Health / 2013
Inspiring Healthy Futures
Most low-income mothers seeking treatment for addiction, mental illness and domestic abuse face a heartbreaking choice: give up their children to a guardian or foster care and get help, or stay with their families and continue to suffer. Prototypes provides Los Angeles’ most vulnerable women and children access to behavioral healthcare and social services to ensure they can become healthy, independent and productive community members. Prototypes’ LA 2050 project is to ensure the robustness and sustainability of our children’s services. Prototypes’ children’s services are critical to the mother’s success and allow for Prototypes to tackle the intergenerational cycle of addiction, abuse and poverty. Children of addicted parents are the highest risk group to become alcohol and drug abusers, and studies have also shown that children with mothers with mental illness are at increased risk for psychological problems as well as alcohol and drug problems. Of the children who arrive at Prototypes, 56% of them suffer from developmental delays, hyperactivity or difficulties with attachment, and 71% of them have witnessed violence in their home or community. Prototypes was founded to fill the gaps left by traditional social service organizations and has pioneered the way to treat complex issues including homelessness, co-occurring substance use and mental health conditions and trauma by allowing mothers to stay with their children through recovery – and by providing a safe, comfortable environment for women and children to receive treatment for all of these issues in one location. A majority of clients have multiple physical and mental health needs, including chronic diseases such as HIV/AIDS. Therefore, Prototypes’ programs reflect these multiple needs by including rehabilitative, educational and vocational services along with life-skills training. In fact, Prototypes’ programs were the first of their kind to offer wrap-around services within a single location to ensure that women who complete the program are strong, self-sufficient and able to care for and support their children. Pregnant and post-partum women receive specialized support, treatment and access to pre- and post-natal care, and children receive a vast array of services including individual and children’s group therapy, onsite childcare and a Head Start preschool as well as pediatric care to ensure their best start at life. This holistic approach to treatment enables Prototypes to serve extremely high-risk women and children with equally high success rates. One of the most high-risk populations that Prototypes serves is women within the criminal justice system. This work started with the addition of Prototypes’ Community Prisoner Mother Program to provide residential substance abuse treatment services to California State inmates. The Community Prisoner Mother Program, in partnership with the California Department of Corrections and Rehabilitation, is truly a unique residential treatment program and provides comprehensive treatment with the goal of preparing inmate mothers and children for successful reintegration into their community. Respecting their important roles as mothers, Prototypes assists in reuniting mothers with their children and preventing separation of mothers and their infants at birth. As Los Angeles looks toward a healthier 2050, today’s children determine the future status of the health indicator. Integrating children into their mother’s treatment, and providing these children with physical and mental health services, reduces their risk of future problems with substance abuse, mental illness, and criminal justice involvement and keeps them out of the child welfare system. Keeping mothers and children together also plays a significant role in helping women maintain a sense of hope and determination as they proceed through treatment. Notably, mothers who receive family-centered treatment have increased rates of post-treatment sobriety. Ultimately, supporting both mother and child together strengthens their bond and ends the intergenerational cycle of addiction, abuse and poverty. Health is a critical component in determining a persons’ overall living condition. Providing critical services to children as early as possible ensures a healthier outcome with reduced risks of physical, mental and emotional health problems, including chronic diseases. And, while Prototypes’ children’s services help improve the health of Los Angeles, they also impact other indicators including education, public safety and income and employment. Preventing future health risks and providing a child a safe home enables them to continue their education, which, in turn, reduces the chances of crime-related activity and keeps them on the path of higher education and employment. While Prototypes’ services aim to address the current health needs of uninsured and vulnerable women, these services also ensure future generations’ health and safety.
What are some of your organization’s most important achievements to date?
When Prototypes first opened its Pomona Women’s Center in 1988, it was the first residential treatment center of its kind to allow women to keep their children with them while they recovered. Since then, Prototypes has rapidly grown to be one of the leading behavioral health care providers of comprehensive treatment for vulnerable families with co-occurring disorders. Prototypes is also one of the largest social service organizations in the United States serving high-risk women and their children. Highlights of Prototypes’ past achievements include:
• In 1989, Prototypes became one of the first agencies in the United States to offer AIDS prevention and outreach programs specifically targeted to women at risk.
• Prototypes opened STAR House in 1999 as a transitional domestic violence shelter for women and their children that provides comprehensive treatment at a confidential location.
• Through an innovative partnership with the LA County Criminal Courts, Probation, District Attorney, Public Defender and California Department of Corrections and Rehabilitation, Prototypes begins providing services for the Women’s Second Chance Re-Entry Court program in 2007.
• In 2011, Prototypes began accepting most PPO and HMO insurance plans and developed affordable payment options for those who do not qualify for Prototypes’ government-funded programs. This allowed us to serve even more individuals while also preparing for healthcare reform.
