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Maternity group homes have a long history. Some of the maternity group homes in operation today — such as Inwood House in New York, St. Ann's in Maryland, and the Florence Crittenton agencies — trace their origins to the 1800s (Reich 1996; Reich and Kelly 2000; and Child Welfare League of America 2004). A number of rescue homes were opened in the United States in the late 19th century to aid unwed mothers who, at the time, faced considerable social stigma in addition to economic hardship. These homes provided a safe place for young “fallen women” to live during and after pregnancy, as well as services intended to “rehabilitate” them and teach them to care for their children. The need for such homes was greatly reduced, however, in 1935, when Aid to Families with Dependent Children (AFDC) was enacted to provide federal support for single mothers, whether widowed or unwed, and their children (Cooper 2003). Over the decades, gradual social changes made single motherhood more socially acceptable, thus further reducing the need for maternity group homes. However, teen mothers still face considerable challenges in caring for themselves and their children.
Recent welfare reform rules that require minor parents live in approved housing as a condition of TANF receipt have contributed to a resurgence of interest in maternity group homes specifically targeted to serve pregnant and parenting teenagers who, for one reason or another, cannot live in their parents' homes. In 2001, there were more than 132 maternity group homes operating in 29 states around the country (Social Policy Action Network 2001). These homes are similar in that they all provide housing and other support services for pregnant or parenting teenagers. Individual homes can differ greatly, however, due to differing program goals and operational contexts. In this chapter, we rely on data from the 2001 Social Policy Action Network (SPAN) survey and other sources in the literature to describe some of the characteristics across which maternity group homes vary, focusing on three questions:
We then attempt to classify maternity group homes across a few major dimensions.
The potential of maternity group homes to address the numerous problems facing pregnant and parenting teens rests in the range of services they can provide to their residents. The most basic components provided by all maternity group homes are housing and adult supervision. Most homes go well beyond that, however, with many offering a comprehensive array of support services to their residents. This section discusses the housing structure, staffing, rules, and support services of maternity group homes.
Housing Structure. Probably the most fundamental need filled by maternity group homes is that of housing. Two basic housing structures are utilized for maternity group homes: congregate homes and clustered apartments. The majority of respondents to the 2001 SPAN survey used congregate structures, while about one-quarter used clustered apartments and another 8 percent used a combination of housing types. Congregate homes are often in buildings that were formerly large single-family houses. Some residents of congregate homes share a bedroom with another teen, while in other such homes each teen family has its own bedroom. Kitchens and living areas are shared, and bathrooms may be either shared or private. Maternity group homes using the clustered apartment structure may fill an entire (small) apartment building with teen families, or they may only have a few units in a larger building. Families may be assigned their own apartment, or two families may share an apartment. Residents of congregate homes typically eat meals together and share chores, while teens living in clustered apartments typically are responsible for preparing their own and their children's meals and for ensuring the cleanliness of their own apartment.
Housing structure varies even within networks of maternity group homes (see Section C for a discussion of maternity group home networks). All of the existing statewide networks include both some congregate homes and some clustered apartment homes. In most networks, this is because decisions about structure are made by the individual organizations that run each maternity group home and depend upon housing available in the local area. However, a few networks vary their housing structure deliberately in order to offer residents a continuum of housing types, so that teens can move in stages toward independent living. Rhode Island has three different levels: young teens begin the program living in congregate homes and work their way to transitional apartments as they prepare for self-sufficiency (SPAN 1999). A few tiny local networks, such as Seton Home in Texas and St. Ann's in Maryland, also provide a continuum of housing types, with congregate structures for most teen residents and more independent structures for older mothers transitioning out of the maternity group home (SPAN 1999; and Reich and Kelly 2000).
House Rules. Maternity group homes can impose numerous restrictions and obligations on residents, both to provide needed structure to the lives of the girls living there and to teach them responsibility and skills they will need to be self-sufficient once they leave the home. Residents typically are required to help with household chores, for example. Residents of congregate homes typically share responsibility for preparing group meals and cleaning common areas; teens living in clustered apartments are responsible for preparing meals for themselves and their children and are required to keep their own apartment clean.
Also, maternity group home residents typically are subject to curfews and restrictions on visitors, particularly overnight guests. Alcohol and drugs are typically forbidden. Maternity group homes may require residents to attend classes on such topics as parenting and life skills and to participate in supervised play sessions with their babies. Some homes require teens to actively pursue formal education or employment while residing in the group home (see below for more on support services).
