PHOTO: SHUTTERSTOCK

Every year, an average of 13,000 babies are born in Allegheny County. The county’s Department of Human Services wants parents to know that it’s okay to ask for help.

“The reality is that parenting is hard for everyone and that everyone can use support,” says Amy Malen, assistant deputy director in DHS’ Office of Community Services. Allegheny County has a wealth of governmental, community and faith-based human services organizations, “but that can make it hard. ‘What do I Google? Which one of these do I trust? Where do I go?’”

To bridge parents and resources, DHS created Hello Baby, a tiered, voluntary prevention and family strengthening program that launched in 2020. Hello Baby is offered to all families with a baby born in Allegheny County’s birthing hospitals.

Hello Baby is unique among similar programs in that it uses a predictive risk model (PRM) to identify families with complex needs. If parents don’t opt out, the PRM weighs 59 universal data points (though many are inherently linked to racial and socioeconomic inequities) to determine the potential risk of the child being removed into foster care by their third birthday.

Malen says they chose an opt-out system because “very few people opt in to an opt-in mechanism. It’s not that people are choosing not to opt in, it’s that people aren’t reading the thing that says you have to check this box” to express interest.

Program engagement is voluntary and can be stopped at any time. Universal services include the Hello Baby website, a “warm line” through the United Way of Southwestern Pennsylvania’s 211 phone number, and texting support through NurturePA. Families with moderate needs are contacted by a neighborhood Family Center. Families with the most complex needs will be offered Hello Baby Priority, a program of Healthy Start, for more intensive care coordination services. Community providers can also make referrals. Across the three tiers, DHS hopes to offer more involved support to more than 3,000 families annually.

Denise Hill, family growth and child development director of the Urban League of Pittsburgh — which oversees three Family Centers in Duquesne, Northview Heights, and East Hills — says, “Whatever mom’s needs might be, we can offer some sort of assistance. If not directly from the center, [then] we can refer.”

Allegheny County, in partnership with 11 organizations, hosts 27 neighborhood-specific centers that provide programming and resource assistance to nearly 6,000 children and their families each year. They connect with community services such as the diaper bank, and each center has a driver to help parents attend medical visits or job interviews. The six centers affiliated with Children’s Hospital have on-site registered nurses.

“We try to be a combination of things,” says Hill. “You may not have a great, essential need, but you may just want to get together with some other moms.” Networking through play groups and family fun nights is a long-standing function of the centers. Centers are also an avenue for families to receive home-visiting services using the Parents as Teachers curriculum, which strengthens parenting through the lens of child development. Evidence shows that services inside the home increase protective factors against neglect and abuse.

While Hello Baby is not part of the county’s Children, Youth and Families department, DHS estimates that 40% of families with complex needs will already be CYF active and can choose to combine services. DHS states that declining Hello Baby will not affect open CYF cases. (An ethical review did express concern that parents might feel pressured to participate anyway.)

Healthy Start also utilizes home visiting for the approximately 650 families they serve each year. Families with complex needs are more likely to be experiencing economic insecurities, substance use and mental health disorders. Using the Camden Coalition’s COACH Model, parents are paired with an experienced social worker and a peer support specialist for up to three years.

Jada Shirriel, CEO of Healthy Start Pittsburgh, is proactive with parents’ concerns about the program, knowing distrust of government or government-seeming services can exist due to “the disproportionate representation of Black families who come into the child welfare system because of biases and racism.” Healthy Start has the explicit goal “to make sure that we are not harming families and to make sure that we are contributing as a resource in the community.”

Healthy Start hires people who reflect the communities in which they serve. “There’s another kind of dimension of effectiveness, I think, when your passion comes from a place of having perhaps been in that situation or coming from a similar background,” says Shirriel.

Fatherhood Coordinator Rick Cobbs’ connection to marginalized communities goes deeper than his job: “I live in those communities, I grew up in those communities … those communities are my badge of honor.” Cobbs grew up in the Hill District and, like his dad, was an involved father. “My children were with me everywhere I went,” he says.

His role is part of a deliberate inclusion of fathers. Shirriel says, “It’s important that we don’t lose the males in the process because a lot of times what happens is they’re not served or we attempt to serve them as an afterthought.”

For all of Hello Baby’s potential for good, the initiative is not without criticisms. “You don’t need a giant algorithm sweeping up people’s data,” says Richard Wexler, Executive Director of the National Coalition for Child Protection Reform.

Wexler wrote in his organization’s blog about his concern that “there is no institutional safeguard in place” to keep DHS from deciding to use the score in child welfare in the future. “When might that be?” he writes. “How about the first time there’s a child abuse tragedy and word leaks out that the family had been labeled ‘high risk?’”

Malen says, “I think families have reason to be cynical of some of these sorts of programs, not just in Allegheny County but around the country.” The onus for a successful program is on the county and community providers. To get the word out, DHS is partnering with prominent organizations such as Brown Mamas.

Family Centers and Healthy Start have the advantage of 24 and 30 years, respectively, of serving families. “We’ve been around long enough now that we’re generational,” says Hill. She wants all parents “to know that we’re here, that they don’t have to be isolated … We’re going to help you, and you’re not going to walk away empty-handed if we can help it.”