[Congressional Record Volume 161, Number 47 (Thursday, March 19, 2015)]
[Senate]
[Pages S1662-S1663]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]

      By Mr. McCONNELL (for himself and Mr. Casey):
  S. 799. A bill to combat the rise of prenatal opioid abuse and 
neonatal abstinence syndrome; to the Committee on Health, Education, 
Labor, and Pensions.
  Mr. McCONNELL. Mr. President, next month I look forward to hosting 
our Nation's newest drug czar at a forum in Covington, KY. It is a 
forum that will allow Director Bottecelli to hear firsthand accounts of 
the devastating impact of one of America's most significant public 
health challenges and one that continues to hit my State particularly 
hard--the growing epidemic of prescription drug and heroin abuse.
  It is hard to overstate the challenge. Drug overdoses, largely driven 
by pain killers, now claim more Kentucky lives than car accidents, and 
rising heroin overdose rates now account for nearly one-third of all 
drug overdose deaths in Kentucky.
  While statistics such as these are devastating enough, they hardly 
paint the full picture because they don't account for the thousands of 
innocent children born dependent on opioids. The numbers are hard to 
hear. Nationwide we have seen a staggering 300-percent increase in the 
number of infants diagnosed with newborn withdrawal since 2000. But in 
Kentucky, we saw similar numbers grow by an almost unbelievable 3,000 
percent.
  It is a tragic challenge, and I say that especially as a father of 
three daughters. But it is a challenge we can do something about. If 
Washington enacts the bipartisan Protecting Our Infants Act that I am 
introducing today, along with Senator Casey of Pennsylvania, it is a 
challenge we will do something about.
  This bipartisan bill will do a number of important things. It will 
direct the Secretary of Health and Human Services to develop 
recommendations both for preventing prenatal opioid abuse and treating 
infants dependent on opioids. It would direct the Secretary to help 
develop a strategy to address research and program gaps--a step 
recommended by GAO in one of their reports released last month--and it 
would encourage the Director of the CDC to work with States to help 
improve surveillance and data collection activities in this area.
  Obviously, no piece of legislation would ever solve the challenge 
overnight, but the bipartisan Protect Our Infants Act can help move the 
country in the right direction. That is why it is supported by the 
March of Dimes, the American Academy of Pediatrics, the American 
Congress of Obstetricians and Gynecologists. That is why an identical 
bill will also be introduced in the House today by Congresswoman 
Katherine Clark of Massachusetts and Congressman Steve Stivers of Ohio.
  I commend these Representatives and Senator Casey for their 
leadership on this issue. I look forward to working with them to 
advance this important measure through Congress, and I look forward to 
discussing it with Director Botticelli during his visit to Kentucky in 
the next few weeks.
  Mr. President, I ask unanimous consent that the text of the bill be 
printed in the Record.
  There being no objection, the text of the bill was ordered to be 
printed in the Record, as follows:

                                 S. 799

       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''.

[[Page S1663]]

     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.
                                 ______