[Congressional Record Volume 161, Number 155 (Thursday, October 22, 2015)]
[Senate]
[Pages S7439-S7441]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




                   PROTECTING OUR INFANTS ACT OF 2015

  Mr. McCONNELL. Mr. President, I ask unanimous consent that the Senate 
proceed to the immediate consideration of Calendar No. 246, S. 799.
  The PRESIDING OFFICER. The clerk will report the bill by title.
  The bill clerk read as follows:

       A bill (S. 799) to combat the rise of prenatal opioid abuse 
     and neonatal abstinence syndrome.

  There being no objection, the Senate proceeded to consider the bill, 
which had been reported from the Committee on Health, Education, Labor, 
and Pensions, with an amendment to strike all after the enacting clause 
and insert in lieu thereof the following:

                                 S. 799

     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;

[[Page S7440]]

       (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.

  Mr. McCONNELL. Mr. President, I ask unanimous consent that the 
committee-reported substitute amendment be agreed to; that the bill, as 
amended, be read a third time and passed; that the committee-reported 
title amendment be agreed to; and that the motions to reconsider be 
considered made and laid upon the table.


 =========================== NOTE =========================== 

  
  On page S7440, October 22, 2015, in the middle column, the 
following language appears: The PRESIDING OFFICER. Mr.President, I 
ask . . .
  
  The online Record has been corrected to read: Mr. McCONNELL. Mr. 
President, I ask . . .


 ========================= END NOTE ========================= 

  The PRESIDING OFFICER. Without objection, it is so ordered.
  The committee amendment in the nature of a substitute was agreed to.
  The bill (S. 799), as amended, was ordered to be engrossed for a 
third reading, was read the third time, and passed.
  The Committee-reported title amendment was agreed to, as follows:

       Amend the title so as to read: ``To address problems 
     related to prenatal opioid use.''.

  Mr. McCONNELL. Mr. President, I was pleased to see the Senate pass by 
unanimous consent just now the bipartisan Protecting Our Infants Act. 
As prescription drug abuse and heroin use have increased in Kentucky 
and other States across the Nation, no demographic, socioeconomic 
status, age, or gender has been left untouched.
  As the father of three daughters, particularly concerning to me is 
the increase in prenatal opiate abuse, which has resulted in a 
staggering 300-percent increase in the number of infants born suffering 
from withdrawal symptoms since 2000.
  To address this crisis, I introduced the Protecting Our Infants Act, 
along with my colleague Senator Bob Casey. The bill would direct the 
Health and Human Services Secretary to conduct a departmental review to 
identify gaps in research and any duplication, overlap, or gaps in 
prevention and treatment programs related to this issue. It would also 
direct the Secretary to work with stakeholders on recommendations to 
address the problem. Furthermore, this measure would encourage the 
Centers for Disease Control and Prevention to work with States in an 
effort to help improve their public health response to this epidemic.
  Also, I want to acknowledge the outstanding work of the Senator from 
New Hampshire, Ms. Kelly Ayotte. I know that one of the things New 
Hampshire and Kentucky actually, unfortunately, share is that this has 
reached epidemic proportions. Nobody has been more involved in this 
issue than the Senator from New Hampshire. She has been on top of it 
from the very beginning. She shares the concerns of others, obviously, 
who have States that are suffering from this enormous problem.
  I would also like to thank Representatives Katherine Clark and Steve 
Stivers for leading the effort to advance a similar message in the 
House of Representatives. I look forward to the House taking up this 
bill and it being sent to the President for his signature.
  The PRESIDING OFFICER. The Senator from New Hampshire.
  Ms. AYOTTE. Mr. President, I want to thank our leader and thank 
Senator Casey for introducing and pushing to pass this very important 
legislation. This legislation, the Protecting Our Infants Act, of which 
I was proud to be an early sponsor, will help address the increasing 
number of newborns born with opioid dependency. I thank the additional 
Members, including the chairman of the HELP Committee and Ranking 
Member Murray, for helping get that through this important committee.
  New Hampshire is facing a public health epidemic. In fact, the heroin 
and prescription drug addiction crisis is the single most urgent issue 
facing my State right now. So many families who have lost children have 
come to me. The other day, I was buying something, and the woman behind 
the counter said to me: Keep working on this issue. I asked her why. 
She said: I lost my granddaughter.
  Too many families are experiencing losing their loved ones, their 
family members who are struggling with addiction. Our first responders 
are inundated. They are saving lives with lifesaving drugs such as 
Narcan. Public health and safety officials in our State--this is truly 
something on which we all need to work together to address.
  One of the tragic results of this growing opioid abuse epidemic--it 
has often been overlooked--is the increasing number of infants who are 
born dependent on opioids and suffering from withdrawal.
  Researchers estimate that almost every hour in this country, there is 
an infant being born who is suffering from withdrawal symptoms or born 
with dependency symptoms from opioid addiction.
  This is an issue which I am so glad is being addressed in this bill, 
the Protecting Our Infants Act. How we treat our children and our 
infants is so much a reflection of who we are. That is why I was proud 
to cosponsor this bipartisan legislation which will call for the 
development of recommendations to prevent and treat prenatal opioid 
use, including neonatal abstinence syndrome.

