August 2008

Candidates visit hospital
Numerous congressional and state legislative candidates have visited Dayton Children’s this spring and summer. Every campaign season, hospital advocates invite all candidates to tour the hospital to learn more about children’s health, successes of the hospital and challenges we face such as cuts in Medicaid and challenges to the State Children’s Health Insurance Program (SCHIP).

These visits are imperative to educating candidates about issues important to children’s health, pediatric professionals and children’s hospitals. Regardless of if they win their elections, they are community leaders and we are eager to help them learn more about children’s health issues and Dayton Children’s.
 
After the election there will be a lot of transition involved with the legislative staffers. These staffers are vital links in the elected officials’ offices.

As we have done in the past, we will again host a legislative staff visit called “Legislative Rounds” to the hospital after the first of the year. These visits allow staff members to engage with our professionals, see firsthand the important work being done at Dayton Children’s and provides a foundation of knowledge that cannot be accomplished with legislative visits conducted in their offices in Columbus and Washington D.C. While these visits to their offices are important educational opportunities as well, nothing tells our story better than walking through the halls, seeing and speaking with patients, staff and physicians.

Presidential candidates invited to visit
Both presidential candidates have been formally invited to visit Dayton Children’s while on the campaign trail.  While securing such visits can be extremely challenging, advocates for the hospital are working hard to ensure that both Sens. McCain and Obama know that we would welcome both candidates to Dayton Children’s to discuss the issues impacting children.

Brace yourself for the ads
This shouldn’t come as a surprise to anybody who owns a television, but Ohio is the second most popular state for presidential campaign TV ad spending.

The presidential campaigns of Sens. John McCain (R-Ariz..) and Barack Obama (D-Ill.) have aired 23,000 more TV ads nationwide from June 3-July 26 than candidates for the office did during the same period in 2004, according to the University of Wisconsin Advertising Project. The total is more than 100,000 versus 77,000 four years ago.

In addition, the Dayton area has several hotly contested races and we will also experience a great deal of political advertising from these campaigns as well.

Family advocacy day
Mindi Thomas and her daughter Justice, of Brookville traveled to Washington, D.C. in June to speak with federal lawmakers about an issue of vital importance to them – the fate of children’s health care and the essential role that children’s hospitals play in the community.

They joined patients and families from children’s hospitals across the country to advocate on behalf of their hospitals as part of the fourth annual National Association of Children’s Hospitals Family Advocacy Day.

Justice Thomas, 13, has suffered from hematemesis – an illness that causes her to throw up blood – since she was born, but her life has been drastically improved through her experiences and treatments provided by Dayton Children’s.

“Dayton Children’s plays a crucial role in our region, providing innovative medical services and medical training tailored specifically to the needs of our children,” says Justice’s mother Mindi. 

The Thomas’ have concerns about health care coverage, costs and continued access to the specialized and high quality of care provided by children’s hospitals.

They spoke with lawmakers about a bill that is currently pending in Congress that could result in $12 to $15 billion in cuts to children’s health coverage.

These proposed changes would drastically reduce important health care programs like rehabilitation services and transportation of disabled children to and from schools. The cuts will severely impact the care that children’s hospitals can provide and could curtail the delivery of health care services needed by children with some of the most serious health care needs.

With diagnoses ranging from leukemia to cerebral palsy, the children and their parents hope to raise awareness for the important specialized care that children’s hospitals provide, and to stress the significant role that SCHIP and Medicaid play in helping ensure that these valuable services are available to all children who need them.

“We want to show lawmakers our serious concern about the proposed cuts,” says Mindi.

“Children’s hospitals like Dayton Children’s are a safety net for kids and provide care to the sickest and most vulnerable children in our nation,” says Vicki Giambrone, vice president for marketing and external relations at Dayton Children’s. “Approximately half of the patients we care for rely on Medicaid. These proposed Medicaid cuts would limit our ability to provide clinical care, training and pediatric health research that benefits all children, not just those on Medicaid.” 

Children’s hospitals account for less than five percent of all hospitals nationwide, but they provide nearly 40 percent of all hospital care for children and the majority of care for children with serious medical conditions. They are responsible for providing training for the majority of pediatricians and virtually all pediatric subspecialists and research scientists.

On average, Medicaid and SCHIP patients account for more than 50 percent of all patient care at children’s hospitals nationwide.

Justice and her mom met with Senator Sherrod Brown and Representatives David Hobson, Michael Turner and Jim Jordan.  In addition, Justice’s blog about her trip appeared on the Dayton Children’s website.

Ohio booster seat legislation moving along
State Representative Shannon Jones (R-Springboro) continues to push the legislature to pass a bill (House Bill 320) that would require children between ages 4 through 8 or less than 4’9” to be restrained in booster seats.

While 98 percent of America’s infants and 89 percent of children ages 1 to 3 are now regularly restrained, not enough children ages 4 to 7 are restrained properly for their size and age. What many parents don’t know is that once a child outgrows a car seat, the next step for safety isn’t the adult seat belt—it’s a booster seat. Children who are 4 to 8 who use booster seats are 59 percent less likely to be injured in a car crash than children who are restrained only by a seat belt, according to a study by Children’s Hospital of Philadelphia.

