In 2010, the Urban Institute launched the one-year planning phase for the Housing Opportunities and Services Together (HOST) Demonstration, an effort to test two-generation strategies to improve the life chances of vulnerable youth and adults in public and subsidized housing. Over three years, housing authorities in Portland, Oregon, and Chicago, Illinois, adopted these strategies. At the end of the demonstration, Urban interviewed all the program staff to gather their reflections. This brief synthesizes these insights to provide practitioners guidance on what it takes to implement an effective, truly integrated two-generation model.
In 2010, the Urban Institute launched the one-year planning phase for the Housing Opportunities and Services Together (HOST) Demonstration, an effort to test two-generation strategies to improve the life chances of vulnerable youth and adults in public and subsidized housing. Over HOST’s three years of implementation the housing authorities in Portland, OR, and Chicago, IL, worked hard to adapt their engagement and outreach, strategize about how to target people within families, and coordinate their teams, all with the goal of building the kind of model that could yield real results for HOST families. At the end of the demonstration, the Urban Institute interviewed all of the program staff for the last time to gather their reflections. This brief synthesizes these insights to provide guidance for practitioners on what it takes to implement an effective and truly integrated two-generation model.
The HOST Demonstration
In November 2010, the Urban Institute (Urban) launched the one-year planning phase for the HOST demonstration, working closely with Home Forward, the housing authority of Portland, and the Chicago Housing Authority (CHA) to design a whole-family wraparound model for high-need residents of public and subsidized housing (Scott, Falkenburger et al. 2013). Both agencies have a history of developing innovative service models for their HOPE VI redevelopment initiatives, collaborating with Urban, and participating in research projects. The partners’ Moving to Work (MTW) status also grants them greater flexibility to shift their federal funds to pay for enhanced resident services, including two-generation models like HOST.
However, the specific sites that the housing authorities chose were very different. In Chicago, CHA chose Altgeld Gardens, an isolated, traditional public housing development located on the far south side of Chicago near the Indiana border. CHA targeted 230 mostly African American families who had not met the housing authority’s work requirement for two consecutive quarters. Under CHA’s basic lease requirements, every “work-able” leaseholder age 18 or older living in public housing must be working, engaged in educational activities, or volunteering two hours a week.1
In contrast, Home Forward chose to focus on two of its new, mixed-income HOPE VI sites, Humboldt Gardens and New Columbia, as well as Tamarack Apartments, a traditional public housing complex adjacent to New Columbia. At each of these sites, Home Forward recruited 136 families with chronic lease violations and rental arrears in the previous year. These families were ethnically diverse and included Caucasian, Hispanic, African American, and Asian families, immigrant and nonimmigrant families, and families enrolled in the Family Self-Sufficiency (FSS) program (called GOALS). FSS is a program funded by the US Department of Housing and Urban Development (HUD) aimed at helping public housing residents and voucher holders move toward self-sufficiency, providing case management to help them to set goals and helping them find employment.2
To support families as they worked to meet their goals, HOST emphasized a core case management component, with low caseloads to facilitate relationship building with vulnerable families, starting with ratios of case managers to families of 1:25 in Chicago and 1:40 in Portland. At Altgeld, CHA contracted with a large nonprofit agency, UCAN to provide this intensive support. UCAN, a large, multi-service child welfare organization, was already under contract with the CHA to provide basic case management on-site as part of CHA’s agency-wide FamilyWorks program.3 In contrast, Home Forward chose to rely on its own team of case managers to provide the intensive adult case management services. Staff came from a variety of backgrounds, including property management, the housing authority’s FSS program, and general resident services at New Columbia.4
Both CHA and Home Forward aimed to provide similarly tailored support for children and youth with the support of separate teams of professionals: Project Match, a venerable welfare-to-work program with a long history of working with CHA families, and Joy DeGruy Associates, a freelance multicultural team of experienced licensed clinical social workers who would coordinate with Home Forward’s HOST case managers to identify children and youth with acute behavioral or academic problems.
Over HOST’s three years of implementation, with feedback from Urban’s on-going formative evaluation, the Chicago and Portland HOST sites found creative ways to keep caseloads low at about 30 families per case manager to intensify the support families received. Both sites also worked hard to adapt their engagement and outreach, strategize about how to target people within families, and coordinate their teams, all with the goal of building the kind of integrated two-generation model that could yield real results for HOST families.
