[Congressional Bills 114th Congress]
[From the U.S. Government Publishing Office]
[S. 799 Reported in Senate (RS)]
<DOC>
Calendar No. 246
114th CONGRESS
1st Session
S. 799
To combat the rise of prenatal opioid abuse and neonatal abstinence
syndrome.
_______________________________________________________________________
IN THE SENATE OF THE UNITED STATES
March 19, 2015
Mr. McConnell (for himself and Mr. Casey, Ms. Ayotte, Mr. Portman, Mr.
Isakson, Ms. Baldwin, Mr. Whitehouse, Mr. Corker, Mr. Brown, Mr. Coons,
Mrs. Gillibrand, Mrs. Capito, Mrs. Fischer, Mr. Vitter, Mr. Boozman,
Mr. Cotton, Mr. Donnelly, Mr. King, Mr. Carper, Ms. Collins, Mrs.
Murray, and Mr. Toomey) introduced the following bill; which was read
twice and referred to the Committee on Health, Education, Labor, and
Pensions
October 1, 2015
Reported by Mr. Alexander, with an amendment and an amendment to the
title
[Strike out all after the enacting clause and insert the part printed
in italic]
_______________________________________________________________________
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,
<DELETED>SECTION 1. SHORT TITLE.</DELETED>
<DELETED> This Act may be cited as the ``Protecting Our Infants Act
of 2015''.</DELETED>
<DELETED>SEC. 2. FINDINGS.</DELETED>
<DELETED> Congress finds as follows:</DELETED>
<DELETED> (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.</DELETED>
<DELETED> (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.</DELETED>
<DELETED> (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.</DELETED>
<DELETED> (4) NAS refers to medical issues associated with
drug withdrawal in newborns due to exposure to opioids or other
drugs in utero.</DELETED>
<DELETED> (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.</DELETED>
<DELETED> (6) Preventing opioid abuse among pregnant women
and women of childbearing age is crucial.</DELETED>
<DELETED> (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.</DELETED>
<DELETED> (8) Addressing NAS effectively requires a focus on
women of childbearing age, pregnant women, and infants from
preconception through early childhood.</DELETED>
<DELETED> (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.</DELETED>
<DELETED> (10) For pregnant women who are abusing opioids,
it is most appropriate to treat and manage maternal substance
use in a non-punitive manner.</DELETED>
<DELETED> (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.</DELETED>
<DELETED> (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.</DELETED>
<DELETED> (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''.</DELETED>
<DELETED>SEC. 3. DEVELOPING RECOMMENDATIONS FOR PREVENTING AND TREATING
PRENATAL OPIOID ABUSE AND NEONATAL ABSTINENCE
SYNDROME.</DELETED>
<DELETED> (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.</DELETED>
<DELETED> (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).</DELETED>
<DELETED> (c) Contents.--The study described in subsection (a) and
the report under subsection (b) shall include--</DELETED>
<DELETED> (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;</DELETED>
<DELETED> (2) an evaluation of--</DELETED>
<DELETED> (A) the causes of and risk factors for
opioid use disorders among women of reproductive age,
including pregnant women;</DELETED>
<DELETED> (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;</DELETED>
<DELETED> (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;</DELETED>
<DELETED> (D) medically indicated use of opioids
during pregnancy;</DELETED>
<DELETED> (E) access to treatment for opioid use
disorders in pregnant and postpartum women;
and</DELETED>
<DELETED> (F) access to treatment for infants with
neonatal abstinence syndrome; and</DELETED>
<DELETED> (3) recommendations on--</DELETED>
<DELETED> (A) preventing, identifying, and treating
neonatal abstinence syndrome in infants;</DELETED>
<DELETED> (B) treating pregnant women who are
dependent on opioids; and</DELETED>
<DELETED> (C) preventing opioid dependence among
women of reproductive age, including pregnant women,
who may be at risk of developing opioid
dependence.</DELETED>
<DELETED>SEC. 4. IMPROVING PREVENTION AND TREATMENT FOR PRENATAL OPIOID
ABUSE AND NEONATAL ABSTINENCE SYNDROME.</DELETED>
<DELETED> (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.</DELETED>
<DELETED> (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--</DELETED>
<DELETED> (1) gaps in research, including with respect to--
</DELETED>
<DELETED> (A) the most appropriate treatment of
pregnant women with opioid use disorders;</DELETED>
<DELETED> (B) the most appropriate treatment and
management of infants with neonatal abstinence
syndrome; and</DELETED>
<DELETED> (C) the long-term effects of prenatal
opioid exposure on children; and</DELETED>
<DELETED> (2) gaps in programs, including--</DELETED>
<DELETED> (A) the availability of treatment programs
for pregnant and postpartum women and for newborns with
neonatal abstinence syndrome; and</DELETED>
<DELETED> (B) guidance and coordination in Federal
efforts to address prenatal opioid use or neonatal
abstinence syndrome.</DELETED>
<DELETED> (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).</DELETED>
<DELETED>SEC. 5. IMPROVING DATA ON AND PUBLIC HEALTH RESPONSE TO
NEONATAL ABSTINENCE SYNDROME.</DELETED>
<DELETED> (a) Data and Surveillance.--The Director of the Centers
for Disease Control and Prevention shall, as appropriate--</DELETED>
<DELETED> (1) provide technical assistance to States to
improve the availability and quality of data collection and
surveillance activities regarding neonatal abstinence syndrome,
including--</DELETED>
<DELETED> (A) the incidence and prevalence of
neonatal abstinence syndrome;</DELETED>
<DELETED> (B) the identification of causes for
neonatal abstinence syndrome, including new and
emerging trends; and</DELETED>
<DELETED> (C) the demographics and other relevant
information associated with neonatal abstinence
syndrome;</DELETED>
<DELETED> (2) collect available surveillance data described
in paragraph (1) from States, as applicable; and</DELETED>
<DELETED> (3) make surveillance data collected pursuant to
paragraph (2) publically available on an appropriate Internet
Web site.</DELETED>
<DELETED> (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.</DELETED>
SECTION 1. SHORT TITLE.