Limits on Length of Stay. While many maternity group homes allow families to remain in residence for as long as they meet the program eligibility requirements (including maximum age), others have limits on the length of time a teen can live in the home regardless of their age. More than a third of respondents to the 2001 SPAN survey reported time limits. Of these, the most common limit was also the longest reported: two years. However, teens do not necessarily remain in the maternity group home for the maximum amount of time these limits would allow. In some cases, they may age out before reaching the limit; in other cases, they may find an alternative housing situation or become dissatisfied with the maternity group home program. For example, although the Family Development Center home in Georgia was designed for families to remain in residence for one year, staff considered a six-month stay to be a reasonable benchmark of commitment (Fischer 2000).
Supervision. Another basic component shared by all maternity group homes is adult supervision. Adults are on hand to provide informal counseling, emotional support, and nurturing to resident girls, as well as to enforce program rules and offer other support services described below. Staffing patterns vary widely across different maternity group homes, depending on funding, intensity of supervision, and amount of support services provided directly. Some have only a few staff (one site reported only a single paid staff person, the director), while others have more than a dozen. Many maternity group homes responding to the 2001 SPAN survey reported more full-time-equivalent staff than teen families. The average staff-to-teen ratio was about one-to-one.
In response to the high needs of teen parents for support and supervision, many maternity group homes are staffed 24 hours a day. Almost 90 percent of respondents to SPAN's 2001 survey reported having staff on duty around the clock. There is variation even among those, however, since some specify 24-hour “awake” staff, while others have resident staff who sleep in the group home. Some other maternity group homes have more limited staff hours. A few small networks have a continuum of staffing intensity. In Rhode Island homes, for example, the number of hours during which staff are on site decreases at each stage, from 24 hours, to 16, to 8, as teens move toward independent living.
The types of staff employed also vary from home to home. Some maternity group homes rely on full-time staff, while others have additional part-time staff. At some sites, all or most staff are paid, while others heavily supplement paid staff with volunteers. The credentials and roles staff play also vary. For example, Bridgeway in Colorado relies on volunteers to fill a number of functions including serving as mentors and teaching over 100 workshops and classes each year, on topics covering life skills, emotional issues, health and employment education (Bridgeway Homes 2004). At another site, credentialed therapists provide mental health services to maternity group home residents pro bono. One home in Maine that places emphasis on serving teen fathers in addition to teen mothers was careful to hire some male staff members (Reich and Kelly 2001).
Support Services Provided. In addition to the basics of housing and supervision, pregnant and parenting teens have a wide variety of needs, from immediate medical and mental health to education and job-training services that will enable them to become self-sufficient in the longer term.(1) Reliable child care and transportation are necessary to ensure that mothers can make use of these other services. Maternity group homes can offer support services to meet these needs themselves or can refer their residents to outside providers for other services. The extent to which maternity group home staff are available to provide support services directly varies, although services tend to be somewhat similar at different homes within networks. For example, Florence Crittenton homes tend to have a wide variety of services available on site, while homes in the Massachusetts and New Mexico networks rely more on external service providers (see Section C for a discussion of these maternity group home networks).
Almost all maternity group homes offer a set of basic services — life skills and parenting classes and assistance connecting with outside services — and homes commonly provide supports to enable teens to avail themselves of outside services. Among the 95 maternity group homes surveyed by SPAN in 2001, almost all reported offering both parenting and life skills lessons to their residents. About three-quarters of the homes SPAN surveyed reported providing transportation for residents to get to school and/or child care. Just under half of the homes reported providing child care themselves, and many others have relationships with off-site child care providers to care for children while their parent is attending school, training, or work.
Many maternity group homes strive to offer additional services on site. Some provide education, GED preparation, or job training to help improve families' economic future. Nearly 60 percent of those responding to the 2001 SPAN survey reported providing job training and counseling, and about 15 percent provided high school and/or GED education. Some provide medical, mental health, substance abuse treatment, family planning, abstinence education, and pregnancy prevention services. About half of the maternity group homes surveyed by SPAN provided mental health services, and about a fifth offered medical services. Some provide mentors, services for fathers, outreach to families, and followup for alums. The most comprehensive maternity group homes offer all these services and have necessary facilities, such as day care centers, health clinics, and even public schools, on site.