At the end of the demonstration in December 2015, Urban visited each site and interviewed all program staff for the last time to gather their reflections on what it takes to implement an effective two-generation model. This brief synthesizes these insights to provide guidance for practitioners in using this model to empower low-income families in communities across the country.
To select families and plan their service models, HOST sites relied on the kinds of data in public and subsidized housing settings for the purpose of lease compliance: basic ages and numbers of people in the household, flags for meeting subsidy requirements, histories of rental payments, lease violations, and compliance with work requirements, if any. However, case managers quickly realized that these data had serious limitations. For example, Portland staff discovered that the household rosters for each family had not been updated since the time of the last lease signing. This lag meant that staff did not have an accurate sense of who lived in the residence or, importantly, how old the children and youth were. Similarly, a manager in Chicago related the experiences of his staff in this way: “I think, in the beginning, when we were given a roster of who was hardest to serve, it didn’t really work. The IT system said something that wasn’t true in real life.”
As a result, the first step for case managers, before defining goals or proposing specific solutions, was to build relationships with families. The success of this process hinged on having low caseloads that enabled case managers to spend more time with each family. One UCAN staff person explained, “When you have 1 case manager to 100 clients, you can’t effectively meet with them and find out their needs. And when you’re going out, you’re just going out to get your numbers. You’re not going to develop relationships.”
To build strong relationships, case managers had to overcome families’ serious issues of mistrust. In Chicago, this suspicion often stemmed from families’ past experiences with federal programs. “So many agencies have been a part of these families’ lives, and they don’t’ trust anyone. [They think], ‘I tell my story over and over and the agencies just change.’” Some families in both sites were reticent to share too much about themselves with case managers because of fear that what they revealed might be shared with property management and jeopardize their housing. And, in Portland, where many HOST families were refugees or other immigrants, strong cultural and language barriers and a lack of familiarity with the concept of case management made building strong relationships difficult.
Overcoming these barriers meant HOST staff had to reach out and engage with families in unconventional ways. Once low caseloads were in place, Urban required case managers to reach out to or meet with all of their families once a week. That guidance gave rise to a whole new set of methods for connecting, including home visits, text messaging, e-mail, and phone calls, as well as traditional in-office visits. One UCAN case manager described the ways that she varied her efforts to connect with families, “You can change to meet them where they are. So every other week I’d alternate being in the field and then being in the office. … Some families were engaged and others were resistant. So I changed my days, sometimes I wouldn’t do a home visit for two weeks, but I’d make it up and go back to back.”
Both sites also held events that were often successful in bringing out families who case managers had difficulty reaching. In Chicago, Project Match held recognition events that grew in size from 20 to nearly 80 families, to celebrate youth achieving their goals throughout the demonstration. In Portland’s third year, the HOST team started organizing weekly family activity nights that spurred high turnout and interest even among isolated families.
Once case managers were able to engage families, they found using a family-centered approach, rather than a parent- or even child-centered approach, helped build meaningful relationships. As one Portland case manager said, “The nature of the relationship changed. Families have [the] perception that we care about the whole family and [that] we’re not focused on just lease enforcement. Now we care about the whole family and youth, and they respond well.” Under the new regime, case managers did not just passively ask about children and youth, they built relationships directly with the children and their parents.
Including multiple family members in conversations allowed case managers to understand the whole family in new ways. A Portland case manager talked about how having family rather than parent meetings helped uncover submerged issues within the household, “It helped fill in the puzzle piece. You’d have mom acting out, and [you] talk with the youth, and they’d have a different outlook…. Conversation in family, when they’re in [a] comfortable space… things come out.” However, other case managers pointed out that even parallel conversations were useful, in particular those with children and youth who did not have the same filters in sharing information as their parents.
When successful, relationship building over the three-year duration of the demonstration allowed case managers to have a much greater understanding of families’ strengths and weakness than would have been otherwise possible. As one Chicago case manager told us, “I had a client since 2006 from Family Works to HOST—and, wow—I had this client for four years and never knew what was really going on in her life.” This deeper understanding enabled case manager to take the next step of setting goals with families.
Setting Family Goals
Although ending intergenerational poverty and achieving self-sufficiency were the ultimate goals of HOST, the time frame in which these goals could reasonably be achieved depends greatly on where families start. Reflecting on caseloads after three years, essentially three different types of families emerged (Scott and Popkin 2016):
- Striver families: Parents in these families have relatively good health, education beyond a high school diploma, work history, and few dependents to support. Children may have a range of strengths and struggles; but, with the right support, these families are poised to escape poverty in the short to medium term, largely through the work of parents.
