The Implementation of Maternity Group Home Programs: Serving Pregnant and Parenting Teens in a Residential Setting. How Much Supervision and Structure Do Homes Provide?


Many pregnant and parenting teens have had little structure in their lives prior to entering a maternity group home. One of the functions group homes can fill is to provide such structure. To this end, maternity group home programs provide adult supervision and establish a set of rules by which residents must live. Adult staff are on hand to provide general supervision, informal counseling, emotional support, and nurturing to residents, as well as to enforce program rules and offer other support services.

Level of Supervision.  In response to the great need of teen parents for support and supervision, maternity group homes typically are staffed round the clock.1 Most of the homes included in our study have staff on site 24 hours a day, 7 days a week, to provide general supervision and other services to their residents. One exception is one apartment-model home in New Mexico, which provides almost constant staffing but does not guarantee that a staff person will be present at all times. The home has only four staff members and attempts to schedule them so that someone is available during the hours that residents are home. However, there may not be any staff on site during school hours, when residents are generally away from the home. The Friends of Youth homes in Washington each have a resident manager who lives on site and is on call during the night, but these staff are allowed to leave the home while on call as long as they go no farther than 20 minutes away.

Nevertheless, there is some variation in the level of supervision provided even among homes with 24-hour staffing. Some programs require overnight staff to remain awake at all times, while others do not, instead having staff who sleep in the group home. For example, both Friends of Youth homes in Washingtonhave resident staff who live — and sleep — in their own apartments on site. Some other homes, such as the St. Andre homes in Maine, have shift staff who do not live on site but who can sleep on sofa beds in the group homes during their overnight shifts. In contrast, most of the homes we visited in Georgia, Massachusetts, Michigan, and New York specify that staff remain awake at all times while on duty. Some homes go a step further, such as one in Michigan that has a minimum of two awake staff on duty at all times.

Some networks have a continuum of staffing intensity, to meet the needs of different types of teens. These networks include some homes with full staffing and others with lower levels of supervision for residents transitioning to independence. Massachusetts’ network includes two types of maternity group homes — congregate homes with 24-hour-awake staffing and apartment model homes that are not required to have awake staff overnight. Massachusetts network staff place residents in the type of home that will best meet their needs. The network in Detroit, Michigan also offers different levels of supervision, requiring most homes to provide 24-hour-awake staff but including one home — targeted to serve slightly older and more mature residents — that does not have awake staff at night.

House Rules. One of the purposes of adult supervision is to provide structure by establishing and enforcing rules under which maternity group home residents must live. Homes often impose numerous restrictions and obligations on residents, both to provide needed structure to the lives of those living there and to teach them responsibility and skills they will need to be self-sufficient once they leave the home. Rules are typically documented in handbooks given to all residents when they move into the home; some homes also require residents to sign a “contract” promising to follow the rules. Although some homes are stricter than others, typical rules include restrictions on the comings and goings of residents and visitors, mandatory activities and schedules, and prohibitions on certain behaviors.2

Maternity group home programs generally monitor the comings and goings of their residents and guests and often place limits on their movements. Most homes have curfews, but the specific times vary. Weekday curfews ranged from as early at 7:00 p.m. to as late as 10:00 p.m. in the homes in our study. Curfews often are an hour or two later on weekends than on weekdays, and some homes offer their residents weekend passes under certain circumstances. In most cases, a curfew simply means that all residents must be in the home by the specified time, but a few homes impose a mandatory bedtime. In one New Mexico home, for example, residents had to be in their own bedrooms with the doors closed by 9:00 p.m. Some homes have both a building curfew and a set bedtime — for example, one home in Maine requires residents to be in the home by 8:00 p.m. and in their rooms and quiet by 10:00 p.m. Some other homes have earlier bedtimes for residents’ children.

In addition to curfews at night, some homes require residents to let staff know where they are when they leave the homes during the day. Some homes use sign-in sheets to keep track of where each resident is at all times. In one New Mexico home, residents must give an address or phone number of their destination each time they leave the home.

Some homes place additional restrictions on residents’ movement. For example, due to state rules concerning minors in custody, residents of maternity group homes in the network in Georgia cannot typically leave the facility without being accompanied by a staff member. Residents of one home in New Mexico are not generally allowed to leave the premises by themselves, due in part to the home’s remote location and in part to the fact that many of the residents are in the child welfare system.

