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OCSE Home Page Return to Table of Contents SNOHOMISH COUNTY HUMAN SERVICES DEPARTMENT
EXCERPT FROM SUMMARY OF FINAL EVALUATION FINDINGS FROM FY 1991 DEMONSTRATION PARTNERSHIP PROGRAM PROJECTS Agency: Snohomish County Human Services Department 2722 Colby, Suite 104 Everett, Washington 98201 Executive Director: Carol Williams Evaluator: Lynn Dodson University of Washington School of Social Work 4101 15th Avenue, N.E., JH-30 Seattle, Washington Contact Person: Carol Williams
Telephone: (206) 388-7245 Type of Project: Youth at Risk Project Title: Teen Parent Self-Sufficiency Project Model: Community-Based Case Management Target Population: Pregnant and/or Parenting Teens Project Period: October 1, 1991 to June 30, 1993 (Continuation Grant) I. Background A. Purpose of Program The Snohomish County Teen Parent Self-Sufficiency Project (TPP) was funded in September of 1988 by Demonstration Partnership Program (DPP), housed in the Office of Community Services (OCS) of the U.S. Department of Health and Human Services (DHHS). This 2-year demonstration project was developed in response to increased numbers of births to teen mothers receiving AFDC within Snohomish County, Washington. Because statistics suggested that the teen mother is likely to remain on welfare longer than any other category of public assistance client (Washington State Department of Social and Health Services, 1984), there was a great deal of concern in the community regarding the rapidly increasing numbers of teen parents who were living independently.
To address the needs of teen parents who were living within the city of Everett (the area with the fastest growing population of teen parents), the Snohomish County Human Services Department (HSD) entered into a partnership agreement with the Everett Community Services Office of the Washington State Department of Social and Health Services (DSHS) to provide enhanced services to pregnant and/or parenting teens participating in the State's Family Independence Program (FIP), a demonstration welfare reform program. Since FIP was a coordinated program which included Washington State Employment Security (WSES), the TPP had the advantage of direct involvement with this agency as well as with DSHS. Also included in an informal partnership were the Everett Housing Authority and Deaconess Children's Services. B. Hypothesis The primary hypothesis guiding TPP was that the provision of an enhanced, integrated program of services to a teen parent and her family would increase the participating teen parent's self-sufficiency. For TPP, self-sufficiency was defined as a process through which an individual reaches economic independence with decreased reliance on social service/income maintenance programs over time. Indications of progress toward self-sufficiency were as follows: 183Increased educational attainment 183Movement toward employment readiness 183Initial increased use of community resources with a gradual decrease in use as the family stabilized and moved closer to self-sufficiency C. Interventions The TPP was designed to provide a coordinated, comprehensive program of services, centering around case management, to a minimum of 50 pregnant and/or parenting teens residing in the Everett catchment area for DSHS. All referrals for TPP came from teen parent social workers at the Everett Community Service Office (CSO) of DSHS. To be eligible for TPP, a teen parent needed to be enrolled in the Family Independence Program, 15 through 19 years of age at the time of referral, living independent of her parents, and in need of completing her secondary education. Because DSHS social workers were inundated with caseloads of over 200 teens, their primary role in the project was the referral of teen parents to TPP, coordination and advocacy for the teens within DSHS, and coordination of service planning with WSES and TPP. The Employment Security workers assigned to teen parents were responsible for approving their employment/education plans and child care. TPP counselors provided "enhanced services" to the teen parents.
Enhanced services were provided through ongoing case management to caseloads of no more than 25 teen parent families. Service to the teen parent participant included the following components: 183Development of individual action plan 183Problem identification and solution 183Identification and use of resources 183Communication skill building 183Life skills training 183Assistance in: - Locating and securing housing - Accessing education/training programs - Accessing other community services 183Counseling and referral to assist with life traumas and building self-esteem 183Follow-up and progress monitoring Services to the family included counseling and/or referrals to outside organizations regarding the following: 183Interpersonal communication skills 183Parenting skills 183Household management 183Financial management 183Extended family relationships 183Health care 183Intimacy TPP developed, or helped the teen parents access support and social groups such as parenting classes and pizza parties. Vouchers were provided to purchase goods and services that would assist participants in stabilizing their families and moving toward self-sufficiency goals. In addition, subsidized housing was provided by the Everett Housing Authority to teen parents who were responsible enough to manage a home of their own. II. Study Approach and Evaluation Methodology A. Phase I: The First 30 Months While case management services were provided mainly to the teen parent, the participant's child(ren) and husband/committed male partner (if any) were also included in assessment of service need and action planning.
