[Congressional Bills 114th Congress]
[From the U.S. Government Publishing Office]
[H.R. 1462 Reported in House (RH)]

                                                 Union Calendar No. 185
114th CONGRESS
  1st Session
                                H. R. 1462

                          [Report No. 114-244]

  To combat the rise of prenatal opioid abuse and neonatal abstinence 
                               syndrome.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                             March 19, 2015

Ms. Clark of Massachusetts (for herself and Mr. Stivers) introduced the 
   following bill; which was referred to the Committee on Energy and 
                                Commerce

                           September 8, 2015

 Additional sponsors: Mr. Barr, Mr. Hastings, Mr. Israel, Mr. Keating, 
   Ms. Meng, Ms. Moore, Ms. Tsongas, Mr. Yarmuth, Mrs. Lawrence, Mr. 
 McGovern, Mr. Newhouse, Mr. Jenkins of West Virginia, Mr. Tonko, Mr. 
  Cartwright, Mr. Kennedy, Mrs. Bustos, Mr. Lance, Mrs. Comstock, Ms. 
 Castor of Florida, Mr. Turner, Mr. Moulton, Mr. Cohen, Mr. Mooney of 
   West Virginia, Mr. Rogers of Kentucky, Mr. Lynch, Mr. Cramer, Mr. 
Harper, Mr. DeSaulnier, Mrs. Brooks of Indiana, Mr. Hanna, Mr. Collins 
 of New York, Mr. Grijalva, Mr. Larson of Connecticut, Mr. Mullin, Mr. 
Peters, Mr. Dold, Mrs. Beatty, Mr. Amodei, Ms. Kuster, Mr. Guthrie, Ms. 
  DelBene, Mr. Hultgren, Mr. Heck of Nevada, Mr. Young of Alaska, Mr. 
 McCaul, Mr. Bishop of Georgia, Mr. Cicilline, Mr. Welch, Mr. Doggett, 
Mr. Brady of Pennsylvania, Mr. Hinojosa, Mr. Pierluisi, Mrs. Black, Ms. 
  Stefanik, Mr. Ted Lieu of California, Mr. Higgins, Mr. Levin, Mrs. 
     Dingell, Mr. Lucas, Ms. Wasserman Schultz, Mr. Whitfield, Mr. 
 Perlmutter, Mr. Rodney Davis of Illinois, Mr. Swalwell of California, 
Ms. Slaughter, Ms. Clarke of New York, Mr. Roe of Tennessee, Mr. Young 
   of Iowa, Ms. Pingree, Ms. Schakowsky, Mr. Jolly, Mr. Tiberi, Mr. 
      Cooper, Mr. Capuano, Mr. Duncan of Tennessee, Mr. Neal, Mr. 
  Fitzpatrick, Mr. Bilirakis, Mr. Young of Indiana, Mr. Sean Patrick 
   Maloney of New York, Mr. Cardenas, Mr. Loebsack, Ms. Matsui, Mr. 
    Kilmer, Ms. Kaptur, Mr. Ryan of Ohio, Mr. Johnson of Ohio, Mrs. 
   Napolitano, Mr. Joyce, Ms. Brownley of California, Ms. Esty, Mr. 
   Messer, Ms. DeLauro, Mr. Costello of Pennsylvania, Ms. Fudge, Ms. 
             Sinema, Ms. Herrera Beutler, and Mr. MacArthur

                           September 8, 2015

Committed to the Committee of the Whole House on the State of the Union 
                       and ordered to be printed

_______________________________________________________________________

                                 A BILL


 
  To combat the rise of prenatal opioid abuse and neonatal abstinence 
                               syndrome.


 


    Be it enacted by the Senate and House of Representatives of the 
United States of America in Congress assembled,

SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Protecting Our Infants Act of 
2015''.

SEC. 2. FINDINGS.

