When Krizia Ramirez Franklin scheduled a double mastectomy last March to reduce her chances of developing breast cancer, the San Antonio mother thought she knew what recovery would look like.
But when she came home from the medically necessary procedure, Franklin quickly realized she had underestimated how difficult that first week would be — and how hard it would be to recover while caring for four children.
“I had gone in ready for the procedure, thinking I was gonna come out the next day ready to walk. After four C-sections, I thought I could take anything on,” Franklin said. “I was truly naive and unprepared for the realities of my recovery during that time.”
But thanks to a coalition of local nonprofits called the Safety Nest Network, her children instead spent a week in the care of Respite Care of San Antonio as part of a pilot for the region’s first crisis nursery.
A crisis nursery provides voluntary, temporary care for children when parents face an emergency, while connecting families with services intended to keep a short-term crisis from escalating into a report of abuse, neglect or involvement with the child welfare system.
“If it hadn’t been for Respite Care, I’m not sure how I would have recovered during my first week,” Franklin said. “The Safety Nest Network will allow people like myself, who are just trying to do the right thing without having to worry about getting caught up in the system … get the help that they need.”
Now, after roughly eight months of quietly helping families on a limited basis, the network is expanding with the opening of a newly renovated 12-bed home at Respite Care near downtown San Antonio. The new home brings Respite Care’s residential capacity up to 42 beds, a portion of which will be available to Safety Nest families.
A ‘Puro San Antonio’ model
Unlike crisis nurseries in some other cities, the Safety Nest Network is not centered around a single facility where children are placed during an emergency. Instead, it is a coalition that stitches together services already provided across San Antonio, including licensed child care centers, case management, transportation, medical care and residential homes.
That approach was deliberate.
Coalition members researched five crisis nurseries around the country and visited three in person before deciding that no single model fit what they believed San Antonio families needed.
Some programs they studied relied heavily on residential care, where a child might stay for days or weeks. Others were built around a single nonprofit responsible for nearly every piece of the operation.
What emerged here instead was what Respite Care President and CEO Rebecca Helterbrand has described as a “Puro San Antonio” approach: rather than create another organization or build an entirely new system, nonprofits that serve thousands of local families would pool the infrastructure, staff and expertise they already have.
“We’ve done what is amazing about San Antonio, which is to collaborate deeply, bring together vested parties that want to make a difference,” Helterbrand said. “No one in the United States has done what we’re doing.”
The network includes ChildSafe, AVANCE, the YMCA of Greater San Antonio, YWCA San Antonio, Family Service Association, Brighton Center, SJRC Texas, Belong, UT Health San Antonio and Respite Care. Each fills a different role in a system designed to give families what they need without automatically turning to residential care.
ChildSafe serves as the network’s coordinator, or what Elizabeth Reeves, the organization’s chief impact officer, described as its “air traffic control.” When a family reaches out, staff assess what is driving the crisis, what support the family already has and what intervention might help stabilize the situation.
Sometimes, Reeves said, child care may not be necessary at all.
“Many times, what we have learned and what we’re learning as we’re doing this work right now is that some of this can be met by just providing case management or providing resources within the community,” Reeves said. “If we can meet that family’s needs that way, that’s what we’re going to do.”
When child care is needed, the network can tap into licensed centers already operated by the YWCA, YMCA, AVANCE, Family Service Association, Brighton Center and Respite Care. SJRC Texas can help with transportation, while UT Health San Antonio provides medical support and Respite Care provides residential beds for children who need to stay overnight.
But organizers say cases like Franklin’s, where children need residential care for several days, are only one piece of the model. They expect many families will need help for only a few hours — enough time to make a job interview, attend a medical appointment or simply give an overwhelmed parent a break.
That shorter-term care is already being tested through the network’s existing child care centers.
Angelica Cervantes, chief operations officer of YWCA San Antonio, said one mother in the pilot had recently started a new job when she learned the night before that she needed to report for an 8 a.m. orientation. The mother had no family or other support nearby and no one to watch her 6-month-old baby.
She had already had to let go of three job opportunities because of child care problems, Cervantes said, and feared the same thing was about to happen again.
Instead, the network found an available spot at one of YWCA’s child care centers for the few hours she needed.
“We enacted our pilot right away, taken care of. She was able to get to the orientation and she continues at the job,” Cervantes said. “This literally has been one of her first jobs that she has not had to let go of because of child care issues.”
Those relatively small disruptions are exactly where organizers hope the network can intervene as a preventative measure before a family reaches a larger crisis.
“Oftentimes in our community, what’s overlooked are those one-offs, but those one-offs build when there isn’t support available for them,” Cervantes said. “When it’s one missed appointment, one missed job interview, it builds and that’s how we end up in these massive-level crisis situations.”
Bringing the network to scale
For now, the Safety Nest Network is making much of that work happen with resources its members already have.
During the pilot, participating child care centers have used openings that happen to be available on a given day rather than reserving slots specifically for families experiencing a crisis. Case managers already employed by the nonprofits have taken on Safety Nest families alongside their existing work.
That has allowed the coalition to test the model, but it had also limited how widely organizers can advertise a service they cannot yet guarantee will have space for every family that calls.
“We’re doing it now because our families need it now,” Reeves said. “We are making this work. But we would love to do it to scale. There’s so many more families that we could help if we had the funds.”
At full capacity, organizers envision reserved child care slots across participating centers, additional case managers and a centralized hotline where families could reach the network 24 hours a day, seven days a week.
Helterbrand said the coalition has spent the past eight months testing its protocols, establishing agreements among participating organizations and working through how families move between services.
The coalition has also received more than $500,000 in charitable support from local foundations, much of it used to help add the 12 new beds at Respite Care.
Coalition members hope some of that funding could come from Bexar County.
County commissioners earlier this month authorized the release of a competitive request for proposals seeking a nonprofit to operate a countywide crisis nursery program. The county anticipates making up to $1.64 million available for an initial one-year contract, although the final amount would still require Commissioners Court approval.
The county’s proposed program closely resembles many of the services Safety Nest is already testing. The solicitation calls for voluntary, short-term care for children whose parents are experiencing an acute crisis, along with case management, referrals and follow-up services intended to stabilize families and keep children safely with their caregivers.
It also calls for a single intake point, after-hours access and coordination with hospitals, emergency responders, law enforcement and other community organizations — pieces Safety Nest organizers say they ultimately hope to build into their network.
The $1.64 million was originally budgeted by the county for programs related to child abuse and neglect, including support for the Texas Department of Family and Protective Services’ Family-Based Safety Services program. After the state began funding those services, commissioners directed county staff in July to explore using the available money for a crisis nursery.
The Safety Nest Network plans to apply for the funding, Helterbrand said, though the competitive process is open to other qualified nonprofits and there is no guarantee the coalition will receive the contract. The county has not yet set a deadline for proposals, and any eventual award would have to return to Commissioners Court for approval.
The coalition had previously approached the City of San Antonio about supporting the program in 2024, which resulted in the creation of a feasibility study that is pending presentation to the city’s public health committee.
While no partnership has been solidified, Helterbrand said the work is essential.
“To really bring this to our community and stop the incredible influx of child abuse and neglect, that is really a scourge for our entire community,” she said. “We need the city and or the county to step up and help us get to scale. We’ve done our part.”