As described in the above section on interventions, counselors provided a broad range of services to the teen parent family. Upon referral from DSHS, the teen parent would meet with a TPP counselor for assessment, including need identification, use of resources, real and potential problem areas facing the teen, and possible solutions to these problems. This assessment often took place over a period of time because of the instability of the teen parent's life. Initial action plans focused on stabilizing the family. After the family was stabilized, goals and objectives toward the next self-sufficiency steps could be developed. If the family was in need of immediate housing, a determination was made regarding the appropriateness of referral for Section 8 or public housing. Because TPP had access to a limited number of Section 8 certificates and public housing units and because many of the teens were minors, liability and stability of the family unit were big issues in considering housing referrals. Many of the teen parents were assisted in another way, such as a voucher payment for deposit, first month's rent of a private apartment, or emergency housing in a motel if the participant was on the verge of homelessness. The main focus in developing the individual action plans was education and, eventually, employment. In the process of setting goals with the teen parents, the counselors helped them access community resources. The counselors accompanied TPP participants to alternative schools and community colleges for registration, helped them fill out financial aid forms, advocated for them with Employment Security and DSHS, helped them find appropriate child care, figured out transportation plans with them, and assisted them in accessing medical care. Counselors also helped the teen parents locate housing, assisted them in accessing parenting skills classes, taught them how to open checking accounts and budget their income, arranged for them to receive nutritional meal preparation classes from Washington State Extension Service, arranged for mental health therapy, provided vouchers for respite child care and driving lessons, helped them study for driver's license exams, arranged for them to learn basic home improvement and cleanliness skills, and directed them to family planning resources, supplemental food programs, and entitlement programs in the community. TPP also facilitated social events in order to break the isolation many of them experienced and to enable them to receive support from and give support to other teen parents. During the initial 30-month period of TPP, vouchers totalling $30,714 were written to help stabilize teen parent families and alleviate crisis situations. Vouchers were written for housing, food, tuition, utilities, child care, transportation, books, and miscellaneous items such as diapers, personal care products, clearning supplies, etc. While FIP assisted many teen parents with education expenses such as books and child care, some TPP participants were not eligible for this assistance. And while other community resources were looked for first, the instability of some of the teen parents' life styles often meant that outside resources were unavilable to them. The client support fund was a vital and invaluable intervention tool. Without this source of funds, many teen parents would not have been able to pursue their goals simply because they did not have the personal resources and energy to persevere in the face of a crisis.
A total of 77 teen parents were referred by DSHS for TPP. Of this number, 8 were 16 years of age, 14 were 17 years, 28 were 18, and 26 were 19. The age of one was unknown. At the time of intake, the 77 teen parents who were referred had a total of 72 children; in addition, 24 were pregnant at the time of referral. At the time of referral, 18 teen parents were enrolled in a high school completion or GED program, 2 had completed their GED or HS diploma and were not eligible for services, 51 expressed interest in completing their secondary education, 4 expressed no interest in returning to school, and the educational status of 2 was unknown. (There was no response to repeat attempts to contact them so intake was never completed.) Of the 77 referred, only 30 were in safe, affordable housing at the time of referral, 45 were in need of housing, and the housing status of 2 was unknown (the same 2 that could not be contacted for intake). Of the 77 pregnant and/or parenting teens who were referred to TPP, 24 left the program within 3 months. Case records verify that 53 teen parents received case management services for a period of over 3 months and were considered active cases. Of the 53, 44 teen parents remained active at the end of the demonstration period on March 31, 1991. At the conclusion of Phase I, the amount of time participants spent in the program ranged from 9 months to 24 months. It is important to note that the length of time in the program had a direct impact upon the end results, as do the age of the teen parent and the educational level when the teen left school. The following table indicates the results in the areas of education and employment at the conclusion of Phase I on March 31, 1991. It is important to remember that at the end of Phase I, the oldest teen parent was only 21 and that most of the children were still infants and toddlers with expensive and special child care needs. It is, therefore, not surprising that the progress toward self-sufficiency was an arduous process. Many teen parents continued to move toward their education and employment goals at the conclusion of Phase I. An important intervention for the control group was the attainment of safe, affordable housing. By the conclusion of Phase I, 20 teen parent families had been housed in Section 8 or public housing, and a total of 33 families had received vouchers to assist them with a rental deposit or payment. The stabilization of teen parent families in safe, affordable housing cannot be overemphasized in evaluating the ability of these teens to pursue their education and employment goals. The desire to protect and stabilize the family unit is a primary need and one that must be met before the teen parent is able to move on to the next level of need attainment. From our experience working with a more mature and highly motivated low-income population in Project Self-Sufficiency, we know that attaining self-sufficiency is a long and hard process that takes most individuals more than 2 years. Given the age of the teen parents, the personal and physical barriers to self-sufficiency this population experiences, the age of their children, and the short period of time that most of the teens were receiving services from TPP, the results shown were very positive.