    Congress finds as follows:
            (1) Opioid prescription rates have risen dramatically over 
        the past several years. According to the Centers for Disease 
        Control and Prevention, in some States, there are as many as 96 
        to 143 prescriptions for opioids per 100 adults per year.
            (2) In recent years, there has been a steady rise in the 
        number of overdose deaths involving heroin. According to the 
        Centers for Disease Control and Prevention, the death rate for 
        heroin overdose doubled from 2010 to 2012.
            (3) At the same time, there has been an increase in cases 
        of neonatal abstinence syndrome (referred to in this section as 
        ``NAS''). In the United States, the incidence of NAS has risen 
        from 1.20 per 1,000 hospital births in 2000 to 3.39 per 1,000 
        hospital births in 2009.
            (4) NAS refers to medical issues associated with drug 
        withdrawal in newborns due to exposure to opioids or other 
        drugs in utero.
            (5) The average cost of treatment in a hospital for NAS 
        increased from $39,400 in 2000 to $53,400 in 2009. Most of 
        these costs are born by the Medicaid program.
            (6) Preventing opioid abuse among pregnant women and women 
        of childbearing age is crucial.
            (7) Medically appropriate opioid use in pregnancy is not 
        uncommon, and opioids are often the safest and most appropriate 
        treatment for moderate to severe pain for pregnant women.
            (8) Addressing NAS effectively requires a focus on women of 
        childbearing age, pregnant women, and infants from 
        preconception through early childhood.
            (9) NAS can result from the use of prescription drugs as 
        prescribed for medical reasons, from the abuse of prescription 
        drugs, or from the use of illegal opioids like heroin.
            (10) For pregnant women who are abusing opioids, it is most 
        appropriate to treat and manage maternal substance use in a 
        non-punitive manner.
            (11) According to a report of the Government Accountability 
        Office (referred to in this section as the ``GAO report''), 
        more research is needed to optimize the identification and 
        treatment of babies with NAS and to better understand long-term 
        impacts on children.
            (12) According to the GAO report, the Department of Health 
        and Human Services does not have a focal point to lead planning 
        and coordinating efforts to address prenatal opioid use and NAS 
        across the department.
            (13) According to the GAO report, ``given the increasing 
        use of heroin and abuse of opioids prescribed for pain 
        management, as well as the increased rate of NAS in the United 
        States, it is important to improve the efficiency and 
        effectiveness of planning and coordination of Federal efforts 
        on prenatal opioid use and NAS''.

SEC. 3. DEVELOPING RECOMMENDATIONS FOR PREVENTING AND TREATING PRENATAL 
              OPIOID ABUSE AND NEONATAL ABSTINENCE SYNDROME.

    (a) In General.--The Secretary of Health and Human Services 
(referred to in this Act as the ``Secretary''), acting through the 
Director of the Agency for Healthcare Research and Quality (referred to 
in this section as the ``Director''), shall conduct a study and develop 
recommendations for preventing and treating prenatal opioid abuse and 
neonatal abstinence syndrome, soliciting input from nongovernmental 
entities, including organizations representing patients, health care 
providers, hospitals, other treatment facilities, and other entities, 
as appropriate.
    (b) Report.--Not later than 1 year after the date of enactment of 
this Act, the Director shall publish on the Internet Web site of the 
Agency for Healthcare Research and Quality a report on the study and 
recommendations under subsection (a). Such report shall address each of 
the issues described in paragraphs (1) through (3) of subsection (c).
    (c) Contents.--The study described in subsection (a) and the report 
under subsection (b) shall include--
            (1) a comprehensive assessment of existing research with 
        respect to the prevention, identification, treatment, and long-
        term outcomes of neonatal abstinence syndrome, including the 
        identification and treatment of pregnant women or women who may 
        become pregnant who use opioids or other drugs;
            (2) an evaluation of--
                    (A) the causes of and risk factors for opioid use 
                disorders among women of reproductive age, including 
                pregnant women;
                    (B) the barriers to identifying and treating opioid 
                use disorders among women of reproductive age, 
                including pregnant and postpartum women and women with 
                young children;
                    (C) current practices in the health care system to 
                respond to and treat pregnant women with opioid use 
                disorders and infants born with neonatal abstinence 
                syndrome;
                    (D) medically indicated use of opioids during 
                pregnancy;
                    (E) access to treatment for opioid use disorders in 
                pregnant and postpartum women; and
                    (F) access to treatment for infants with neonatal 
                abstinence syndrome; and
            (3) recommendations on--
                    (A) preventing, identifying, and treating neonatal 
                abstinence syndrome in infants;
                    (B) treating pregnant women who are dependent on 
                opioids; and
                    (C) preventing opioid dependence among women of 
                reproductive age, including pregnant women, who may be 
                at risk of developing opioid dependence.

