[Congressional Record Volume 161, Number 128 (Tuesday, September 8, 2015)]
[House]
[Pages H5798-H5801]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]
PROTECTING OUR INFANTS ACT OF 2015
Mr. GUTHRIE. Mr. Speaker, I move to suspend the rules and pass the
bill (H.R. 1462) to combat the rise of prenatal opioid abuse and
neonatal abstinence syndrome.
The Clerk read the title of the bill.
The text of the bill is as follows:
H.R. 1462
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.
[[Page H5799]]
(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.
The SPEAKER pro tempore. Pursuant to the rule, the gentleman from
Kentucky (Mr. Guthrie) and the gentleman from Texas (Mr. Gene Green)
each will control 20 minutes.
The Chair recognizes the gentleman from Kentucky.
General Leave
Mr. GUTHRIE. Mr. Speaker, I ask unanimous consent that all Members
have 5 legislative days in which to revise and extend their remarks and
insert extraneous materials in the Record on the bill.
The SPEAKER pro tempore. Is there objection to the request of the
gentleman from Kentucky?
There was no objection.
Mr. GUTHRIE. Mr. Speaker, I yield myself as much time as I may
consume.
I rise today in support of H.R. 1462, the Protecting Our Infants Act
of 2015, introduced by my colleagues, Ms. Clark of Massachusetts and
Mr. Stivers.
Over the past several years, opioid addiction has risen dramatically
in the United States, reaching epidemic proportions. The death rate for
heroin overdose doubled in just 2 years, from 2010 to 2012.
One of the issues that has arisen as a result of this epidemic is
neonatal abstinence syndrome, known as NAS.
These are infants born addicted to opioids and suffer medical issues
associated with drug withdrawal. Symptoms can last for weeks, keeping
otherwise healthy infants confined to the hospital at the start of
their lives.
NAS can result from the use of prescription drugs or from the use of
illegal opioids. Sadly, over the past 15 years, a prevalence of NAS has
tripled in the United States. This is a rapidly growing problem that
needs to be addressed for the safety of our mothers and children.
H.R. 1462 would address the increasing problem of prenatal opioid
abuse and neonatal abstinence syndrome. Preventing opioid abuse among
pregnant women and women of childbearing age is crucial in addressing
NAS.
The Government Accountability Office has identified that more
research is needed in this area to help treat babies born with NAS and
mothers addicted to opioids.
This legislation would help fill this research gap by studying issues
and developing recommendations for preventing and treating prenatal
opioid abuse and neonatal abstinence syndrome.
Mr. Speaker, I urge my colleagues to support this bill. I reserve the
balance of my time.
Mr. GENE GREEN of Texas. Mr. Speaker, I yield myself as much time as
I may consume.
I rise in support of H.R. 1462, the Protecting Our Infants Act, led
by Representatives Katherine Clark and Steve Stivers.
The Centers for Disease Control and Prevention has found drug
overdose to be the leading cause of injury death in the United States.
[[Page H5800]]
According to a recent study by the New England Journal of Medicine,
from 2004 to 2013, the incidence rate of neonatal abstinence syndrome,
NAS, has quadrupled.
NAS refers to medical complications in newborns associated with drug
withdrawal due to exposure to opioids and other drugs during pregnancy.
Babies born with NAS often require weeks of hospitalization and can
suffer from seizures and other severe complications.
There is an urgent need for further research to facilitate the
identification and treatment of infants with NAS and determine long-
term health impacts.
The GAO and other experts identified specific research gaps related
to best practices for treating pregnant women with opioid use
disorders, the long-term effects of prenatal drug exposure, and best
practices in the screening, diagnosis, and treatment of NAS.
The Protecting Our Infants Act takes proactive steps to help reduce
the number of newborns born exposed to opioids and other drugs and to
improve their care if they are exposed.
It will facilitate the development of recommendations for treatment
and coordinate a national strategy to close the known gaps in research
and coordination. It will also help States improve data collection and
surveillance activities.
I want to thank Representatives Clark of Massachusetts and Stivers
for their leadership. I also want to thank Chairman Upton, Ranking
Member Pallone, Chairman Pitts, and my colleagues on the Energy and
Commerce Committee for advancing this important legislation.
I urge my colleagues to support H.R. 1462. I reserve the balance of
my time.
Mr. GUTHRIE. Mr. Speaker, I yield 3 minutes to the gentleman from
West Virginia (Mr. Jenkins).