- High-risk families: Parents in these families need to overcome substantial barriers in the short term. Some of these barriers are personal, like low literacy or English language capacity, mental or physical health problems, limited work history, or simply too many young dependents in the household to support with wages alone at the beginning of a work trajectory. And some of the barriers these parents face are structural, including policies that exclude those with criminal history and undocumented parents from employment. Because of chronic difficulties making ends meet, children in these families may be under more stress than in striver families. In the short term, family goals may have more to do with stabilization and hardship alleviation while parents work on overcoming their own barriers. However, in the medium to long term, high-risk families may be able to build a path out of poverty either through parents’ efforts, changes in policy, or children’s efforts as they become healthy adults in their own right.
- Severely distressed families: In the remaining families, parents experience the types of chronic physical or mental health problems or disability that make stabilization the primary family goal, not only in the short term, but often into the medium and long term as well. Children in these families may have more problem behaviors, get suspended from school more often, and experience lower quality health than children in striver or high-risk families. But they can escape intergenerational poverty should their families receive the kind of support that creates stability within the home and helps young people stay on track until adulthood.
Most HOST families are high risk or severely distressed for several reasons. Public housing is one of the last sources of affordable housing for large, low-income families (Hunt 2010). Families in both HOST sites are large, with up to 9 people in Chicago and up to 13 in Portland (Scott, Popkin et al. 2013), and have relatively large numbers of children per household. Further, the initial targeting strategies ensured that HOST served many of the most vulnerable families in each site’s assisted housing. As a result, most HOST participants’ primary family goals in the short and medium term revolved around stabilization.
From the beginning, HOST partners defined family stabilization as housing stability, in part because of their immediate concerns as public housing authorities, but also because its fundamental role in bolstering family well-being. Despite their significant level of housing subsidy, HOST families experience tremendous difficulty making basic ends meet; this situation threatens parents’ and children’s ability to thrive. The baseline survey showed that 45 percent of Chicago families had paid their rent more than 15 days late and nearly 70 percent of Portland HOST families had paid their utilities more than 15 days late at least once in the last year, putting them at risk of losing their housing (Scott, Popkin et al. 2013). To measure housing stability, HOST service partners tracked lease violations and evictions, both of which are linked to basic things, like paying rent and utilities.
However, over the course of the HOST demonstration, the service teams became aware of other basic needs that had to be filled to stabilize families. Many were experiencing acute episodes of hunger. About 50 percent of Chicago HOST families and 60 percent of Portland HOST families reported worrying that food would run out before they got money to get more at least once in the last 12 months, according to the baseline survey. In comparison, only about 20 percent of American households share this concern (Coleman-Jensen et al. 2012; Scott, Popkin et al. 2013).
In addition, many HOST case managers found that strengthening interpersonal relationships was critical for stabilizing families. Many HOST case managers described situations in which the break down in these family relationships hindered their ability to succeed as a whole as well as individuals. A Chicago mental health specialist gave this example of a family that was constantly in crisis, “I started working with the [son], and we realized it was partially his issue and partially a family issue. Most of the cases are… but most families don’t have enough insight to see that…. They were blaming the son for a lot of the family behaviors and the behaviors going on with each individual, not realizing they had a part.”
Because of the level of need of the majority of families and the demonstration’s relatively short time horizon, HOST partners generally did not explicitly establish any short- or medium-term outcomes directly related to self-sufficiency or ending the cycle of intergenerational poverty. However, individual case managers, working with a small number of striver families and some high-risk families with older youth and young adult children, did indeed set ambitious but reachable goals, including transitioning off housing assistance and homeownership.