In addition to restrictions on leaving the home, some programs maintain schedules that residents must follow while they are there. Fixed meal times are common, and some homes have requirements that residents be engaged in some sort of productive activity at certain times. Some homes give their residents wake-up calls or require them to be dressed and downstairs for breakfast at a certain time. Residents of one home in Michigan, for example, typically receivewake-up calls at 7:30 a.m., are expected to dress and get ready before they go to the kitchen, must talk to their assigned case worker before 9:00 a.m., and spend the next three hours in designated “constructive time” (often devoted to attending school or employment outside the home).

Most maternity group homes require residents to attend at least some program activities, which range in frequency from a few times a month to as often as several sessions per week. The most common type of required program activity is attendance at classes on parenting and life-skills topics (discussed in detail below). In addition, some homes hold mandatory house meetings or other group activities. One of the most intensive schedules found in our study is a home in New York whose residents must attend seven mandatory group activities per week — including classes on independent living skills, childbirth, caring for an infant, health, and substance abuse prevention; a special workshop, and a house meeting. Besides group activities, many homes require residents to attend individual case management meetings or therapy, most often weekly. Some homes in Maine also require all residents to participate in some type of support group not affiliated with the home (a requirement intended to help them learn to access outside services and connect with some kind of group that they will be able to continue after they leave the home).

Home staff recognize how busy young mothers are and try to create a balance between program activities, the responsibilities of motherhood, and often school or work. However, some suggested that there is a tradeoff between providing a rich and intensive set of services to address all of residents' needs and adding too much to their already busy lives. For example, some homes limit the number of mandatory meetings to just three or four each month to avoid overwhelming residents. Other homes prohibit or discourage residents from working. Exceptions from requirements for residents to attend school, for example, are often made for some period of time immediately after a baby just born or reunited with a parent. Still, some residents complain that their schedules are too busy.

In addition to these requirements, homes often prohibit their residents from engaging in behaviors considered undesirable or dangerous. It is common for homes to have rules against fighting and being disrespectful of other residents or staff; also, homes often have rules governing child safety. They commonly prohibit the use of alcohol and drugs, and many ban smoking, at least indoors. Residents typically are forbidden to engage in sexual activity on the premises and are discouraged from doing so away from the home as well.3 One home in New Mexico even has rules against dating. In a few other homes, residents who become pregnant again would have to leave, typically due to limits on the number of children.

In part to enforce their prohibitions against sexual activity, maternity group homes typically place some restrictions on visitors, especially overnight guests. Many homes have set visiting hours. These may be narrow ranges — such as allowing guests in the home only for a few hours each evening or on weekends — or they may simply be intended to prohibit guests from staying overnight. In addition to restrictions on time, there are often restrictions on where visitors can go in the homes — many congregate homes allow visitors only in common areas. Some homes limit the number of guests a resident may have, and some restrict who can visit. For example, in some homes in the network in Georgia, visitors of teens in state custody must be approved by their child welfare worker, and visitors of other teens must be approved by their parent or guardian. A few homes do not allow male visitors on the property at all. One home in Michigan does not allow any visitors inside the house, for safety and confidentiality reasons, and does not allow any males to enter even the yard. Some homes also have restrictions on telephone usage.

At the Federation of Youth Services maternity group home in Detroit, yelling and using disrespectful language is not allowed. Curfews are set at 9:00 P.M. on weekdays and 11:00 P.M. on weekends, although residents over 18 can sign up to be away for the whole weekend. Visitors are allowed only during set hours and are not allowed in the residents' bedrooms at all; residents can meet with their visitors in the home's common areas only. Residents must attend three weekly group activities (life skills, parenting, and a house meeting) and regular therapy sessions with the home's social worker, either individually or in groups. They are also required to attend school, unless they have graduated, in which case they may either attend community college or find jobs. Each resident is assigned a different chore-such as cooking or cleaning a particular common area-each week. Each must also keep her own bedroom and bathroom clean and is assigned a day to do her laundry.