• When Assembly Bill 109 became effective on October 1, 2011, Prototypes was notified that its Community Prisoner Mother Program would close. Through legislative action and advocacy, Prototypes was able to keep the program open after its scheduled close date on June 30, 2012. Today, Prototypes operates the only program in the State of California that allows mother to serve their sentence in residential treatment instead of prison.
• Given its history and success, Prototypes has led other social service organizations in strategic advocacy efforts. In October 2012, Prototypes conveyed its First Annual Think Tank, bringing together experts in the field of treatment for women and children. With rapid changes in health care, it is imperative that organizations have a unified voice that helps shape further legislative action. The discussion and understanding that arose from the Think Tank is currently being developed as a white paper to disseminate throughout the State.
Please identify any partners or collaborators who will work with you on this project.
Prototypes maintains many partnerships throughout Los Angeles to provide comprehensive services and to reach highly vulnerable individuals. Partnerships with local and state agencies such as the Los Angeles County Department of Mental Health and Department of Children and Family Services provide a foundational support for the organization. Prototypes also partners with the Pomona Unified School District to provide Head Start programs and academically enriched after-school programs. Prototypes also collaborates with a federally qualified health clinic to ensure rapid access to primary and pediatric care of its clients, especially those with chronic health issues such as HIV/AIDS, whether or not they are insured.
Please explain how you will evaluate your project. How will you measure success?
The success of Prototypes’ programs is dependent on both the well-being of women and children and addresses four objectives. The most immediate is to decrease the use and/or abuse or prescription, alcohol and other harmful drugs. Additionally, Prototypes aims to increase self-sufficiency and parenting skills, improve mental and physical health and decrease recidivism and exposure to crime and violence. Prototypes success is dependent on the mothers being able to find a job, provide housing and a safe environment for their children. Short-term outcomes include: 75% of clients will show increased job skills, 70% will find safe and stable housing and 90% will demonstrate an increase in effective parenting skills.
Specifically for children, this project will ensure that 100% of children will receive mental and physical health assessments and will receive treatment and/or referrals for treatment if needed. Additionally, Prototypes’ infant and toddler daycare will provide developmental assessments to ensure young children are meeting appropriate stages. Long-term outcomes would impact the future of these children and include lower rates of chronic diseases and lower mortality and morbidity rates. Successful outcomes also include lower rates of substance abuse, mental illness and domestic violence as well as lower incarceration rates.
How will your project benefit Los Angeles?
Prototypes is often a last stop for women and their children who have immediate needs like access to shelter and food, but also complex mental health and substance use issues. With 11 locations in Los Angeles, and serving 12,000 people annually, Prototypes currently reaches underserved communities as a critical safety net for individuals seeking intensive and individualized treatment. Prototypes works to make sure that health disparities are reduced for the most underserved communities, increasing this population’s overall health and access to care. Additionally, Prototypes has made infrastructure changes in preparation for healthcare reform ensuring that our services continue to reach underserved care as individuals gain access to health insurance.
Prototypes’ unique social service model fills a much needed gap in care in Los Angeles and is directly benefiting children who may have not received services or who may have been sent to the child welfare system when their mothers entered residential treatment. Each day, Prototypes provides children with shelter, food, counseling and therapeutic daycare in a safe and nurturing environment alongside their mothers. The women receive intensive and integrated services that give the tools to care for and support their children, ensuring their health and that their opportunities for success are not denied. This project works to remove health as a “hindrance to human development” as we envision a better Los Angeles.
What would success look like in the year 2050 regarding your indicator?
The children that Prototypes serves today will be between 40 and 50 years old in 2050 and, due to Prototypes’ intervention, will enjoy better outcomes than their parents because their opportunities were not limited due to addiction, violence or mental illness. Rates of gainful employment and stable housing will be higher, and their overall quality of life will be greater. This group will also have significantly less problems with substance use, mental health and domestic violence, and, since they were able to stay with their mothers, they have continued to build strong bonds within their own family and community. They will also have reduced risk for chronic diseases such as HIV/AIDS, diabetes or cardiac disease due to their own knowledge and ability to seek preventive care. Therefore, their own children will have better health outcomes because of their access to preventive health care services and educational and career opportunities.
Today, many children at Prototypes have complex histories including experiencing extreme poverty and witnessing violence and abuse. Many children have severe behavioral problems, while others have reversed roles with their mothers, becoming her and their siblings’ caretaker. Yet, others display a lack of attachment or trust toward others due to past unstable living arrangements such as homelessness, having attended numerous schools in one year or being left unattended for long periods of time. This story of neglect and unequal access to basic needs should not be a part of Los Angeles’ future. By treating these children and their mothers now, Prototypes greatly improves the health and wellness of many families in the future.
Including children with their mother’s recovery has the longest and greatest impact and works to make sure that LA’s low-income communities of color no longer paint a dismal health picture. Not only do women have higher rates of post-treatment sobriety, but the children receive critical services that keep them out of the child welfare system and prevent them from repeating the cycle of abuse, addiction and poverty.