Maternity Group Homes Classification and Literature Review. Program Components and Service Delivery in Maternity Group Homes


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).

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