[Congressional Record Volume 140, Number 100 (Wednesday, July 27, 1994)]
[Extensions of Remarks]
[Page E]
From the Congressional Record Online through the Government Printing Office [www.gpo.gov]


[Congressional Record: July 27, 1994]
From the Congressional Record Online via GPO Access [wais.access.gpo.gov]

 
 ENDORSEMENTS FOR THE INTEGRATED CHILD HEALTH CARE NETWORKS ACT OF 1994

                                 ______


                            HON. LYNN SCHENK

                             of california

                    in the house of representatives

                        Wednesday, July 27, 1994

  Ms. SCHENK. Mr. Speaker, last week I joined with my good friend and 
colleague from California [Mr. Lehman] in introducing H.R. 4810, the 
Integrated Child Health Care Networks Act of 1994. This legislation 
aims to ensure that children in managed care networks receive a basic 
level of pediatric and specialty pediatric services.
  In drafting this legislation, I have enjoyed the input of the 
National Association of Children's Hospitals and Related Institutions 
[NACHRI] and the American Academy of Pediatrics [AAP]. These groups, 
which are on the front lines of children's health care, have released a 
joint statement of support for my legislation. I submit these words of 
support for the Record.

                                                    July 26, 1994.
     Hon. Lynn Schenk,
      House of Representatives,
     Washington, DC.
       Dear Representative Schenk: On behalf of the American 
     Academy of Pediatrics [AAP] and the National Association of 
     Children's Hospitals and Related Institutions [NACHRI] we 
     want to thank you for seeking our response to your new 
     legislation, H.R. 4810, the ``Integrated Child Health Care 
     Networks Act.'' Our organizations represent respectively the 
     nation's pediatricians and the nation's hospitals specialized 
     in the delivery of care to children.
       We strongly support your efforts through H.R. 4810 to 
     address an important issue that the members of the AAP and 
     NACHRI are raising--``Increasing consolidation of adult 
     health care systems, including enrollment of more and more 
     Americans in capitated managed care plans, has the potential 
     to put children at risk if the new systems fail to focus on 
     children's needs.''
       Because of this, the AAP and NACHRI are collaborating to 
     promote a vision of how children should receive care in such 
     an environment. We believe that ``ideally, every child should 
     receive care through an `integrated child health care 
     network'--a network of pediatrician, pediatric subspecialists 
     including perinatologists, family physicians, and other 
     health care professionals, which is:
       Expert in meeting the full continuum of children's 
     preventive, primary, acute, subspecialty, postacute, 
     habilitative and rehabilitative, and long-term care, as well 
     as mental health needs;
       Organized to work together to assume responsibility for 
     managing the full continuum of care for a specific population 
     of children, and to provide quality care in a cost efficient 
     manner; and
       Accountable to the public for the health status--the 
     ``wellness''--of the population of children covered, as well 
     as their use of services, according to agreed-upon measures 
     of children's health status and pediatric care outcomes.''
       We are enclosing a copy of our joint statement which 
     explains in more detail the vision of integrated child health 
     care networks we are developing.
       Your legislation translates this vision into the public 
     program that most directly affects children's access to 
     health care--Medicaid--by requiring the Secretary of Health 
     and Human Services to define integrated child health care 
     networks and requiring Medicaid managed care plans to 
     demonstrate how they provide access to care for children 
     through such networks.
       This approach makes sense, because today Medicaid is 
     responsible for paying for the health care of one quarter of 
     all of the children in the United States. As a consequence, 
     children represent half of all Medicaid recipients, even 
     though they represent only a quarter of the Nation's 
     population, and they will be affected the most by the rapid 
     shift in Medicaid programs to managed care. Your legislation 
     will ensure a focus on what is in the interests of children, 
     not just the management of Medicaid.
       At the same time, H.R. 4810 also serves as a model for 
     private health insurance. That is why we are pleased that you 
     have included authorization for demonstrations of different 
     kinds of integrated child health care networks in private and 
     public sectors. What works for children in one region will be 
     different than in another region, depending on organization 
     of providers, economics of the area, extent of urbanization, 
     and other factors.
       We applaud your leadership in articulating in legislation 
     the desire our members know every family has to make sure the 
     health care their children receive is appropriate to their 
     needs. Please call upon our organizations and our members to 
     assist you in promoting the development of integrated child 
     health care networks through H.R. 4080.
           Sincerely,
     Joe M. Sanders, Jr., M.D.,
       Executive Director, American Academy of Pediatrics.
     Lawrence A. McAndrews,
       President and CEO, National Association of Children's 
     Hospitals and Related Institutions.
                                  ____


  A Statement by the American Academy of Pediatrics and the National 
    Association of Children's Hospitals and Related Institutions on 
                 Integrated Child Health Care Networks

