It’s hard enough to be a parent. Imagine trying to parent while struggling with addiction.
Last month, the Minnesota Department of Human Services tried to lessen the burden for pregnant and parenting women working to overcome addiction when it awarded 12 grants totaling $4.25 million annually for three years to 12 Minnesota agencies [PDF] that work to help women remain alcohol- and drug-free, obtain or retain employment, stay our of the criminal justice system, find and secure stable housing, access physical and mental health service for themselves and their children and deliver babies who test negative for substances at birth.
The grants, known as the Women’s Recovery Services program, have been ongoing since 2011, said DHS Assistant Commissioner Claire Wilson.
Targeting state funds for recovery programs that offer comprehensive services for addicted pregnant and parenting women is a unique approach, Wilson said. For the women helped by these programs, the roadblocks to sobriety are many; Women’s Recovery Services grants are designed to bolster agencies that strive to provide assistance in areas where addicted mothers need it most.
“What’s unique about this grant program in the world of chemical dependency and substance abuse is that the funding is going to women to sustain their recovery by addressing the kinds of issues that traditional treatment programs don’t,” Wilson said. “If you are a pregnant mom who is working with one of these programs, you can get help with things like diapers or parenting skills. These programs give the women they serve the opportunity to have a recovery coach. They help with employment, housing, all these wrap-around services that help pregnant and parenting women sustain their sobriety.”
As a population, addicted pregnant and parenting women are usually in the shadows, Wilson said. And programs that serve them are often underfunded.
“When you think about chemical dependency, most people think about single adults, especially single adult men. Women who are pregnant or parenting and dealing with addiction usually are not mentioned. There is a lot of bias and shame built around that reality.”
Many of the women served by the grantee agencies were raised in generations of poverty, addiction and abuse, Wilson said. Working to reduce the shame that many mothers feel about their addictions may actually help them come forward to get themselves — and their children — the help they need. When the entire family gets help, history is less likely to repeat itself.
“This population of mothers experiences chemical dependency at higher rates than the rest of the population,” Wilson said, “Programs like these work to treat addiction like a disease and show clients that they and their children can recover when given the right kind of help.”
While the multimillion-dollar price tag of the Women’s Recovery Services program may seem high at first glance, Wilson explained that research provided by St. Paul’s Amherst H. Wilder Foundation [PDF] has found that the grants produce a high rate of return.
“Wilder researchers found that $5.5 million in costs for this program reaped about $22.8 million in benefits for the state that included reduced emergency room visits, decreased hospitalizations, decreased child welfare costs, increased income to recipients, lower levels of homelessness, higher employment rates and increased family stability,” Wilson said. “This is hopeful news. Programs like these maximize benefits in the long run. If mothers can be stabilized in their recovery, the overall societal benefits are huge.”
How do these programs work? I talked to staff from two 2016 Women’s Recovery Services grant recipients, Grand Rapids-based Project Clean Start, a division of Hope House of Itasca County, and Twin Cities-based Wayside House. They told me more about their client populations and the special challenges they face.
Project Clean Start
Many of the women served by Project Clean Start begin life with the odds stacked against them.
“These women often come from generational poverty and addiction,” said Terri Blaha, Project Clean Start program manager and recovery coach. “By the time they get to us, they are chronic. They’ve been in treatment several times. They’ve been in and out of treatment hospital. They often have a hard time finding a safe place to live. Sometimes they’ve struggled to keep custody of their children.”
The pregnant and parenting women enrolled in Project Clean Start have direct access to the program’s comprehensive services for up to a year, Blaha said. After they’ve graduated from the sobriety program, they can remain connected to Clean Start through community support groups and by participating in mentor programs.
That consistency of connection is key to participants’ extended sobriety, Blaha said: “Thanks to this grant, we can hang with them for up to a year. We still have them come to our groups. We use them as mentors for others. As long as they are connected with our support, that can continue. And if they do relapse, we’ve found they don’t stay down for long.”
A focus on mothers
The program was founded in 1998, thanks to an earlier DHS grant, as a post-treatment support program for women in the region.
Today, the after-care program’s small staff helps participants access a rage of assistance options designed to help lighten their load and make recovery easier, including transportation help (public transportation in the region is limited-to-non-existent), housing assistance (the rental vacancy rates in the Grand Rapids area is as low as 1 percent), parenting classes, rent assistance and financial support for purchasing necessities such as baby supplies and food. Clean Start even maintains a “transitional trailer” where up to three women can live temporarily with their children until they can find more permanent housing.
