Bill seeks federal study on substance-impacted newborns, with clinics like Maddie’s Place serving as inspiration

Rep. Cathy McMorris Rodgers introduced a bill earlier this month seeking a federal study on Neonatal Abstinence Syndrome, caused when newborns withdraw from opioids and other substances they’re exposed to before birth.

She said the move is inspired by Maddie’s Place, a Spokane pediatric transitional care nursery for drug- and alcohol-exposed infants that launched in 2022.

The Maddie’s Infant Recovery and Children’s Legislative Emergency (MIRACLE) Act would require a Secretary of Health and Human Services study and report within three years to Congress. It would review how widespread the problem is nationally and the outcomes at four pediatric transitional care facilities in different states, including the Spokane site.

Babies’ withdrawal symptoms often include tremors, seizures, eating issues, sensory overload and excessive crying. Untreated, the syndrome can lead to developmental issues, behavioral problems and struggles with bonding.

An estimated six out of every 1,000 babies are born with abstinence syndrome in the United States, based on 2020 data from the Healthcare Cost and Utilization Project. Within 72 hours of birth, exposed newborns can experience life-threatening withdrawal symptoms.

“Our country is in the midst of a devastating opioid crisis that is tearing apart families and taking too many innocent lives,” McMorris Rodgers said in a news release. “My heart breaks at the growing number of babies being born with NAS, which is a tragic reminder of the work we still have before us to restore hope and healing in our communities.”

There is little federal data available on the syndrome and outcomes.

“There is a growing concern that the prevalence of NAS in our communities far exceeds the most recent CDC data, which needs to be updated to more accurately reflect the current reality of the opioid crisis, especially post-fentanyl,” the release said.

Medicaid funding to treat newborns withdrawing from substances ends when the mother and baby get discharged from hospital care, said Maddie’s Place CEO Shaun Cross.

He believes the legislation could pave the way for states to amend Medicaid plans to provide reimbursements to transitional nurseries. He said Sen. Patty Murray toured Maddie’s Place recently.

“There are two aims to the study: one is what is the prevalence, how bad is this problem in every state and Indian tribe and the obstacles to getting good data, and the second aim is to study the outcomes of the pediatric transitional care facilities in the country, of which there are a handful, including Maddie’s Place,” Cross said.

The other transitional clinics are in Ohio, West Virginia and Arizona, he said.

“There are only four of these clinics in the country, and there really should be hundreds because of fentanyl and everything,” Cross added. “We’re so behind on this. People need to know how bad this problem is, and they need data in order to make public policy decisions. I think this has the potential to do so at the national level.”

Abrupt movements, bright lighting and noises tend to be overwhelming for abstinence syndrome infants. Maddie’s caregivers are trained in comfort techniques, careful feeding schedules and frequent human touch in a quiet, calm and darkened space. It works with mothers who are in treatment recovery to support bonding with their babies.

The facility has treated 85 babies so far, Cross said, and its leaders plan to expand space soon into an adjacent property.