Targeting within Families and Personalzing Solutions
With employment rates among HOST families hovering around 50 percent, almost all parents set some goals related to eliminating barriers to employment and finding and sustaining a job, though the purpose of this employment varied depending on whether family goals included stabilization or self-sufficiency (Scott, Popkin et al. 2013). For the case managers of many high-risk and severely distressed families, addressing parents’ chronic physical and mental health problems became a separate goal in and of itself, regardless of whether it improved parents’ labor market prospects. Nationally, only about 17 percent of adults under the age 65 report fair or poor health,5 but more than a quarter of HOST parents in both Chicago and Portland rated their health this way. Moreover, in both Portland and Chicago, parents reported levels of elevated worry,6 depression,7 and anxiety at rates more than three times higher than other adults in the United States.8
For HOST children and youth, the most common goals focused on keeping children on track in school. In the baseline survey more than half of parents in Chicago and Portland said their school-age children were not highly engaged in school; and a quarter of youth ages 12 to 16 in Chicago and more than a third in Portland reported being chronically absent from school (Jordan 2013). However, like their parents, addressing mental health concerns with many of these children proved to be just as important as making sure they got to school every day. According to parents’ reports of their children’s behavior, nearly half of all younger children ages 6 to 11 were already exhibiting two or more problem behaviors, such as difficulty getting along with teachers, disobedience at school, bullying other children, and being overly active and restless. Moreover, according to the self-reports of youth ages 12 to 16, almost 56 percent in Chicago and 44 percent in Portland reported being anxious or nervous compared with 19 percent of youth nationwide.
HOST sites’ biggest challenge in the first year of implementation was figuring out how to serve so many individuals within families. Case managers always intended to engage with the head of household, but many staff had not anticipated working with other adults in the household (e.g., spouses, partners, relatives, adult children). Moreover, at the beginning of the demonstration, the sheer number of children also overwhelmed staff, with more than 350 in Portland and more than 500 in Chicago on the HOST caseload. As a result, neither site was really able to implement the kind of tailored approach to youth programming they originally planned. Instead, they primarily relied on big events and youth programming through events or group activities to try to maximize the number of young people served.
Through the formative evaluation, we learned that this strategy of trying to maximize the number of youth served at a low intensity was not yielding the kind of results we sought. As a result, in the second year, both sites decided to narrow their youth target population from all young people from birth to age 18 to mostly elementary school–age children. Within this smaller group, the two HOST sites set goals of academic engagement and achievement. Case managers actively worked to identify children struggling the most to achieve these outcomes through direct relationship building with parents and young people as well as more structured programming to meet those needs.
For example, the Portland team implemented a summer Sylvan reading tutoring program for children who were a grade level or more behind. The case managers uncovered this need during their advocacy for HOST children at schools and found a way to close the summer gap for high-risk kids. With this great demonstrated need, the program had clear objectives, evidence-based practice, trained staff, high participation, and ultimately successful outcomes. The principal at the school the target children attended successfully advocated for year-round school based on the results of HOST program.
In Chicago, Project Match also primarily targeted elementary and middle school students, encouraging them to participate in both UCAN’s clinical groups and out-of-school time activities. Project Match shut down in the third year of the demonstration and UCAN’s case management team took the lead in connecting HOST youth to services. In addition, the CHA directed the Chicago Department of Family and Support Services (DFSS) to bring in programming for older teens. DFSS contracted with Youth Guidance to target HOST youth for participation in its after-school programming and summer camps, as well as deliver its evidence-based Becoming a Man (BAM) programming to HOST youth, along with its companion program for girls, Working on Womanhood (WOW).9 Youth Guidance programs are school based, and the agency collaborated with UCAN staff to identify HOST youth in local high schools and target them for programming. Another organization, SGA Youth and Family Services, also provided some group social-emotional programming for HOST youth.10
However, by the third year, many of the HOST case managers felt limited by the narrow focus on elementary school children, particularly given the unique dynamics within each family. As a result, each site’s integrated teams found themselves moving more and more towards whole-family case management, personalizing the focus on particular individuals, the types of supports, and the intensity of their work with families after building strong relationships and setting family goals together.
Approaches to targeting individuals within families as well as the types of solutions offered varied significantly depending on the type of family. The following are examples of such approaches:
- Striver family: The Anderson family in Portland consisted of a mother and her 12-year-old son.11 At the beginning of the demonstration, she lived in subsidized housing for many years and was enrolled in a bachelor’s degree program. Her son was very smart but had long-standing emotional and behavioral problems. Fortunately, his mother had a high capacity to advocate for him on her own and had ensured he had an Individualized Education Plan (IEP) and additional supportive services at school from the time he was in kindergarten. HOST mainly focused on supporting the mother to finish her education, find a living-wage job, and maintain a positive relationship with her son.