Less is known about the extent to which participation in the classes offered and the use of available services are required of maternity group home residents, although the literature includes a number of examples of sites with requirements. Under welfare reform, all minors who have not yet earned a diploma are required to attend school as a condition of receiving TANF. Many maternity group homes incorporate this requirement into their program rules; others go a step further, requiring all residents to participate in some education, training, or employment activity. For example, Bridgeway in Colorado requires all residents to participate in continued education, counseling, and attendance in a series of semiweekly workshops on topics covering life skills, emotional issues, and health and employment education (Bridgeway Homes 2004). Massachusetts' Teen Living Program residents must spend at least 20 hours engaged in some type of educational or job-training activity and participate in several hours of parenting or life skills activities (including supervised play or discussions on money management) each week (Wood and Burghardt 1997). One home in Georgia requires that each resident choose a GED, vocational, or employment track and participate in relevant activities (Fischer 2000). St. Ann's in Washington, DC has a high school located on site and requires high school attendance of all its residents (Sylvester 1995).
The structure and services maternity group homes provide can depend on the particular needs of the population being served. Individual homes serve different numbers and types of residents, who make their way to the maternity group homes through different avenues. The reasons a home serves the population it does may be due to program goals, or they simply may be the result of practical considerations or local context. This section discusses the capacity, target populations, and referral and screening processes of maternity group homes.
Capacity. The maximum number of residents that an individual maternity group home can house at one time may be decided by the managing organization based on program goals, or they may be dictated by limited funding and the housing facilities available in an area. The number of families living in a facility contributes to the home environment and thus potentially affects program outcomes. For example, there is some evidence from a study of Massachusetts' Teen Living Program network that home size may be negatively correlated with satisfaction (Collins, Lemon, and Street 2000). On the other hand, larger facilities may benefit from economies of scale.
There is considerable variation in the number of families that can be served by individual maternity group homes, but the majority of homes are quite small. Some homes serve as few as two teen families at a time, while others may serve as many as 47 (SPAN 2001). Just over half of the maternity group homes surveyed by SPAN in 2001 reported capacities below 10 families, and only 11 homes had room to serve more than 20 families. The mean capacity of the homes in the 2001 SPAN directory is about 11 families.(2)
Program capacity, of course, is only the upper limit on the number of families actually residing in a home. Actual program size also depends on the demand for maternity group home beds among eligible teens in the local area. Some homes may have open slots, while others may have waiting lists.
Target Population. Pregnant and parenting teens are not a homogeneous population. While the residents served by each maternity group home varies naturally depending on the types of teen parents in need in their service area, some maternity group homes deliberately target specific subgroups of teens. Teens in group homes can derive emotional support and learn from one another, as well as from program staff; housing similar types of teens together may encourage this peer support and allows staff to specialize. Many maternity group homes target a particular subset of teens defined by age, family composition, or eligibility for or participation in a specific social service:
Some networks have different homes that serve different populations (see Section C for a discussion of maternity group home networks). For example, one home in Massachusetts' Teen Living Program network is specifically for victims of domestic violence. St. Ann's, a two-home network in Maryland, provides residential care for 21 pregnant adolescents and young mothers and their babies through its Teen Mother-Baby Program and operates a separate facility of transitional apartment housing for eight young mothers (18 to 25 years old) and their children. Another two-home network, St. Elizabeth's in Indiana, operates both a Maternity Home with the capacity to serve 17 pregnant teens and a Transitional Home with capacity to serve seven young families after the baby is born.
Referrals and Screening. The type of population served by a particular maternity group home can depend on the organizations that refer teens to the home and the process by which applicants are screened. A variety of organizations — including welfare agencies, child protective service agencies, courts, homeless shelters, faith-based and other community-based organizations — refer pregnant or parenting teens to maternity group homes. Some teens find maternity group homes on their own. Many maternity group homes accept referrals from several different places, but some homes (about one-fifth of respondents to the 2001 SPAN survey) accept only referrals from a single source. For example, homes that serve foster children exclusively may accept referrals only from child protective services agencies. Homes tied to welfare reform minor living arrangement rules may accept only referrals from welfare agencies.
