Padua™

The Issue

Over 7.5 million families live in poverty in the U.S. That’s over 25.5 million people. Of these, 11.4 million are children under the age of 18—meaning  16% of all American kids live in poverty. And though these numbers are already telling, how we define “poverty” puts the severity of the issue into perspective. 

Each year, the U.S. Department of Health and Human Services publishes new poverty guidelines. These guidelines define “poverty” in monetary terms and they’re used to decide whether someone is eligible to receive public benefits. In 2020, “poverty” for a family of four means earning less than $26,200 annually. For a family of three, it’s $21,720. 

But, researchers at MIT argue the poverty threshold is tragically outdated. It only accounts for a basic food budget, and does not incorporate taxes, childcare, or healthcare. In place of the poverty thresholds, they offer the concept of a “living wage,” which incorporates all necessary expenses families face. For a family of two working adults and two children, the living wage is $66,842. This means that families earning below a living wage will have difficulty covering basic expenses and necessities. Imagine supporting a family of four on less than $26,200 a year. It’s not just difficult. It’s impossible.

And many of those struggling in poverty are doing everything right. Parents often work two or more jobs and balance extreme schedules to support their families. But, stuck in low-wage jobs, they can’t make ends meet.

Encouragingly, social service providers around the country are working tirelessly to support families in poverty and offer them a way out. But their solutions are often one-dimensional. And poverty has many dimensions. Families in poverty juggle numerous complex, co-occurring issues. 

Take, for example, a family that can’t maintain stable housing. While participating in a supportive housing program may be helpful, the underlying issue might be that the family can’t maintain employment or guarantee a steady source of income. Which leads to missed rental payments. And eviction. 

In the National Survey of America’s Families, Loprest and Zedlewski (2006) identify eight barriers to work among low-income families: low skill, lack of transportation, poor mental or physical health, low work experience, the presence of a young child, having a child on Supplemental Security Income (SSI), and language barriers. And these are just a few of many. Providing temporary housing to a family in need of employment, then, is merely a short-term solution to a collection of deeper, long-term problems. 

Today, many case management programs aim to reconcile these short-term needs with long-term solutions to poverty. Still, their models are limited. Case managers weave together long lists of community services and organizations that families in poverty might be able to leverage to meet their needs. But often, the organizations themselves are siloed and uncoordinated. 

With multiple case managers across a multitude of organizations, families in poverty are forced to fill out reams of paperwork while explaining their story again and again. But many of the organizations they reach out to offer programs with differing eligibility requirements, leaving families frustrated and disappointed. And to make matters worse, they often face significant logistical challenges. Many organizations are physically far apart, which makes transportation difficult for those who don’t have a car. And many only offer appointments during the weekdays, which is inconvenient for working families who often have inflexible working schedules. It’s a broken juggling act.   

We need a more holistic approach to poverty. We need one that addresses its complexities from all angles. If we focus on poverty’s individual symptoms, rather than its many causes, we allow it to persist. And persistent poverty is expensive. In 2017, the federal government spent $670 billion on public welfare programs, including Medicaid, housing vouchers, and disability insurance. All programs that address the symptoms of poverty, not its causes. 

To lift families up, we need to unleash comprehensive solutions and attack poverty at its root. We need evidence around what programs ensure not only a brighter today, but also a brighter tomorrow.

The Intervention

Padua is a holistic case management program designed by Catholic Charities Fort Worth to address the unique assortment of barriers faced by families in poverty. The program has five main elements: a detailed assessment, a service plan, a case management team with small caseloads, case management services, and strategic, flexible financial resources. 

After enrolling into the program and completing the detailed assessment, participating families are matched with a two-person case management team. Together, families work with their case managers to design an individualized service plan that helps them prioritize and methodically tackle issues in order to achieve their goals. 

To enhance their service plan, case workers provide families with the services and referrals they need to be successful. And to ensure participants have easy and efficient access to the services they need, the Padua model forms strong relationships between key service organizations. These partnerships are designed to break down the silos that often exist across community organizations, freeing up the time and energy clients need to focus on meeting their goals. 

Similarly, because the Padua case management teams have small caseloads, they’re able to build strong relationships with the families they serve. These relationships support participants over the long haul--families can participate in Padua until they reach self-sufficiency, which often means they’re engaged in services for a number of years. And as part of the program, families also have access to strategic, flexible financial assistance that case managers can use to incentivize the behavior that leads them to achieve their goals. 

With a long-term, dedicated case management team, a comprehensive service plan, and flexible financial resources, Padua is intended to lift families out of poverty for good. For Catholic Charities Fort Worth, this means independence from means-tested public support, a stable and self-sufficient wage income level based on family composition, three months of savings at a self-sufficient wage level, and appropriate levels of debt.

Research Question

Do holistic, intensive, wraparound case management services help lift low-income families out of poverty? Are the results large enough to justify the high cost of the program?

Intended Outcomes

• Families who participate in Padua will have better earnings and employment outcomes than non-participants. 
• They will also have smoother spending patterns, higher savings, and lower debt than non-participants, and they will be less likely to depend on public benefits.
• In addition to improved labor market outcomes, families participating in Padua will also have better health and housing stability. 

Research Study Design

The Padua project is a randomized controlled trial. To be eligible to participate, families must have at least one household member between the ages of 18 and 62 who is willing and able to work. They must also have an annual income below 125% of the federal poverty line and reside in Tarrant County, Texas. 

After a brief intake interview, eligible families are invited to participate in the study and complete an extensive baseline survey. However, because Catholic Charities Fort Worth does not have the resources to serve everyone interested in Padua, a lottery is used to determine who receives a spot in the program. 

Those selected by the lottery are invited to enroll into the program and connect with a case management team. They become members of the treatment group. Those not selected by the lottery, while not invited to participate, receive a list of the organizations and services available to them in the broader community. They become members of the control group. 

Members of both the treatment and control groups completed in-person surveys one and two years after opting into the study and were followed in administrative data sources. At the study’s conclusion, LEO researchers compared outcomes across both groups. 

(Photo credit: Padua program at Catholic Charities Fort Worth)

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