Nearly every day, a silver Subaru makes its way through the tiny towns and white pine woods of Wexford County, in northern Michigan.
Behind the wheel is Jeannie Schnitker, a nurse with the state’s Maternal and Infant Health Program.
Last week, I tagged along for a ride.
We start off on an overcast Thursday, Jeannie Schnitker’s station wagon packed with patient files, scales, diapers, formula, and spare baby clothes.
"All right," Schnitker says as we pull out of the parking lot of District Health Department #10 in Cadillac, "we’re going to head north, and we’re hoping to find some girls home."
By "girls," Schnitker means moms. Young moms. She’d been texting with clients all morning. Only a few have gotten back. We head out toward the tiny town of Manton.
Schnitker works for the Maternal and Infant Health Program. It sends out nurses and social workers to the homes of pregnant moms, or moms with newborns all over the state. To qualify, moms have to be eligible for Medicaid, which means they don’t have a lot of money.
Many of Schnitker’s clients live in rural areas, and she says it’s tough for many of them to make appointments in town.
"We do have transit authority in our county," Schnitker tells me, "but the girls that are in the outreaching areas, if they’re coming into Cadillac for an appointment, it’ll take them all day."
That’s one of the reasons home health visits are so important. But there are other uncertainties that make setting up the appointments difficult. We pull off onto a dirt road in search of one of Schnitker’s clients, a young mom who hasn’t responded to her texts.
"So we’re going to go to a home here," Schnitker says. "This girl doesn’t know we’re coming, so keep your fingers crossed that she will be home."
Schnitker leaves me in the car, while she goes up to the front porch. The person who answers the door tells Schnitker her client, the mom, isn’t there. She hasn’t been there for at least a few days.
This kind of thing happens a lot. It happens to home health nurses and social workers all over the state. Their clients lead unpredictable lives, and there are a lot of no-shows.
Schnitker and I drive back into town, so she can text other clients.
Soon, we’re pulling up to a little house with pink flamingoes in the yard.
"It’s Jeannie!"Schnitker beams, knocking on the front door.
This is the home of Savannah Sutton, and her almost-four-month-old daughter, Olive.
"Are you bearing weight, are you bearing weight?" Schnitker coos, balancing baby Olive on her lap. "Oh yeah!"
Olive, by the way, is adorable.
And Schnitker, who’s been a home visit nurse for 26 years, goes way back with this family, and with Savannah.
"Her mother was on the program," Schnitker says of Savannah Sutton. "She has siblings also."
"So it’s a whole family thing," Sutton says, smiling.
"So was Savannah as cute of a baby?" I ask Schnitker.
"Savannah was adorable," she says.
And when baby Savannah grew up and became a mommy, she knew she wanted her daughter to see Nurse Jeannie too.
"I think it gives you an extra resource you can kind of tap into when you have a problem," Sutton says. "Because, there’s been many times, I kind of been like, I don’t know who I should contact with a problem, because people are hesitant sometimes I think.… But I guess I feel more comfortable talking to Jeannie about something."
The way Schnitker explains this to me is that doing home visits taps into much more social and emotional aspects of health care. And here’s the thing: Home visits have proven to be one of the most effective ways of improving health for mothers and babies. There’s a lot of research now backing it up. Home visits reduce stress, lead to healthier habits for both moms and babies and they ultimately save health care costs by preventing problems before they pop up.
Schnitker finishes her visit at Sutton's house, and we get back in the car. She tells me one of the reasons she thinks this works is because of the personal relationship she gets to develop with her clients.
It’s good for the clients. It’s good for her too.
"I love my job," she says, as we head back to the office in Cadillac. "Even with all the trials and things. It’s still ... I think one of the best."