On Wednesday, May 11, the House of Representatives passed the Infant Plan of Safe Care Improvement Act, H.R. 4843, by a vote of 421 to zero. Late last year a Reuters investigation examined the care for infants born to parents struggling with opioid and heroin addiction. It caught the attention of Congress especially the parts that dealt with a lack of enforcement of the Child Abuse Prevention and Treatment Act, (CAPTA).  Provisions in that law include a plan of safe care for infant exposed to substance use at birth.  In one form or another it has been a part of CAPTA for more than a decade.  The House and Senate bills amend that part of the law.

After the Wednesday vote, bill sponsor Rep. Lou Barletta (R-PA) issued a statement:

“Through a number of commonsense measures, this legislation will strengthen protections for infants born with illegal substance exposure and ensure states have the help they need to prevent and respond to child abuse and neglect. These are the kinds of reforms we should all embrace. By working together, we can help ensure vulnerable children, mothers, and their families have the help they need and the care they deserve.”

House Education and Workforce Chair John Kline (R-MN) added:

“The opioid epidemic has led to painful consequences for families and communities across the country, but none are as tragic as those suffered by the infants of parents struggling with addiction.  This bill will help ensure the most vulnerable victims of the opioid epidemic receive the help and care they desperately need.”

The bill is actually a negotiated bill between the House and Senate Committees over the differences between the House version and the Senate bill, S 2687.  The House bill had placed the burden on HHS as far as enforcement and guidance whereas the Senate bill expanded directives to HHS and expanded on the definition of what a plan of safe care should be. The final bill as passed by the House is a combination.  The Senate will likely move quickly by voice vote (unanimous consent).

According to Kline’s description the bill will

  • Require the department to review and confirm states have put in place CAPTA policies required under the law;
  • Strengthen protections for infants born with illegal substance exposure by clarifying the intent of safe care plans;
  • Improve accountability related to the care of infants and their families by requiring additional information be shared on the incidents of infants born with illegal substance exposure and their subsequent care;
  • Ensure the secretary provides states with best practices for developing plans to keep infants and their caregivers healthy and safe;
  • Encourage the use of information made available through other child welfare laws in verifying CAPTA compliance; and
  • Prevent the department from adding new requirements to state assurances and plans.

The legislation is part of a broader House effort that may eventually merge with Senate efforts on the opioid epidemic.  On April 27 and 28, the House Energy and Commerce passed a series of 11 bills in response to the opioid/heroin addiction problem.  The bills ranged from a new GAO report to better regulation of prescription medication and control through the FDA and other federal government oversight.  Those bills were merged with other bills from other committees.  The House began debating on the legislation mid-week.

CAPTA was enacted in 1974 to coordinate federal efforts to prevent and respond to child abuse and neglect. In order to receive funds under CAPTA, states have to assure HHS that they have implemented certain child protection policies. Funding is very small with 13 states receiving less than $150,000 a year in state grants.  Data collection requirements under CAPTA (which are expanded under this bill) are also voluntary and the new requirements on infant care  are likely to yield limited information over the next several years.

Congressman Barletta and Congresswoman Katherine Clark (D-MA) introduced H.R. 4843, with the committee approving the bill in April.  See comments during the debate here.