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 ISSUES
/ ACTION ALERTS
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Government programs and policies
that affect children's health care;
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Sufficient government funding for
children's health programs and issues; and
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Childhood health promotion and injury
prevention.
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Action
Alerts |
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Here's where
you can get involved by taking
action
on issues important to children. |
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We seek to support all issues that benefit
children and the professionals who provide care to children,
including:
Children’s Hospital Graduate Medical
Education (CHGME)
CHIP
Children's Medicaid
Childhood Obesity
Immunizations
Child Passenger Safety/Injury
Prevention
Mental Health
Child Abuse and Neglect
The
issues can change over time as new situations arise in Texas and
nationally. Congress is currently in session, and the Texas
Legislature meets for the 80th regular session beginning in January
2007.
Each year, approximately 170 residents are
trained at Texas Children's Hospital. To offset the cost of this
training, independent children’s teaching hospitals such as ours
receive funds from the government.
Children’s Hospital Graduate Medical Education (CHGME) funding was
authorized in 1999 to offset this cost and aid children’s hospitals,
since they teach 30 percent of all pediatricians and nearly half of
all pediatric specialists.
On June 21, 2006, Congress reauthorized the CHGME program, which
means the program will continue for five more years, funded at $300
million annually. This legislation passed with strong bipartisan
support, with a vote of 421-4. All but one member of the Texas
Congressional Delegation voted for the reauthorization and funding
of CHGME. The next step is a House-Senate conference committee to
resolve the minor differences in the legislation. Texas Children's
Hospital continues to monitor support for this critical funding.
CHGME helps fund the training of many pediatricians and pediatric
subspecialists. Out of approximately 170 pediatric residents trained
at Texas Children's Hospital, about 100 (60 percent) remain in the
Houston area and another 40 percent stay in Texas.
ACTION ALERT!
Please write to your member of Congress
to thank him or her for supporting children’s hospitals and our
mission of medical education and care. To
find out who represents
you.
Please include in your letter the following points:
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Thank you for your vote on HR 5574, the Children's Hospital
Graduate Medical Education (CHGME) reauthorization bill.
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CHGME funding is not only essential to our hospital, but also the
other free-standing children's hospitals across the country and
their ability to train the next generation of pediatricians and
pediatric subspecialists.
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This support allows us to attract outstanding physicians to lead
and grow our residency and fellowship programs, resulting in our
ranking as a top five children's hospital in the
country.
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The Children’s Health Insurance Program (CHIP) was created during
the 1999 Texas legislative session and is designed for uninsured
children in families that earn too much to qualify for Medicaid but
cannot afford private health insurance, and earn income that does
not exceed 200 percent of the federal poverty level (FPL). In 2006, the
upper limit of eligibility for a family of three is $33,200.
During the 79th Legislative Session in 2005, changes were made to
the program that restored some of the services reduced in
the previous session, including dental and vision benefits. However,
some changes from the previous session still remain, such as the
90-day waiting period for eligible children to receive CHIP coverage
and co-pays. In addition, families must pay an enrollment fee and
verify their income every six months. An assets test has also been
implemented for families earning above 150 percent of FPL.
Texas Children's Hospital and the Government Relations Department
have been involved in the CHIP program since its inception, and will
continue to be at the forefront of CHIP advocacy. This year, we are
working to restore 12-month continuous eligibility, work with the
Texas Health and Human Services Commission to improve the enrollment
and re-enrollment process as the Commission transitions to a new
vendor, and improve or eliminate barriers to the CHIP program, such
as the assets test and income verification, both of which include child care
costs and child support in determining eligibility.
CHIP is a federally funded, state-administered program and will be
eligible for reauthorization in 2007. Texas Children's Government Relations staff
will follow this program closely in the next few years and
keep you apprised of any developments or changes.
More than 1.8 million Texas children get health coverage through
Medicaid, which provides comprehensive health services for
low-income children and children with disabilities.
No major changes to Children’s Medicaid were made by the 79th
Legislature. However, as the number of families attempting to enroll
increases, children actually enrolled has
decreased. Children’s Medicaid applications are now being processed
by a new enrollment broker, the Texas Access Alliance (TAA), which
has experienced some system problems.
Texas Children's Government Relations Department and Texas
Children’s Health Plan continue to work with the Health and Human
Services Commission and various Houston-area community based
organizations to resolve the problems, educate families, and enroll
children in the program as expediently as possible.
Also, as of July 1, 2006, Medicaid recipients must now provide
proof of citizenship when applying or reapplying for benefits.
