“The need is huge and still growing,” said Jill Kingston, a co-founder and executive director of Brigid’s Path. “We have women calling. They are just ready for this kind of service to be available.”
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An average of six babies a day — or 2,174 total — were admitted to Ohio hospitals in 2015 for neonatal abstinence syndrome (NAS), a consequence of the opioid crisis. In 2006, just slightly more than 300 cases were reported statewide.
Depending on the opioid used by a mother, a baby’s withdrawal will typically begin within the first 48 hours of life but may stretch to 96 hours, said Dr. Stephen Hunter, a MEDNAX-affiliated neonatologist at Dayton Children’s Hospital and Brigid’s Path’s medical director.
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Infants born exposed to drugs typically begin treatment in neonatal intensive care units, where they receive special care to overcome a number of symptoms, said Kingston, who began developing the nonprofit four years ago after becoming a foster parent to drug-exposed infants.
“They shake — they have what’s called tremors — and that’s just one of the reactions that they are withdrawing,” Kingston said. “They are vomiting, they have diarrhea. They are hard to console.”
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When treatment is under control with medication and an infant’s symptoms are manageable – they are able to eat, sleep and stop losing weight — the family and physicians may decide the next step to recovery is Brigid’s Path, so long as the baby has no other health problems, said Lisa Jasin, a neonatal nurse practitioner at Dayton Children’s Hospital,
“Most of these babies are well kids … I don’t want to say normal babies,” said Jasin. “They are babies whose only health issue is that they are withdrawing.”
During 2015, drug-exposed babies born in Ohio were hospitalized on average 14 days costing more than $133 million in Medicaid charges, according to Ohio Department of Health data.
Kingston said about 90 percent of NAS babies could be cared for at Brigid’s Path rather than at a hospital.
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Brigid’s Path’s ability to help bring some health care costs down “is definitely a foreseeable outcome down the road,” but the quality of care the center plans will require “a full complement of medical professionals,” Hunter said.
“It would definitely be much more economical from an insurance standpoint to house a baby in this type of environment. They will still be under the care of registered nurses, neonatologists, and nurse practitioners, so in terms of the quality of care from a medical standpoint, they will be getting that equivalency of care. But as far as the overhead costs comparing this facility with a hospital, it should help decrease the overall costs of care for these kids.”
Withdrawing babies will stay in nurseries designed to be quiet rooms with dim lighting and little stimulation besides being physically soothed through therapeutic handling by family members and volunteers. The medical staff at Brigid’s Path will continue seeing the newborns’ withdrawal through if necessary with low doses of methadone or other medication, Jasin said.
Lily’s Place in Huntington, W.Va. was the first such facility in the U.S. to open and provided a model for Kingston and co-founder Deanna Murphy, who is no longer with the Brigid’s Path.
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The nonprofit raised about $2.5 million, putting about $2 million toward transforming a donated building into a medical facility. State funding provided $1 million split over two years for the pilot program.
Kingston said about $2 million more in private donations is needed to keep the pilot program running through October 2018. A major hurdle to clear in order to keep the doors open permanently will require changes in federal law being worked on now that would allow Brigid’s Path and similar programs to receive Medicaid reimbursements.
Infants will stay at Brigid’s Path two to three weeks as they are weaned from the prenatal drug exposure, but the family mentoring components of the program that will extend up to a year are perhaps more important in determining the long-term outcomes for the newborns, Jasin said.
“The home environment is one of the most important environment for them,” Jasin said. “The attention and care they get at home is the most helpful thing.”
“We are just scratching the surface of what the problems are. But I can tell you there’s a lot more emphasis on that now.”