Allegheny County, PA, home to the “City of Bridges,” has built a reputation of bridging services and entities that serve birthing people, children from birth to age 3, and their families. For the last decade, leaders across government and the nonprofit sector have bridged gaps between maternal child health systems, early learning systems, basic needs providers, and child welfare prevention. These leaders have (1) developed relationships, (2) braided and blended funding, (3) collected data, and (4) been held accountable by the community—especially Black and brown families. These four steps have allowed local leaders to address complex problems like rising maternal mortality, systemic racism, child abuse prevention, reducing adverse childhood experiences, and access to quality early learning programs.

The Allegheny County PN-3 Collaborative (The Collaborative) is made up of three Allegheny County government agencies—Department of Human Services, Health Department, and Department of Children Initiatives—and three nonprofit organizations that hold contracts with some of these government agencies—Trying Together (early childhood); Healthy Start Inc., Pittsburgh (maternal child health); and The Alliance for Infants and Toddlers (early intervention). When individual members of The Collaborative found themselves interacting on different initiatives multiple times a month, they began to imagine not just successful projects but entire community systems that benefit children and families. Bolstered by data collection and evaluation from local government and universities, The Collaborative began to grow financial investments (government and philanthropic) in infants and toddlers by demonstrating that its approach, programs, and interventions have a meaningful impact.

The Collaborative pursued multiple efforts to create a comprehensive and integrated approach to support the needs of Allegheny’s birthing people, infants, toddlers, and their families: 

1. The Allegheny County Health Department’s research concluded that Black infants were almost four times more likely than white infants to die before their first birthday—a disparity greater than that seen at the national level. In response, the Health Department collaborated with Healthy Start to develop the BEST Allegheny Initiative and the Healthy Baby Zone. Healthy Start also created a Community Health Advocate Training Program to equip the community with knowledge and skills, and led the community to develop the BIRTH Plan, which uplifted the voices of community members in addressing the racial disparities in maternal and infant mortality.
2. Simultaneously, Allegheny County Department of Human Services analyzed its programs, including the Family Centers that are funded by child welfare prevention dollars and state Office of Child Development and Early Learning Family Support grants. The centers are run by community partners, and most offer center-based programming and home visiting services. From 2017 to 2018, the county worked to create a coordinated home visiting referral system to refer families to the multiple home visiting models the county oversees. This initiative attempted to create bridges behind the scenes while maintaining multiple entry points for families seeking services.
3. Meanwhile, Trying Together obtained state and local data about the lack of high-quality child care, and launched Start Strong PA in 2019 to advocate for federal and state investments in child care. At the same time an opportunity opened to create an Early Learning Resource Center to implement the state’s child care quality rating and improvement system and oversee subsidy applications. Trying Together partnered with The Alliance for Infants and Toddlers and Allegheny County Department of Human Services to win the state contract. The contract required the Early Learning Resource Center to help families apply for subsidized child care and for providers to participate in the quality rating and improvement system. But Allegheny County took the center a step further. Everyone who interacted with the center—from families seeking child care to child care providers who received payments through the center—received connections to other resources such as home visiting, early intervention services, nutrition programs, health care, and housing or basic needs assistance.
4. From 2018 to 2020, Allegheny County Department of Human Services engaged a community advisory board in the conceptualization and development of a comprehensive network of supports called Hello Baby. The Hello Baby network offers universal support to all families. Through community referrals and a predictive risk model, Hello Baby also provides proactive outreach to some families and more intensive services to families with the greatest need. This program was piloted in late 2020 and implemented countywide in 2021. A family council continues to provide feedback and engage families who receive services through the network.

Throughout these efforts to coordinate services, The Collaborative was willing to pilot new initiatives quickly, receive feedback, and adjust its approach before scaling implementation. The Collaborative learned several valuable lessons as the members created an integrated support system for families with young children:

1. Identify situations where relevant service providers, government and nonprofit officials, and other key community leaders already gather and collaborate and the projects and funding streams that bring them together.
   The Collaborative developed a network of shared power where no one organization or service dominated the group. As a result, relationships between organizations grew, which fostered trust across partners inside and outside of county government.
2. Identify the funding streams that support individual services for birthing people, children, and families, and where flexibility exists in how to use the funds.
   There are myriad funding streams in Allegheny County. Early learning partners created a map of the funding streams that support early childhood services in the county and maternal child health partners are working on a similar concept. The county continues to find opportunities to expand services by leveraging all available federal and state funds, local government funding streams, and philanthropic funding.
3. Identify where to find key data about children and families.
   In Allegheny County, partners and the public have access to large sets of data about families thanks to the Allegheny County Data Warehouse. The warehouse, which has existed since 2000, integrates data from across county departments, the 43 school districts, and the state departments of Human Services and Education.
4. Determine how program providers seek and receive community feedback and incorporate it into their service delivery.
   Remaining connected to the day-to-day impact of the county’s efforts to serve infants, toddlers, and families—especially Black families and other marginalized groups—is a priority for all partners that support the county’s prenatal to 3 efforts.

The Collaborative is encouraged by the progress it has made to develop comprehensive supports that provide multiple entry points for families with young children, from the prenatal stage to age 3. While there still is more work ahead to increase investments and access for families in need, The Collaborative is proud of its learnings and excited to share them with other communities.

This blog was written by Lissa Geiger Shulman on behalf of The Allegheny County PN-3 Collaborative, which includes      

• Allegheny County Department of Human Services; 
• Allegheny County Health Department;
• Allegheny County Department of Children Initiatives;
• Trying Together;
• Healthy Start Inc., Pittsburgh; and
• The Alliance for Infants and Toddlers.

If you would like to learn more about Allegheny County’s efforts to support prenatal to 3 services, contact Shulman at [email protected].