B. Phase II: The Continuation Grant Period In the summer of 1991, the Snohomish County Human Services Department applied to DPP for a continuation grant. Because Phase II was a continuation of the services to the same population served between February of 1989 and March of 1991, TPP became a longitudinal study of the effectiveness of case management services to the teen parent population. Interagency agreements were signed between HSD, DSHS, and WSES, the primary partners in the project. While not included in the interagency partnership agreements, representation from the Everett Housing Authority was also included on the management team because many of the teen parents still remained in Section 8 of public housing. Phase II of TPP can be divided into three periods: start-up and reconnecting with the teens, continuation of case management services with identification of special needs of the population, and closure. 1. Start-Up The start-up and reconnecting phase is identified as the period between October 1991 and March 1992. During this period, one of the teen parent counselors who had taken another position within the agency was transferred back to TPP. She immediately began contacting the teen parents who were active at the end of Phase I to reengage them in the project. By the end of March 1992, 41 teens had updated their action plans and were once again receiving case management services. Of the 44 teens who had been active at the end of March 1991, 3 had moved out of the service area or failed to respond to repeated attempts to contact them. In addition, a teen who had been involved in Phase I for more than 3 months and had moved out of the service area returned, requesting services. She was "reinstated," bringing the number of teen parents who received services during Phase II to 42. It soon became apparent that circumstances had changed for many of the teens in the 6-to-12-month period they had not received services. During this period there had been at least 10 new pregnancies, 9 participants had married, 3 had divorced, 2 had relinguished their children to their husbands, 3 had given up their Section 8 Housing, and 3 had moved back to their parent's homes. In addition, two of the participants were waiting to enter drug/alcohol treatment programs. Action plans were revised in relation to life changes the participants had undergone during the interim period. As contact with the teen parents was made, action plans were updated and services reinstated. Mental health services were assisted in arranging services from providers in the community who accepted Medicaid coupons; in many instances participants had not taken advantage of these services. Participants either did not follow through after an appointment was made or went once or twice and did not return. Teen parents entering addiction treatment programs did not complete the program and one participant, who attempted suicide, did not continue with therapy when released from the hospital. Patterns of denial about or fear of addressing their mental anguish were apparent in a number of teen parents.
