Hello Baby is a countywide initiative in Allegheny County, Pennsylvania, designed to offer differentiated service tiers (priority, family support, and universal), to match families with newborns at greatest risk of out-of-home placement with individualized supportive services intended to mitigate their needs and support their parenting. The evaluation seeks to understand how Hello Baby was implemented and whether its impact followed what county leaders intended—to reduce the need for contact with the child protection system.

Why This Matters

Infants are the children most frequently in contact with child protection systems, a significant public health cost across the United States. Child protection agencies have been slow to build a prevention strategy around families with infants. With Hello Baby, the Department of Human Services in Allegheny County is working to change that. If the initiative reaches enough families and the outcomes improve, we have a template for solving one of America’s most pressing family issues.

What We Found

After controlling for the effects of COVID-19, we see strong evidence that Hello Baby resulted in a reduction of child maltreatment investigations and substantiated investigations compared with the pre–Hello Baby era. We did not find a reduction in out-of-home placements.

The reduction in investigations and substantiated reductions followed the implementation of a robust network of family-focused services through Hello Baby investments. We observed the following: 

• By 2023, Hello Baby outreach staff successfully contacted 79 percent of priority-tier families and 66 percent of family support–tier families. To accomplish this, the county fortified the outreach process in ways that have proved successful in both increasing the number of families reached and decreasing the time it takes to reach them.
• Not only have more families been reached over time but more have chosen to enroll in Hello Baby. A large share of families reached (41 percent in the priority tier, 22 percent in the family support tier) decided to enroll in Hello Baby by 2023, exceeding the county’s goal of enrolling 30 percent of priority-tier families.
• A substantial subset of enrolled families (36 percent in the priority tier, 30 percent in the family support tier) engaged further with their Hello Baby service providers, using services related primarily to case management and accessing concrete supports for basic needs. Hello Baby had additional success engaging priority-tier families in clinical relationships.

The county has the opportunity to refine their approach and increase the impact of their efforts:

• As a consequence of Hello Baby’s successful reach, referrals and caseloads have continued to increase, straining providers.
• Like many jurisdictions, the county sees persistent unmet need for mental health and substance use disorder services. Hello Baby provider staff reported struggling to provide for families’ basic needs when they perceive families to additionally need other services that those families are reluctant to use. In addition, the county’s resources for basic needs are limited and intended to help resolve acute incidents and alleviate hardship in the short term but cannot realistically resolve long-term poverty.

How We Did It

We collected two types of data: (1) interview, focus group, and program data that tell us whether Hello Baby has developed into a network of sufficient scale to generate a public health benefit; and (2) administrative data that can demonstrate whether maltreatment and placement rates declined during the Hello Baby era compared with prior years using a discrete time hazard model in conjunction with an interrupted time series approach.