Shay and Jaydon Moss are the reason the Nurse Family Partnership exists, and it is quite possible the reverse is also true.
Were it not for the Spokane Regional Health District’s home nursing program for first-time mothers, the twin boys may not have made it to their second birthday in good health last week.
On Monday, public health nurse Jan Bostian paid her last official visit to the north Spokane apartment of Tahne Moss, 22, and her husband, Arnold Moss, 27, the twins’ parents.
The Moss family is the first to complete the Nurse Family Partnership. A coalition of community groups received a five-year federal grant in 2007 to launch the program in Spokane. It also receives state and local funding.
“I don’t think we would have been able to do it without her help,” Tahne Moss said of Bostian and the program.
Bostian is one of eight public health nurses, each with a caseload of 25 families, in the Nurse Family Partnership program. The nurses connect with the first-time mothers through social service agencies or health care providers.
Tahne Moss was referred to the program through the Women, Infants and Children nutrition program. Expectant mothers can be no further along in pregnancy than 28 weeks, and Moss just beat the eligibility cutoff when Bostian started seeing her.
Since the Nurse Family Partnership began in New York in 1977, research has shown that babies born to families in the program are healthier, suffer fewer childhood injuries and are better prepared for school. Children whose families are in the program are less often abused, neglected or arrested by the time they’re 15.
Under the program, nurses visit an expectant mother’s home weekly for the first month and then every other week until the baby is born. Once the baby comes, the nurse resumes weekly visits for the first month of life and then every other week until the child is 2.
But Shay and Jaydon were born in the 31st week of pregnancy, and their birth weights were dangerously low – 3 pounds, 11 ounces and 3 pounds, 4 ounces.
“I was afraid to hold them when they were first born,” Moss said. “They were so little and fragile.”
The Moss twins’ troubles did not end when they left the hospital. Premature infants do not develop as quickly as infants carried to term, and the twins were unable to give the signals that they were in jeopardy, Bostian said.
But at nine months, the twins’ low weight and the fact that the family had missed medical appointments alarmed Bostian. Jaydon weighed only 13 pounds, 14 ounces and Shay weighed 13 pounds, 4 ounces – about what a 3- to 4-month-old should weigh.
Bostian informed Child Protective Services, which already had opened an investigation into the Moss family following complaints filed with the state agency concerning Arnold Moss’ son by a previous relationship. That child is currently in foster care in Idaho.
After Bostian’s call, CPS took the twins away from the parents, who admitted to using drugs, including methamphetamine, according to the parents. The babies spent nearly two weeks in a hospital and then were placed in a foster home.
“We messed up and can’t blame anybody but ourselves,” Tahne Moss said. “We understand we made the biggest mistake.”
The state action was a wake-up call for the parents, who underwent drug treatment as a critical part of the CPS family preservation services plan.
“It was all uphill from there,” said Bostian, who was part of the team of health care and social service professionals involved in the Moss case. She said the couple did everything the state required of them.
Tahne and Arnold have regained custody of the twins and remain close friends with the foster family who kept the boys for nine months.
When Bostian weighed the twins on Monday, their weights were up about 8 ounces in two weeks. They remain small, in the 25th percentile. Their development, including speech, is delayed, but they are making progress.
The boys are beginning an early Head Start program, and another public health nurse will make regular visits to the Moss home until the boys are 3 years old.
Late last month, a court dismissed the Moss’ case earlier than scheduled, and the twins are no longer wards of the state.
By the end of the year, 37 clients will have completed the Nurse Family Partnership program, which has served more than 261 families in Spokane County, said program director Susan Schultz.
The program is financed for another two years, but the Affordable Health Care for America Act, recently passed by Congress, authorizes $1.5 billion to be spent nationwide on home health care visits over the next five years.
Schultz hopes part of that allocation may be used to extend the Nurse Family Partnership.