Sept. 29, 2004 - Adrianna Serbousek noticed her unborn baby was no longer moving inside her, so she went to see her doctor. He performed an emergency caesarean section, surgically removing the baby from her uterus. The child was born, eight weeks early, with blood clogging her throat.

The infant survived and spent the first two months of her life in the hospital. It was Serbousek's second child, and the second born premature.

"My son was also born premature and I just didn't know what to do," she said.

After the birth of her daughter, Serbousek was approached by representatives of the Arizona Healthy Families Program. They offered her in-home assistance taking care of her child. She accepted.

Now the program will be available through the Marana Health Center, due to an increase in state funding that began in July. This fiscal year the Healthy Families Program received nearly $13.9 million from the state, whereas last year the program received $6.6 million, said Pima County Program Manager Mary Hauk.

The program sends trained specialists to the homes of families who may need extra help in the first years of their children's lives. The supervisor at the Marana site, Irma Marquez, said that two family health specialists will complete their training Sept. 24 and begin making visits to two Northwest families already enrolled in the program. Eventually the site will have four family health specialists in addition to Marquez.

The situation doesn't need to be as extreme as Serbousek's, when her child came near to death. The program provides information about child abuse and neglect, early development and the availability of community resources. Families are eligible from conception until the child turns five years of age.

Michelle Ellis, director of Behavioral Health at MHC, said Marana was selected for the program because of the high number of births in the area. Hauk said an increase in the number of births over the years made Marana an appropriate location.

"We knew Marana is a growing area and we knew there was enough births there to support a site," Hauk said. "We also know that there's not a lot of services in that area."

Hauk said families must go through a screening and assessment process to get on the program. During the screening process, families are administered a questionnaire that asks if the family has a support network in place, the mother's marital status and whether or not the pregnancy was planned. She added that the program is completely voluntary and families can decide to end their participation at any time. The assessment consists of an hour-long interview where the family learns what the program provides.

The intent of the program is to make contact with every mother having a child, Hauk said. In reality, this does not happen, but Healthy Families does talk with most mothers, either during prenatal care or after childbirth. An estimated 15 percent of families pass the screening process. Based on that and the number of births in Marana, enough families would qualify for the program, Hauk said.

Serbousek began the program when her daughter, Leilani, was born in Flagstaff. Her five-year-old son, Lamont, was also born premature and she struggled taking care of him, she said. Leilani also had colic, a misunderstood ailment that causes babies to cry inconsolably, adding to Serbousek's difficulties. She had to care for both children while her husband finished his degree at Northern Arizona University. He's now an engineer at Raytheon, a technical services company.

For Serbousek, the family health specialist provided information about child development and introduced her to the resources available in her community. She said, the specialist would even visit in the night, because Leilani would constantly cry and Serbousek rarely found time to sleep.

She said that she and her family health specialist worked together to establish goals for her and her children. One of Serbousek's goals was to pass the General Education Development test, which she did.

"It's difficult because you're scared of the unknown, and when you're not informed about the resources, you don't know where to start," Serbousek said. She credits Healthy Families with helping her achieve her goal.

When Serbousek moved to the Northwest in 2004, she stayed in the program and Cornetta Vereen began to assist her. Vereen is a family health specialist who works out of the La Frontera site in south Tucson and has worked with the program for four years. She currently assists 21 families, including the Serbouseks. She can handle that number of families because, as the children get older, they require less visits, she said. Usually the specialist will visit once a week following a child's birth and the visits will decrease as the baby approaches a year old. In Serbousek's case, she sees Vereen every week because her child requires special attention. The program is flexible depending on the needs of the family, Vereen said.

Vereen said she tries to help the family understand what the baby is communicating when he or she cries. Often babies will have different types of cries when they're hungry, tired or have soiled their diaper. She also tries to teach the family how to make inexpensive toys. She said parents can make a face with a paper plate and electric tape and use it to play with their child. The most important aspect is that the parent is interacting with his or her child, Vereen said.

The specialists undergo three weeks of training, Hauk said. One of the most important lessons they learn during that time is how to establish appropriate boundaries. The specialists must know when a family's problem is outside their knowledge and when they should refer the family to another professional.

It's also important for the specialist to allow the family to be in control of the parenting, Hauk said.

All of the decisions regarding the child must be approved by the parents, and the family health specialist must also consider the needs of the child. In this way the job requires an "intricate weave," Vereen said.

Parenting can be a sensitive issue. Especially when it involves a teen-age mother who has older family members with a traditional way of raising children. In these situations, Vereen said she makes it clear that she is not trying to tell the family how to raise the child.

She'll tell the family member, "what I'm bringing is information. This is just something you can use, if you don't like it or don't want the information, you don't have to use it."

Serbousek said she appreciates the program, because it provides access to important information and resources, and the specialists respect the choices she's made as a parent.

"They're not too judgmental, and that's real important to me," Serbousek said

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