Mr. JENKINS of West Virginia. Mr. Speaker, every day in hospitals
across the Third Congressional District of West Virginia and the
country babies begin their lives going through drug withdrawal because
they were exposed during pregnancy. As you have heard, it is the
diagnosis known as neonatal abstinence syndrome, or NAS.
No baby--no baby--deserves to start his or her life in withdrawal
from heroin or other opioids. But, sadly, the rate of babies born with
NAS, again, as you have heard, has skyrocketed nationally.
Doctors, nurses, and caregivers are providing innovative care for
newborns with NAS, but there are still gaps in research and our
understanding of how best to care for our most vulnerable.
The Protecting Our Infants Act makes significant strides in
addressing this nationwide gap and developing these strategies, and I
am proud to be a cosponsor of this bill.
West Virginia has been at the forefront of this epidemic, with NAS
rates much higher than the national average.
Our nurses and doctors are tirelessly working to care for newborns
with NAS, and having additional resources and research will only
further their efforts in providing the best possible care.
I have met with caregivers throughout my district to discuss their
approaches to treating NAS, and I know this legislation will help in
their efforts to treat these babies.
While we must continue to guarantee that newborns receive the
absolute best care, we must also address the issue of addiction in
pregnant and postnatal women.
This legislation will help identify and develop treatment methods for
expectant mothers with opioid addictions, leading to healthier outcomes
for mother and baby alike.
NAS is a nationwide crisis, one that impacts urban, rural, and
suburban areas. Nearly every district in America has been touched by
heroin and opioid addiction. We must address the impact this addiction
has on our most vulnerable in society, our newborn babies.
I commend Congresswoman Clark for her efforts on this important
legislation, and I urge my colleagues to support this bill.
Mr. GENE GREEN of Texas. Mr. Speaker, I yield such time as she may
consume to the gentlewoman from Massachusetts (Ms. Clark), the
cosponsor of the bill.
Ms. CLARK of Massachusetts. Mr. Speaker, I thank the gentleman from
Texas for yielding.
Our Nation is experiencing a deadly opiate epidemic, an epidemic that
knows no boundaries and destroys lives, families, and communities.
Today 58 babies--one baby every 25 minutes--will be born suffering
from the same pain adults describe as the worst pain of their lives. It
is the pain of drug withdrawal.
Neonatal abstinence syndrome, or NAS for short, occurs when babies
are born dependent on opioids, and it is one of the chief causes of the
significant surge of newborns in neonatal intensive care units across
the Nation.
Over the last decade, the number of infants born dependent on
powerful drugs has grown nearly fivefold. In States like Massachusetts,
NAS is occurring at a rate three times the national average.
NAS births are five times more costly than healthy ones. Costs have
risen to more than $1.5 billion a year, 80 percent of which are paid
for by Medicaid.
Because of this skyrocketing rise of NAS cases and costs, doctors are
desperately trying to find the most effective method of diagnosis and
treatment.
{time} 1630
There is little coordination of data and best practices and protocols
among States, healthcare systems, and practitioners; and no medications
have been approved by the U.S. Food and Drug Administration for
treating these babies.
The Protecting Our Infants Act is the first Federal bill to take
proactive steps in addressing the rise of NAS. With broad bipartisan
support in both Chambers, this is an opportunity for Congress to make a
difference for babies suffering from opioid exposure and the families
struggling with addiction.
This bill directs the Department of Health and Human Services to
develop the protocols for treating and preventing NAS. The Protecting
Our Infants Act helps babies suffering from opioid withdrawal by making
sure they get the best care available.
This act will ensure that every hospital has access to the best
practices and that States have the public health data they need to
address this crisis. This is good for families, good for our healthcare
providers, and good for our Nation's bottom line.
I want to thank my colleagues in the House and, in particular,
Congressman Steve Stivers for his partnership in this bill. I am
grateful for his deep commitment to addressing this problem and
crafting a solution. I am also grateful to Senators McConnell and Casey
for sponsoring this legislation in the Senate.
Today, we have a chance to help the youngest of those suffering from
the opioid crisis.
I urge my colleagues to pass the bipartisan Protecting Our Infants
Act.
Mr. GENE GREEN of Texas. I reserve the balance of my time.
Mr. GUTHRIE. I yield 5 minutes to the gentleman from Ohio (Mr.
Stivers), my friend.