       Increasing consolidation of adult health care systems, 
     including enrollment of more and more Americans in capitated 
     managed care plans, has the potential to put children at risk 
     if the new systems fail to focus on children's needs. In 
     response, the American Academy of Pediatrics [AAP] and the 
     National Association of Children's Hospitals and Related 
     Institutions [NACHRI] are collaborating to promote a vision 
     of how children should receive care in such an environment.
       Ideally, every child should receive care through an 
     ``integrated child health care network''--a network of 
     pediatricians, pediatric subspecialists including perinatol- 
     ogists, family physicians, and other health care 
     professionals, which is:
       Expert in meeting the full continuum of children's 
     preventive, primary, acute, subspeciality, post-acute, 
     habilitative and rehabilitative, and long-term care, as well 
     as mental health care needs;
       Organized to work together to assume responsibility for 
     managing the full continuum of care for a specific population 
     of children, and to provide quality care in a cost efficient 
     manner; and
       Accountable to the public for the health status--the 
     ``wellness''--of the population of children covered, as well 
     as their use of services, according to agreed-upon measures 
     of children's health status and pediatric care outcomes.
       Whether it operates as part of a larger system managing 
     health care for adults and children or it operates as a free-
     standing network serving only children, the integrated child 
     health care network should have an explicit mission devoted 
     to maximizing the health status of each enrolled child by 
     managing budgeted resources to ensure access to high quality, 
     cost effective care.
       In order to fulfill such a mission, an integrated child 
     health care network should be characterized by enrollment of 
     all children in a ``medical home'' with emphasis on 
     prevention and wellness, regionalization of complex and 
     specialized services, financing based on children's health 
     care requirements, medical education and research devoted to 
     children's needs, and active family involvement in the 
     delivery of care.
       The AAP and NACHRI are working together to ensure there is 
     a seamless system of care for children, which guarantees 
     their access to appropriate pediatric services. To this end, 
     AAP and NACHRI members are seeking to further define and 
     promote a shared vision of children's access to care through 
     integrated child health care networks.
  Mr. Speaker, both versions of health care reform reported by the 
Committee on Ways and Means and the Committee on Education and Labor 
include language which would require health plans to provide children 
with access to pediatric primary and specialty health care providers. 
These provisions are consistent with the intent of my legislation.
  I believe it is important that the House leadership retain these or 
similar provisions in the final version of health reform. We need to 
put children first in our health care system, and I look forward to 
working with NACHRI and the AAP toward this end.
  


                       SENATE COMMITTEE MEETINGS

  Title IV of Senate Resolution 4, agreed to by the Senate on February 
4, 1977, calls for establishment of a system for a computerized 
schedule of all meetings and hearings of Senate committees, 
subcommittees, joint committees, and committees of conference. This 
title requires all such committees to notify the Office of the Senate 
Daily Digest--designated by the Rules Committee--of the time, place, 
and purpose of the meetings, when scheduled, and any cancellations or 
changes in the meetings as they occur.
  As an additional procedure along with the computerization of this 
information, the Office of the Senate Daily Digest will prepare this 
information for printing in the Extensions of Remarks section of the 
Congressional Record on Monday and Wednesday of each week.
  Meetings scheduled for Thursday, July 28, 1994, may be found in the 
Daily Digest of today's Record.

                           MEETINGS SCHEDULED

                                JULY 29
     9:30 a.m.
       Commerce, Science, and Transportation
       Communications Subcommittee
         To hold hearings on proposed legislation authorizing 
           funds for programs of the Federal Communications 
           Commission (FCC).
                                                            SR-253
       Governmental Affairs
       Regulation and Government Information Subcommittee
         To hold joint hearings with the Committee on the 
           Judiciary's Subcommittee on Juvenile Justice to examine 
           the video rating system, focusing on violent video 
           games.
                                                            SH-216
       Judiciary
       Juvenile Justice Subcommittee
         To hold joint hearings with the Committee on Governmental 
           Affairs' Subcommittee on Regulation and Government 
           Information to examine the video rating system, 
           focusing on violent video games.
                                                            SH-216
     10:00 a.m.
       Banking, Housing, and Urban Affairs
         To hold hearings to examine issues relating to 
           Whitewater.
                                                            SD-106
       Labor and Human Resources
         To hold hearings on S. 2238, to prohibit employment 
           discrimination on the basis of sexual orientation.
                                                            SD-430

                                AUGUST 1
     2:00 p.m.
       Indian Affairs
         Business meeting, to mark up S. 2269, to protect the 
           Native American cultures and to guarantee the free 
           exercise of religion by Native Americans, S. 2075, to 
           authorize funds for and to strengthen programs of the 
           Indian Child Protection and Family Violence Prevention 
           Act, S. 2036, to specify the terms of contracts entered 
           into by the United States and Indian tribal 
           organizations under the Indian Self-Determination and 
           Education Assistance Act, and S. 2150, to establish a 
           Native Hawaiian housing program; to be followed by 
           hearings on the proposed Mohican Nation of Connecticut 
           Land Settlement Act.
                                                            SR-485