2. Continuation During the first year of TPP, counselors determined that over 50 percent of the teen parents in this project had been physically and/or sexually abused as children. Because this was such a high figure, the assumption was made that many of the problems facing the teen parents could be related to unresolved abuse issues. This assumption was supported by a study at the University of Washington (Boyer, et. al, 1992) of 535 pregnant and parenting adolescents in Washington State. Findings indicated that child sexual abuse is a critical factor in teen pregnancy and that "for a large number of pregnant adolescents, a history of physical maltreatment and sexual victimization may have disrupted their developmental processes and undermined their basic competence. In turn, these failures may have been compounded by victimized young women's inability to comprehend and make decisions about increasingly complex situations." Unresolved childhood abuse and abandonment appeared to be a huge barrier in the progress toward self-sufficiency goals. TPP staff and managers struggled with a way to provide mental health services that TPP participants would access and continue with. Because of the reluctance of participants to partake of traditional mental health services, efforts were made to contract for in-home services with the hope that taking the services to the teen parents would not only make the services accessible but would also place the services within their comfort zone. By the time liability and contracting issues for such services were resolved, TPP was in the final 2 months of operation and time was too short to provide such intensive services. Also, during Phase II, TPP sponsored parenting classes that were attended by seven participants and one partner. These classes ran for 6 consecutive weeks, with child care and transportation provided. Even with door-to-door van service, on-site child care, and an excellent instructor, these classes were not well attended. 3. Closure The final quarter of TPP focused on preparing participants for life without the support and advocacy of TPP. The counselor spent time with each participant, talking with them about where they were when they came into TPP and where they were at the present, so that they could see the progress made toward their goals. She asked them what they would do in certain situations in order to make sure they knew how to find resources on their own. She accompanied some of the most vulnerable participants to agencies or women's centers and introduced them to staff at these organizations so that they would have a name and face to turn to if needed. Most "goodbyes" were said in person. A pizza party was planned as a final social activity and was well attended. The personal growth and maturity of the individuals attending that social event was evident to all staff who interacted with these young women and their families during the 4-year period of TPP. It was an emotional occasion for all who attended. 4. Accomplishments The largest number of teen parents who completed the project were those who were 18 when they entered TPP. The largest percentage of dropouts, by age group, were in the youngest category, those who were 16 when they entered TPP. Of the 77 teen parents who were referred to TPP during Phase I, the following numbers, by age at time of referral, completed Phase II:
It is also important to note that of the 24 participants who were pregnant at the time of intake, only 13 percent (3) remained active until the end of the program. Therefore, it appears that the age of the child(ren) as well as the age (or maturity) of the participant has a direct effect upon the desire and ability to move toward self-sufficiency goals, thus affecting participation in a project of this nature. At the end of TPP, 39 active participants had a total of 72 children, or an average of less than 2 children each. These same participants had a total of 45 children when they entered TPP approximately 4 years earlier; 3 participants were pregnant when referred. The following table shows the number of children at the end of TPP by age of participant at time of referral.
As indicated earlier in this report, there was a great deal of concern about the number of children the teen parents were having. While concern is valid for many reasons, it must be noted that one third of the participants had only one child at the end of TPP. The greatest number of teen parents who completed TPP had only one or two children (34), and only five participants were parenting more than two. The major goal of the Teen Parent Project was to help pregnant and/or parenting teens who did not have a high school diploma or GED to attain education and employment skills which would move them closer to self-sufficiency. The following chart shows the progress of the teen parents between the end of Phase I (March 1991) and the end of Phase II (March 1993).
More than 80 percent of the teen parents who completed the continuation phase of TPP moved further along the continuum toward self-sufficiency. Of the 53 TPP participants who were active more than 6 months over the length of TPP (both Phase I and II), 66 percent enrolled at some point during TPP in classes toward their high school degree or GED, 55 percent of the 53 completed their high school degree or GED, and 70 percent were employed at some time during the project. Of the 42 teen parents who received services during the second phase, 25 were not receiving FIP (public assistance) at the end of the project. This represents a savings of over $140,000 in monetary entitlement, plus an unknown amount of savings in Medicaid. All public savings will compound in years to come as more teens finish post-secondary education/training and enter employment. In addition, as those who became employed continue to work and build job skills, they will be less likely to return to the public assistance roles. 5. Expenditures Between January 1992 and the end of March 1993, participants' support vouchers were written for a total of $12,382. The categories with greatest expenditures were child care, housing, and tuition. TPP participants needing to relocate following breakups with abusive partners or who were moving to be closer to school or employment requested assistance with rental deposits and partial first month's rent. The provision of on-site child care during parenting classes and respite child care for participants in danger of abusing their children increased expenditure in this category. Tuition needs remained steady across this time period as new students registered each quarter for classes at community colleges or vocational schools. 6. Partnership The TPP management team continued to meet during Phase II. During the second half of this phase, the management team spent a great deal of time on the subject of repeat pregnancies and the dangers of indiscriminate sexual activity, as well as mental health access. While these problems were not resolved by the management team, the Everett Community Service Office (CSO) of DSHS was concerned enough about the time issue to implement a pilot family planning outreach program, providing information to all teen parents receiving public assistance through their office, during this period. III. Evaluation Findings A. Conclusions The Teen Parent Self-Sufficiency Project was successful. More than 80 percent of the teen parents who completed the continuation phase of TPP moved along the continuum toward goals of self-sufficiency. Over 50 percent of the teen parents participating in this demonstration project made excellent progress toward their goals of self-sufficiency by completing their high school degree or receiving a GED. A total of 37 teen parents were employed at some time during the project, gaining job experience and skills that they lacked prior to their participation in TPP. Others, who may have some developmental problems as a result of physical or sexual abuse, did not make as much progress as we had hoped. Mental health issues and unstable life styles may follow these teen parents for years. During the course of this project, staff learned a great deal about the teen parent population and how they differ from an older single parent population. The process of reaching self-sufficiency goals is a long, hard road in which there are no shortcuts. The more education/training individuals receive in this process, the better equipped they will be to support their families. Single parents with small children or larger numbers of children will take a longer period of time to achieve their self-sufficiency goals. But for those who truly desire to break the bonds of poverty, who set goals and move toward those goals a step at a time, self-sufficiency will become reality. The keys to this reality are motivation, belief in self, empowerment, and support by others.
