[Congressional Record (Bound Edition), Volume 161 (2015), Part 13]
[House]
[Pages 18130-18132]
[From the U.S. Government Publishing Office, www.gpo.gov]




                   PROTECTING OUR INFANTS ACT OF 2015

  Mr. PITTS. Mr. Speaker, I move to suspend the rules and pass the bill 
(S. 799) to address problems related to prenatal opioid use.
  The Clerk read the title of the bill.
  The text of the bill is 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. 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.

  The SPEAKER pro tempore. Pursuant to the rule, the gentleman from 
Pennsylvania (Mr. Pitts) and the gentleman from Texas (Mr. Gene Green) 
each will control 20 minutes.
  The Chair recognizes the gentleman from Pennsylvania.


                             General Leave

  Mr. PITTS. Mr. Speaker, I ask unanimous consent that all Members may 
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 Pennsylvania?
  There was no objection.
  Mr. PITTS. Mr. Speaker, I yield myself such time as I may consume.

[[Page 18131]]

  Mr. Speaker, the bill before us today begins to combat the rise of 
prenatal opioid abuse and neonatal abstinence syndrome.
  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 resulting from this epidemic is neonatal abstinence 
syndrome, known as NAS. Babies born with NAS are infants that are 
addicted to opioids and that 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, the incidence 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.
  S. 799, Protecting Our Infants Act of 2015, introduced in the Senate 
by Majority Leader McConnell and led in the House by my colleagues, Ms. 
Clark of Massachusetts and Mr. Stivers, 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 directing the 
Agency for Healthcare Research and Quality, AHRQ, to conduct a study 
and develop recommendations for preventing and treating prenatal opioid 
abuse and neonatal abstinence syndrome.
  Mr. Speaker, the House companion to S. 799 was approved by a voice 
vote in the Subcommittee on Health and the full Committee on Energy and 
Commerce. Today we have a chance to approve this important bipartisan 
and bicameral legislation. I urge my colleagues to support the bill.
  Mr. Speaker, I reserve the balance of my time.
  Mr. GENE GREEN of Texas. Mr. Speaker, I yield myself such time as I 
may consume.
  Mr. Speaker, I rise in support of S. 799, Protecting Our Infants Act 
of 2015. This legislation, sponsored by Senator Mitch McConnell and 
championed in the House by Representative Katherine Clark, would help 
combat prenatal opioid abuse epidemic.
  The Centers for Disease Control and Prevention, CDC, has found drug 
overdose to be the leading cause of injury death in the United States 
and declared prescription drug abuse to be an epidemic.
  Prescription opioid use in pregnancy is strongly associated with 
neonatal complications. According to a recent study in the New England 
Journal of Medicine, the incidence rate of neonatal abstinence 
syndrome, NAS, quadrupled from 2004 to 2013, a fourfold increase in 
less than a decade.
  NAS is a group of problems that occur in newborns who have been 
exposed to opioids while in the womb. The symptoms are often severe. 
Newborns with NAS require specialized care, typically in a neonatal 
intensive care unit.
  In February 2015, the Government Accountability Office, the GAO, 
released a report entitled ``Prenatal Drug Use and Newborn Health: 
Federal Efforts Need Better Planning and Coordination.'' The report 
identified a number of different research gaps in the treatment of 
opioid use during pregnancy and in the treatment of infants with NAS.
  S. 799 will help combat prenatal opioid abuse and neonatal abstinence 
syndrome. Addressing these issues is a critical part of our effort to 
fight the ongoing prescription drug abuse epidemic.
  The legislation will facilitate the development and recommendations 
for the treatment of prenatal opioid abuse and NAS and coordinate a 
national strategy to close research program gaps. It will also require 
CDC to help States improve data collection and surveillance activities 
related to prenatal opioid abuse and NAS.
  I urge my colleagues to support S. 799, the Protecting Our Infants 
Act, and I thank the sponsors for their commitment to this important 
issue.
  Mr. Speaker, I reserve the balance of my time.
  Mr. PITTS. Mr. Speaker, I am pleased to yield 1 minute to the 
gentleman from West Virginia (Mr. Jenkins), a leader on this issue.
  Mr. JENKINS of West Virginia. Mr. Speaker, every day in hospitals 
across my district and the country, tragically, babies begin their 
lives suffering through drug withdrawal because they were exposed 
during pregnancy.
  Sadly, the rates of babies with NAS have skyrocketed. NAS is a 
nationwide crisis. The Protecting Our Infants Act addresses the many 
gaps in the care and treatment of NAS babies.
  How do I know there are gaps? Today, in a facility in my hometown 
that I helped start, Lily's Place is caring for 10--10--babies 
suffering the ravages of withdrawal.
  It took years of working through the regulatory burdens and 
certification limitations just to do what is right for our most 
innocent. The gaps in care are real and so are the obstacles treating 
NAS babies.
  This legislation will pave the way to consider new models of care, 
like Lily's Place, for our NAS babies.
  I commend my colleagues, Leader Mitch McConnell and Representatives 
Katherine Clark and Steve Stivers, for helping to give every child a 
chance at a healthy start in life.
  Mr. GENE GREEN of Texas. Mr. Speaker, I yield 4 minutes to the 
gentlewoman from Massachusetts (Ms. Clark), the House Democratic 
sponsor.
  Ms. CLARK of Massachusetts. Mr. Speaker, today 58 babies, 1 baby 
every 25 minutes, will be born suffering from the same pain adults 
describe as the worst pain of their lives, the pain of drug withdrawal.
  Over the last decade, the number of infants born experiencing 
withdrawal from powerful drugs has grown nearly fivefold. It is a 
condition called neonatal abstinence syndrome. It results from prenatal 
exposure to opioids like heroin and prescription painkillers. In States 
like Massachusetts, we are seeing this happen at a rate three times the 
national average.
  In addition to the human suffering, the costs associated with NAS 
births are staggering. They are five times more expensive than healthy 
births, totaling $1.5 billion for hospitals in 2012, with 80 percent 
being paid by Medicaid.
  But despite the best efforts of doctors, nurses, and others, there is 
no coordinated response to this crisis. There are no clear best 
practices for treating these infants, and more research is needed to 
help understand the problem. That is why I have worked with my 
colleagues, researchers, doctors, and advocates to introduce the 
Protecting Our Infants Act, the first Federal bill to take proactive 
steps in addressing the rise of NAS births.