- High-risk family: In the Calvin family, a single mom was living with two adult children and their younger brother at the Portland site. Ms. Calvin was working steadily but was never able to finish high school or get her general education degree (GED) or earn enough to support the family on her own. Both of her older sons were high school graduates and relationships within the family were strong. During the course of the HOST demonstration, the family’s case manager met with them and helped them set family goals. Through HOST, “They created a culture of a family as a single unit—that’s a huge shift…. We had a family meeting and I said, ‘This is not about [your mom] as the head of the household. It’s about you guys… be part of the household, support with the bills, be part of your [younger] brother’s life.’ … It really opened up the art of possibilities.” Goals for the HOST demonstration primarily focused on employment for the adult sons to achieve the goal of family self-sufficiency in the short term.
- Severely distressed family: In the Dennis family in Chicago, a mother and son are working together to ensure the son has access to more opportunities than generations before him. The mother was on the waiting list for housing assistance for 25 years and moved into Altgeld Gardens a couple of years before HOST began. The mother suffers from mental illness and untreated diabetes and was never able to attain her GED. Her youngest son, a high school student at the time, was on track to graduate from high school and looking to explore college options. Goals for the mother focused on stabilizing her treatment for health issues so that she could more fully support her son and connecting her to resources that would alleviate material hardship. In contrast, the son’s goals revolved around finishing high school and successfully transitioning to higher education to achieve self-sufficiency in the long-term independently.
A light touch sufficed for low-need adults or children; this approach meant meeting with them less frequently over time and referring them to existing community supports, programs, and resources. Higher-need adults and children required much more time and attention for case managers, including direct advocacy for children in schools, one-on-one coaching for adults, and referrals to more costly and more intensive outside services, like clinical mental health services, provided on site in Chicago but referred out in Portland.
Making Decisions and Programs and Policy
In the planning and early implementation stages, HOST sites took a much more programmatic approach to solutions, particularly for youth. That is, they tried to bring new programs to their sites immediately, assuming that the problem was lack of services rather than ensuring that families were effectively linked to existing programming. In retrospect, some case managers felt strongly that it would be better to wait to make programmatic decisions until case managers knew the families well and had clearly defined family goals, identified with whom to work most intensively within the family, and what their needs were. By pooling this information, sites would have been able to make much more strategic decisions about whether new services or programs were necessary and whether to fund original programming or refer people out to existing programs. One case manager advised, “Be more intentional in program development. We had to jump in right away. Use some months to plan and learn.”
Case managers and families also found that existing policies impeded their progress. For example, the institutional framework used as the launching pad for HOST in Portland lacked some of the flexibility needed to serve the diverse caseload. Before enrolling in HOST, some HOST families were already participating in a five-year FSS program called GOALS (Greater Opportunities to Advance, Learn, and Succeed) that provided low-intensity help with job training and placement. Some of these families were forced to move out of subsidized housing at the end of the original five-year time limit and were dropped from HOST, regardless of whether they wished to keep participating. Other families found out nearly a year into their HOST participation that they were not eligible for HOST because they had previously participated in the GOALS program.
Case managers also recognized ways in which housing assistance rules and regulations discouraged families from making progress toward their goals. In Chicago, a case manager explained, “One woman [had] a house full of kids, but they were all grown up. They were all working and so the rent would be calculated on all their incomes…. She didn’t want to do anything for herself. She would work then come home and take care of her daughter’s kids so her daughter could go to school, but she didn’t want to do anything for herself until her daughter got her degree.” In his close-out interview, one Portland case manager suggested that allowing families more time to adjust after their wages go up would help them learn how to budget and better cope with the rising cost of rent.
Taking this type of deliberate approach to decisionmaking could also free up vital discretionary resources for families. In their close-out interviews, families also emphasized that solutions are not all programmatic in nature. Sometimes families just need short-term discretionary funds for expenses like professional counseling, car repair, and debt payments. Very little cash assistance is available through government programs in the wake of welfare reform and having these discretionary resources is a place where a wraparound program could help to stabilize a situation before the family goes into crisis (e.g., losing their housing).
Building trusting relationships with whole families is the core of two-generation work. However, most HOST case managers did not have much experience with this approach. As described above, Portland’s HOST model grew out of Home Forward’s GOALS program, which was focused exclusively on adults and in which the role of the case manager consisted of responding to resident requests and making sure participants complied with program rules. As one staff articulated, “In traditional [FSS], it falls on [the] participant to be actively engaged, not on the worker.”
