In the latest installment of our occasional conversations with Fort Worth newsmakers, Tiffany Smith, nurse supervisor at the Nurse-Family Partnership, discusses the program and offers resources for finding baby formula.  

This conversation has been edited for length and clarity. For an unabridged version, please listen to the audio file attached to this article.

Alexis Allison: Tiffany, can you tell us about the Nurse-Family Partnership?

Tiffany Smith: Yes, the Nurse-Family Partnership Program is for first-time moms. The goal is to improve pregnancy outcomes, child health and development and economic self-sufficiency. We keep our moms in the program for two years so that they can get a really good feel of the program. 

Allison: And during those two years, what does the program look like?

Smith: During pregnancy, it’s a lot of education. But after the moms give birth, there’s focus on development. So the nurses do assessments. Developmental tools are used to determine the baby’s developmental milestones to see that the baby is developing and meeting all the milestones as necessary up until 24 months of age.

Allison: It’s my understanding that the nurses visit the moms. Can you tell me a little bit about those visits?

Smith: Yes, the nurses make home visits. And now it looks a little bit different, because we are considered to be a hybrid program, where we do visit moms at the home, and we also do virtual visits through video conference. So during that time, the nurses do have a very good therapeutic relationship with these clients. And the bond is very close because they spend two years or more with the clients. They provide lots of support for these clients because it’s such a vulnerable population. 

Some clients do not have a mom present. So, with the nurses coming in, they also take on the role of a support person and a life coach. And some of them are called “mom” by some of our clients, because they build such a close bond with them. So with all the education and getting to know the baby, weighing the baby and seeing the baby grow developmentally, the baby even gets really close to a lot of them, the nurses. So this is a very rewarding program for all of the nurses here.

Allison: I know it’s specifically for first-time moms. Why? 

Smith: Well, first-time moms, like I said before, it’s a very vulnerable population. And a lot of our moms are afraid because they do not have access to essential resources needed to have a healthy pregnancy. So when they do come to us, they don’t really know what to do. They don’t know where to go. We have really young clients, sometimes as young as 12 years old, and sometimes they are homeless. So in situations like that, then the nurses step in, and we give them resources to give them immediate housing as we do have it available.

It is a very vulnerable group of women who do not always get the attention that I feel that they should in the community. So that’s why we have programs like this: to address this population, to decrease the infant mortality rates.

Allison: Who specifically is eligible to apply?

Smith: They have to be first-time moms. They have to be 28 weeks or less pregnant. They also have to fit in the 185% Federal Poverty Level to qualify for services and, depending on where they live for different Nurse-Family Partnership sites, it depends on the county. But here, since we are in Tarrant County, they have to be Tarrant County residents for us to provide services.

Allison: Are people who may not be documented allowed to join the program as well? 

Smith: Yes, they are. 

Allison: OK, and what does the application process look like?

Smith: The application process is on the Nurse-Family Partnership public website. But clients can also call in to the site directly and do a self-referral. And our number is 817-413-6320. We do get a lot of our potential clients calling in. Some clients who are on current nurses’ caseloads have other family members that they know who are first-time moms, so they call in and they refer themselves.

Allison: And then after that self-referral, what sort of paperwork do the moms need to get together in order to apply?

Smith: So after the self-referral, the client is assigned to a nurse. And that nurse determined eligibility. And we discuss the program with the clients just to be sure that it is a good fit. And that is something that they would want to commit to since it is a two-year commitment. It’s also voluntary, so they can leave at any time during that two-year period. 

The first month, the nurse will meet them once a week. After that is every other week. Once the child turns 22 months, it’s monthly. And that can always change depending on the situation with the client. So if there’s high-risk clients, and what I mean by high-risk is, when clients are really struggling with housing, food, finances and infant car seats — they do not have one but getting ready to have a baby. Those are some of the common issues that we do get, and we can provide immediate assistance.

Allison: I’m glad you brought that up, because we know there’s the national formula shortage and I’m wondering how the Nurse-Family Partnership is addressing it and trying to help moms in the program find formula?

Smith: Yes, we do. We do have resources that we give our clients. There are WIC stores that they can go to for the formula. There is a website that we use quite often, because it’s very helpful: With, all you have to do is just put the zip code and it will give you resources close to where you live. A lot of our clients do not always have transportation, or if they do, I mean with the gas prices going up, they cannot go as far. 

I’m also planning on connecting with other programs who serve moms and babies to collaborate together and determine what is the easier way we can address this issue.

Allison: Thank you for sharing. Is the program free for the moms?

Smith: Yes, the program is free for all moms. It is a grant-funded program.

Allison: Wonderful, and out of curiosity, if there’s a first-time dad, for example, is he able to be part of the program?

Smith: Yes, we do encourage our dads to be involved. We also tell them about different fatherhood summits and other coalitions going on in the county, or wherever they live so that they can be a part of that. And (they’re) included also in the visits. If they have questions, most of the time, they do not initiate a conversation about it. They kind of stay outside of the conversation because they feel as if this doesn’t pertain to them because they are afraid to talk and speak up. So the nurses are trained on how to pull the fathers into the conversation and get their perspective on different things and find out what they need to know. And get them involved in different conferences for that first time, so that they can be prepared for the child also. 

Allison: Thank you so much. And is there anything else that you’d like to share?

Smith: I’ve been with Nurse-Family Partnership for almost 11 years now. I used to work in labor and delivery. And that was so fast-paced, so fast-paced, that you really couldn’t get that relationship that you wanted, to find out the information that you wanted. 

I remember this one incident with one of my clients in labor and delivery, and she was only 15 years old. She came in, she was crying and she didn’t have anybody with her. And I was trying to help her out with explaining everything. Because I’ve been there, we’ve all been there, those who have children, you’ve been a first-time mom. And can you just imagine being 15 years old, and having a baby by yourself in the hospital and just hurting and in pain? She was five centimeters dilated. And I was trying to explain everything that was going to take place, and as soon as I got into it, someone pulled me out of the room and told me that I had to assist in delivering another baby. 

So, the hospital setting is so fast-paced that you do not get a chance to really do the work. And my passion is really being involved in, being a part of my client’s life and being able to make a difference holistically. This program created that for me. 

You get to see the beginning when they are pregnant, and then you get a chance to see after the baby is born and when the baby starts to grow. And it’s not only the baby growing, but it’s the client growing. They come out on the other side like, “I can do this.” They have a degree — they have a certificate of completion — and they have a baby that they are taking care of, and they feel like they can do it and work independently, and that is, to me, very rewarding to be a part of something like that. 

Alexis Allison is the health reporter at the Fort Worth Report. Her position is supported by a grant from Texas Health Resources. Contact her by email or via Twitter. At the Fort Worth Report, news decisions are made independently of our board members and financial supporters. Read more about our editorial independence policy here.

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Alexis AllisonHealth Reporter

Alexis Allison covers health for the Fort Worth Report. When she can, she'll slip in an illustration or two. Allison is a former high school English teacher and hopes her journalism is likewise educational....