Potential maternity group home residents must be screened, if only to ensure they meet the program's minimum eligibility requirements. However, information about screening criteria and methods is limited in the maternity group home literature, particularly in cases where programs themselves, rather than referring agencies, conduct the screening. Screening of potential residents is done by referring organizations for some maternity group homes. In Massachusetts, for example, state Department of Social Services staff consider the case of new teen applicants for TANF benefits who state that they are unable to live at home or with an adult guardian and make a determination of whether they should live with their parents or be referred to a maternity group home in the state's Teen Living Program network (Collins, Lane, and Stevens 2003). Other homes do their own screening. Even some homes where teens are placed by social service agencies, such as several in New York, New York, for which all admissions are approved by the Child Welfare Administration (CWA), have the right to accept or reject each placement (Reich 1996).
Everything about maternity group homes — from program goals and the population targeted to the services offered and the methods of delivering these services — is determined by their operating organizations, sometimes with input from networks and funding organizations. Membership in a network of homes may open up avenues of funding and can have an impact on decisions made by managers of individual homes, since networks may have rules that all members must follow concerning what types of teens to accept and what services to provide. Funding organizations also can play a role in these decisions, particularly in homes where a single source provides the majority of program funds. Within any constraints placed by their networks and funders, the individual organizations that operate homes have considerable latitude to design their own programs. This section discusses networks, management, funding, and operating costs of maternity group homes.
Network Membership. While many maternity group homes are independent institutions, others are members of larger networks of homes. Networks can be a loosely affiliated set of homes with little more in common than geographical location and a shared funding stream, or they can follow a more prescriptive structure with similar goals, target populations, and services. Even within the most centralized maternity group home networks, there can be considerable variation in the characteristics of individual homes.(4) There are several statewide networks of maternity group homes, some homes are part of smaller local networks, and others are affiliated with the national Florence Crittenton organization. In fact, more than half of the 132 homes listed in the 2001 SPAN directory were part of some type of maternity group home network.(5)
In addition to these networks, the Family and Youth Services Bureau (FYSB) of the U.S. Department of Health and Human Services (DHHS) has established 10 Regional Training and Technical Assistance Providers which provide relevant information, assistance, and training to all of the FYSB grantees in their region, including some maternity group homes. To the extent that these regional providers deliver similar information, assistance, and advice to all maternity group homes they serve, the homes involved with a given regional provider may loosely be described as a network.(6)
Operation and Management. Individual homes are operated by separate organizations, even within all but the smallest networks of maternity group homes. Thus, there is considerable variation in the characteristics of individual homes within most networks, as discussed below. A study of Massachusetts' Teen Living Program network found that the specific emphasis of each home in the network depended on the mission and history of the individual organization running that home (Collins, Lane, and Stevens 2003). For example, there was disagreement among different Teen Living Program homes as to which of the network's several desired goals and outcomes should be primary.
Almost all maternity group homes are operated and managed by community-based organizations. Some may have religious affiliations, while others are secular. Some have broader functions than only operating maternity group homes. For example, Florence Crittenton agencies often provide a variety of support services to nonresident teens. Some organizations that run maternity group homes also provide adoption services. For example, in addition to operating a small network of maternity homes and an outreach program for nonresident teens, St. Andre Home, Inc. in Maine offers comprehensive adoption services to birth mothers and adoptive parents.
Sources of Funding. The operation of maternity group homes can be affected by which agencies or organizations provide their funding. Funding streams may come with instructions as to how the funds are to be used; for example, TANF funds may be used only to support families that meet TANF eligibility requirements. Thus, maternity group homes that receive all, or even the majority, of their funding from a single source may need to follow their funding program's guidelines as to what types of populations to serve or what types of services to provide.
Most maternity group homes rely on a variety of funding sources, however. Even maternity group homes that are part of a statewide network, and thus receive at least some state funding, typically report a number of other sources of funds. Sources of financial support for maternity group homes include:
Some homes rely on a single funding stream for all or most of their financial support. While foster care reimbursement is perhaps the most common funding source for these single-source homes, it is not the only source adequate to entirely sustain a maternity group home. The type of funding organization may have more impact on the operations of homes that rely on a single source, since such homes may be more closely bound by their funders' guidelines.
