OVERVIEW

The second session of the 110^th Congress began on January 15, 2008. This followed the conclusion of the first session of the 110^th Congress that was marked by both grand action and great inaction on issues related to children and adolescents.  On one hand, the five-year reauthorization of the Best Pharmaceuticals for Children Act (BPCA), the Pediatric Research Equity Act (PREA) and new pediatric device legislation, the Pediatric Medical Device Safety and Improvement Act, was passed by Congress and signed by the president in September. On the other hand despite several bipartisan proposals, strong advocacy from the pediatric community, two vetoes, Congress failed override the vetoes and reauthorize the State Child Health Insurance Program (SCHIP). In the final hours, Congress settled for an extension of SCHIP with $1.6 billion in funding through March 2009. 

The following is a summary of federal legislative and regulatory actions of interest to the pediatric academic community.  We hope that this information will assist you in your advocacy during the second session of the 110^th Congress.  We encourage you to share this information with your colleagues.  Members of the American Pediatric Society, Society for Pediatric Research and the Association of Medical School Pediatric Department Chairs are urged to reach out to their Members of Congress to advocate for key child health and pediatric-specific issues. 

The report includes information on the following issues: 
·        Pediatric Research
·        Pediatric Drugs and Medical Devices
·        Pediatric Workforce
·        Access to Health Care
·        FY 2009 Budget
·        FY 2008 Budget & Appropriations
·        Pandemic Influenza
·        Emergency Medical Services for Children
·        2008 PAS Annual Meeting
·        Congressional Calendar
·        How to Contact Congress and the President
·        AAP- Federal Advocacy Action Network (FAAN) and Key Contact Program
 

PEDIATRIC RESEARCH 

National Institutes of Heath (NIH)—Appropriations: The president’s FY 2009 budget proposal, released on February 4, 2008, includes level funding (FY 2008) - $29.23 billion - for the NIH. The pediatric community, including the Public Policy Council, will join the advocacy efforts led by the Ad Hoc Group for Medical Research is requesting an increase of $1.9 billion, for a total of $31.1 billion.

The National Institute of Child Health and Human Development (NICHD) allocation is $1.256 billion. 

National Children’s Study (NCS) – Appropriations: Once again the president’s FY budget proposal for FY 2009 has eliminated funding for the NCS. We will begin to work with members of Congress to provide funding for FY 2009. Our request is $192 million the next step in funding the NCS.

The funding picture for the NIH’s National Children’s Study (NCS) in the current fiscal year, FY 2008, was at the advocacy community’s requested amount of $111 million, despite the President’s FY 2008 budget proposal to provide no funding for the NCS. The $111 million allocation, in new funds, was a result of the extensive advocacy efforts of the pediatric community in conjunction with the March of Dimes and the support of members of Congress such as Representatives Doris Matsui (D-CA) and Chris Smith (R-NJ) who co-chair the congressional NCS caucus. We will reach out to the community once again to ensure adequate funding for the NCS in FY 2009. 

National Children’s Study— Research Plan: The NCS Research plan was made available for public review and comment in July 2007.  The Research Plan describes the Study's background, design, measures, and the rationale for those selections in sufficient detail so that readers can understand the basis of the Study and how it will be carried out.  In addition, the NCS Program Office sought review of its research plan by the National Academy of Sciences (NAS). Members of the NAS review panel include pediatricians Ellen Wright Clayton, MD, JD and Marie McCormick, MD, ScD. The NAS has commenced their review of the plan that is anticipated to take approximately 6-9 months.  Further information and updates on the NCS may be found at: http://www.nationalchildrensstudy.gov. 

NICHD – name change: Prior to adjournment, the Congress approved and the president signed a bill to rename the National Institute of Child Health and Human Development (NICHD) of the NIH the "Eunice Kennedy Shriver National Institute of Child Health and Human Development" in recognition of Mrs. Shriver's role in the creation of NICHD. 

NIH Consultation Meeting on Peer Review with Professional Societies: On July 30, 2007, the Peer Review Working Group of the Advisory Committee to the Director of the National Institutes of Health (NIH) hosted a consultation meeting with professional societies on the NIH peer review process.  Dr Elias Zerhouni, Director of the NIH, and Drs. Keith Yamamoto and Lawrence Tabak, Co-Chairs of the Peer Review Working Group, were the moderators.  Tina Cheng, MD, President-Elect of APA; Renée Jenkins, MD, President of the AAP; Phyllis Dennery, MD, President of SPR; and Elizabeth Goodman, MD, liaison to the AAP’s Committee on Pediatric Research, representing the Society for Adolescent Medicine; and Washington Office staff represented the pediatric and adolescent health community at the meeting.  Participants commented on a variety of topics, including who should serve on study sections, how the review process should be structured, how the burden on reviewers can be decreased, and how the plethora of NIH grant mechanisms can be consolidated or simplified to streamline the review process.  In a December NIH meeting on peer review several suggestions were made: including, a rolling review of grants similar to journal review might be considered; possibly decreasing the length of the application to 7-pages down from 25 pages; applications from young investigators would receive some priority, consider the elimination of the point scale. 