For years, Ohio has lagged behind in the area of child vehicle safety. Currently, Ohio is one of only 12 states without some form of booster seat legislation.

Through Rep. Jones’ diligence, House Bill 320 made it through committee and a full House vote before the Ohio House of Representatives finished before summer.

The bill now moves to the Ohio Senate, where Dayton Children’s advocates will continue to inform legislators about the importance of a booster seat law.

Stay tuned for how you can help but contacting your legislators about this important legislation. If you are not already, please become a member of the ASK Network and stay informed about legislative issues we need your help with.

Federal drug pricing program rules still stalled
Dayton Children’s along with the National Association of Children’s Hospitals has sent a letter to Department of Health and Human Services Secretary Michael Leavitt and Office of Management and Budget Director Jim Nussle urging them to issue final guidelines on the implementation of the federal 340B Discount Drug Program.

The federal 340B drug-pricing program provides access to a discounted price on outpatient prescription drugs to certain health care facilities, including hospitals serving a disproportionate share of Medicaid and uninsured patients. Until Congress enacted the Deficit Reduction Act (DRA) of 2005, children's hospitals exempt from Medicare's
Prospective Payment System could not participate in the program despite their status as disproportionate share hospitals.

Under provisions in the DRA, freestanding children's hospitals can now participate in the program. However, the Health Resources and Services Administration, the federal agency charged with administering the program, has yet to finalize guidelines to allow the children's hospitals to begin to receive the 340B discount.

At Dayton Children’s we estimate we could save $1 million per year by participating in the 340B program.

Labor-HHS appropriations bill still in limbo
Sens. Tom Harkin (D-IA) and Arlen Specter (R-PA), champions of funding for the National Institutes of Health, have introduced legislation to provide an additional $5.2 billion in emergency FY 2008 funding for the agency. Harkin, chair of the Labor, Health and Human Services (Labor-HHS) Appropriations Subcommittee, and Specter, the subcommittee's ranking Republican member, also intend to recommend $500 million for NIH in an economic stimulus package that will be considered in September.

The Harkin/Specter bill would provide $1.2 billion for the National Cancer Institute, with the rest of the funds disbursed among other NIH institutes. The president's FY 2009 budget request freezes NIH funding, and the Senate FY 2009 Labor-HHS Appropriations Bill, which is pending Senate approval, provides an $875 million increase for NIH over FY 2008. Sens. Harkin and Specter and other supporters of NIH assert that the agency's funding levels have not kept pace with inflation during the past five years, "putting the nation at risk of losing a generation of talented investigators."

Meanwhile, the FY 2009 Labor-HHS Appropriations Bills in both the Senate and the House remain in limbo, the victim of ongoing debate. In the Senate, it is unlikely that Majority Leader Harry Reid (D-NV) will heed the wishes of Appropriations Committee Chair Robert Byrd (D-WV) and schedule floor votes for each of the 12 appropriations bills. In the House, the Appropriations Committee may or may not vote on the Labor-HHS Appropriations Bill after Labor Day. The prospects in the House depend upon the degree of political jockeying that occurs after the summer recess. In any event, congressional leaders are indicating that they will begin work in early September on a continuing resolution that would fund most federal programs until early 2009.  Funding for several Dayton Children’s projects are earmarked in the Labor-HHS Bill.

Temporary federal medical assistance percentage (FMAP) increase likely in economic stimulus package
Rep. John Dingell (D-MI), chair of the House Energy and Commerce Committee, predicted last week that Congress would enact an economic stimulus package that includes a temporary, targeted increase in federal Medicaid matching funds to states. He also predicted, correctly, that any action on a stimulus package would not occur until the fall.

Dingell made his prediction at a July 22 Health Subcommittee hearing on state fiscal relief, which focused on the need for an increase in Medicaid's federal matching rate, known as the Federal Medical Assistance Percentage (FMAP). The subcommittee's chair, Rep. Frank Pallone (D-NJ), has introduced a bill (H.R. 5268) that would increase the FMAP by 2.95 percent from April 1, 2008 through June 30, 2009.

Pallone's office estimates that the bill would result in an additional $10 - 15 billion in federal Medicaid spending. The Pallone bill has 78 cosponsors, including Dingell. Meanwhile, Speaker of the House Nancy Pelosi (D-CA) has stated that she intends to move a $50 billion stimulus package that could include a temporary FMAP increase, but not before September.

On July 22, the Senate Appropriations Committee canceled a scheduled markup of a stimulus package that would have been the legislative vehicle for additional aid to state Medicaid programs. Despite the Appropriations Committee's action, the Senate Democratic leadership appears to be committed to passing an economic stimulus package and is meeting with House counterparts to develop a bill.