“We’re really out there to advocate for our clients,” Blaha said. “They’ve had so little of that in their lives. We will supply gift cards to the gas station so that they can get to treatment or recovery meetings or work. We want to help them with whatever they need to be successful. We can even give them money to buy a crib. When you think of all the different things you have to manage as a parent, it can be tough just for person with a great car or great credit. Then just think about all the different things these women are up against.”
Project Clean Start’s Women’s Recovery grant totals $258,180 per year for three years.
Blaha said that, given her clients’ challenging backgrounds and the prevalence of highly addictive drugs like opioids and methamphetamines in their communities, her program has achieved an impressive success rate.
“Wilder did an analysis of our results,” Blaha said. “They found that a high percentage of our graduates achieved housing. Many were sober by the time they left. Six months later some had dropped a little bit, but by 12 months they were doing well again. When they leave here, 50 percent of our graduates or higher are sober. They have completed parenting classes and have their goals met. With the clients we have and the types of addictions they are struggling with, this is a very good rate.”
Founded in 1954, Wayside House is one of only a handful of providers in the state that allow children to stay with their mothers while the mothers are enrolled in residential substance use treatment.
Keeping families together is an important part of Wayside House’s ability to help mothers in the grip of addiction break the cycle of drug and alcohol abuse and learn to be more affective parents, said Karina Forrest Perkins, Wayside House CEO.
“The way our system is currently set up, when a woman deals with substance use issues and she is parenting, many times child welfare will separate that relationship and take the children out of the home,” Perkins said. “This separation can be traumatic to both the children and the mother. The ability to keep that relationship intact can be key to many women’s success.”
Chronically addicted women who are pregnant and parenting often come from desperately challenged backgrounds, Perkins said.
“Most of the time the women we see in our programs are the women who have grown up with very severe trauma in their lives,” she said. “They’ve been exposed to some of the most severe forms of poverty. They have been trafficked sexually. They have been exposed to emotional, physical or sexual abuse. By the time we see them, many of our clients come from the street. When they present to us they may have active diabetes or hepatitis C or be exposed to HIV-AIDS. They may have severe dental problems. Their children often have pediatric and health deficiencies. We serve a complex population on a very limited budget: This isn’t the Hazelden population.”
Success on a limited budget
Perkins explained that reimbursements for her program are at a Medicaid level, which means that without the help of grant programs like Women’s Recovery Services, participants would be eligible for only the lowest level of reimbursement for care.
“We serve some of the most complicated populations at the lowest level of reimbursement,” Perkins said. “The grant money helps provide the support to Mom that insurance does not pay. The substance-use treatment world is based on a fee-for-service structure. Under Medicaid, you don’t get support for room and board or recovery coaches or parenting education, but our women all need that.”
Wayside House is able to offer those services to the 600 clients they serve in their three facilities each year, thanks to their Women’s Recovery Services grant. The grant totals $490,000 a year over three years.
“We’ve been a grantee of DHS for 10 years,” Perkins said, adding that in the program’s 60-year history, they have served some 30,000 women and 6,000 children. “This year’s grant is a higher amount than we have received in the past. That’s because we are working with an even more complicated population.” Last year, the Wayside House won the Minnesota Council of Nonprofits’ Nonprofit Award of Excellence.
The DHS grant money helps Wayside House, which has capacity for 19 women and their children age 11 or younger at their family treatment center in Minneapolis is and 41 women without children in their St. Louis park location, provide a “robust package of care so that our clients have a higher chance of being successful,” Perkins said. “In programs like ours, the chance for relapse is much, much lower than it is for women who only have one weekly meeting with a counselor and no other support.”
Supports offered at Wayside House include, but are not limited to, specialized services for different cultures, financial literacy classes, vocational rehabilitation, telepsychiatry sessions with a female psychiatrist, parenting classes, yoga and medication management.
Thanks to this heightened level of care, Wayside House’s results are impressive, Perkins said.
“The women that come to us have had on average three unsuccessful care experiences at other recovery facilities. They have the odds stacked against them. For the last four years, our success rate has hovered around 69 to 72 percent. We have improved the statistics.” With financial support from programs like Women’s Recovery Services, Perkins said, “We’ve done a remarkable job — and we’ve saved a number of lives.”