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114th Congress}                                           {  Report
                        HOUSE OF REPRESENTATIVES
 1st Session  }                                           {  114-244

======================================================================

 
                   PROTECTING OUR INFANTS ACT OF 2015

                                _______
                                

 September 8, 2015.--Committed to the Committee of the Whole House on 
            the State of the Union and ordered to be printed

                                _______
                                

  Mr. Upton, from the Committee on Energy and Commerce, submitted the 
                               following

                              R E P O R T

                        [To accompany H.R. 1462]

    The Committee on Energy and Commerce, to whom was referred 
the bill (H.R. 1462) to combat the rise of prenatal opioid 
abuse and neonatal abstinence syndrome, having considered the 
same, report favorably thereon without amendment and recommend 
that the bill do pass.

                                CONTENTS

Purpose and Summary..............................................     1
Background and Need for Legislation..............................     2
Hearings.........................................................     2
Committee Consideration..........................................     2
Committee Votes..................................................     2
Committee Oversight Findings.....................................     2
Statement of General Performance Goals and Objectives............     3
New Budget Authority, Entitlement Authority, and Tax Expenditures     3
Earmark, Limited Tax Benefits, and Limited Tariff Benefits.......     3
Committee Cost Estimate..........................................     3
Congressional Budget Office Estimate.............................     3
Federal Mandates Statement.......................................     3
Duplication of Federal Programs..................................     3
Disclosure of Directed Rule Makings..............................     3
Advisory Committee Statement.....................................     3
Applicability to Legislative Branch..............................     4
Section-by-Section Analysis of the Legislation...................     4

                          PURPOSE AND SUMMARY

    H.R. 1462, Protecting Our Infants Act of 2015 was 
introduced by Rep. Clark (D-MA) and Rep. Stivers (R-OH), on 
March 19, 2015, to address the rising incidence of neonatal 
abstinence syndrome.

                  BACKGROUND AND NEED FOR LEGISLATION

    Neonatal abstinence syndrome (NAS) refers to medical issues 
associated with drug withdrawal in newborns due to exposure to 
opioids in utero. 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. NAS can result from the use 
of prescription drugs as prescribed for medical reasons, abuse 
of prescription drugs, or the use of illegal opioids like 
heroin.
    Addressing NAS effectively requires a focus on women of 
childbearing age, pregnant women, and infants from 
preconception through early childhood. With little Federal 
coordination on the issue, it is important to improve the 
efficiency and effectiveness of planning and coordination of 
Federal efforts on prenatal opioid use and NAS.
    H.R. 1462 would take needed steps towards addressing the 
increasing prevalence of NAS in the United States.

                                HEARINGS

    The Subcommittee on Health held a hearing on H.R. 1462 on 
June 25, 2015. The Subcommittee received testimony from:
           Joanne Kurtzberg, M.D., President, Cord 
        Blood Association;
           Jeff Chell, M.D., Chief Executive Officer, 
        National Marrow Donor Program;
           Patti Freemyer Martin, PhD, Director of 
        Audiology and Speech Language Pathology, Arkansas 
        Children's Hospital;
           Stephen W. Patrick, M.D., M.P.H., M.S., 
        Assistant Professor of Pediatrics and Health Policy, 
        Department of Pediatrics, Vanderbilt University School 
        of Medicine; and,
           Mishka Terplan, M.D., M.P.H., FACOG, Medical 
        Director, Behavior Health System Baltimore.

                        COMMITTEE CONSIDERATION

    On July 23, 2015 the Subcommittee on Health met in open 
markup session and forwarded H.R. 1462 to the full Committee, 
as amended by a voice vote. On July 29, 2015 the full Committee 
on Energy and Commerce met in open markup session and ordered 
H.R. 1462 reported to the House, without amendment, by a voice 
vote.

                            COMMITTEE VOTES

    Clause 3(b) of rule XIII of the Rules of the House of 
Representatives requires the Committee to list the record votes 
on the motion to report legislation and amendments thereto. 
There were no record votes taken in connection with ordering 
H.R. 1462 reported. A motion by Mr. Upton to order H.R. 1462 
reported to the House, without amendment, was agreed to by a 
voice vote.