In Chicago, the case managers who staffed HOST were transitioning from the agency’s FamilyWorks program where they had high caseloads and their work focused on enforcing the CHA’s work requirement for its public housing residents. The on-site supervisor described the change in this way:
“Our role use to be collect data and paperwork… and deliver that information through Salesforce [The CHA’s service management database]. To go from that to what we do for HOST is a big jump… Staff didn’t think they were even equipped to do that work… [so] just to teach [them] another way of engaging clients was a challenge.” From the perspective of a Chicago case manager, “I hadn’t realized that people have barriers that I didn’t know about, and I just kept getting frustrated. So then I learned how to ask the hard questions.”
As a first step, both sites needed to provide training to case managers on the basics of good social work.
Portland provided co-active coaching training as well as a three -day intensive training in assertive engagement for all case managers. Chicago required motivational interview training for its entire staff to help them develop a goal-oriented, client-centered counseling style.12 In addition, UCAN took additional steps to make sure case managers used these skills with the whole family. All Chicago HOST staff learned how to facilitate a genogram process to better understand how family patterns shape individual’s circumstances and state of mind.13 During this process, the case manager works with the client to map out her family tree as well as factors like education, occupation, major life events, chronic illnesses, emotional relationships, as well as challenges like alcoholism, depression, and chronic health problems. This process allowed case managers to get to know families better and shift their orientation away from the head of household to the family as a whole. Finally, as discussed below, the Chicago HOST team held meetings to review their cases and talk about strategy for assisting challenging families.
After establishing trusting relationships, many case managers found that they needed the support of mental health professionals to address underlying issues within the families. In Chicago, the CHA required UCAN, like its other FamilyWorks providers, to offer clinical mental health services on-site. The low caseloads and additional staffing that HOST brought meant that there were two providers assigned to the demonstration who could respond to service requests and facilitate clinical groups. The Portland site did not have this kind of expertise in-house since the housing authority, Home Forward, was providing HOST case management directly. However, in practice, the team subcontracted to work with youth—all of whom were clinical social workers. The case managers quickly came to rely on the youth team to provide direct therapeutic support to families in crisis as well as to coach the case managers themselves on how to handle volatile situations.
Because of how individualized goals and solutions are for families, adults, and youth, both the Chicago and Portland sites needed to leverage a wide array of expertise across the HOST teams, including knowledge of and connections to the workforce development, mental health, adult education, immigration, and other social service systems. In their everyday functions, different team members also interacted independently with different members of the family to fill different needs.
Thus, the experience of actually implementing a two-generation model raises significant questions about the roles and responsibilities of individual team members and requires a higher level of coordination than more conventional program models. In response, the Chicago site team designed a system for all team members to regularly review cases and communicate. At all-day interdisciplinary team meetings, staff present cases to the clinical and supervisory team once a month. Generally, the group reviewed nine family cases each session, each taking approximately 45 minutes. Initially, case managers disliked the process, but they came to value how it helped them understand everything that was going on with families and connect to appropriate resources.
Putting such a structure in place proved challenging in Portland, where the adult and youth teams often worked during completely different hours of the day. The youth team manager explained, “Our [youth team often] works in the evenings and on weekends, and communication has been a challenge with the larger team. [They] do things together, but they don’t see each other every day.” To promote a more integrated approach, the Portland team tried many different things throughout the demonstration including all-hands-on-deck meetings every two weeks with all staff, separate coordination meetings of youth and adult staff at New Columbia and Humboldt, and whole-family meetings with parents, children, and their adult and youth case managers.
Portland also struggled with how to effectively share information about families across teams. Because the youth team members were not Home Forward employees, they could not use and access the database that the adult team used to maintain all their notes and observations about families. As a result, the youth team maintained hard copy files and recorded data for the evaluation in a separate spread sheet. This bifurcated way of storing information made it difficult for both adult and youth staff to coordinate how they interacted with families. For example, there was no way for adult case managers to quickly look up what happened at the youth case manager’s last home visit, or vice versa.
Implications for the Field
When they started out, the practitioners in the two HOST sites had never before attempted to implement a two-generation or whole-family approach to addressing poverty for high-need residents of public and subsidized housing. At the beginning, partners started out by designing parallel tracks for adults, children, and youth; but in the end, after much experimentation, the HOST sites moved toward a much more integrated model that puts family goals first and tailors the kinds of supports and services provided to the unique needs of families.
The experiences of the HOST sites provide many insights into what it takes to implement the kind of two-generation model that may actually address intergenerational poverty, including alignment at the program, organization, and policy levels. The following are just some of the implications for practitioners and policymakers.
