Editorials

Nurse Family Partnership provides such important support. Why isn’t it fully funded?

When Rachel Young was pregnant for the first time, she was struggling financially, in a turbulent relationship with the baby’s father, and scared. That’s when she met Gretchen Thaller, who works for the Thurston County Nurse Family Partnership program.

For the next two-plus years, Thaller visited her frequently and helped guide her through her pregnancy, addressing her fears about childbirth, and coaching her on breastfeeding, weaning, early childhood development, goal-setting and healthy relationships.

“I learned so much about parenting,” Young says, “and l was surprised later, when friends started to have children, that I knew so much more than they did.”

Thaller is now the supervisor of the Thurston County Nurse Family Partnership; Young is the owner of the nationally famous Miss Moffett’s Mystical Cupcakes, and a former member of the Lacey City Council.

Since its inception in 2004, the local program has grown to include three counties — Thurston, Mason and Lewis — and employs 15 nurses. It serves low-income first-time moms who, more often than not, were themselves raised in families in poverty. Starting in pregnancy, each mom receives nurse visits a minimum of once every two weeks until her child turns 2. Each nurse has 25 clients.

This voluntary program follows a 40-year-old national model that has been thoroughly researched and proven to produce a 48 percent reduction in infant mortality, a 33 percent reduction in child maltreatment, improved kindergarten readiness and family self-sufficiency, and a plethora of other improvements in the lives of both parents and children.

“We are non-judgmental; we recognize that each of our clients is the expert on her own life, and we focus on working on her heart’s desires,” says Thaller. “We want each visit to end with the client feeling better. We say things like ‘Oh, look at how your baby looks at you, she loves you so much!’”

The nurses’ menu of services includes coaching on parenting and other life skills, and help with accessing services ranging from housing to mental health to how to enroll in education and job training programs. At the end of each visit, nurses ask clients what they would like to focus on during the next visit.

Thaller reports that when one client neared completion of her GED degree and was asked if she’d like to go on to college, her surprised response was “Really? I could do that?”

But to focus on achieving goals like those often requires overcoming daunting obstacles. “Many of our clients have very insecure housing situations,” Thaller says. “If they are leaving their family or an abusive relationship, or if a job doesn’t work out, they may lose housing,” so nurses must also become experts in how to access housing help.

So why, one might ask, would it take a nurse to play this role? That’s a question that has been tested by research, which found that even well-trained non-nurses didn’t achieve the same results. Building trust through the early, medical focus on healthy pregnancy, breastfeeding and healthy babies means nurses create a special, intimate and effective bond with clients. It’s hard to argue with that success.

A rational person might expect that this program, which produces $6.20 in cost savings and increased social benefits for every dollar invested, would be fully funded. But it’s not. Fortunately, funding has been increased recently in Thurston County and in Washington state. Thurston County currently has no waiting list, though Thaller doesn’t expect that to last long. And the lack of a waiting list doesn’t mean that all the families who need this help are being served; it just means that all those who learn about the program and apply are. Statewide, waiting lists are the norm.

Even if the measurable return on investment were not so compelling, the moral dimension of this funding shortfall would still be painful. As the school poster says, “Nothing you do for a child is ever wasted.” When we invest in lifting up moms and helping them give their children a good start in life, we are reducing poverty, misery, mental illness, addiction and homelessness. We are making the next generation smarter, safer, happier, and more fully alive.

This is all so utterly obvious it’s almost embarrassing to write about it. But until the Nurse Family Partnership is fully funded statewide, and until high quality early learning and child care are universally available and affordable, we should all be embarrassed.

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