The AACAP’s top legislative priority, the Child Health Care Crisis Relief Act, was reintroduced for the 109th Congress in the House of Representatives by Reps. Patrick Kennedy (D-RI) and Ileana Ros-Lehtinen (R-FL) on March 3rd , and in the Senate by Sens. Jeff Bingaman (D-NM) and Susan Collins (R-ME), on March 7. The new bill numbers are H.R. 1106 for the House bill and S. 537 for the Senate bill. H.R. 1106 has 22 cosponsors 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 six cosponsors 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 bill would cost $45 million annually for 4 years.

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 and 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.”

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. The bill would cost $55 million annually for 4 years. H.R. 823 has 4 cosponsors and S. 380 has 11 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. Rep. Paul introduced the bill in response to the New Freedom Commission on Mental Health’s recommendations for increased screening. The bill and some communications circulated in the House to support it allege that the Commission 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 28 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 Representatives to request their opposition to this bill. Please contact them immediately to request that they withdraw their support for H.R. 181. Call 1-202-224-3121 to reach the Capitol Switchboard, and ask for your representative’s office. When connected to the office, ask for the Health Legislative Assistant. If you leave a voicemail message, include your name and phone number. The following are sample message points:

• I am a practicing child and adolescent psychiatrist in (your county) and I am calling to ask Rep._____ to oppose or (if your rep. is cosponsor of the bill) withdraw his/her support for H.R. 181, the Parental Consent Act, because the bill is unnecessary and discriminatory towards mental illness and the field of psychiatry (refer to the underlined quote from the first paragraph of this alert).
• The bill alleges that the President’s New Freedom Commission on Mental Health recommended mandatory screening of all children. This is false. The Commission emphasized the need for full parental involvement in all decisions relating to the mental health of children.
• I agree that mental health screenings for children must include parental consent, but this is already a required procedure in screening programs, so federal legislation is unnecessary.
• I am concerned that H.R. 181 will lead to fewer children with mental illnesses being identified due to its negative characterization of mental illness. Children with untreated mental illness are at high risk for school failure, substance abuse and entrance into the juvenile justice system.

If you have questions or comments, please call 1.800.333.7636 ext. 127 or 126 or e-mail Nuala Moore at nmoore@aacap.org. If you visit Washington D.C., or attend a meeting in the area and would like to talk to your legislators, please contact the AACAP for help in making appointments, securing background material and using talking points.