A woman wakes for a job interview and the phone rings. It's the neighbor. She can't watch the woman's 2-year-old after all.
The mother has no one else to ask. This is her first job interview in years. She becomes agitated. The child begins shrieking.
In many cities, there's at least one number the woman can call to arrange to leave her child so she doesn't lose the job opportunity or worse, abuse the child in frustration. By mid-January, Jeremiah's Place will be up and running as Pittsburgh's first crisis nursery at the Kingsley Association in Larimer.
A fine line separates some stressed-out parents and the system that can spiral from child welfare to jails to courts and hospitals and cost taxpayers millions a year. Drop-in relief centers can prevent that spiral for some people.
Jeremiah's Place will be one of about 60 such centers in the country that operate independent of public service agencies. It will be funded by foundations and other private support.
Pediatrician Lynne Williams co-founded Jeremiah's Place, which is named for a child her mother fostered.
It will begin operating in about 3,500 square feet of rental space at the Kingsley Association. It has a $100,000 funding commitment from the R.K. Mellon Foundation, which is one-fourth or one-fifth of what will be needed, Dr. Williams said. Other funding requests are pending.
Jeremiah's Place will be open to parents or guardians who are stressed, overwhelmed and at risk of hurting or neglecting their kids. It also could be a relief shelter for children of people who have a medical emergency, or are at risk of being abused themselves, such as by a spouse who violates a restraining order.
Besides diffusing possible child-welfare emergencies, crisis nurseries are staffed with social workers and other professionals who can counsel families to mitigate crisis situations in the future.
"Nobody wakes up and thinks 'I am going to beat my kid today,' " Dr. Williams said. "We want people who feel in that moment to call us. We can talk them through it" with crisis counseling.
Jeremiah's Place will accommodate six to 12 children under the age of 6 overnight and up to 20 during the day, she said.
The nonprofit's officers expect to expand to at least three locations within three to five years, she said.
Dr. Williams said she does not expect people to use the service as day care "because we will have them meet with social workers and hook them up with goals. We have talked to other centers around the country" whose staffs report little abuse of the service.
One of the oldest, Providence House in Cleveland, started in 1981 as a day crisis center and has grown to provide an average of 27 days' care for about 200 children a year, said Natalie Leek-Nelson, CEO and president.
"The closest apples-apples comparison" of a crisis nursery's cost "would be the cost of foster care," she said. "Foster care is hugely expensive. You're paying someone to take care of a child, plus legal, medical and case management costs. A lot of kids have other issues, so you pay for specialty services."
Marc Cherna, director of the Allegheny County Department of Human Services, said one year in foster care for one child averages about $20,000, but many children are in foster care less than a year.
He said it would be too hard to quantify how much a crisis nursery would save the public in foster services, "but there will be savings."
He said he consulted with the founders of Jeremiah's Place. "I put them through the paces," he said. "That's why I'm quite optimistic they're going to make it work. These are professional women who have done their homework."
Jeremiah's Place held several fundraisers this summer, including the first Jeremiah's Place 5k Run/Walk and Family Fun Day in April, which raised almost $10,000.
Anna Marie Lewarchik did the initial survey to determine whether there was a need for a crisis nursery. She was a medical student working in the primary care outpatient clinic at Children's Hospital when one day a mother had a meltdown.
"A pediatrician said, 'Let's call the crisis nursery,' " she recalled. "I asked what that is; she's from Minnesota and knew of them. We did a search and didn't find one here. I decided that for my scholarly project I would do a needs assessment."
Copies of a survey were left at the front desk of the same outpatient clinic, where she said there is "a large underserved population." Of 100 surveys, 56 came back and 31.4 percent of respondents reported they would likely use a crisis nursery for up to three days at least once.
Dr. Williams, who co-founded Jeremiah's Place with fellow physician Tammy Murdock, did a follow-up survey that found that 68 percent of respondents "had trouble finding child care when a sudden need arose," Dr. Lewarchik said. "Fourteen percent admitted to leaving their children in a high-risk situation."
"We see this every day in pediatrics," she said. "We have adults who ended up in ICU and police were called because a 2-year-old was home alone."
There are sympathetic and not-so-sympathetic situations. If a woman leaves her young children at home to go to a bar down the street, she said, "that would not be an ideal reason" to use a crisis nursery, "but we would still rather have the children safe at Jeremiah's Place."
Diana Nelson Jones: firstname.lastname@example.org or 412-263-1626. Read her blog City Walkabout at www.post-gazette.com/citywalk. For more information, visit www.jeremiahsplace.org.