WASHINGTON, D.C. –U.S. Senator Sherrod Brown (D-OH) announced the final legislative addiction package announced by Congressional leaders today includes Brown’s Caring Recovery for Infants and Babies (CRIB) Act. The CRIB Act would bolster the work of treatment centers like Brigid’s Path in Dayton. Brown introduced the CRIB Act with Sen. Shelley Moore Capito (R-WV) and Rob Portman (R-OH) and helped pass it out of the Finance Committee in June. The final package, which has been agreed to by both the House and Senate, will need to be passed by both chambers and then sent to President Trump to be signed into law.
This week, Brown and U.S. Rep. Evan Jenkins (R-WV-3) wrote to Congressional leaders as lead sponsors of the CRIB Act urging them to include the bill in the final addiction package.
“There isn’t a community in Ohio that hasn’t been touched by the addiction epidemic, and we are doing all we can to fight it,” said Brown. “Too many victims of this epidemic are the infants born to mothers who struggle with addiction. With the right care, newborns born with neonatal abstinence syndrome have every shot of growing up healthy. This is an important step forward in getting moms and babies in Ohio care that best fits their needs.”
- Brown’s CRIB Act would help newborns suffering from neonatal abstinence syndrome (NAS), a withdrawal condition often caused by the use of opioids and other addictive substances in pregnant women.
- The bill would allow Medicaid to cover certain health care services provided to infants in residential pediatric recovery facilities in addition to hospitals and also clarify that babies receiving services in residential pediatric recovery centers can continue to receive services after one year of age, and provide for activities to encourage caregiver-infant bonding.
Recently, Brown was joined on a news conference call to discuss the CRIB Act by Jill Kingston, the CEO of Brigid’s Path in Dayton, one of two residential treatment centers in the U.S. that specializes in treating babies with NAS.
“Babies born exposed to opioids are the most vulnerable victims of this epidemic. It is imperative to create a continuum of care for these babies, so that they and their families can get the right services at the right time in the right setting. Under current federal law, pediatric recovery centers like Brigid’s Path are not eligible to receive Medicaid reimbursement. But passage of the CRIB Act can change this by creating a pathway to Medicaid reimbursement for pediatric recovery centers like Brigid’s Path,” said Ms. Kingston.
Neonatal abstinence syndrome (NAS) is a withdrawal condition often caused by use of opioids and other addictive substances in pregnant women. Babies with NAS are usually treated in the neonatal intensive care unit (NICU), where treatment costs can be more than five times the cost of treating other newborns. With the bright lights and loud noises, the NICU is not always the best place for newborns suffering from withdrawal.
Residential pediatric recovery facilities, an alternative setting to a NICU, offer specialized care and an environment conducive to treating newborns with NAS, as well as counseling for mothers and families that emphasizes caregiver-infant bonding. The CRIB Act, which Brown has been pushing since 2016, would allow Medicaid to reimburse for covered Medicaid services in residential pediatric recovery facilities in addition to hospitals.
Studies show that cases of NAS have tripled over the past decade. In Ohio alone, NAS increased six-fold between 2004-2011, from 14 cases per 10,000 live births in 2004 to 88 cases per 10,000 live births in 2011. In 2015, the Ohio Department of Health released data that there had been 2,174 hospital admissions for NAS, and reported that an average of 84 infants were being treated for drug withdrawal by Ohio hospitals every day.
OHIO VICTORIES IN FINAL ADDICTION PACKAGE
As part of the final opioid package, Brown was also able to secure some other important wins for Ohio, including:
- Brown and Portman secured a key victory that will make more treatment beds available in Ohio. Brown and Portman, with the inclusion of their bipartisan proposal to lift the Institutions for Mental Disease (IMD) exclusion, will expand Americans’ access to treatment for opioid addiction. The IMD exclusion is an arcane, decades-old policy that prohibits states from using federal Medicaid dollars to pay for treatment at residential mental health or substance abuse facilities with more than 16 beds. The senators’ bipartisan bill would lift this outdated cap for five years, covering all substance-use disorders, so more Americans can access treatment services at these inpatient facilities.
- The final package also included a provision based on Brown’s work to expand access to medication-assisted treatment (MAT) for Ohioans. The final provision would ensure all doctors who are authorized to prescribe MAT, like buprenorphione, can treat up to 275 patients and also eliminates the time limit under which authorized nurse practitioners and physicians assistants can prescribe MAT, to ensure continuity of care. The provision also allows authorized advanced practice nurses, such as certified nurse midwives and certified nurse specialists, to prescribe MAT for a limited, five-year period in states where they have prescribing authority.
- The Trauma Informed Care Act for Children and Families, which would create an interagency taskforce to develop best practices to support at-risk children and families who have experienced trauma, such as parental substance use. The taskforce would also promote practices to help parents, foster parents, and kinship caregivers to prevent and treat childhood trauma and allow the CDC to work with states to collect and report data on childhood trauma. Finally, this bill would increase funding to the National Child Traumatic Stress Network and create grants to support mental health care for youth in schools. Brown was a cosponsor of this bill, which was introduced by Senator Heitkamp (D-ND).
- Language based on Brown’s Full-Service Community Schools in Distressed Communities Act, which would help Ohio school districts and students working to achieve academic success in light of Ohio’s addiction epidemic. Full-service community schools, which provide comprehensive academic, social, and health services, have a proven record of success in meeting the needs of students, families, and their communities and can help address the needs of students in Ohio communities hit particularly hard by the addiction crisis.
- The Fighting the Opioid Epidemic with Sunshine Act: Brown introduced this bill with Senators Chuck Grassley (R-IA) and Richard Blumenthal (D-CT). It would require drug companies and medical device makers to publicly disclose the payments that they make to nurse practitioners and physician assistants for promotional talks, consulting, and other interactions, just as they are required to for payments made to physicians and academic medical centers. This legislation will add additional transparency around prescribing practices and, by shining a light on the relationship between drug companies and prescriptions for opioids, help ensure greater accountability across all healthcare professionals who can prescribe controlled substances.
- The Informing Seniors about Opioids Act: Brown introduced this bill with Senators Bill Nelson (D-FL) and Dean Heller (R-NV). This legislation was included in the Finance-Committee passed package earlier this year, and would update the “Medicare and You” handbook to include information relevant to patients about substance use disorder and pain management.
- The Help for Moms and Babies Act: Brown worked with Senator Debbie Stabenow (D-MI) to introduce this bill, which would help protect pregnant and postpartum women seeking treatment for a substance use disorder at an IMD facility by ensuring that women who rely on Medicaid for their form of insurance but have some other way of paying for care in an IMD don’t lose access to their primary health services while at the IMD.