Streetcred Seeks to Be a National, Self-Sustaining, Social Impact Organization Providing

StreetCred

VISION StreetCred seeks to be a national, self-sustaining, social impact organization providing free tax preparation in hospitals and clinics, targeting families eligible for the Earned Income Tax Credit (EITC) and Child Tax Credit (CTC). Through this service, StreetCred aims to: (1) Alleviate poverty while synergistically improving health care delivery. (2) Improve child health outcomes via increased financial stability, increased participation in pediatric care, and reduction of traumatic stress. (3) Engage pediatric residents as advocates for underserved families.

BACKGROUND  More than 16 million children in America live in poverty. That’s 1/5 of kids in the US facing an increased risk of delayed development, preventable disease, poor educational outcomes, and decreased future economic productivity.  The EITC and CTC are federal monies available to low-income, working Americans raising children. They are designed to incentivize the US workforce while improving living standards.  In 2013, the EITC and CTC lifted 3.2 million and 1.7 million children out of poverty, respectively. The credits are shown to improve infant health outcomes, employment rates of single mothers, educational achievement, and a child’s future adult earnings.

PROBLEM Every year, 20% of US households entitled to the EITC do not claim the credit because eligibility is unknown, filing taxes can be complicated, and free tax preparation sites are inaccessible.

PROGRAM Consider Jane. Jane is expecting her second child; she’s a single mother making less than $25,000 yearly. She knows she’s eligible for some tax credits but struggles to find time off work to visit a free tax preparation center, especially because she doesn’t have a car and prenatal visits with her obstetrician seem more pressing. Before her first child’s next pediatric check-up, a StreetCred professional calls Jane to tell her Boston Medical Center is offering free tax preparation and asks if she’d like to sign up for an appointment in conjunction with her pediatric visit. She happily agrees, so StreetCred schedules her and reviews a checklist of documents (photo ID, W-2 forms, etc.) she should bring to her next visit. Before the next visit, StreetCred calls Jane to remind her of the documents and appointment. The day of the visit, she arrives to the clinic, drops off her tax documents with StreetCred, and takes her child in to see the pediatrician. Afterwards, she swings back by the StreetCred desk where she sits down with a StreetCred tax preparer to review and finalize her tax return. The preparer teaches her about tax credits, and Jane learns she’s receiving $3000 from the EITC. After tax season, StreetCred follows up both to ensure she received the credits and to ask about her experience with the program. She asks her neighbors, “Did you get your StreetCred?” and the model spreads.

GOALS Year 1: Launch pilot program at Boston Medical Center in partnership with Boston Tax Help Coalition. Recruit and train volunteer tax preparers. Return $2.2 million in EITC monies to low-income families via 1100 tax returns. Refine service delivery model. Evaluate program acceptability and feasibility. Year 2: Expand nationally to 5 health care sites. $11.2 million returned to clients via 5500 tax returns. Recruit local community members as tax preparers to strengthen the community-based model and provide job training. Develop self-sustaining financial model. Seek longer-term executive leadership, permanent space, and expansion to non-healthcare sites (schools, shelters, community centers, etc.). Evaluate impact on health outcomes and resident advocacy experience.

STAKEHOLDER BENEFITS  Children have improved health, education, and financial outcomes  Families have more money for life’s necessities with minimal hassle  Tax preparers gain service experience with tangible impact  Physicians have better appointment adherence; hospitals offer more comprehensive care  Local economies are stimulated as more money is spent

IMPACT EVALUATION  Yearly PDSA cycle assessing strengths and weaknesses for annual service improvement  Quantitative data: demographics, income, tax refund amount, measures of short- and long-term financial security, health and education outcomes  Qualitative data: Focus groups and interviews evaluating financial security, social needs, or health perception before and after StreetCred intervention. Evaluate family experiences “getting paid” to see the doctor.