Spring 2001

If you could pick where you were to be born, Baltimore might not be the place. Compared to the other largest U.S. cities, Baltimore has, for example, the highest rates of low birth weight or premature babies, according to an Annie E. Casey Foundation study.

Baltimore's Safe and Sound Campaign and its partners believe its Success By 6® effort will change that. "The intent is, Baltimore will be known as a place where you're lucky to have your baby born," says Hathaway Ferebee, executive director of Safe and Sound.

One of Safe and Sound's five priority goals is, "Children are born healthy and enter school ready to learn." To achieve that goal, Safe and Sound has led the development of the Success By 6® Partnership. Among other things, Safe and Sound brought together experts and service providers to develop a data-driven strategy based on best practices; helped set up management systems through the United Way and the Family League of Baltimore City to ensure accountability; developed a mechanism to pool public and private dollars; and hired an evaluator from Johns Hopkins University School of Medicine.

The Success By 6® strategy involves outreach through home visitation and at neighborhood-based service centers. Examples of home-based services include helping families get needed medical care and registered for services such as food stamps for which they are eligible but not enrolled. Ongoing visits support caregivers by addressing long-term goal setting and decision making, health-related behaviors during pregnancy and other issues. Center-based services include, for example, parent education and skill building, and family literacy support.

Safe and Sound and the city's health department hired Barbara Squires as strategist for the Success By 6® Partnership, which also includes United Way of Central Maryland and the Family League of Baltimore City.

"The partnership is setting standards, based on best practice research, and providing money for others," Squires explains. "The partnership determined the core components of effective family support and grantees have to include some or all of these elements. At the same time, we are flexible and rely on collaboratives within neighborhoods who know best which service providers can best carry out the core components."

Major institutions commit to the effort

Seven initial communities are each receiving grants of up to $1.8 million through the United Way and Family League. Safe and Sound's goal is to expand the effort to 15 neighborhoods identified as the most in need. That plan is being developed, and sources of potential funds are being identified, such as the federal Title IV-E and Medicaid reimbursement dollars. The state is providing about $2 million over five years through the Negotiated Community Partnership, and generous amounts of private money are being contributed. The United Way, March of Dimes, Annie E. Casey Foundation and Bank of America are among the donors. The United Way's contribution of $10 million over five years is its largest investment ever to a single program.

"We recognized that Baltimore City had voted family support as its number one priority," says Muriel Gates Cromwell of the United Way of Central Maryland in explaining the extraordinary contribution. During the Baltimore Promise Summit in 1997, 7000 citizens helped chose the community priorities that would become the goals of the Safe and Sound Campaign. Family support received the most votes.

"Also, we'd been inspired by other United Way organizations that had implemented Success By 6® strategies, and their understanding that the ultimate success of a child begins at birth," adds Cromwell. "There are many indicators that need to be improved, and we want to be a part of the effort."

According to Safe and Sound Executive Director Ferebee, more than $9 million in public funds and $12.5 million from private sources has been raised for a total of $22 million new dollars over five years for the strategy. The estimated number of families being served through either the home visiting or center-based supports now stands at 3,770, or 27 percent of the families Safe and Sound hopes to reach once the strategy has been expanded to the 15 targeted neighborhoods.

Data gathering essential

Essential to this and all of Safe and Sound's strategies is the use of data and information to guide decision making, focus investment and monitor progress. Safe and Sound formed the Baltimore Data Collaborative as a mechanism to monitor health and safety status of the city's children. The collaborative has collected data on a core set of outcome indicators citywide, with neighborhood-by-neighborhood comparisons, and this work is ongoing. In addition to Safe and Sound, lead partners in the collaborative are the Family League and the Maternal, Child and Community Health Science Consortium at Johns Hopkins University School of Hygiene and Public Health. Many other public and private agencies are members.

Through Success By 6®, Safe and Sound hopes to improve a number of statistics that indicate the health, functioning and self-reliance of families with young children. These include infant mortality, percent of births of low birth-weight babies, and first graders' grade equivalents compared to national percentiles.

"The indicators do not get changed in one or two years," says Dr. Peter Beilensen, director of the city health department. But in three to five years, he says the city could see measurable improvements. He believes the Success By 6® strategy of bringing disparate agencies together could hold more promise than previous efforts.

"My personal goal," says the United Way's Cromwell, "is that in five to ten years, through significant amount of leveraged funds and collaboration, Baltimore will have greatly improved indicators - and many more kids healthy and ready to learn."