The Implementation of Maternity Group Home Programs: Serving Pregnant and Parenting Teens in a Residential Setting. Where Do Maternity Group Home Programs Get Referrals?


An important issue to consider when examining maternity group home programs is how these programs get their referrals.  In this section, we describe the sources of referrals used by these homes.  We then discuss briefly how the application and referral process works in the programs visited.  

Referral Sources.  Although most programs accept referrals from multiple sources, they often have a primary source from which they receive the bulk of their referrals (Table II.3).  For example, the Georgia and Maine programs receive most of their referrals from local child welfare agencies, while the New York program receives all its referrals from this source.  In the Georgia program (which receives two-thirds of its referrals from child welfare), those referred to the program are typically minors in state custody through the foster care system.7  In many cases, the homes represent the only setting available where these young mothers can be placed together with their babies.  The New York program has a contract with the city child welfare agency to serve pregnant teens from the foster care system and is contractually obligated to receive all its referrals from this agency.  In some cases, these primary referral sources tie closely with primary funding sources.  Both the Georgia and New York programs receive the bulk of their funding from monthly payments that come from the referring child welfare agencies to cover the cost of housing and support services for these teens in state custody.

Table II.3. Referral Sources for the Maternity Group Home Programs in the Study
Program (State) Referral Source
Child Welfare TANF Agency Other
GCAPP Second Chance Homes (Georgia) X   O
St. Andre Group Homes (Maine) X   O
Teen Living Program (Massachusetts) O X  
Teen Parent Supportive Housing Services
Collaborative (Michigan)
  X O
Teen Parent Program (New Mexico) O   O
Inwood House Maternity Residence (New York) X    
Friends of Youth Transitional Living Program (Washington)   O O
X= Primary referral source.
O= Secondary referral source.

GCAPP = Georgia Campaign for Adolescent Pregnancy Prevention.
TANF = Temporary Assistance for Needy Families.

Although the Maine program also relies primarily on child welfare referrals, most young mothers in the program are older than age 18 and are thus not themselves active child welfare cases (although some were in foster care as children).  Instead, child welfare referrals are typically situations in which the baby — and not the mother — is a child welfare case.  In many instances, the young mother and baby have been separated because of a child welfare issue, and the mother must now live in the home as a condition for reuniting with her child.  Child welfare authorities view placement in these homes as an opportunity to reunite the young mother with her child on a (closely monitored) trial basis.  The Massachusetts program also receives reunification referrals of this type from local child welfare agencies; however, these cases make up a fairly small fraction of referrals to the Massachusetts program.

The Massachusetts and Michigan programs both receive most of their referrals from the TANF agency.  These programs were started in conjunction with state welfare reform initiatives that imposed the requirement that minor parents must live in an adult-supervised setting as a condition for receiving cash assistance.  In these states, funding for maternity group homes was secured in response to this new requirement.  When these programs were created, the homes were viewed as a means of providing an appropriate, supervised living situation for young mothers on TANF who could not live with their own families.  Because of this tie to TANF and welfare reform, these programs receive the bulk of their referrals from TANF agencies.  In addition, referrals to the Massachusetts program are closely tied to funding.  The program receives state funding through two sources: the state TANF agency and the state child welfare agency.  All referrals to the Massachusetts program must come from one of these two funding agencies.

The New Mexico and Seattle programs have no primary referral source.  Instead, these programs rely on a mix of referral sources that include schools, child welfare agencies, the juvenile justice system, homeless shelters, hospitals, and public health clinics.  The Georgia, Maine, and Michigan programs rely on a similar mix of referral sources to fill some of their beds.  In addition, these programs sometimes receive referrals through more informal channels, such as friends, relatives, or churches.  In other cases, the young mothers themselves request assistance from the program.  In contrast to the other study programs, the Massachusetts and New York programs do not rely on a wide mix of referral sources.  The Massachusetts program can only receive referrals from a small set of approved sources (the state TANF agency and local child welfare agencies), while the New York program receives all its referrals from the city child welfare agency.

The Referral and Application Process.  Although most homes in the study are part of larger programs, the referral and application process is usually handled directly by the homes themselves.  If a home receives a referral and has a vacancy, potential residents typically complete a detailed application form.8  The information gathered on these forms helps the program assess the needs of new applicants and helps the program detect issues that may create problems after the applicant is admitted. In addition, programs usually conduct background checks as part of the application process.  These checks help programs detect serious emotional or behavioral issues.  Applicants with especially serious problems are not allowed to enroll in the program.  In some cases, programs perform psychological assessments as an additional means of detecting potential problems and determining service needs.

"Ines" is 17 years old and pregnant with her first baby. She always fought a lot with her mother and for some time had been moving back and forth between her boyfriend's house and her mother's house. When her mother found out that Ines was pregnant, she kicked Ines out of the house. Ines went to live with her boyfriend and his mother. Then child welfare got involved and took Ines into state custody. Ines's social worker sent her to live in the maternity home, where she has been for the past few months. Ines goes to a GED program nearby and hopes to pass the GED test before her baby is born. She would like to go to college, but first she wants to spend some time with her baby. Sometimes Ines thinks the maternity home has too many rules and is too strict. But she still likes living there and thinks the program is helping her get ready for her life after the baby comes.

In many cases, homes require face-to-face meetings with applicants before they can be admitted to the program.  During these meetings, home staff conduct detailed interviews with applicants and carefully review the rules and expectations of the program.  In some cases, would-be residents decide not to pursue their applications further once they gain a better understanding of the structure and requirements that the home imposes.  Some homes interview multiple applicants for a single vacant slot.9  When using this method to choose among applicants, staff consider multiple factors, including their level of need and whether they would fit in well with other residents and with life at the home generally.  In homes where multiple applicants are interviewed to fill a single vacancy, staff indicated that this process enabled them to create and maintain a more harmonious environment in the home.  In other programs, homes accept the first applicant who meets their eligibility and screening criteria.

Although most study programs follow referral and application procedures similar to those described above, two of the programs have very different, more centralized, procedures.  In the Massachusetts program, most referrals are handled by the state child welfare agency (the network agency for the program) and not by the homes.  The network-level program coordinator decides where to place new referrals, and homes generally must accept the referrals they receive.  Similarly, in the New York program, all referrals come from the city child welfare agency and the program is generally expected to accept all referrals.

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