Visitors to Maddie’s Place likely will see staff members caring for infants in a Moby Wrap—a cloth that wraps around the caretaker and secures the baby close to their keeper’s chest.
“Hearing a heartbeat and having that warmth and skin-to-skin touch is profoundly important in the development of a child,” says Shaun Cross, president and CEO of Maddie’s Place.
Since opening in October, the pediatric transitional care facility has cared for 40 infants with neonatal abstinence syndrome, meaning the infants are withdrawing from pre-birth exposure to substances including opioids, alcohol, and marijuana, says Cross.
The operating budget for Maddie’s Place is about $3 million a year. Services provided by the center currently aren’t covered by Washington state’s Medicaid plan, says Cross.
To make a case for the necessity of these services, Maddie’s Place recently has been awarded $5.5 million from Washington state’s opioid abatement settlement account, says Cross.
The funds will be used to implement a pilot program that studies and evaluates the efficacy, outcomes, and impact of providing these services to infants with neonatal abstinence syndrome to avoid more costly medical interventions, he says.
Of these funds, $190,000 is provided solely for Maddie’s Place to contract with Washington State University Health Sciences Spokane to conduct research analyzing the prevalence of neonatal abstinence syndrome and infant maternal health outcomes associated with neonatal transitional nurseries in Washington. The remaining funds will be used to cover the bulk of the facility’s operating expenses over the next two years, says Cross.
The research team is made up of five substance abuse experts with a focus on neonatal abstinence syndrome from WSU’s College of Nursing and the Elson S. Floyd College of Medicine, says Celestina Barbosa-Leiker, vice chancellor for research at WSU Health Sciences.
Barbosa-Leiker says the research team will identify barriers to starting pediatric transitional care facilities, partner with Maddie’s Place to follow-up with mothers and their children, analyze developmental outcomes, and provide a descriptive cost analysis of these services.
“We’re doing prep work now while we wait for funding, so we can hit the ground running once it comes in,” says Barbosa-Leiker, who has been collaborating informally with Maddie’s Place for about five years.
Funds will be distributed in eight quarterly installments beginning Sept. 1, says Cross.
Maddie’s Place is the vision of Trisha Hughes, a registered nurse of over 30 years. Hughes who is also a foster and adoptive parent first began caring for infants born dependent on drugs when she and her husband, Carey Hughes, a pastor at Christ the Redeemer Church, adopted a baby boy withdrawing from heroin in 2002.
Cross remembers Hughes telling him about her baby and an increase of babies in Spokane being born dependent on drugs.
“It went over my windshield at the time,” says Cross. “But in 2017, she called a meeting with me and other people, and I learned (since 2002) she had been taking care of these babies in the community suffering from neonatal abstinence syndrome.”
Cross, a corporate lawyer with 44-years of experience, incorporated Maddie’s Place in 2018. In March of 2020, he and Hughes began fundraising via Zoom to purchase the organization’s headquarters, a 12,000-square-foot facility located in the South Perry District at 1004 E. Eighth, formerly the home of Vanessa Behan Crisis Nursery, a child refuge center.
The property was purchased for $1.25 million in December of 2020.
Cross says Maddie’s Place received donations from Spokane-based Avista Foundation, the Cowles Foundation, and Excelsior Wellness, among others.
Maddie’s Place is named for Hughes’ youngest daughter, Madeline. Maddie was delivered to the Hughes home, which had become known for taking in infants born dependent on drugs. At 3 weeks old, Maddie showed all the signs of drug withdrawal, including tremors, sweating, and digestive problems.
“The passion of caring for these children grew in me over the years,” says Hughes, who is also the center’s clinical director. “With Maddie, I was compelled to do something different to help even more (infants).”
In Spokane, there are about 6,000 live births a year, says Cross.
The federal Centers for Disease Control and Prevention estimates that about 12.6% of all live births have some form of substance-abuse background, he says.
That statistic, however, precedes the emergence of the fentanyl crisis.
“We think that it’s way higher, because we are one of 11 cities in crisis, because we’re a fentanyl center,” he says.
Last year, the U.S. Drug Enforcement Administration designated Spokane as a crisis spot for fentanyl addiction, says Cross.
The average infant born with neonatal abstinence syndrome isn’t treated, says Cross.
A report by Ira Chasnoff, an expert on pre-natal exposure to substances cites 94% of all boys and girls in foster care with a background of neonatal exposure to substances will have psychiatric mental health issues at some point in their lives, says Hughes.
Cross adds, “We know from epigenetics that trauma that infants experience including drug exposure, is carried on to the next generation genetically. So you’ll have mental health issues, homelessness issues, criminal justice issues.”
The ramifications of the drug exposure on infants can be long term, but they can be minimized if steps are taken early, says Cross.
“If you take a lot of steps during the first 60 to 90 days, which is what our purpose is, you can reverse or avoid a lot of the long-term damage,” he says.
Infants with neonatal abstinence syndrome have been exposed to toxic drugs for up to nine months, which can damage their digestive systems, says Cross. Specialized types of formula—some costing up to $80 per bottle—can assist such infants.
The facility also started a breast milk bank to supplement milk for mothers who are unable to nurse.
“We spent $7,500 on breast milk in January alone,” says Cross.
Infants with neonatal abstinence syndrome often will have mouth deformities or tongue-tie that can interfere with breast feeding, says Cross. Maddie’s Place has about 30 different types of baby bottle nipples that can assist infants during feeding.
Consistent physical contact is also an important part of the baby’s recovery, says Cross.
“You’ll see in some circles that if a baby cries, that’s OK, they need to learn that kind of thing,” says Cross. “When these babies cry, their needs are addressed. You’re trying to get them to understand that when they are in pain, someone is going to be there to help them.”
Maddie’s Place, which is staffed 24/7, has 52 employees, including three receptionists, 19 registered nurses, 19 infant care specialists, and other support staff. The center also has 40 volunteers, says Cross.
Since the purchase of the building, a $1.3 million, Phase 1 remodel has been completed, Cross says.
Phase II construction, which began in June, is valued at $350,000 and is expected to be completed in September, he says.
Spokane-based Bouten Construction Co. is the contractor on the remodel phases and Paul Herrington, of Spokane-based ROMR Architects, designed them.
Once the current project is completed, the center will have the capacity to treat up to 16 infants and provide care for 13 mothers, says Cross. The center currently treats up to nine infants.
Maddie’s Place plans to hire an additional 15 to 20 nurses and infant care specialists, and a visitation coordinator, Cross says.
Cross, who is 73 years old, was an attorney with Spokane-based Paine Hamblen LLP for 30 years. In 2008, he became CEO of Lee & Hayes PLLC. He stepped down from that role in 2015 and remains a partner and general counsel of the firm.
He says he joined Maddie’s Place because he wanted to find something he could be passionate about.
“I was really praying to God that he would create a passion in me for something that is worth the struggle,” he says. “I think I have that passion now, and I think that this is something that is worth the struggle.”
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