This Act may be cited as the ``Protecting Our Infants Act of
2015''.
SEC. 2. ADDRESSING PROBLEMS RELATED TO PRENATAL OPIOID USE.
(a) Review of Programs.--The Secretary of Health and Human Services
(referred to in this Act as the ``Secretary'') shall conduct a review
of planning and coordination related to prenatal opioid use, including
neonatal abstinence syndrome, within the agencies of the Department of
Health and Human Services.
(b) Strategy.--In carrying out subsection (a), the Secretary shall
develop a strategy to address gaps in research and gaps, overlap, and
duplication among Federal programs, including those 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;
(2) gaps, overlap, or duplication in--
(A) substance use disorder treatment programs for
pregnant and postpartum women; and
(B) treatment program options for newborns with
neonatal abstinence syndrome;
(3) gaps, overlap, or duplication in Federal efforts
related to education about, and prevention of, neonatal
abstinence syndrome; and
(4) coordination of Federal efforts to address 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 concerning
the findings of the review conducted under subsection (a) and the
strategy developed under subsection (b).
SEC. 3. DEVELOPING RECOMMENDATIONS FOR PREVENTING AND TREATING PRENATAL
OPIOID USE DISORDERS.
(a) In General.--The Secretary shall conduct a study and develop
recommendations for preventing and treating prenatal opioid use
disorders, including the effects of such disorders on infants. In
carrying out this subsection the Secretary shall--
(1) take into consideration--
(A) the review and strategy conducted and developed
under section 2; and
(B) the lessons learned from previous opioid
epidemics; and
(2) solicit input from States, localities, and Federally
recognized Indian tribes or tribal organizations (as defined in
the Indian Self-Determination and Education Assistance Act (25
U.S.C. 450b)), and nongovernmental entities, including
organizations representing patients, health care providers,
hospitals, other treatment facilities, and other entities, as
appropriate.
(b) Report.--Not later than 18 months after the date of enactment
of this Act, the Secretary shall make available on the appropriate
Internet Website of the Department of Health and Human Services a
report on the recommendations under subsection (a). Such report shall
address each of the issues described in subsection (c).
(c) Contents.--The recommendations 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 have opioid use disorders;
(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 affected by such disorders;
(D) medically indicated uses 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
(G) differences in prenatal opioid use and use
disorders in pregnant women between demographic groups;
and
(3) recommendations on--
(A) preventing, identifying, and treating the
effects of prenatal opioid use on infants;
(B) treating pregnant women who have opioid use
disorders;
(C) preventing opioid use disorders among women of
reproductive age, including pregnant women, who may be
at risk of developing opioid use disorders; and
(D) reducing disparities in opioid use disorders
among pregnant women.
SEC. 4. IMPROVING DATA AND THE PUBLIC HEALTH RESPONSE.
The Secretary may continue activities, as appropriate, related to--
(1) providing technical assistance to support States and
Federally recognized Indian Tribes in collecting information on
neonatal abstinence syndrome through the utilization of
existing surveillance systems and collaborating with States and
Federally recognized Indian Tribes to improve the quality,
consistency, and collection of such data; and
(2) providing technical assistance to support States in
implementing effective public health measures, such as
disseminating information to educate the public, health care
providers, and other stakeholders on prenatal opioid use and
neonatal abstinence syndrome.
Amend the title so as to read: ``To address problems
related to prenatal opioid use.''.
Calendar No. 246
114th CONGRESS
1st Session
S. 799
_______________________________________________________________________
A BILL
To combat the rise of prenatal opioid abuse and neonatal abstinence
syndrome.
_______________________________________________________________________
October 1, 2015
Reported with an amendment and an amendment to the title