Allow Medicaid to help babies born drug-dependent

It is a heartbreaking growth industry, especially in Ohio: helping babies born dependent on drugs to get through the hell of withdrawal.

As the cost of such care has skyrocketed along with opioid abuse, a better approach is emerging. But if it is to reach its potential, state and national leaders need to clear away a bureaucratic obstacle.

The typical course for babies with what’s called neonatal abstinence syndrome is to care for them in hospital neonatal intensive-care units. There, the high-level medical expertise and available technology are beyond question, but those don’t necessarily produce the best environment for an NAS baby.

Innovative health-care professionals, including a group in suburban Dayton, have come up with a better alternative in homelike settings where moms and babies can stay together and care can be more hightouch than high-tech.

The problem? Most babies with NAS are covered by Medicaid, and Medicaid rules don’t allow payment for infant drugaddiction services outside of hospitals.

This can be fixed one of two ways: a federal law change or a state-based waiver allowing the state’s Medicaid program to cover NAS care in standalone facilities. Efforts are underway on both tracks, and we hope one will succeed soon.

U.S. Sen. Sherrod Brown, D-Ohio, teamed with Republican senators Shelley Moore Capito of West Virginia and Rob Portman of Ohio on a measure that would allow Medicaid to pay for NAS care in “pediatric recovery facilities” as well as in hospitals.

Meanwhile, the Ohio Department of Medicaid is working on a request for a waiver to allow Medicaid coverage in case the senators’ legislative fix doesn’t go through.

Encouraging NAS recovery care makes sense on multiple fronts.

Babies suffering from NAS do better with calm, quiet settings and plenty of human contact. At Brigid’s Path, the Dayton-area infant recovery center, babies have cribs in private rooms with dim lighting.

With moms on hand and lots of volunteer “cuddlers,” babies who are irritable and anxious and suffering abdominal discomfort, tremors and difficulty eating and sleeping can be comforted and soothed through the misery rather than quieted with medication.

Nurses and staff members work with parents, who often are overcome by shame and guilt. Giving them the skills and confidence to care for their babies increases the chances that babies will be healthy and families will stay together.

Even better, care at a recovery center is far cheaper than in a hospital NICU. But right now, only eight of the 24 rooms at Brigid’s Path can be filled at one time because too many families who need the services can’t afford them without Medicaid help so the center can’t afford to hire enough staff members.

In 2006, according to the Ohio Department of Health, 305 Ohio babies were treated in hospitals for NAS — 222 of them covered by Medicaid. The total cost was $12 million. By 2015, the number of NAS babies had grown to 2,174, with 1,950 covered by Medicaid and a total cost of more than $133 million.

Most of those babies could be better cared for in facilities better designed for their needs. Professionals at Nationwide Children’s Hospital would like to develop a program like Brigid’s Path for central Ohio.

Pointless funding restrictions shouldn’t stand in their way.