited our coalition members to do implicit bias training. That's a one-off, but we've been trying to also align our internal organization so that we can better do this external work.

We have also taken on a separately funded commitment that leverages our PN-3 work, which is not just to focus on the children in the room, but on the adults that are serving them. We'll have a report coming out soon on the early childhood workforce - an initial look at our data and trying to understand what equity means in terms of the adults that are serving our youngest children.

Also, building upon the foundation of our understanding of the barriers of pregnant women, infants, and toddlers and our commitment to equity, we have engaged more deeply in policy that explicitly recognizes race and racism as determinative to outcomes for children and families. In response to the brutal murder of George Floyd, we shared an organizational response from our staff in the form of resolutions. Since then, in acting on these resolutions, we've provided testimony before the Ohio Senate in support of SCR14, a resolution that would declare racism a public health crisis in the state of Ohio. We are planning on engaging our Ready, Set, Soar coalition more deeply in supporting this resolution along with its federal companion legislation which has Ohio Senator Sherrod Brown as a primary sponsor. Most of our large cities have had a similar local resolution. We were also asked to provide testimonyto the Minority Strike Force created by Governor DeWine to provide recommendations in response to the fact that the virus is disproportionately impacting people of color. Our testimony was provided to inform their final recommendations which also are anticipated to include much broader recommendations focused on health equity.

We’re currently working with Marie St. Fleur, our fearless NCIT Hub Lead, and the NCIT/BUILD team to support a learning opportunity for Ohio early childhood professionals to support an anti-racism dialogue in the early childhood field in our state—we are trying to support our collective understanding of why racial justice work is “in our lane.” Based upon our experience across the state in introducing an equity dialogue by leading with the data, we find that, not unlike many communities, the early childhood community needs a common language and a framework for understanding racism. This introductory response to this need includes a webinar and a survey that coincides with it to identify what people's needs are beyond this first step so we can act on those needs alongside our partners. We are being as thoughtful and courageous as we can and doing a lot of listening. I hope we can continue to learn from and take our next steps with support from the leaders at the NCIT Hub and other states to support equitable outcomes for young children and their families. It’s the most important work we’ll ever do.

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