1. M OVING F AMILIES T OWARD E CONOMIC I NDEPENDENCE Emily Feinberg, ScD, CPNP Sara Donahue, MPH, DrPH(c) Instructional Innovation Conference March 25, 2011

2. O VERVIEW Innovation purpose Moving Families Toward Economic Independence exercise Application to other courses Questions

3. I NNOVATION P URPOSE

4. C ONTEXT Course: Women, Children and Adolescents: Public Health Approaches Class session: Poverty and Family Self- Sufficiency: Understanding Social Indicators Need: Younger students may lack experience in examining social indicators or an understanding of poverty/low income status

5. P OVERTY INDICATORS Poverty thresholds Indicator of overall economic well-being Determine eligibility for public programs Family/individual level Community/school district level Federal Poverty Level (FPL) used as eligibility criteria for numerous programs serving the maternal and child health population Economic Independence Index (EII): alternate measure describing income adequacy and economic self-sufficiency

6. I NNOVATION : M OVING F AMILIES T OWARD E CONOMIC I NDEPENDENCE EXERCISE In-class computer simulation exercise Objectives Improve understanding of a major social indicator, the federal poverty measure, and its application Recognize the relationship between poverty levels and a family’s ability to meet basic needs Evaluate the impact of participation in public programs in families’ efforts to attain income independence

7. M OVING F AMILIES T OWARD E CONOMIC I NDEPENDENCE EXERCISE

8. B ACKGROUND

9. E CONOMIC INDEPENDENCE How much income is needed for a family of a certain composition in a given place to adequately meet their basic needs- without public or private assistance

10. F EDERAL P OVERTY L EVEL VS. E CONOMIC I NDEPENDENCE I NDEX $22,050 $67,749 Federal poverty line for a family of 4 Real costs for family of 4 living in Boston

11. E XERCISE C OMPONENTS

12. F AMILY A SSIGNMENT AND A CTIVITY STRUCTURE In-class computer exercise, students work in pairs or groups of 3 Each group is assigned a unique family structure One or two parents and two children of varying ages Hourly wage of $8, $11, or $18 Health insurance status: private paying 30% of premium, private paying 50% of premium, uninsured Students can determine other characteristics of their family Materials: Students use personal computers to complete calculations and access websites Students are given a packet of materials with website links and program eligibility guidelines

13. A CTIVITY 1: C ALCULATE EII Goal: Understand the relationship between the Economic Independence Index and the FPL Output For an example family of three: 1. Current income if earning $11/hour: $23,232 2. Income if self-sufficient: $65,238 (36% EII) 3. FPL: $18,310 (127% FPL) 4. Difference between current income and income required to be economically self-sufficient: $42,006

14. A CTIVITY 2: D EVELOP AN ECONOMIC INDEPENDENCE STRATEGY Goal: develop a strategy to help the family move toward economic independence Key assumptions All programs accessible Health insurance and tax liability requirements Childcare needs Steps and considerations Use family characteristics and program websites to select a strategy; document approach Struggle with balancing family needs with realities of public program restrictions

15. E XERCISE 3: E VALUATE APPROACH Assess impact of strategy on hourly wage needed to be self-sufficient Evaluate economic independence Consider feasibility of approach in current environment

16. D EBRIEFING Students reflect on their experiences in a class discussion facilitated by the class instructor Instructor role Encourage students to share their reflections on the simulation experience, to discuss experiences that were difficult or frustrating Provide details on programs as they are discussed, including review of the reality of program and service availability

17. E XAMPLE FAMILY

18. T HE C OLVINS Mary earns $11/hour at CVS and lives with her two children in Dorchester YearlyFPLEII%FPL%EII Self- sufficient income $65,238$18,310$65,238356%100% Income now $18,304$18,310$65,238100%28%

19. M ARY ’ S STRATEGY Monthly expensesCostValue of support New cost with support/subsidy Housing & Utilities$1,345$581 (subsidy)$788 Food$533$90 (WIC)$443 Transportation$59 Child care$1,790$1,295 (subsidized care)$495 Personal & household needs$434 Health care$412$412 (MassHealth)$0 Taxes$1,130 Tax credit-$267$863 (Child tax credit)-$1,130 Total$5,436$3,325$2,096 % EII, Original expenses% EII, New expenses 28%78%

20. S TUDENT REACTIONS “It’s so hard to navigate the system!” Eligible for some programs, not others Literacy level required for program websites “Child care is really expensive.” Surprise at the costs of certain budget items

21. A PPLICATION TO OTHER COURSES AND STUDENTS

22. A PPLICATION TO OTHER COURSES Use Help explain the role of public programs for low income families Clarify the concept of economic self-sufficiency Support in-depth analyses of the implications of life events on families’ economic status and access to public programs Audiences Medical students Advanced graduate students in public health or social work Students less experienced in public programs and policies Students in courses that examine the impact of poverty from a more theoretical perspective

23. S UMMARY

24. K EY BENEFITS Improves students’ understanding of economic self-sufficiency and poverty measures Engages and challenges students to think creatively and develop their own solutions while communicating important information and concepts Offers flexibility for a range of audiences and educational goals

25. Q UESTIONS

26. M OLLIE O RSHANSKY

27. F EDERAL P OVERTY G UIDELINES 2010 Federal Register, Vol. 75, No. 148, August 3, 2010 Persons in family Poverty guideline 1$10,830 2$14,570 3$18,310 4$22,050 5$25,790 6$29,530 7$33,270 8$37,010 For families with more than 8 persons, add $3,740 for each additional person.

28. F EDERAL P OVERTY L EVELS 2010 Persons in family 100% FPL 150% FPL 200% FPL 300% FPL 1$10,830$16,245$21,660$32,490 2$14,570 $21,855$29,140 $43,710 3$18,310$27,465$36,620$54,930 4$22,050$33,075$44,100$66,150 5$25,790$38,685$51,580$77,370 6$29,530$44,295$59,060$88,590 7$33,270$49,905$66,540$99,810 8$37,010$55,515$74,020$111,030 Each additional person$3,740$5,610$7,480$11,220

29. FPL AND MEDIAN INCOME, M ASSACHUSETTS 2009/2010 Family size 100% FPL 200% FPL 300% FPL State median income 1 $10,830$21,660$32,490$54,842 2 $14,570$29,140$43,710$66,437 3 $18,310$36,620$54,930$83,104 4 $22,050$44,100$66,150$100,280

30. W HAT IS THE E CONOMIC I NDEPENDENCE I NDEX ? Measure of income adequacy Takes into account costs of living differences family size and composition age of children community variations in costs of housing and childcare Measures categories of costs independently recognizes that families spend greater share of income on housing and childcare than food cost Includes costs associated with working Includes impact of taxes and tax credits

31. A SSUMPTIONS OF E CONOMIC I NDEPENDENCE I NDEX Employment - all adults work full-time Child care - uses rates from Child Care Resource and Referral Agencies, adjusted for age of child Transportation - use public transportation in cities, car ownership in other areas Housing rents- set at 40th%ile of market rate Food - l ow cost food plan, no allowance for take-out, fast food, restaurant meals Health Care - responsible for 30% of health insurance premium ($9,600/year) http://www.liveworkthrive.org/site/assets/docs/Mass_Index_Methodology_030810.pdf