                      COMMITTEE OVERSIGHT FINDINGS

    Pursuant to clause 3(c)(1) of rule XIII of the Rules of the 
House of Representatives, the Committee has not held hearings 
on this legislation.

         STATEMENT OF GENERAL PERFORMANCE GOALS AND OBJECTIVES

    Pursuant to clause 3(c)(1) of rule XIII of the Rules of the 
House of Representatives, the goal of the legislation is to 
improve Federal coordination and develop recommendations for 
addressing the rise in neonatal abstinence syndrome.

   NEW BUDGET AUTHORITY, ENTITLEMENT AUTHORITY, AND TAX EXPENDITURES

    In compliance with clause 3(c)(2) of rule XIII of the Rules 
of the House of Representatives, the Committee finds that H.R. 
1462 would result in no new or increased budget authority, 
entitlement authority, or tax expenditures or revenues.

       EARMARK, LIMITED TAX BENEFITS, AND LIMITED TARIFF BENEFITS

    In compliance with clause 9(e), 9(f), and 9(g) of rule XXI 
of the Rules of the House of Representatives, the Committee 
finds that H.R. 1462 contains no earmarks, limited tax 
benefits, or limited tariff benefits.

                        COMMITTEE COST ESTIMATE

    The Committee adopts as its own the cost estimate prepared 
by the Director of the Congressional Budget Office pursuant to 
section 402 of the Congressional Budget Act of 1974. At the 
time this report was filed, the estimate was not available.

                  CONGRESSIONAL BUDGET OFFICE ESTIMATE

    At the time this report was filed, the cost estimate 
prepared by the Director of the Congressional Budget Office 
pursuant to section 402 of the Congressional Budget Act of 1974 
was not available.

                       FEDERAL MANDATES STATEMENT

    The Committee adopts as its own the estimate of Federal 
mandates prepared by the Director of the Congressional Budget 
Office pursuant to section 423 of the Unfunded Mandates Reform 
Act.

                    DUPLICATION OF FEDERAL PROGRAMS

    No provision of H.R. 1462 would establish nor reauthorize a 
program of the Federal Government known to be duplicative of 
another Federal program, a program that was included in any 
report from the Government Accountability Office to Congress 
pursuant to section 21 of Public Law 111-139, or a program 
related to a program identified in the most recent Catalog of 
Federal Domestic Assistance.

                  DISCLOSURE OF DIRECTED RULE MAKINGS

    The Committee estimates that enacting H.R. 1462 
specifically directs to be completed no rule making within the 
meaning of 5 U.S.C. 551.

                      ADVISORY COMMITTEE STATEMENT

    No advisory committees within the meaning of section 5(b) 
of the Federal Advisory Committee Act were created by this 
legislation.

                  APPLICABILITY TO LEGISLATIVE BRANCH

    The Committee finds that the legislation does not relate to 
the terms and conditions of employment or access to public 
services or accommodations within the meaning of section 
102(b)(3) of the Congressional Accountability Act.

             SECTION-BY-SECTION ANALYSIS OF THE LEGISLATION

Section 1. Short title

    Section 1 states that the legislation may be cited as the 
``Protecting Our Infants Act of 2015.''

Section 2. Findings

    Section 2 includes relevant findings.

Section 3. Developing recommendations for preventing and treating 
        prenatal opioid abuse and neonatal abstinence syndrome

    Section 3 would direct the Agency for Healthcare Research 
and Quality (AHRQ) to conduct a study and develop 
recommendations for preventing and treating prenatal opioid 
abuse and NAS. One year after enactment, the Director of AHRQ 
would be required to release a report on the study and relevant 
recommendations.

Section 4. Improving prevention and treatment for prenatal opioid abuse 
        and neonatal abstinence syndrome

    Section 4 would instruct the Secretary of the Department of 
Health and Human Services to lead a review of planning and 
coordination within the department related to prenatal opioid 
use and NAS. The section also would direct the Secretary to 
submit a report to Congress on research and program gaps for 
NAS.

Section 5. Improving data on and public health response to neonatal 
        abstinence syndrome

    Section 5 would direct the Centers for Disease Control and 
Prevention to provide assistance to States to improve 
surveillance activities regarding NAS.

                                  [all]