- Allocate resources to prioritize relationship building with the most vulnerable families. The existing cost structures for administering housing and social services do not allocate adequate resources for the kind of low caseloads that facilitate the relationship building that developed over time in HOST. There are many potential ways that systems could be reoriented to support this approach. Social service agencies and housing authorities alike could change their practices to dedicate resources first to support relationship building before funding or continuing to fund discrete programs and services. It is vital for organizations to get away from trying to fit people into programs, and rather look to how to design a suite of solutions organically that fit the families they serve. In addition, local communities could explore ways in which the innumerable federal and local programs touch the poor could pool resources and consolidate the case management for multiple programs under a single point person for each family.
- Provide appropriate and substantial support and training to staff. To put this approach into action, case managers need both substantial training and flexible policies and work environments. Because most two-generation models have their origins in either a parent- or child-centric program or service, case managers must be mindful from the beginning of these inherent biases and have training on coaching and other social work techniques that emphasize getting to know the whole family with a certain degree of agnosticism about family goals, who in the family will need the most time and attention, and what solutions might look like. In addition, service providers considering a two-generation approach should make sure that they have staff are well connected to a diverse set of resources for low-income families and have access to support from partners who are formally trained in counseling or clinic social work to deal with the depth of issues that arise once close relationships are established.
- Plan and provide a structure for collaboration. Two-generation models are often complicated, and many different providers and staff may need to interact with families to help them meet their goals. Consequently, it is vital to anticipate the degree of coordination that will be required to share information, avoid duplication, and build trusting relationships. This means cultivating a sense of a team, both through regular family-focused meetings and in providing other structured ways for staff to share information with each other, particularly when they belong to different organizations or primarily work off-site. Case management systems may provide important space not only for discrete data points but also for the kind of qualitative information that helps everyone who touches a family stay on the same page. In addition, staff need a system and time in their work days that they can dedicate to this kind of coordination.
- Align policies to support two-generation work. The most intensive outreach and the best-designed two-generation programs may not succeed if organizational policies are not aligned to help families meet their goals. Partners who enter into this kind of wraparound work should go into the process expecting not just to provide services but also to reexamine their programs’ policies and make adjustments as case managers get to know families and understand some of the structural barriers that make it difficult for families to succeed.
Many practitioners and policymakers around the country are looking to two-generation models as a solution to persistent poverty in their communities. Careful design and implementation, based on the kind of insights gleaned from the HOST demonstration, can help these communities anticipate the kinds of challenges they will face and proactively design and implement their models in a way to best positions them to achieve positive results for the families they serve.
- “One Year Later, CHA Work Requirement Yields Results,” Chicago Housing Authority, last modified February 5, 2010.
- In general, participants enter into a five-year contract with the housing authority, which outlines family goals and obligations and the services available to them to help meet those goals. HUD requires every participant contract include the following two goals: that the head of household become employed and that no member of the family is receiving cash Temporary Assistance for Needy Families benefits for 12 months before completion of the contract. The most distinctive feature of the FSS program is the escrow account, which functions like an individual development account. If a participant’s income rises, his/her required rent contribution rises as well (since rent is set at 30 percent of income), but the public housing agency deposits the difference from initial rent and increased rent in an interest-bearing escrow account, which the participant can claim at the end of five years(Turner, Cunningham, and Popkin, forthcoming). http://www.thecha.org/residents/services/.
- “Family Self-Sufficiency (FSS) Program,” US Department of Housing and Urban Development, accessed December 10, 2015.
- USDA, Economic Research Service analyses of data from the December 2011 Current Population Survey (Coleman-Jensen et al. 2012).
- National data for all 50 states, DC, and US Territories are from the Behavioral Risk Factor Surveillance System (BRFSS) in2011, the same year as the HOST survey. For the cited statistic on health status, use the BRFSS data system found on the CDC website.
- The question measuring elevated worry is one of the components of the CIDI depression screener. Respondents were asked, “Did you have a time in the past 12 months when you worried a lot more than most people.” Those answering ‘yes’ are defined as having elevated worry. National data are from the 1999 National Health Interview Survey. “WORMORE,” Integrated Health Interview Series, accessed December 10, 2015.
- Depression is measured by the CIDI, a validated depression screening tool used in the National Health Interview Survey (NHIS). In the baseline survey, adults were asked a series of seven questions to determine major depression - gauging behavior such as loss of interest in hobbies, trouble concentrating, thoughts of death, and feeling worthless. Answering “Yes” to three or more of these questions (a score of at least 3 on a scale of 0 to 7) classified respondents as having major depressive symptoms. National depression comparisons were calculated using the same method in the 1999 National Health Interview Survey. “DEPDYSWHO,” Integrated Health Interview Series, accessed December 10, 2015.