Senate efforts to nullify SCHIP directive thwarted
On July 17, Sens. John D. Rockefeller (D-WV) and Max Baucus (D-MT) introduced a joint resolution that would nullify the so-called "Aug. 17 directive," which limits states' ability to enroll uninsured children in the State Children's Health Insurance Program. Five days later, on July 23, the Senate Finance Committee canceled a vote on the resolution (S.J. Res 44) after the Senate parliamentarian ruled that it was filed too late. S.J. Res 44, with 41 original co-sponsors, challenges the Aug. 17 directive based on an April 2008 ruling from the U.S. Government Accountability Office. That ruling asserted that the directive, issued in the form of a letter from the Centers for Medicare and Medicaid Services (CMS) to state health officials, is in fact a regulation. The Rockefeller/Baucus resolution states that the directive should be nullified because the CMS letter violated the Congressional Review Act, which requires congressional notice and review of new regulations. Rockefeller and Baucus have vowed to find other avenues to nullify the SCHIP directive, which will go into effect on Aug. 17.

Other efforts to stop or delay implementation of the Aug. 17 directive also have not yet been successful. Sen. Frank Lautenberg (D-NJ) had planned to introduce an amendment to pending economic stimulus legislation that would delay implementation of the directive until April 1, 2009. However, his efforts were thwarted by the Senate Appropriations Committee's cancellation of their scheduled markup of the stimulus package. Sen. Robert Byrd (D-WV), chair of the committee, intends to consider the package in September after the directive goes into effect.
Though there appears to be substantial support in the Senate for overturning the SCHIP directive, its prospects in the House are less clear. Some advocates believe that the House is more likely to reconsider legislation to reauthorize SCHIP than to enact a measure specifically aimed at nullifying or delaying the directive. Reauthorization legislation could wipe the slate clean, however, and nullify the directive.  The National Association of Children’s Hospitals and other children's advocacy groups continue to support all efforts to overturn the directive.

Children's cancer research bill enacted
In a victory for advocates of children's cancer research, President Bush has signed H.R. 1556, "The Caroline Pryce Conquer Childhood Cancer Act" into law.  Rep. Deborah Pryce (R-OH), the lead sponsor of the legislation, was with the president at the White House for the bill signing ceremony on July 29. "The Caroline Pryce Conquer Childhood Cancer Act" expands pediatric cancer research at the National Cancer Institute, establishes a population-based childhood cancer database, and provides for expanded outreach and education on childhood cancer. The bill authorizes appropriations of $30 million annually for five years to carry out its provisions. The bill is named to honor Pryce’s daughter, Caroline, who died of neuroblastoma in 1999 at age 9. Pryce, who is retiring at the end of the 110th Congress, introduced this legislation in each of the last three Congresses.

ASK Network –Please Help Us Grow!
Thanks to your help, Dayton Children’s Advocates Speaking for Kids (ASK) Network continues to expand.

Too often, kids don't have a voice in the decisions that affect them and their families. Dayton Children's advocacy efforts are aimed at making sure kids' concerns are always heard when public policies are made.

If you haven’t already, join our ASK Network - Advocates Speaking for Kids today. If you are already a member, thank you! Please share this information with your friends and family so that they can help us speak for kids.
As a member, you will:

• Receive a quarterly update on local, state and federal legislative issues--including special briefings and event notices.
• Receive legislative alerts asking you to take immediate action, such as contacting your legislators about a specific bill or policy.
• Have the opportunity attend a training event to help you understand the best way to be an effective advocate for children.
• To learn more about joining, check out our advocacy webpage.

March 2008

In September 2007, State Representative Shannon Jones (R-Springboro) introduced important legislation requiring the use of booster seats for children ages 4 through 8 or under 4’9” tall.

While 98 percent of America’s infants and 89 percent of children ages 1 to 3 are now regularly restrained, not enough children ages 4 to 7 are restrained properly for their size and age. What many parents don’t know is that once a child outgrows a car seat, the next step for safety isn’t the adult seat belt—it’s a booster seat. Children who are 4 to 8 who use booster seats are 59 percent less likely to be injured in a car crash than children who are restrained only by a seat belt, according to a study by Children’s Hospital of Philadelphia.

For years, Ohio has lagged behind in the area of child vehicle safety. Currently, Ohio is one of only 12 states without some form of booster seat legislation.

Dayton Children’s as been working to educate parents and families as well as legislators about the importance of booster seats, but we need your help. 

We are expecting the current legislation to go for a vote before the Ohio House of Representatives in March. We need to let our legislators know that parents and other safety advocates support this legislation.

Please take just three minutes to write your member of the Ohio House of Representatives and urge them to support booster seat legislation for Ohio’s children.

To do this, visit the Legislative Action Center.

Under the “Action Alert!” box, click the link, “click here.” You will be asked to type in your home ZIP code, and an action alert box will appear on the next screen. 
 
We encourage you to personalize your message – describe why you support this legislation and why booster seats matter to children in our community. Personalized letters make the greatest impression on elected officials.
 
Thank you for volunteering to be a voice for children in Ohio.

If you would like more information about this campaign, please contact Vicki Giambrone at 937-641-3666 or Lori Kershner by e-mail.

Legislative update archives
Visit the legislative update archives to see what other issues Dayton Children's has been involved in.