Policymaker and Practitioner Perspectives: Insights from Ohio: An Interview with Dr. Wendy Grove and Jennifer Vargo

I wondered if you could begin by talking with us about some of the highlights of your approach in Ohio?

Since around 2016, we have had a monthly meeting with the early childhood leads across six child-serving state agencies, including the departments of Health, Job and Family Services, Education, Mental Health and Addiction Services, and Developmental Disabilities. It also has included the governor’s office staff overseeing children’s initiatives or issues. We use that two-hour meeting once a month to collaborate, coordinate, communicate—just to make sure that we are taking a systems approach to the kinds of initiatives that we are investing in, the kinds of things that we’re putting in our budgets, and how we are communicating and engaging parents along the way. This year, we added the Department of Youth Services because we were very birth-to-five-focused, and we have expanded that upwards a bit now. We also have Ohio Family and Children First and a few others who are engaged in the work.

And what are some of the topics or things that you work on together?

One of the things that we are currently working on is talking about how best to utilize data. We have spent some time identifying some of those high-interest data metrics for data dashboards. We’re a locally controlled state, so data by county is always a big interest. Bold Beginning, for example, is a web page that has all child-serving state agencies contributing to the content, which links back to our original home pages. It’s a one-stop shop of all our service information for families as well as early educators and childcare staff.

In our office, we have programs that support the whole child. We administer policies, programs, services, supports, and funding that support the whole child, including mental health, physical health, school safety, family-community engagement, attendance, student well-being, and positive behavioral interventions and supports. We also have our vulnerable youth supports for students who are justice-involved, military- connected, in the foster care system, English learners, and experiencing homelessness. We connect a variety of different ways with our sister agencies, our child- and family-serving agencies. I’ll highlight two.

We have a very strong relationship with the Ohio Department of Mental Health and Addiction Services. We also have a very strong relationship with the Ohio Department of Public Safety. Collectively as three agencies, we have come together and created a comprehensive framework for school safety, which includes physical and emotional safety for children and staff in schools. So that’s some of the work that we do. And we look at the system of the school in terms of what kinds of supports and resources could be grant funded collectively to address emotional safety as well as physical safety. With the Department of Mental Health and Addiction Services, we have been focused on prevention education. We work very closely together on providing mental health prevention through treatment support to schools through federal grants or funding provided through our state legislature. On a biweekly basis, we meet to talk about how we can strengthen the implementation and partnerships between local ADAMH (Alcohol, Drug, and Mental Health) boards and school districts.

The other thing is our Whole Child Framework and Whole Child Advisory Group. The advisory group consists of members from all different roles in the school system, from teachers to student support professionals to superintendents. We also have representation from all child-serving state agencies. Collectively we created Ohio’s Whole Child Framework. We’ve been meeting quarterly to discuss implementation and created an implementation plan. We have a Whole Child Network that includes individuals from education, local child-serving agencies, and parents who come together monthly to really learn best-practice models for setting up whole-child supports for schools. We have superintendents who share the various ways they are connecting social services to students and families within the school and community.

For example, Wickliffe City Schools in northeast Ohio has in their family resource center a variety of different supports. They have physical health supports where they partner with a local health care provider and are doing wellness checks. They have mental health supports from a providing agency that works with their schools. They have WIC (Women, Infants, and Children), which is also co-located so families can get their WIC services. They have a food pantry, a clothing pantry, and a clothing store. All these resources are brought in from the community to support families as kind of a one-stop shop. And that is just one example.

What has helped you do this work that you’re doing right now?

I think Ohio has a long history of collaboration, honestly. All agencies are engaged. If there is a need identified, one agency reaches out to the other agencies to figure out how to build the system. I think there is a lot of conversation right now about how we can have our data systems connect so when we are implementing something collectively—a service for a student or for a family—we know that it actually is working. State agencies are collectively working together to support the whole person.