Additionally, Medicaid Primary Care Case Management (PCCM) will no
longer exist after September 1, 2006, and all families enrolled in
PCCM must switch to a new provider. Texas Children's Government Relations Department and Texas Children’s Health Plan
Community Outreach are also diligently working to educate families
so that they are aware of the change and can make the transition as
seamless as possible.
More information on Medicaid and CHIP (pdf)
Medicaid private
health spending graph (pdf)
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More than half of Houston’s children – around 56 percent – are
overweight. Nationally, childhood obesity, generally defined as
being at least 30 to 40 pounds overweight, has more than doubled in
30 years. This increase puts more children at risk for heart
disease, diabetes, certain cancers, depression and low self-esteem.
Unfortunately, the 61 percent of American adults who are overweight
or obese do not present a model of good behavior.
Texas Children's Hospital’s Government Relations department monitors
legislation that affects children’s health and potential for
becoming obese. These issues include regulation of certain foods in
vending machines on school campuses and curriculum of physical
education programs. During the 79th Legislative Session, Senator
Jane Nelson authored Senate Bill 42, which emphasizes proper
nutrition and exercise in conjunction with school health classes.
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Immunizations have become a major concern of Texas residents since
June of 2003 when the governor signed House Bill 2292, which
included an amendment allowing an exemption to immunization
requirements for reasons of conscience, including religious beliefs.
Beginning in September of 2003, exemptions from Texas immunization
requirements could be granted by school officials provided the
parent or guardian submitted an official Texas Department of Health
affidavit to the school.
The Centers for Disease Control (CDC) reports that Houston's rate of
vaccination among one to three year-olds against common childhood
diseases dropped from 69 percent in 2003 to 66 percent in 2004, the
latest year for which statistics are available. Houston ranked
second from the bottom in that statistic among major U.S. metro
areas in 2004. Since then, Harris County hospitals have seen only a
59.2 percent consent rate The diseases covered in the survey
included measles, mumps, whooping cough, tetanus and polio.
Meningitis was not included. Unexpected outbreaks of illnesses such
as meningitis have created a concern over the past few years of
immunization regulations.
National Immunization Rates 2004 (pdf)
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Motor vehicle crashes are the leading cause of unintentional
injury-related death among children ages 4 to 18. Use of any type of
restraint by children ages 5 to 9 in Houston,
according to a survey by Texas Transportation Institute, is only
19 percent, with only eight percent using the seatbelt properly.
Only 2.2 percent of parents of children ages 5 to 9
use booster seats.
Current Texas law does not regulate the use of a booster seat for
children older than four years old or taller than 36 inches in
height. Texas is one of only 12 states that do not have a
booster seat law in place protecting the safety of children using a
vehicle safety belt.
During the 79th Legislative Session, Representative Fred Brown
authored and passed legislation that allows for increased safety of
children who are younger than 5 years old and who are less than
36 inches in height. The proposed law would require children in this
age and height range to ride in a child passenger safety seat system
according to the manufacturer’s instructions during the operation of
the vehicle.
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A recent report published by the Children’s Hospital Association of
Texas, in conjunction with the LBJ School of Public Affairs at the
University of Texas, showed that children in Texas are not receiving
adequate mental health care. Some of the contributing factors,
according to the report, are limitations of public and private
insurance, inadequate state funding, inadequate community-based
care, and lack of prevention and early intervention services, among
others. The report made several recommendations to improve mental
health services to children, including increased funding targeted to
support development of community-based services, supporting
insurance parity for mental health services, identifying and
treating from birth to age 5, reducing barriers to CHIP and
Medicaid enrollment (see above) and providing continuous coverage
for 12 months instead of six, and increasing oversight and
coordination of children’s mental health services.
Full report (pdf)
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For federal fiscal year 2004, an estimated 3 million children were
alleged to have been abused or neglected and received investigations
or assessments by state and local child protective services (CPS)
agencies. Approximately 872,000 children were determined to be
victims of child maltreatment. While the exact number of children
affected is uncertain, child fatalities due to abuse and neglect
remain a serious problem in the United States. Fatalities
disproportionately affect young children and are most often caused
by one or both of the child's parents. Child fatality review teams
appear to be among the most promising current approaches to
responding to and preventing child abuse and neglect fatalities.
There is no current data showing where Texas ranks in comparison
with other states. Comparisons among states based exclusively on
national child welfare data sources can be misleading and should not
be used to judge the effectiveness of one state versus another.
While the national data sets provide good national estimates, they
lack reliability for interstate comparisons due to variations in
state laws, policies, definitions, and data collection processes.
The federal government is currently addressing some areas of
variation among the states’ data.
  
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