- The question measuring anxiety is one of the components of the CIDI depression screener. Respondents were asked “During the past 12 months, have you ever had a period of time lasting one more or longer when most of the time you felt worried, tense, or anxious?.” Those answering ‘yes’ are defined as having anxiety. National data are from the 1999 National Health Interview Survey. “WOR1MO,” Integrated Health Interview Series, accessed December 10, 2015.
- “B.A.M. — Becoming a Man,” Youth Guidance, accessed January 6, 2016; “W.O.W. – Working on Womanhood,” Youth Guidance, accessed January 6, 2016.
- “Where Adversity Meets Opportunity,” SGA Youth and Family Services, accessed January 6, 2016.
- All family names have been changed to safeguard HOST families’ identities.
- Motivational interviewing was developed by Stephen Rollnick and William R. Miller and published in 1991. The technique has been widely adopted in counseling professions to address diverse issues and support clients in achieving their goals.
- Genograms were first developed by Monica McGoldrick and Randy Gerson and disseminated Genograms: Assessment and Intervention originally published in 1985.
Chase-Lansdale, P. Lindsay, and Jeanne Brooks-Gunn. 2014. “Two-Generation Programs in the Twenty-First Century.” Future of Children 24 (1): 13–40.
Coleman-Jensen, Alisha, Mark Nord, Margaret Andrews, and Steven Carlson. 2012. Household Food Security in the United States in 2011. Washington, DC: US Department of Agriculture.
Hunt, D. Bradford. 2010. Blueprint for Disaster: The Unraveling of Chicago Public Housing. Chicago, University of Chicago Press.
Jordan, Reed, Amanda Mireles, and Susan J. Popkin. 2013. "HOST Youth: The Challenges of Growing up in Low-Income Housing." Brief 4. Washington, DC: Urban Institute.
Scott, M. Molly, Elsa Falkenburger, Marla McDaniel, Amy Khare and Susan J. Popkin. 2013. "HOST Year 2: Implementation and Expansion." Brief 2. Washington, DC: Urban Institute.
Scott, M. Molly, and Susan J. Popkin. 2016. "A Theoretical Framework for Two-Generation Models: Lessons from the HOST Demonstration." Washington, DC: Urban Institute.
Scott, M. Molly, Susan J. Popkin, M. McDaniel and R. Jordan. 2013. "Serving HOST Families: the Challenges to Overcome." Brief 3. Washington, DC: Urban Institute.
This brief was funded The Urban Institute thanks the Open Society Foundations, Paul G. Allen Family Foundation, Kresge Foundation, W. K. Kellogg Foundation, US Department of Housing and Urban Development, Annie E. Casey Foundation, and National Institutes of Health. We are grateful to them and to all our funders, who make it possible for Urban to advance its mission. We also thank the Chicago and Portland HOST communities that opened their doors to us and shared valuable information and life experiences.
The views expressed are those of the authors and should not be attributed to the Urban Institute, its trustees, or its funders. Funders do not determine our research findings or the insights and recommendations of our experts. Further information on the Urban Institute’s funding principles is available at www.urban.org/support.
The authors also thank our colleagues, Abigail Baum, Mary Bogle, Elsa Falkenburger, Sarah Gillespie, Chantal Hailey, Chris Hayes, Reed Jordan, Marla McDaniel, Amanda Mireles, and Priya Saxena.
About the Authors
Molly M. Scott is a senior research associate in the Metropolitan Housing and Communities Policy Center. In recent years, much of her work has focused on providing practical research support for nonprofits and local government agencies in planning, implementing, and testing innovative, place-based strategies to improve the lives of the ever-more-diverse low-income population.
Susan J. Popkin is a senior fellow and director of the Neighborhoods and Youth Development initiative in the Metropolitan Housing and Communities Policy Center at the Urban Institute, a research program that focuses on the ways neighborhood environments affect outcomes for youth and on assessing comprehensive community-based interventions. A particular focus is gender differences in neighborhood effects and improving outcomes for marginalized girls.
Jasmine K. Simington is a research assistant in the Metropolitan Housing and Communities Policy Center, where her work focuses on assessing housing needs and conditions, school-based wraparound services, and community-based participatory research.