    [Public Papers of the Presidents of the United States: William J. Clinton (1998, Book I)]
    [June 22, 1998]
    [Pages 1015-1017]
    [From the U.S. Government Publishing Office www.gpo.gov]

    Excerpt of Remarks During the Family Re-Union VII Conference in
    Nashville
    June 22, 1998

    Family-Centered Health Care

        The President. Is there any kind of national organization of people
    like you, who are working for family-centered
    care everywhere and advocating it?
        Julie Moretz. There is. There actually is--
    the Institute for Family-Centered Care, as matter of fact. And there are
    also a lot of family support programs, such as Parent To Parent,
    because, as anyone knows, parents need to be around other parents who
    have gone through similar situations. And there is a lot of support out
    there and I do encourage parents who have been through situations like
    this to get involved. And that is one way parents can get involved.
        The President. Don't you believe that recovery rates are better when
    there's family involvement when the people are in the hospital, whether
    it's children or parents or siblings?
        Ms. Moretz. There is no question about it.
    Daniel has had at least 47 doctors--that I can count--47 doctors come in
    and come out of his room at some given point over 7 years. And I have to
    recognize that we, David and I, we are the constant--and his brother and
    sister--we are the constant in his life, and we are the ones that can
    help to promote and facilitate his health care. Yes--and I have to say
    that his health care has been extremely wonderful. Obviously, he
    wouldn't be here today if it wasn't. So, thank goodness, and we are very
    proud of the health care that he has received.

    [The discussion continued.]

    Patients' Bill of Rights

        The President. If I could just reinforce something Tony said--and I
    thank you for everything you said--you may hear this in the debate in
    the Congress when this comes up this year. There may be some who really
    don't want this to pass who say, ``Well, look, a lot of companies are
    embracing these principles anyway.'' If a company is willing to say all
    the things Tony said--``If you've got to go to an emergency room, you
    can go; if you need a specialist, you can have it; the doctors can't be
    gagged, they can recommend whatever good care is; if you have a problem
    with your plan, you can have an appeal''--if you have all those things,
    if he does that, why should somebody else be able to put him at a
    financial disadvantage, in whether his plan can make money as compared
    to their plan, by simply not following the same thing?
        It would be even--it's even more unfair to the good HMO's and the
    good managed-care operations in this country not to have this
    legislation, because if they go out and do the right thing, then other
    people who are unscrupulous can come in and try to undercut them by
    appearing to offer the same service at a lower cost. So he just made a
    terrific argument for why this bill ought to pass this year--by doing
    the right thing and because he's doing the right thing.
        I thank you very much.

    [The discussion continued.]

    Children's Health Insurance Outreach

        The President. I would just like to thank you for what you said. I
    hope that this order that I'm signing today will deal with that by
    essentially telling all the Government agencies that, whenever possible,
    they have to work through people like you to do the outreach--because--
    well, this weekend Hillary and I spent some

    [[Page 1016]]

    time with some friends of ours, and one of them commented that he'd just
    been to a high school graduation in northern Virginia where it was
    announced that the graduates, just a few hundred kids, came from 70
    different national and ethnic groups. That's just one high school. We
    have so many communities--the Asian communities, alone, if you think--
    from Southeast Asia and all the different language groups, that a lot of
    these people are, as you pointed out, two-thirds or more are working
    people; many of them, their first language is not English, and if there
    is not some affirmative attempt to reach them through someone they know
    and trust, their children will not get on this program. I don't care how
    many flyers we put out or PSA's we do or anything else.
        This is very valuable, what you've said, and I think we need to work
    a little harder on it. But I thank you for being here.

    [The discussion continued.]

    Violence in Schools

        The President. First of all, I'd like to thank you for the work you
    do. And I'd also like to thank Mrs. Gore for
    being our administration's leading person on mental health issues. If it
    hadn't been for her, we wouldn't have had a strong mental health
    component in the child health insurance program or the mental health
    parity legislation. And I'm very grateful for that.
        I'd like to ask a question which may be a little unfair, because I
    know you haven't been prepared for it
    exactly, but I'm sure you've thought about it. I just got back from a
    very moving trip out West, and you may have seen it. I visited
    Springfield, Oregon, where they had one of the many, many school
    shootings we've seen. And I've been studying the facts of all these
    cases, and it does appear that in each case or, in most of the cases
    where we've had these terrible tragedies--I might add, against a
    background of dropping juvenile crime overall--that there was some kind
    of early warning. And I wonder if you could recommend to me, because the
    Congress wants to do something on this, everybody is interested in this,
    this is--how do you think we ought to deal with children who--6,100 kids
    were removed from school last year for bringing a gun to school. I'd be
    very surprised if more than 10 percent of them got some sort of
    comprehensive mental health analysis as a result of it.
        We have--goodness knows how many kids made threats that they had no
    earthly intention of doing anything about it, but in one of these school
    shootings there was an explicit threat made beforehand. What advice can
    you give us about what the role of mental health ought to be in sort of
    early warning systems, preventive care, and that sort of thing, and
    particularly--like I said, I don't want to put you on the spot on the
    Springfield thing, but it's very much on my mind because of what was
    told to me out there about the facts and because the young man did have
    a gun in the school the day before and was sent home.
        Sheila Savannah. Well, one of the
    responses that we have pulled together is we have a family resource
    center in an elementary school and so we work with the teachers. And
    we've had to do a lot of training of teachers, of youth development
    workers, of child care workers, to really identify the early signs of
    mental health needs.
        There are so many children with unmet needs. And so often those--
    their activities get interpreted as behavior problems, as discipline
    actions, and we don't ever stop and do a strong assessment of what are
    the needs of these children.
        Children that carry guns are afraid. They really have very strong
    reasons for carrying them. And we work with a lot of children that have
    been suspended or expelled because they've been carrying weapons to
    school, and we've been real fortunate in Houston. But I know it's of
    growing concern because there are so many children that don't think that
    they'll live to see 20. And so those are kids that carry guns to protect
    themselves.
        Or, we've spent a lot of time and a lot of prevention efforts that
    focus on children being okay, and so I've seen a lot of children who
    suppress their emotional disturbance. They see violence on the streets;
    they see violence in their homes; and rather than being emotionally
    disturbed, they're being trained to be okay. And so when children
    respond that way, their sensitivity becomes dull, and they can act out
    in those kinds of ways that really hurt humanity.
        And I think one of the things that we need to do is make sure that
    everyone is well aware of some of the signs of mental health needs and
    really work to make sure that we remove the stigmatism to receiving
    mental health services.

    [[Page 1017]]

        The President. Thank you.

    Note: The President spoke at approximately 2:15 p.m. in Langford
    Auditorium at Vanderbilt University. In his remarks, he referred to
    discussion participants Julie Moretz, chair, Family Advisory Council,
    Medical College of Georgia Children's Medical Center; Anthony Watson,
    chairman and chief executive officer, New York HIP Health Plans; and
    Sheila Savannah, executive director, People in Partnership, a nonprofit
    organization working with recipients of mental health services.