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Amid the push for federal health care reform has been a push for more home visiting programs that help increase access to care for those in need. One such program was born in Connecticut almost seventeen years ago. WNPR’s Neena Satija reports on the Nurturing Families Network, which provides home visits to young mothers.
(Child's voice yells “Marta!”)
Nathan Carreno is three and a half years old. He’s greeting Marta Santana, a home visitor with the Nurturing Families Network.
SANTANA: "Hi! How are you?"
NATHAN: "Good."
Santana has been visiting Nathan’s family every week since he was born.
NATHAN: "Do you need help?"
MARTA: "Do I need help? Thank you!"
NATHAN: "You're welcome."
When Nathan’s mom Imari Troche found out she was pregnant, she was just 14 years old. She was a little scared, and she looked for help at the prenatal clinic at Fair Haven Community Health Center in New Haven. That’s how she found out about Santana and the Nurturing Families Network. Before Santana, Troche knew how to change diapers. But she didn’t know why kids do what they do. Now she understands how Nathan learns.
TROCHE: “What’s this?”
NATHAN: “Uh-bellah.”
TROCHE: “Umbrella. How about this one? It’s a tent.”
NATHAN: “A tent.”
TROCHE: “I think sometimes they come out smart already. They’re born baby geniuses.”
The Nurturing Families Network was created in 1995. That’s when 9-month-old Emily Hernandez died after suffering rampant abuse at the hands of her parents. After her death, the Connecticut Children’s Trust Fund pushed for a statewide home visiting program for at-risk parents. Karen Foley-Schain is Executive Director of the Children's Trust Fund, which is now an arm of the state’s Department of Social Services.
FOLEY-SCHAIN: “I think for the first time in a really serious way, people started thinking about what could we do to actually prevent child abuse and neglect from happening.”
The Nurturing Families Network is now the largest home visiting program in the state, with a budget of $10 million a year. 125 home visitors in the network visit about 2000 families each year. They’re certified with 200 hours of training and they use a standardized teaching method called the “parents as teachers” curriculum.” For today’s visit, Santana wants to focus on Nathan’s gross motor skills – or as she puts it, how he uses his big muscles.
SANTANA: “OK can you jump for me?”
NATHAN: “Yes.”
SANTANA: “Show me how you jump.”
[sound of jumping]
SANTANA: “Very good. See, that’s another example of large muscles…”
Santana is a lot more than a parenting teacher for Troche. She’s also a kind of social worker. She’s helped Troche try and find her own apartment and get rental assistance from the government. If Troche is having trouble getting Nathan’s father to help with child care, Marta will help negotiate between the two of them. She’s called a therapist in to provide counseling for Troche, who lives with her mom and many other siblings in a crowded second-floor apartment. Santana doesn’t think the family would have looked for that kind of help without her prodding.
SANTANA: “They will not come out and get services. You have to go to them and really offer, offer what you have.”
That’s the beauty of the home visiting program.And it makes many argue that these kinds of behavioral health care workers – sometimes called community health workers – can do more than a primary care physician in many cases. Michelle Afanador is another home visitor in New Haven. She used to be a medical assistant, but she finds this job more fulfilling. You can find out a lot more about someone in their home, she says, than at a doctor’s office.
AFANADOR: “Some people might not tell you they don’t have food. Because they feel ashamed. But if you’re in their home and the kids asking for milk and she’s like ‘I don’t have nothing,’ you know she doesn’t have milk.’”
The mothers that get help from the Nurturing Families Network often come from tough backgrounds. 62 percent were abused as children. Less than a third of them live with the father of their child. But the program has collected data to show that it helps families access the resources they need.
FOLEY-SCHAIN: “They’re accessing more resources, they’re getting better at finances, they’re building informal networks of support. They’re babysitting for each other, and grocery shopping.”
There’s no question in Troche’s mind that Santana has made her and Nathan’s lives better. Even her mother, Damaris Stimpson, has learned a thing or two about good parenting.
STIMPSON: “How about when he was having a lot of mood swings that you didn’t understand?”
TROCHE: “Oh his tantrums. Oh my Jesus.”
STIMPSON: “Yeah, and she helped her a lot with that….”
TROCHE: “Yeah. Like. Like, if he grabs something he don’t need. Replace it. I thought you just take it. So he don’t have to throw a fit. And that worked pretty good. Because he can throw a fit. Yes he could.”
This kind of interaction between the two mothers was unheard of when Santana first arrived at the house more than three years ago. The arguing in the family was constant, and sometimes dangerous.
SANTANA: “This family had a long history of violence, and they were able to really change the way they’re living because they want the best for all their families. And the mother is determined that her children are going to make it!”
The federal health care law provides grants for these types of home visiting programs, and Connecticut has already gotten more than $1 million through the law and other new federal grants. The Nurturing Families Network will use some of that money to hire more home visitors, but they’ll have a different function from most current workers, who visit young mothers. These new home visitors will be hired specifically to visit the young fathers.
For WNPR, I’m Neena Satija.
A version of this story appeared in the Connecticut Mirror at http://ctmirror.org/story/15799/nurturing-families.