[[Page S7441]]

  This bill would also ask the Centers for Disease Control and 
Prevention to assist States in data collection and increased 
surveillance to better monitor the prevalence and causes of neonatal 
abstinence syndrome so that we can work on more support for prevention, 
treatment, and recovery to help mothers get support and get into 
treatment so that we don't have infants who are born with opioid 
dependence and withdrawal symptoms.
  As the leader said, across the Nation the number of infants diagnosed 
with newborn withdrawal has increased 300 percent since 2000. In my 
home State of New Hampshire, in May of this year, I visited the 
Catholic Medical Center in Manchester and heard directly from medical 
personnel there and first responders who have been treating and 
responding to cases of newborn withdrawal. Catholic Medical Center 
officials reported that 7 percent of newborn babies at that hospital 
were born with neonatal abstinence syndrome. That is a significant 
increase from last year. According to officials at Catholic Medical 
Center's Pregnancy Care Center, close to half of the mothers cared for 
are struggling with addiction.
  I thank the leader. I thank Senator Casey. Today's passage of the 
Protecting Our Infants Act is one very important step to address the 
crisis of opioid abuse seen in New Hampshire and across this country. 
Now that we have passed this in the Senate, I want to thank those 
Members in the House who have led this effort. I hope the House quickly 
passes this and sends it to the President of the United States.
  I hope the Senate will continue to focus on this public health 
epidemic because there are many solutions that are bipartisan. One is 
called the Comprehensive Addiction and Recovery Act. This is a bill I 
helped introduce with Senator Whitehouse, Senator Portman, and Senator 
Klobuchar. This is a bill which will deal with prevention so that we 
can make sure we get that message out to prevent people from overusing 
and misusing prescription drugs and also turning to heroin. It is so we 
can have more support for treatment and recovery where there is a big 
gap in my State and so we can support our first responders and make 
sure they have access to the lifesaving drug Narcan.
  One experience I had recently was I went on a ride-along with our 
largest police department, and I had previously gone on a ride-along 
with our largest fire department. Within half an hour of the fire 
department ride-along, we went to a heroin overdose. I watched the 
emergency personnel--police, fire, emergency first responders--bring 
someone back to life using Narcan. When I did the police ride-along, 
within an hour and a half, we went to two heroin overdoses. Again, 
first responders saved those two individuals' lives.
  I have to tell you, I was a murder prosecutor. I saw a lot of tough 
things when I was attorney general. But I couldn't breathe when I was 
sitting in that room and watching that second individual, a young man, 
on the ground, the first responders doing everything they could, 
another dose of Narcan--I thought he was gone. This is what our first 
responders are dealing with every single day.
  Mr. McCONNELL. Will the Senator yield for a question?
  Ms. AYOTTE. Yes.
  Mr. McCONNELL. I naively thought that my State was uniquely afflicted 
with this scourge--we had the drug czar come down to Northern Kentucky, 
which is a part of my State, a suburb of Cincinnati--only to find that 
it is a problem all over the country. I was curious as to how this 
rates with the people of New Hampshire as one of the things they are 
concerned about.
  Ms. AYOTTE. Leader, I will tell you, Director Botticelli came to New 
Hampshire as well, and he testified at a field hearing Senator Shaheen 
and I had in New Hampshire. For the people of New Hampshire right now, 
this is a crisis. It is a public health epidemic. I did a townhall last 
night, and the single biggest issue I got asked about was this because 
I believe this is one of the top issues, if not the top issue on the 
minds of people in New Hampshire because they see their friends and 
family being impacted by this. Every socioeconomic group is being 
impacted by, unfortunately, prescription drugs and then heroin, which 
is so cheap on our streets right now, also sometimes mixed with a 
deadly drug called Fentanyl. In fact, we had a 60-percent increase in 
drug deaths. There were 320 drug deaths last year.
  Mr. McCONNELL. Now we are losing more to drug overdoses and heroin 
overdoses than we are losing in car accidents. Is that true in New 
Hampshire as well?
  Ms. AYOTTE. It is the exact same thing in New Hampshire. In our 
State, more people are dying from heroin, Fentanyl, and abuse of 
prescription drugs than car accidents, which is staggering when you 
think about it. This is a national epidemic. That is why I appreciate 
the bill that was passed today. I think there is more that we in this 
body could do that would benefit the Nation and would benefit our 
States of Kentucky and New Hampshire to help give tools to the first 
responders, the public health officials, treatment providers, those 
supporting recovery and helping prevent this in the first instance. It 
is something that would obviously help address this crisis but also 
something that is a public health issue we should all care about.
  Mr. McCONNELL. I thank the Senator from New Hampshire for her 
outstanding work on this important issue. I have a feeling we will be 
grappling with this in all of its various forms for many years to come.
  Ms. AYOTTE. I thank the leader for this bill today, which I am glad 
was passed, and I look forward to working on additional legislation.
  Mr. President, I yield the floor.

                          ____________________