For 34-year-old single father José Gonçalves, moving his two young children from Portugal to Boston last year was an extremely stressful endeavor. Juggling parenting responsibilities and confronting a language barrier, the computer science expert wasn't sure where to turn to gain traction in the city's competitive job market. The answer came from an unlikely source: his children's pediatrician.
At Boston Medical Center, his pediatrician told him about StreetCred, a program that provides free tax preparation services, financial coaching, and job training to help low-income families who seek their care at the hospital. For José, accepting job training as a tax preparer through StreetCred offered a chance to earn income, work on his English fluency, and build a resume in the United States.
"I really like my job. It is great to help families receive tax refunds. It also offers me flexible hours, which helps me earn money while I continue my education and parent my two children," explains José, who underwent a two-day training to become a certified tax preparer. He now earns $800 a month working for the program during tax season.
StreetCred co-founder and pediatrician Lucy Marcil, MD believes that StreetCred’s pilot job training program could be a new step in reimagining pediatric care for low-income children.
“Financial stress has a huge impact on the health of children,” Marcil explains. “Helping parents in need of work build new skills in tax preparation and office administration can provide them income in the short-term while building their resumes to reach their long-term employment goals.”
Integrating tax prep into pediatric care: A starting point
Marcil is no stranger to seeing the effects of poverty on children’s health: mold inside walls exacerbating asthma, empty pantries leading to failure to thrive, and the many other daily obstacles that create toxic stress and impair physical and cognitive development over lifetimes. She and her colleague Michael Hole, MD wanted to alleviate financial stress on families by putting money directly in their patients’ pockets. Free tax preparation can do just that.
On average, low-income families are eligible for a $3,000 to $4,000 tax refund each year through the Earned Income Tax Credit and Child Tax Credit. Yet, one in five families in the U.S. don’t claim these credits. In addition, traditional tax preparation services can be costly — charging, on average, $400 for filing each year. StreetCred aims to help families by offering free tax preparation services at the hospital around children’s appointments, ensuring they receive the maximum refund.
Taking financial services in healthcare to the next level
Since its inception in 2016, the program has expanded to healthcare settings across six states and returned more than $7.3 million to more than 3,700 families.
"Once we found success with tax preparation, it was a launching point to offering other financial services to families, like helping to balance budgets and pay off debt. Moving forward, we hope to use the lessons learned from our job training pilot program to strengthen our commitment to hiring parents for roles at StreetCred," says Marcil. "We also are working with partners across the hospital to think about how to expand upon this pilot to identify more long-term and sustainable methods for hiring parents of patients and patients at BMC."
Pediatricians offering financial services and job opportunities is far beyond the typical physician-parent conversation at the doctor's office. Still, StreetCred surveys indicate that participants appreciate the intervention while also feeling more connected to their doctor, Marcil says. Marcil and Hole plan to conduct future studies to gauge StreetCred’s impact on child health.
They anticipate easing the financial burden on struggling families might shape healthier children more than a conversation about the benefits of broccoli ever could.