Mr. STIVERS. Mr. Speaker, I rise today to support a bill that my
colleague from Massachusetts, Representative Katherine Clark, and I
introduced, H.R. 1462, the Protect Our Infants Act. I want to thank
Representative Clark for her leadership, her hard work, and her
commitment to protecting America's children.
This bill has the support of 95 bipartisan cosponsors. It is a
targeted effort to address a national epidemic of babies being born
addicted to drugs.
Recent data has shown that this issue, called neonatal abstinence
syndrome, is sadly on the rise throughout the country. A baby is born
with neonatal abstinence syndrome every 25 minutes, and symptoms can
last for months and lead to weeks of hospitalization and have a
lifelong impact.
A report by the Journal of the American Medical Association showed
that the number of newborns diagnosed with NAS tripled from 2000 to
2009. In my home State of Ohio, the rate of neonatal abstinence
syndrome grew over 600 percent between 2004 and 2011.
It has taken a heavy toll on Ohio's healthcare system and Ohio's
families. Treating newborns with NAS was associated with over $70
million in charges and approximately 19,000 hospital stays, and that
was back in 2011. It has been on the rise ever since.
This issue is especially devastating to our families and especially
devastating to the youngest among us, the
[[Page H5801]]
babies who are born addicted to drugs. I recently heard from a
grandmother to three babies who were born with NAS. She was pleading
for help for her innocent grandchildren, and she wanted to make sure we
did something about this terrible disease.
I am proud to say that the response in my district has been strong to
our bill. There is a healthcare system called Adena Regional Medical
Center in Chillicothe, Ohio, and they actually have an incredible
program which was piloted with a bunch of OB/GYNs, and they started
with just 15 pregnant women who were addicted to drugs, and they have
served those women. Now, they are on their second class to try to get
those women off of drugs before they deliver.
I am happy to report that, because of the support of the Adena Health
System, none of the women in that group delivered a baby with NAS. Due
to the success of the pilot, there is a permanent program that is
starting now, and it already has a wait list, so I am really excited to
say that there are people out there showing real leadership.
Last week, I hosted my fourth annual opiate roundtable in my district
to bring together a lot of issues, and we talked about this bill and
how important it was, so I am so proud that it is on the floor today.
Mr. Speaker, I urge all my colleagues to support the Protecting Our
Infants Act, H.R. 1462, to help our Nation's most innocent citizens.
Again, I want to thank Katherine Clark for her incredible leadership on
this bill and her commitment.
Mr. GENE GREEN of Texas. Mr. Speaker, I have no other speakers, and
in closing, I encourage our colleagues to support this bill.
I yield back the balance of my time.
Mr. GUTHRIE. Mr. Speaker, during the hearing in the Committee on
Energy and Commerce, one of the physicians testifying, a neonatologist,
turned out to practice with my first cousin, so I got to do research
further into what is moving forward in this bill.
I learned even more from personal stories about how important it is
and how critical this is and how sad it is for children to be born
addicted and how the opportunity is for us to help.
I certainly appreciate my friend from Massachusetts, Ms. Clark, and
my friend from Ohio, Mr. Stivers. I would encourage all my colleagues
to vote for H.R. 1462, Protecting Our Infants Act of 2015.
I yield back the balance of my time.
Mr. PALLONE. Mr. Speaker, I support H.R. 1462 the ``Protecting Our
Infants Act of 2015.'' This legislation would address the urgent need
for a comprehensive strategy for one of the harmful outcome of our
nation's opioid epidemic. Neonatal abstinence syndrome, or NAS, occurs
in newborns who were exposed to opioids, including pain killers, while
in their mother's womb. NAS is associated with negative health outcomes
like preterm births and low birthweight.
I'm saddened to say that the opioid epidemic has resulted in a steep
increase in the occurrence of NAS over the past decade. H.R. 1462 would
require HHS to develop recommendations for the treatment and prevention
of prenatal opiate abuse and neonatal abstinence syndrome. It would
also require the collection of data to better monitor the problem.
I want to thank Representative Katherine Clark for her leadership on
this issue and I urge my colleagues to join me in supporting this
necessary legislation.
The SPEAKER pro tempore. The question is on the motion offered by the
gentleman from Kentucky (Mr. Guthrie) that the House suspend the rules
and pass the bill, H.R. 1462.
The question was taken; and (two-thirds being in the affirmative) the
rules were suspended and the bill was passed.
A motion to reconsider was laid on the table.
____________________