The Society of Professor’s of Child and Adolescent Psychiatry (SPCAP) first annual Advocacy Day in Washington, DC, on April 29th, was an outstanding success! With the workforce shortage bill, the Child Health Care Crisis Relief Act, H.R. 1106/S.537, as the primary issue, 55 SPCAP members from 29 states participated in almost 100 pre-scheduled meetings with their House representatives and Senators. Prior to the congressional visits, SPCAP members were given an advocacy training by AACAP Department of Government Affairs and Clinical Practice staff, APA/AACAP Jeanne Spurlock Congressional Fellow Jose Vito, M.D., and Darcy Gruttadaro, Director of the National Alliance for the Mentally Ill’s (NAMI) Child and Adolescent Action Center. We expect to see bipartisan support for the Child Health Care Crisis Relief Act increase soon as a result of the SPCAP’s advocacy. Other issues for the Advocacy Day included the Keeping Families Together Act, H.R. 823/S.380, the Paul Wellstone Mental Health Parity Act, H.R. 1402, the Parental Consent Act, H.R. 181, the recently reintroduced Child Medication Safety Act, H.R. 1790, and the Fair Access to Clinical Trials Act, S. 470.

Workforce Bill Gains Support
The AACAP’s top legislative priority, the Child Health Care Crisis Relief Act, H.R. 1106/S.537, sponsored by Reps. Kennedy (D-RI) and Ros-Lehtinen (R-FL), and Sens. Bingaman (D-NM) and Collins (R-ME), is quickly gaining support in the 109th Congress. H.R. 1106 has 38 cosponsors, up from 22 one month ago, and has been referred to the Energy and Commerce Committee, chaired by Rep. Barton (R-TX), and the Ways and Means Committee, chaired by Rep. Bill Thomas (R-CA). S. 537 has 9 cosponsors, up from 6 one month ago, and has been referred to the Health, Education, Labor and Pensions Committee, chaired by Sen. Enzi (R-WY).

The Child Health Care Crisis Relief Act addresses the critical national shortage of child and adolescent psychiatrists and other children’s mental health professionals by creating education incentives to encourage recruitment into these fields. For child and adolescent psychiatry training programs, the legislation would extend Medicare graduate medical education (GME) funding support for two years after general psychiatry, and create a loan forgiveness program for use by child and adolescent psychiatrists. Other mental health professionals eligible for the scholarships, loan forgiveness and training grants in the bill include psychologists, social workers, psychiatric nurses, marriage and family therapists, and all school-based professionals, such as school psychologists, school social workers and school counselors.

The bills gained record bipartisan support in 2004, thanks to the efforts of AACAP members and friends. The House bill finished off the year with 62 cosponsors and the Senate bill had 12 cosponsors. Some of last year’s cosponsors will rejoin the bill as supporters quickly, but most will need to be recontacted in 2005 by AACAP members and friends.

All AACAP members are asked to contact their Senators and House Representative as soon as possible to request their cosponsorship of the Child Health Care Crisis Relief Act. Call 1-202-224-3121 to reach the Capitol Switchboard, and ask for your representative or Senator’s office, or give your zip code. When connected to the office, ask for the Health Legislative Assistant. If you leave a voicemail message, include your name and phone number. A sample message is as follows:
"I am a practicing child and adolescent psychiatrist from (your town), and I am calling to urge Sen. (or Rep. )______ to cosponsor the Child Health Care Crisis Relief Act, S. 537/ H.R. 1106, sponsored by Sens. Bingaman and Collins, and Reps. Kennedy and Ros-Lehtinen. This legislation will help children and their families gain access to treatment by increasing the numbers of children's mental health professionals. Please contact Rachel Nuzum in Sen. Bingaman's office (or Mike Zamore in Rep. Kennedy's office) to cosponsor this important legislation."

Child Medication Safety Act Reintroduced
The Child Medication Safety Act (CMSA), H.R. 1790, was reintroduced in the House in late April by Rep. Kline (R-GA). H.R. 1790 would prohibit school personnel from requiring that students be placed on psychotropic medications as a condition of attending school. Schools that fail to comply with this mandate would lose their federal funding. The CMSA passed the House last year as an amendment to the Individuals with Disabilities Education Act (IDEA) reauthorization, and then again as a stand-alone bill, to strengthen its implementation, but was defeated in the Senate IDEA bill. While the AACAP agrees that school personnel should not make medication recommendations to parents, we are concerned that the bill increases stigma against children's treatment options by singling out psychotropic medications, and that the bill's harsh enforcement would discourage the early identification of children and adolescent with mental illnesses in schools. A Senate bill has not yet been introduced. ACTION: AACAP members and friends are asked to contact their House representative to request their opposition to H.R. 1790.

Keeping Families Together Act
Another of the AACAP's legislative priorities, the Keeping Families Together Act, H.R. 823 and S. 380, has been reintroduced for the 109th Congress in the House and Senate by Reps. Ramstad (R-MN) and Kennedy (D-RI), and Sen. Collins (R-ME). The bill would help prevent parents from having to relinquish custody of their children in order to access mental health treatment. A General Accounting Office (GAO) study found that in 2001, 12,700 families were forced to give up custody of their children to child welfare or juvenile justice agencies. The Keeping Families Together Act would provide grants to states to develop systems of care between state child welfare, juvenile justice and mental health agencies for these children and expands eligibility for Medicaid's home and community-based services waiver to children and adolescents in residential treatment facilities. H.R. 823 has 4 cosponsors and S. 380 has 13 cosponsors. ACTION: AACAP members and friends are asked to contact their Senators and Representative to request their cosponsorship of S. 380 and H.R. 823.

Anti-Screening Legislation
AACAP member action is needed to oppose legislation that, if enacted, could stifle efforts to support state and local efforts to identify children and adolescents with mental illnesses. The bill, entitled the Parental Consent Act, H.R. 181, was introduced in the House by Rep. Paul (R-TX) and would prohibit the use of federal funds for mental health screening. The bill alleges that President Bush's New Freedom Commission on Mental Health has proposed mandatory screening of all children. This is not true. In fact, the Commission emphasized the need for full parental involvement in all decisions relating to the mental health of their children. The New Freedom Commission report is available at www.mentalhealthcommission.gov.

Additionally, the bill includes language that is discriminatory towards psychiatry, mental illness, and particularly, medications used to treat children. The following is an excerpt from the bill's findings section: "(5) Because of the subjectivity of psychiatric diagnosis, it is all too easy for a psychiatrist to label a person's disagreement with the psychiatrist's political beliefs a mental disorder." H.R. 181 currently has 33 House cosponsors. To find out if your Representative is a cosponsor of H.R. 181, go to http://thomas.loc.gov, enter the bill number, H.R. 181, then click on "Bill summary and status." ACTION: All AACAP members are asked to contact their Representative to request their opposition to this bill. Please visit the AACAP website, www.aacap.org, for talking points on H.R. 181.

If you have questions or would like more assistant in contacting your member of Congress, please call 800. 333. 7636, ext. 126, or e-mail Nuala Moore at nmoore@aacap.org.