Early childhood expulsions are a systemic issue in early care and education (ECE) that have negative consequences for children, families, ECE programs, and communities. The Ohio Preschool Expulsion Prevention Partnership (OPEPP) represents one state's attempt to reduce the incidence of early childhood expulsions using infant and early mental health consultation distributed statewide in a hub-and-spoke arrangement. The study merges records from the first four years of OPEPP implementation (N = 569 expulsion prevention referrals) with child care licensing data (N = 3408 ECE programs) and data from the American Community Survey to assess OPEPP's reach in both the hub and spoke regions and identify what program and community characteristics were associated with OPEPP uptake. We found that 16.7 % of center-based ECE programs operating in Ohio between April 2016 and December 2019 participated in OPEPP, but distribution of referrals was uneven, with 36 % of ECE programs in the hub participating but just 10 % of programs outside of the hub doing so. ECE programs with higher quality ratings had greater odds of participating in OPEPP, as did ECE programs outside of the hub area that accepted publicly funded child care reimbursements. The differences in participation rates and predictors of participation between the hub and spoke regions suggest a need to explore how the hub-and-spoke arrangement of OPEPP may need to be adjusted to reach ECE programs outside of the hub region more effectively and have implications for other large-scale early childhood expulsion prevention efforts. (author abstract)