I think we have grown in the past 10 years, particularly in elevating learning from lived experiences and families’ voices. When I started in this realm about 16 years ago, not many people talked about that; it was the exception rather than the norm. And I have found that through the work of things like the Whole Child Advisory Group, we are now doing that. Listening to the lived experience and hearing how hard it is to go here for this and here for that, telling your income story 17 times, and you’re still not having all of your needs even seen—let alone met—I think that’s where we get our impetus to do better by the folks that we are trying to serve. Along with that comes the public display and knowledge of the research that informs the work. We know now that it matters.

One of the greatest examples I think we have in Ohio right now is Ohio Benefits. It’s actually not in our agency, but we know about it because we have these regular meetings. Ohio Benefits is a one-stop online application, and programs are added to it all the time. They won’t stop until they have the whole landscape of them, which I think will be ideal.

What would you like to see tomorrow, in five years, in 10 years from now, as you think about how this trajectory could play out?

There needs to be some funding to provide individuals with lived experiences the opportunities to participate, have their voices heard, and be at the table. We need to think about our system in terms of how we modify it to serve families that have a variety of different types of work hours. I still think it’s incredibly difficult to find a mental health therapist after 5:00 p.m. If we are really meeting the needs of our families, and especially those who might need it the most, we have to start thinking about how we structure our employment practices to accommodate those needs or accommodate families if they need to take time off. For our most vulnerable families, time off is limited because they are not salaried and they don’t have extra sick days. Those are the types of supports families need.

What else would you like to see moving forward?

I’d like to see more growth of the technologically based “no wrong door” and one time of signing up for multiple services if needed: something that is a nonbiased assessment of needs. If you are already connected with an early intervention service coordinator or a home visit coordinator or you already have somebody who knows what those needs are because you’ve already articulated them, there should be some way for that information to get in. I think we are not utilizing technology to the benefit of our population as we could be.

One example I can give is from Nationwide Children’s Hospital in Columbus, Ohio. They have a national campaign that is trying to reduce the stigma of mental health problems in children. And it is working here, I will say that. I think it is amazing. I remember the days when we used to talk about infant mental health programming and no one would talk to us. We had to change the language because nobody could conceive of infants as having mental health issues. And part of it is they didn’t know why or how could that be possible. So, another huge thing here in the state that is underway is the transformation of our children’s services system.

What else would you like to see moving forward?

I’d like to see more money for things like family resources or school-based health centers. I think a big deterrent of that is capital costs because they are based on local school dollars. I would like us to look to fund one-stop shops for families. I also think it would be helpful if there were ways to have dollars focused on systems collaboration. We work hard in our state to figure out how to make the funds come together. If we could give more flexibility in the way that we’re giving out funding, we could fund the alignment as opposed to connecting the alignment. Fund what you need based on the needs.

What else would you like to see from policymakers?

Data systems: families and individuals tell their stories and needs once, and whether it’s technology or something else that does it, the family or individual gets their needs met without having to go to each agency asking for each piece.

I will put my plug in for federal universally available preschool. It takes the stigma away from it being a low-income program. Universal preschool addresses school readiness in the right period of life. It increases each child’s likelihood of being proficient readers, and thus graduating, and decreases reliance on social service supports. We already know the trajectory. We already know what it looks like for vulnerable populations, who are vulnerable through no fault of their own. I just wish we would get a little more proactive. That’s all of us. I think there are a few shining examples of this across the nation, but not many. Even here in our state, we have some local initiatives that fully fund for low income, but preschool is not universally available in all places. I want to put that plug in because I think it would make a significant difference for all social service utilization and access through these children’s later lives and into their adulthood.

I don’t know how this would be done, I don’t know the system that would need to be built in order for this to happen, but we need to find a way to ensure sustainability of funds for these systems. Everything is so grant-based for a particular project that needs to meet a particular goal, and there is a time limit. Then it ends. So, people are hesitant to build something because they won’t be able sustain it or they are expected to go get the funding somewhere else, which to me is difficult because they would have done it already if they had funding in the beginning. Can we look at funding differently so it is not through piecemeal grants? We need to be able to look at the systems, identify specific community needs, and directly fund those needs.