                              {time}  1745

  We were able to pass this bill in the House in September, thanks to 
the help of my partner on this bill, Representative Steve Stivers. A 
slightly modified version was passed a few weeks ago, due to the hard 
work of our Senate sponsors, Majority Leader McConnell and Senator 
Casey. With broad support in both Chambers, this is an opportunity for 
Congress to make a difference for moms and babies suffering because of 
the opioid epidemic.
  The Protecting Our Infants Act will require the Department of Health 
and Human Services to develop recommendations to prevent and treat 
prenatal opioid abuse and NAS, and to develop a strategy in the 
Department to coordinate programs and research. This will help ease the 
suffering of the smallest victims of the opioid crisis. It will help 
hospitals and Medicaid save money, and ease the burden on doctors and 
nurses that are overwhelmed by this problem.
  This is not controversial, partisan, or political. It is just good 
policy. I thank my Republican partner in the House, Steve Stivers, for 
his leadership in getting this bill to where it is today.

[[Page 18132]]

  I ask the House to come together and help the thousands of babies and 
mothers who are fighting this epidemic, and I urge my colleagues to 
pass the bipartisan Protecting Our Infants Act and send this 
legislation to the President for his signature.
  Mr. GENE GREEN of Texas. Mr. Speaker, I yield back the balance of my 
time.
  Mr. PITTS. Mr. Speaker, I urge all Members to support this important 
bipartisan, bicameral legislation.
  Mr. Speaker, I yield back the balance of my time.
  Mr. PALLONE. Mr. Speaker, I rise in support of S. 799--the Protecting 
Our Infants Act of 2015. This legislation addresses a sad reality of 
our country's opioid epidemic: prenatal opioid abuse and the steep 
increase in the incidence of neonatal abstinence syndrome or NAS.
  NAS occurs in newborns who were exposed to opiates while in their 
mother's womb and is associated with negative health outcomes such as 
preterm births, low birthweight, and respiratory distress. A recent 
study found the incidence of NAS quadrupled between 2004 and 2013. This 
legislation would respond to that dramatic increase by requiring HHS to 
create a comprehensive national strategy to address prenatal opioid 
abuse and NAS. That strategy would include a coordinated research and 
programming strategy to address the public health challenge of NAS and 
prenatal opioid abuse as well as develop a comprehensive set of 
recommendations for preventing and treating prenatal opioid use 
disorders and NAS.
  I want to thank Rep. Katherine Clark for her leadership on this 
critical and timely issue. I urge my colleagues to support this 
legislation.
  The SPEAKER pro tempore. The question is on the motion offered by the 
gentleman from Pennsylvania (Mr. Pitts) that the House suspend the 
rules and pass the bill, S. 799.
  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.

                          ____________________