Enforcement of Rules.  Effective enforcement of these rules requires both determining when a rule is broken and administering the appropriate consequences for any violations. Homes have developed a variety of methods for monitoring compliance with different program rules. In addition, maternity group homes often define positive incentives to encourage residents to follow the established rules, as well as negative consequences for violating them. To ensure consistency and so that residents know what to expect, these incentives and consequences typically are set forth in the handbook given to all residents.

The primary means of monitoring adherence to program rules is observation by staff. For example, staff on duty pay attention to whether residents engage in prohibited behaviors and whether they are following any set schedule. Staff also monitor attendance at mandatory program activities and may make calls to find out if residents missed a scheduled appointment off-site. Staff conduct regularly scheduled or random checks to ensure that assigned chores were completed.

To detect any violations of curfews and restrictions on visitors (and, in some cases, to supervise residents’ interactions with their children), homes employ various methods to monitor their residents — especially overnight. Most of the homes we visited have staff on duty 24 hours a day. In some homes, night staff check on each resident during the night — visual checks are made hourly in at least one home in Massachusetts; but in other homes, checks may be conducted only once or twice during the night.  Some programs rely on electronic sound monitors to alert them to any problems in resident areas. One home in

Most of the residents we met with are generally satisfied with the amount of structure provided by the maternity group homes in which they live. Although they may dislike one or two specific rules, residents typically understand the necessity of the rules. Some residents are relieved to be in a safe environment-sometimes for the first time in their lives-and many are willing to sacrifice a great deal of personal freedom for the security and support provided by the homes. Still, some residents complain that the rules are too strict. Dissatisfaction is particularly common among residents who are in some way required to live in a maternity group home (such as being sent there by a juvenile justice or child welfare agency). Staff noted that many of the teens have never had to follow rules before, and staff credit dislike of rules as the main reason some residents have very short stays in the homes. It can be a challenge for homes to strike the right balance between imposing necessary structure on residents' lives and allowing them some degree of freedom. Some homes have deliberately relaxed at least some rules to increase resident satisfaction and encourage them to remain in the program.

Georgia — housed in a facility specifically designed as a maternity group home — sets alarms on residents’ bedroom doors and windows to warn staff if they are opened at night. Some homes have video cameras at each entrance so that staff can monitor all comings and goings of residents and their visitors; this can catch anyone attempting to sneak out after curfew or attempting to sneak in an overnight guest. In some cases, such high-tech methods are used instead of requiring overnight staff to remain awake at all times.

Homes tend to be patient with most violations of program rules. Staff believe in giving residents second — and often third, and fourth — chances, and they recognize that teens will violate minor rules (by missing curfew, for example) every once in a while. The consequences for most offenses typically are short-term loss of privileges — such as suspension of telephone privileges, loss of weekend time off, or the imposition of an earlier curfew — or, possibly, a fine (one home in Michigan charges residents 25 cents for using curse words, for example, while curfew-breaking residents in one home in Washington have to pay a $10 fine or lose a weekend). Some homes have specific penalties for specific rule violations, while others use a points system that determines the level of restriction for each resident based on an overall measure of her behavior over a period of time. Sometime specific consequences are developed appropriate for certain violations — for example, at the Friends of Youth homes in Washington, guests who violate rules covering visiting hours can be banned from entering the home again. Some homes issue written warnings to rule-breakers, and residents may be required to attend a meeting with staff to discuss any violation. Termination from the programs only results in the relatively rare cases of chronic rule-breaking or if a resident poses a danger to herself or others.4

Besides the fear of negative consequences for violating rules, some homes use positive incentives to encourage residents to obey. For example, one home pays residents $10 or $15 to attend program classes and meetings, including those that are mandatory. Another home in the same state has a mini-store where residents can spend credits they earn from doing assigned chores, attending scheduled meetings, school/work attendance, and so on. (The home also imposes fines against these credits for violations of some rules.) Staff at another home can adjust residents’ curfews by an hour in either direction in response to their behavior. Some homes have established various levels of rules that allow residents to attain more independence within the program as they demonstrate increasing levels of responsibility. For example, some homes in one state have “phase systems” with different levels of rules for different residents, depending on how well they are doing in the program. Residents of a few homes can qualify for a situation with more independent living — either their own individual apartment within the same facility or a space in a different, less restrictive, facility within the larger network.

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