Operating Costs. The cost of operating maternity group homes varies depending on location, staffing, services provided, number of families served, and other factors. Among homes surveyed by SPAN in 2001, the annual cost per family ranged from $5,000 to $85,000, with a mean of about $36,000. These numbers are self-reported, were likely calculated in different ways, and may not accurately account for all program costs. Still, they indicate considerable variation in program costs. Some of this variation may be due to decisions made by the homes, such as the intensity of supervision and the amount of services provided directly by maternity group home staff — two factors that are likely to be correlated with costs. Some programs may rely heavily on volunteer staff or receive considerable in-kind donations, which may not be factored into reported cost amounts. In addition, some homes may have partnered with Job Corps or other systems to achieve cost efficiencies. However, some factors outside of program control, such as the local housing market, will also affect their costs.
The discussion above has demonstrated that maternity group homes vary greatly across many different dimensions, each of which could be an element of a classification scheme, though many are closely related, and some characteristics are more central than others. We have selected a few areas in which some of the most critical of these characteristics can be collapsed to create a classification framework to organize our understanding of maternity group homes. The three elements we believe most essential to understanding the types of maternity group homes are:
Using some type of framework to classify these programs, which vary on numerous dimensions, can be helpful as we think about designing an evaluation of these programs. For instance, one might choose to be representative of the diversity of maternity group homes and deliberately select programs that vary across some elements of our classification system. Alternatively, one might choose to focus on programs that fall within a single model of particular interest within this typology.
This dimension covers the number of residents served and the basic characteristics that made them eligible to live in the maternity group home. Homes range along this dimension from those that welcome a broad population, and include a wide variety of types of residents, to those that focus on a particular subgroup. The resident population may be correlated with program goals or with an individual home's sources of funding or referrals.
At one extreme of this dimension are homes with very few eligibility requirements. They tend to accept teen applicants of all ages, whether pregnant or parenting, regardless of their eligibility for TANF, foster care or other social services. Some even have the capacity to serve families with more than one child. Homes that serve broad populations are likely to rely on a number of different funding sources and accept referrals from a variety of organizations and agencies. Examples of maternity group homes close to this end of the spectrum are St. Elizabeth's in Indiana, which has no age restrictions and serves both pregnant and parenting teens, and the Northwest Pregnancy Center and Maternity Home in Washington, DC, which serves both teens and young women in their early 20s who are either pregnant or parenting as many as two children (Sylvester 1995).
At the other extreme are homes that serve a narrowly defined population. Eligibility requirements for residence in these maternity group homes could be based on age, family composition, or eligibility for a particular social service. For example, some homes accept only mandatory placements of minors in foster care, while others serve only older teens, possibly due to consent issues related to serving minors. Some homes further restrict their target population to pregnant girls or those parenting their first child. The reasons for targeting a particular population are in some cases due to program goals, while in other cases are the result of practical considerations. Some homes with narrow target populations receive funding and referrals from a single source, such as child welfare or TANF agencies, which determine the eligibility of applicants. Examples of homes at this end of the spectrum include Massachusetts' Teen Living Program homes, which serve only TANF recipients, and the Tapestry Home in Georgia, which serves only teen mothers in state custody.
This dimension covers the physical and social structure of the housing being supplied, the amount of supervision provided, house rules, restrictions and obligations. Maternity group homes range along this dimension from highly structured, nurturing, family-like environments to virtually independent living situations. Structure and supervision may be correlated with homes' target populations (for example, younger teens may require more structured living arrangements than older teens) or with costs (for example, 24-hour supervision is likely to cost more due to the need to pay salaries to additional staff).
At one extreme of this dimension are maternity group homes that provide a highly structured living situation. These are most likely congregate houses, in which teens share kitchens, living areas, and possibly even bathrooms and bedrooms with other families. They are supervised 24 hours a day, often by staff who live in the house. Curfews and restrictions on visitors are strictly enforced. Teens take turns doing chores, such as cleaning shared spaces and preparing meals for the entire household. This type of home may be more likely to serve younger teens. Some homes of this type may be the first step in a continuum, leading to a more independent housing situation still within a maternity group home program. Highly structured homes may require higher staff-to-teen ratios and thus may have higher costs per resident family. Level 1 homes in Rhode Island's network are an example on the highly structured side of this dimension; these are congregate homes in which kitchen and living areas are shared by several teen families, there is an awake staff person on duty at all times, and finances are managed by program staff (SPAN 1999).