                                AUGUST 2
     10:00 a.m.
       Governmental Affairs
         Business meeting, to consider pending calendar business.
                                                            SD-342
       Joint Economic
         To hold hearings on economic implications of health care 
           reform.
                                             2255 Rayburn Building
     2:00 p.m.
       Judiciary
         To hold hearings on the nomination of H. Lee Sarokin, of 
           New Jersey, to be United States Circuit Judge for the 
           Third Circuit.
                                                            SD-226
     2:30 p.m.
       Energy and Natural Resources
       Public Lands, National Parks and Forests Subcommittee
         To hold hearings on S. 1222, to revise the boundaries of 
           the Blackstone River Valley National Heritage Corridor 
           in Massachusetts and Rhode Island, S. 1342, to 
           establish in the Department of the Interior the Essex 
           Heritage District Commission, S. 1726, to provide for a 
           competition to select the architectural plans for a 
           museum to be built on the East St. Louis portion of the 
           Jefferson National Expansion Memorial, S. 1818, to 
           establish the Ohio and Erie Canal National Heritage 
           Corridor in the State of Ohio as an affiliated area of 
           the National Park System, S. 1871, to establish a 
           Whaling National Historical park in New Bedford, MA, S. 
           2064, to expand the boundary of the Weir Farm National 
           Historical Site in Connecticut, S. 2234, to amend the 
           Mississippi River Corridor Study Commission Act of 1989 
           to extend the term of the commission established under 
           that Act, and S. 2303, to provide for the exchange of 
           lands within the Gates of the Arctic National Park and 
           Preserve.
                                                            SD-366

                                AUGUST 3
     9:00 a.m.
       Labor and Human Resources
         Business meeting, to mark up S. 1629, to revise the 
           Public Health Service Act to provide for expanding and 
           intensifying activities of the National Institute of 
           Arthritis and Musculoskeletal and Skin Diseases with 
           respect to lupus, proposed legislation authorizing 
           funds for the National Science Foundation, and proposed 
           legislation relating to mental health and substance 
           abuse programs.
                                                            SD-430
     9:30 a.m.
       Commerce, Science, and Transportation
         To hold hearings on S. 2101, to provide for the 
           establishment of mandatory State-operated comprehensive 
           one-call systems to protect all underground facilities 
           from being damaged by any excavations.
                                                            SR-253
     10:00 a.m.
       Environment and Public Works
         Business meeting, to mark up proposed reforms to the 
           Superfund law.
                                                            SD-406

                                AUGUST 4
     9:00 a.m.
       Select on Intelligence
         To hold closed hearings on intelligence matters.
                                                            SH-219
     9:30 a.m.
       Energy and Natural Resources
       Public Lands, National Parks and Forests Subcommittee
         To hold hearings on S. 399 and H.R. 457, bills to provide 
           for the conveyance of lands to certain individuals in 
           Butte County, CA, H.R. 2620, to acquire certain lands 
           in the State of California through an exchange pursuant 
           to the Federal Land Policy and Management Act of 1976, 
           S. 1998, to provide for the acquisition of certain 
           lands formerly occupied by the Franklin D. Roosevelt 
           family, S. 2001, to improve the administration of the 
           Women's Rights National Historical Park in the State of 
           New York, S. 2033, to provide for the exchange of 
           certain lands within the State of Montana, S. 2078, to 
           designate the Old Spanish Trail for potential inclusion 
           into the National Trails System, and H.R. 1716, to 
           amend the Act of January 26, 1915, establishing Rocky 
           Mountain National Park, to provide for the protection 
           of certain lands in Rocky Mountain National Park and 
           along North St. Vrain Creek.
                                                            SD-366
       Governmental Affairs
         To hold hearings to examine voter representation for the 
           District of Columbia.
                                                            SH-216
     2:00 p.m.
       Energy and Natural Resources
       Water and Power Subcommittee
         To hold joint hearings with the Committee on Indian 
           Affairs on provisions of S. 2259, to provide for the 
           settlement of the claims of the Confederated Tribes of 
           the Colville Reservation concerning their contribution 
           to the production of the hydropower by the Grand Coulee 
           Dam.
                                                            SD-366
       Veterans' Affairs
         To hold hearings on the nomination of Linda Marie Hooks, 
           of Georgia, to be an Assistant Secretary of Veterans 
           Affairs (Acquisition and Facilities), and pending 
           legislation.
                                                            SR-418
       Indian Affairs
         To hold joint hearings with the Committee on Energy and 
           Natural Resources' Subcommittee on Water and Power on 
           provisions of S. 2259, to provide for the settlement of 
           the claims of the Confederated Tribes of the Colville 
           Reservation concerning their contribution to the 
           production of the hydropower by the Grand Coulee Dam.
                                                            SD-366

                               AUGUST 10
     2:00 p.m.
       Veterans' Affairs
         Business meeting, to consider the nomination of Linda 
           Marie Hooks, of Georgia, to be an Assistant Secretary 
           of Veterans Affairs (Acquisition and Facilities), and 
           to mark up pending legislation.
                                                            SR-418

                               AUGUST 11
     9:30 a.m.
       Commerce, Science, and Transportation
         To hold hearings on S. 1991, to provide for the safety of 
           journeyman boxers; to be followed by hearings on the 
           oversight of activities of the Olympic Committee.
                                                            SR-253

                               AUGUST 12
     2:00 p.m.
       Indian Affairs
         To hold hearings on the nomination of Harold A. Monteau, 
           of Montana, to be Chairman of the National Indian 
           Gaming Commission, Department of the Interior.
                                                            SD-628