SEC. 4. IMPROVING PREVENTION AND TREATMENT FOR PRENATAL OPIOID ABUSE 
              AND NEONATAL ABSTINENCE SYNDROME.

    (a) Review of Programs.--The Secretary shall lead a review of 
planning and coordination within the Department of Health and Human 
Services related to prenatal opioid use and neonatal abstinence 
syndrome.
    (b) Strategy To Close Gaps in Research and Programming.--In 
carrying out subsection (a), the Secretary shall develop a strategy to 
address research and program gaps, including such gaps identified in 
findings made by reports of the Government Accountability Office. Such 
strategy shall address--
            (1) gaps in research, including with respect to--
                    (A) the most appropriate treatment of pregnant 
                women with opioid use disorders;
                    (B) the most appropriate treatment and management 
                of infants with neonatal abstinence syndrome; and
                    (C) the long-term effects of prenatal opioid 
                exposure on children; and
            (2) gaps in programs, including--
                    (A) the availability of treatment programs for 
                pregnant and postpartum women and for newborns with 
                neonatal abstinence syndrome; and
                    (B) guidance and coordination in Federal efforts to 
                address prenatal opioid use or neonatal abstinence 
                syndrome.
    (c) Report.--Not later than 1 year after the date of enactment of 
this Act, the Secretary shall submit to the Committee on Health, 
Education, Labor, and Pensions of the Senate and the Committee on 
Energy and Commerce of the House of Representatives a report on the 
findings of the review described in subsection (a) and the strategy 
developed under subsection (b).

SEC. 5. IMPROVING DATA ON AND PUBLIC HEALTH RESPONSE TO NEONATAL 
              ABSTINENCE SYNDROME.

    (a) Data and Surveillance.--The Director of the Centers for Disease 
Control and Prevention shall, as appropriate--
            (1) provide technical assistance to States to improve the 
        availability and quality of data collection and surveillance 
        activities regarding neonatal abstinence syndrome, including--
                    (A) the incidence and prevalence of neonatal 
                abstinence syndrome;
                    (B) the identification of causes for neonatal 
                abstinence syndrome, including new and emerging trends; 
                and
                    (C) the demographics and other relevant information 
                associated with neonatal abstinence syndrome;
            (2) collect available surveillance data described in 
        paragraph (1) from States, as applicable; and
            (3) make surveillance data collected pursuant to paragraph 
        (2) publically available on an appropriate Internet Web site.
    (b) Public Health Response.--The Director of the Centers for 
Disease Control and Prevention shall encourage increased utilization of 
effective public health measures to reduce neonatal abstinence 
syndrome.
                                                 Union Calendar No. 185

114th CONGRESS

  1st Session

                               H. R. 1462

                          [Report No. 114-244]

_______________________________________________________________________

                                 A BILL

  To combat the rise of prenatal opioid abuse and neonatal abstinence 
                               syndrome.

_______________________________________________________________________

                           September 8, 2015

Committed to the Committee of the Whole House on the State of the Union 
                       and ordered to be printed