Healthy Beginnings: Housing Stabilization Program for Pregnant Women

January 2, 2018

CelebrateOne, through a near $1 million grant from Ohio Housing Finance Agency (OHFA), has created a new research program to help extremely low-income women find stable housing during their pregnancy.

The program, Healthy Beginnings, will be implemented through a partnership with Homeless Families Foundation and Columbus Metropolitan Housing Authority (CMHA) to provide rental subsidies and medical services to Medicaid-eligible pregnant women who are near homeless or homeless. The results of the birth outcomes will then be compared to a similar group of pregnant women who are only receiving prenatal healthcare services.

CareSource has provided $250,000 to the program and will play a role in identifying those in need of housing and providing data that shows the impact of the program. After the success of CareSource’s Care Homes, a small pilot program of 10 formerly-homeless pregnant women who went full-term, we believe this bigger project could produce results that would make a huge impact on our work and the lives of many women.

More Healthy Babies

The goal of the program is to evaluate whether having stable housing will improve birth outcomes and reduce infant mortality. Our research team will conduct data analysis and prepare a report on completion of the two-year program. Children’s Health Watch and Nationwide Children’s Hospital will be evaluating the research.

Some of the data that will be collected:

– Birth Data (i.e. weeks of gestation, birth weight)
– Social Vulnerability (i.e. housing stability, trauma, other factors)
– Health Risks (i.e. illicit drug/opiate use, mental illness)
– Frequency of Ongoing Prenatal Care
– Prenatal and Postpartum Care (i.e. frequency and timeliness)

Program Outline

We will help 100 pregnant women within our priority neighborhoods. The women chosen will have extremely low incomes and be in unstable housing or homeless. Fifty of the women will be randomly assigned to receive community based services, while 50 will receive community-based services, a rental subsidy, and housing stabilization services.

The housing stabilization services include:

– Funding for housing related expenses, such as furniture, utility arrangements, and application fees.
– Funding to resolve housing needs and barriers (e.g. security deposits, rent/utility arrearages, application fees, etc.).
– Assistance in housing selection and move-in support.
– Teaching tenant about tenant rights, financial capability, or other tenancy-supporting trainings/supports.

The program will roll out into four different phases, divided by the introduction and birth of the child.

Phase 1: First 30 Days
The main priorities will be to effectively engage the family in a needs assessment, develop a personalized plan with the mother, and rapidly connect them to safe and affordable rental apartments.

Services include:
– Assistance in housing selection, housing barriers, move-in support, and furnishings.
– Fully subsidized rent for the term of the intervention.
– In-person (mobile) or home-based visits weekly by a CHW.
– Teaching tenant about tenant rights, financial capability, or other tenancy issues that result in moving less frequently and increased housing stability.
– Continual coordination with CMHA on changes in income and ensure tenant pays rent and resolve any issues that arise with the landlord.
– Coordination with CareSource MCP services.

The design follows many components of Family Critical Time Intervention (CTI), an evidence-based, time-limited case management model designed to help homeless families re-establish themselves in stable housing along with needed emotional and practical support.

We can help the mother address issues and challenges from a positive, strength-based perspective and engage in other services. All planning and interventions throughout the process will be trauma-informed, a practice that emphasizes physical, psychological and emotional safety for both clients and providers, and helps survivors rebuild a sense of control and empowerment.

Phase 2: 30 Days through Birth of the Child
This phase continues personalized assistance for the mother including:
– Home-based visits.
– Income stabilization services that focus on both earned income from work and benefits.
– Financial coaching and budgeting education, including credit repair and employment services.
– Screening for eligibility for and linkage to benefits and services.
– Food and nutrition assistance, including SNAP (food stamps), food pantries, etc.
– Education and programs for children, such as Head Start/Early Head Start or public pre-K.
– Family planning and parenting education.

Phase 3: Post-Partum
We want to ensure that long-term links to community supports are in place, while assisting with education and best practices on breast-feeding, infant care, and childcare.

CelebrateOne’s Community Health Workers (Connector Corps) will help provide appropriate resources to care for their newborn, ensuring access to information on proper maternal/infant nutrition, and any other services appropriate to assure healthy birth outcomes.

During the six month transition phase, if the mother cannot find employment or housing, the program will pick up the full rental cost until the mother is able to return to work and begin contributing again. Each family will develop a housing retention plan that includes how the family will meet monthly rent obligations and plans to address disruptions in income.

Phase 4: Aftercare and Housing Retention
Phase 4 occurs at the end of the rent subsidy and provides additional assistance to the families to ensure continued housing stability. The family will begin paying rent in full to the property manager.

There will also be eviction prevention programming (EPP) to create a set of coordinated, integrated strategies and tactics designed to avoid loss of tenants for landlords and housing for renters. This may include:
– Emergency assistance funds.
– Financial coaching and budgeting.
– Payment plans.
– Service referrals.
– Behavioral education (e.g. housekeeping coaching).
– On-going benefits screening and employment services.

There is still an additional $185,000 to fully fund the 2-year program. We believe with this evidence-based research, we have an opportunity to create a pathway to help more women have healthy babies. The hope is that this research could impact birth outcomes and housing policies across the state and the nation.