B. Recommendations In retrospect, there are several elements that would have strengthened the design of the Teen Parent Project and some design elements that were especially effective. The following recommendations are offered as assistance to those who may be developing research and demonstration projects and/or programs providing case management services to pregnant and parenting teens. 1. Sample Size and Comparison Groups The evaluation component of TPP would be stronger had the sample size for both the control and comparison groups been larger. It also would have been desirable to select both groups during the same time frame. Tracking the comparison group became a difficult task because these individuals were not receiving services or compensation, and they grew more reluctant to respond to follow-up questions as time went by. Also, having the control group intake spread out over such a long time frame meant less data on those who entered as part of the transition group. 2. Renumeration for Comparison Group Had renumeration been offered to the members of the comparison group at each 6-month follow-up, there may have been a stronger response. Without renumeration, the number of respondents dwindled with each 6-month period. 3. Selection Criteria Initially, TPP accepted all referrals from DSHS for the control group. The goal of TPP was to move teen parents toward goals of self-sufficiency, yet self-sufficiency seemed to be a foreign concept to some of the teens. After the initial intake period when countless hours were spent trying to locate a number of teen parents referred, it was decided to change the intake process. Rather than placing the responsibility for engaging the teen parents on the counselors, the teen parents were required to show interest and motivation in being involved in TPP. Requiring the referred teen parents to come to the office for an orientation to TPP and to sign a contract was very effective in recruiting teen parents who were ready and more committed to moving toward their self-sufficiency goals. For this reason, it is strongly recommended that a program orientation and intake process that requires a show of motivation on behalf of the program applicant be part of the program design. 4. Case Management When working with teen parents and other vulnerable or highly mobile populations, it is important to keep caseloads small. During the first phase of TPP, caseloads were kept at 25; during the second phase, one counselor, with assistance from a student intern, provided services to the remaining 42. Small caseloads allowed the counselor to spend a great deal of time with the teen parents in their own environment, which was essential to gathering information about the client's needs and ability to meet those needs.
5. Integral Services In designing a program that serves individuals and families as vulnerable as teen parents, some very basic services, in addition to case management, need to be considered an integral part of the program. These services include providing participant support vouchers, mental health services, and housing assistance. Without these services, the most vulnerable clients will not be able to move toward or reach goals of self-sufficiency. 6. Differentiated Needs and Services Final data from TPP suggest that younger teen parents and those who are pregnant at intake are less likely to complete a project aimed at goals of self-sufficiency than teen parents who are older or who are not pregnant at intake. This reinforces our experience that not everyone is ready for self-sufficiency at the same time and that applicants for a self-sufficiency program should be carefully screened in order to make best use of available resources. At the same time, services must be available for individuals who are not ready for self-sufficiency in order for them to some day reach the point of readiness. It is important for program managers to differentiate what population is being served, for the goals and expectations are different for each. It is also of vital importance for case managers to differentiate between those who are ready for a program aimed at self-sufficiency and those who have not reached that place in their lives. |
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