Phase 3 Mother Up Eligibility Screening and Application Survey

Screener Instructions

This is a screening survey for people interested in the "Mother Up", a guaranteed income research pilot for mothers in DC with children in the foster system or other people's home due to CFSA/CPS involvement. Mother Up is a guaranteed income research pilot created by the nonprofit Mother's Outreach Network. If you end up entering the Mother Up pilot, you will also be entering a research study. Eligible mothers selected may receive $500 a month for 36 months. A lottery will decide which eligible mothers receive the cash benefits.

To be eligible* for the program, you must:
  • Be age 18 or older
  • Speak English
  • Live in Washington, DC - specifically in wards 4,5,6,7 or 8 - or are currently experiencing housing instability
  • Be eligible to receive public benefits (such as TANF)
  • Not be receiving Supplemental Security Income (SSI) Benefits**
  • Be a biological mother with custodial responsibilities to a child age 14 or younger who was removed from the home by CFSA within the last three years prior to program enrollment
    • The eligible child has been or was removed from the home of the qualifying mother at the initiation of legal action by the DC Child & Family Services Agency (CFSA) / Child Protective Services (CPS) within the last three years prior to research pilot enrollment
    • The eligible child has been removed from the qualifying mother's home as a result of extra judicial action by the DC CFSA/CPS within the last three years prior to research pilot enrollment (For example: Informal custodial changes, formal third-party custody changes by the court)
*Not all eligible applications are guaranteed to be selected for the Mother Up program.
**Participation in the Mother Up program could result in the loss of some or all of your SSI benefits.


Everyone in the research pilot will have the opportunity to receive incentive payments for participating in research like surveys and interviews. All participants will also be eligible to participate in Mother's Outreach Network's empowerment and leadership programs. Roughly half of the people in the research pilot will also receive $500 a month, no work and no other strings attached, and will get access to Mother's Outreach Network's legal program. The other people will receive referrals to legal services at other organizations. A computer will randomly select which participants will be given the $500 a month and access to the MON legal program.

By taking this survey, you are saying you're interested in the research pilot. If you are eligible for the pilot, which is determined through the screener, you will be allowed to continue on to the application portion of the survey. Not all eligible applicants are guaranteed to be selected for the pilot.

The screener should take 5-10 minutes to complete. If you are found eligible for the pilot, you will be directed to the application portion of the survey, which takes an additional 20 minutes. Your answers for the survey will be saved in the event you have to stop; you can return to complete the survey. All questions are required unless they are marked as "optional." If you have any questions, please call us at 202-818-8649 or email pilot@mothersoutreachnetwork.org. You can learn more about Mother's Outreach Network at https://mothersoutreachnetwork.org/

Mother’s Outreach Network will use this information to identify and contact people who are likely to be eligible for the Mother Up program. By filling out our survey, you agree to the collection and use of information in accordance with our Privacy Policy. For the full version of our Privacy Policy, please visit our website here: mothersoutreachnetwork.org/privacy
1.Please check the box if you understand the information above and wish to continue.(Required.)