The Implementation of Maternity Group Home Programs: Serving Pregnant and Parenting Teens in a Residential Setting. St. Andre Home, Inc. (Maine)


Basic Program Structure. St. Andre Home, Inc. operates four maternity group homes in Maine, which can serve a total of 16 pregnant and parenting young women and their children. The organization was founded in 1940 by a local order of nuns, the Good Shepherd Sisters, which owns the buildings out of which the four group homes operate. Three of the homes opened in the mid-1970s; the fourth opened in 1998. The four homes are quite similar to each other, providing similar services and serving similar populations. The central St. Andre office handles all financial issues and provides general oversight of the homes. However, treatment planning, as well as the day-to-day functioning of the homes, is handled by staff at each home. Central office staff and staff from the four group homes work closely together and have regular and frequent contact with each other.

Funding Sources and Levels. The St. Andre group homes are funded primarily by Medicaid funds (covering about two-thirds of operating expenses) and by a state contract to provide residential services to young mothers (covering just over one-fourth of the operating expenses). Other funding comes from a mix of sources. In some cases, the children of the young mothers who reside in these homes are in state custody. In these situations, the program receives monthly payments from the Maine Department of Human Services (DHS), which are provided to organizations that house children in the foster care system. These payments cover less than 5 percent of the operating expenses of the homes. The program also receives small amounts of funding from religious organizations, the United Way, and private donations. In addition, residents with income are required to pay program fees, representing either one-fourth or one-third of their income, depending on their circumstances. Each home has an annual budget of between $364,000 and $448,000 and the average monthly cost per family served is about $8,600. Costs vary somewhat across the four homes, with one home specifically designed to accommodate young mothers with more than one child having the highest per-family costs. Unlike most other group homes visited as part of this study, the budget for the St. Andre group homes includes Medicaid-funded mental health, drug treatment, and other medical services residents receive, all of which contribute to the high per-family cost of the program.

Eligibility Rules and Referral Sources. To reside in a St. Andre group home, young women must be Medicaid-eligible and be either pregnant or parenting a child younger than age three. All homes serve young mothers ages 15 to 24, while one home serves women up to the age of 30. Most homes can accommodate only mothers with one child; however, one can accept mothers with two children. Residents cannot be a danger to themselves or others, must not be active drug users, and must be willing to follow program rules. Applications and admissions are handled by individual homes. Most referrals to the program are from DHS. Many of these referrals are situations in which the children are in state custody and are being reunited with their mothers on a trial (and closely supervised) basis. Other DHS referrals may involve young women who must live in the homes as a condition of retaining custody of their child. Other referrals come from a variety of sources, including hospitals, counselors, churches, shelters, family, and friends.

Setting and Structure of the Homes. The four St. Andre homes are located in southern and central Maine: two in Lewiston, one in Biddeford, and one in Bangor. All the homes follow the congregate model, in which the residents share living, dining, kitchen, playroom, and other common areas. Residents have their own bedrooms that they share with their children. In one home each mother has her own suite with bedroom, small living room, and bath. This home is a large four-story former rectory, while two of the other facilities are converted single-family homes in residential neighborhoods. The fourth home is a new facility specifically built as a maternity group home. Each home can serve three to five families.

Staffing Patterns. Although there is some variation, the basic staffing pattern at each of the St. Andre homes is very similar. All homes have staff on site 24 hours a day; however, overnight staff are not required to remain awake. The homes all have low resident-to-staff ratios, with each employing six full-time and one part-time staff member. Staff typically include a supervisor, a masters-level clinical social worker, and four “group life workers” who provide general supervision for residents. In addition to the staff who work directly for the homes, the program contracts with a number of consultants, including psychiatrists, medical doctors, and public health nurses.

Core Program Services. In addition to housing and supervision, each home provides a number of individual and group services to its residents. Homes convene group sessions three or four times each week. These sessions include parenting and life-skills classes, as well as house meetings. In some cases, sessions are conducted by group home staff; in other cases, outside experts are brought in to teach the classes. In addition to the group sessions, residents must meet weekly with the home's social worker. Some residents also meet regularly with psychiatrists who come to the home to provide therapy. Finally, homes occasionally provide child care and transportation for their residents.

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