At the other extreme are maternity group homes that provide a more independent living situation. Typically, these are clustered apartments in which each teen family has their own unit. Each teen is generally responsible for preparing her own meals, for herself and her children, and for keeping her apartment clean. Staff may reside in a separate apartment nearby or offsite and may be available less than 24 hours a day. This type of home may be more likely to serve older teens. Some homes of this type serve only teens who lived in congregate-type maternity group homes within the same network before and are moving toward entirely independent living. Level 3 homes in Rhode Island's network are an example of the independent side of this spectrum; teens live in transitional apartments, are supervised by staff only eight hours per day, and budget and manage their own finances.
This dimension covers the range of support services provided by maternity group home program staff to residents, in addition to basic housing and supervision. Homes range along this dimension from basic to comprehensive. The intensity of services provided may be correlated with program goals, staffing, and costs.
At one extreme of this dimension are maternity group homes in which program staff offer only basic services. Teens residing in these homes receive a safe place to live during and/or after pregnancy, which is a critical need for many. Staff at these maternity group homes usually also provide lessons on parenting and life skills. In addition, they assist residents in connecting with outside providers for other needed services. Staff of basic maternity group home programs may have developed strong relationships with outside service providers to make accessing these services easy for residents. In some cases, homes may have decided not to provide certain services themselves because they are readily available in the local community. Other homes that provide only basic services directly may consider providing safe housing to be their primary goal. Homes that provide only temporary, emergency, or short-term housing for teens are likely to fall into this category, since residents would not be around long enough to benefit substantially from more extensive services. Most homes in New Mexico's statewide network are examples near this end of the spectrum; they provide only basic services themselves, but program directors are responsible for linking residents to various services provided by community partner agencies outside the homes (SPAN 1999).
At the other extreme of this dimension are maternity group homes that directly provide a comprehensive array of support services. In addition to the basic services provided by almost all programs, these homes would provide medical and mental health care, education (high school or GED programs or both) and job training, on-site child care, transportation, outreach to fathers and families, and follow-up services for participants after they leave the maternity group home. Homes that offer comprehensive services may have broader goals than those that provide only basic services, they may be located in areas where other service providers are not readily available, or they might just be better funded and thus able to provide directly services that other homes consider important but must rely on outsiders to provide for their residents. Homes that provide more services directly may require higher staff-to-teen ratios and thus have higher costs per family served. The Florence Crittenton home in West Virginia is one example that would fall at the comprehensive end of the spectrum; it provides an array of services to their residents and has impressive facilities, including an alternative school, day care center, and health clinic on-site (Sylvester 1995).
In addition to providing a useful tool with which to organize our understanding of maternity group homes, this preliminary classification system will assist us in developing protocols for telephone conversations with maternity group home sites. However, we may further refine this classification framework as our design study progresses. Screening telephone calls may provide more information on these and other characteristics of maternity group homes, and visits to select sites may inform the feasibility of evaluating different types of homes. In addition, our calls to sites will help provide a better sense of where each home falls along the continuum for each of the three classification elements.
1. In addition to meeting the needs of their residents, some maternity group homes provide support services or links to outside services to teens who do not reside on site.
2. Homes for the Homeless American Family Inns in New York, New York reportedly serves 540 families, but includes a broader population than teenage parents, and so was excluded from calculation of the mean. Including this very large site results in an average capacity of about 16 families.
3. Some homes that serve only pregnant teens are part of networks that operate separate homes for parenting teens. Others may focus on serving teens who plan to give their babies up for adoption.
4. For example, although all homes within Massachusetts' Teen Living Program network met the required specifications, an implementation study of the Teen Living Program concluded that the emphasis of each home differed somewhat due to differences in managing organizations, local community resources, and program staff (Collins, Lane, and Stevens 2003).
5. However, this percentage is not necessarily representative of all maternity group homes nationwide, since the SPAN directory is not exhaustive; it is possible that independent homes were more likely than networked homes to escape the notice of the catalogers.
6. Telephone calls to sites will determine how structured these relationships are and whether the different maternity group homes served by these regional providers are similar enough to conform to our definition of a network.
7. This is not always the case, however. Some homes rely on outside providers to supply residents with other support services they consider important. For example, Massachusetts' Teen Living Program intervention assumed “that a broad array of comprehensive services is most effective,” and all homes in the network were required to offer their residents access to case management, parenting and life skills curriculum, child care, and educational, counseling, and health services, but no homes within the network provided all services directly (Collins, Lane, and Stevens 2000; Collins, Lane, and Stevens 2003; and SPAN 2001).
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