Comments on NIH National Center for Research Resources (NCRR) Strategic Plan:  On July 6, the National Institutes of Health (NIH) National Center for Research Resources (NCRR) published a notice in the Federal Register requesting comments and input as it develops a new Strategic Plan covering 2009 - 2013.  The purpose of the plan is to ensure that NCRR remains responsive to the emerging needs of biomedical researchers and provides them with the infrastructure, tools, and training they need to understand, detect, treat, and prevent a wide range of diseases. The NCRR requested input from biomedical scientists, by August 31, to define future needs for shared research resources and technologies that facilitate NIH-supported biomedical research. Widely disseminated in the pediatric community with individual pediatricians encouraged to submit comments through the web site. One of the notable comments expressed was the concern that the Clinical and Translational Science Awards’ (CTSA) current configuration and focus on “institution-specific awards” may bring unintended consequences and potentially jeopardize pediatric clinical research.  

Following the strategic planning forum held by NCRR in December 2007, the director of the NCRR advised that the NCRR had received over 500 comments on their web site. The next steps of the NCRR is to seek comments on the draft plan by February 2008 and share the NCRR strategic and action plan with the public in May 2008. Additional information on the strategic plan is available online at: http://www.ncrr.nih.gov/strategic_plan/  

Stem Cells: For the second time in two years, President Bush vetoed the Stem Cell Research Enhancement Act of 2007, S. 5, on June 20, 2007.  This legislation would expand the number of stem cell lines that are eligible for federal funding and allow federal funding for research using stem cells derived from embryos originally created for fertility treatments and willingly donated by patients. Currently, federal funding for embryonic stem cell research is allowed only for research using embryonic stem cell lines created on or before Aug. 9, 2001, under a policy announced by President Bush on that date.  

Although an effort was made to add a stem cell expansion provision to the FY 2008 L-HHS-E Appropriations it was not included in the final FY 2008 Omnibus appropriations bill. The next steps at this time are uncertain. 

Genetic Information Nondiscrimination Act (GINA): H.R. 493/ S.358 The Genetic Information Nondiscrimination Act (GINA) was reintroduced in the House of Representatives and the Senate in January 2007. By an overwhelming vote of 420-3, the House bill passed on April 25.  The Senate bill still awaits a vote on the Senate floor.  A vote had been scheduled to occur prior to adjournment; however, Senator Tom Coburn (R-OK) continues to have a hold on the legislation delaying such a vote from moving forward. 

GINA prohibits discrimination on the basis of genetic information with respect to health insurance and employment. Its purpose is to establish basic legal protections that will enable and encourage individuals to take advantage of genetic screening, counseling, testing, and new therapies that will result from the scientific advances in the field of genetics. The legislation also prevents health insurers from denying coverage or adjusting premiums based on an individual's predisposition to a genetic condition, and prohibits employers from discriminating on the basis of predictive genetic information. Additionally, GINA would stop both employers and insurers from requiring applicants to submit to genetic tests, maintain strict use and disclosure requirements of genetic test information, and impose penalties against employers and insurers who violate these provisions.  The Public Policy Council continues to strongly support genetic nondiscrimination legislation. 

Agency for Healthcare Research and Quality (AHRQ): The president’s FY 2009 budget proposal includes $325.7 million, a decrease from the current fiscal year level of $335 million. Working with the Friends of AHRQ, the pediatric community is requesting $360 million for FY 2009, with a goal of $500 million in five years. 

The amount included in the FY 2008 spending bill included an additional $5 million provided for activities to reduce infections for methicillin-resistant staphylococcus aureas (MRSA) and related infections. There is also a $30 million allocation to AHRQ’s overall budget, consistent with the House and Senate for comparative effectiveness research.  

At this time there is some interest that has been expressed by the Senate Health, Education, Labor and Pensions Committee (HELP) on the reauthorization of AHRQ that is now long overdue.

PEDIATRIC DRUGS AND MEDICAL DEVICES 

The Best Pharmaceuticals for Children Act (BPCA) and the Pediatric Research Equity Act (PREA): was reauthorized by Congress in 2007. The president signed the Food and Drug Revitalization Act of 2007 (P.L. 110-85) legislation into law on September 27. PREA gives FDA the authority to require pediatric studies of drugs for the on-label indication only, i.e., when the pediatric use for the product would be the same as the designated adult use. When PREA was codified in 2003, it for the first time, established the presumption that certain new drugs and biologics must be tested for children and be produced in formulations (e.g., liquids or chewable tablets) appropriate for children. BPCA provides an incentive to drug manufacturers of an additional six months of marketing exclusivity for conducting pediatric studies of drugs that the FDA determines may be useful to children.

Pediatric Medical Device Safety and Improvement Act of 2007: As part of the Food and Drug Revitalization Act of 2007 the Pediatric Medical Device Safety and Improvement Act of 2007 was included and as such was signed into law on September 27. The legislation provides incentives to the medical device industry to produce new pediatric devices by lifting restrictions on profit from the Humanitarian Device Exemption (HDE) and creating new consortia to stimulate device development from idea to marketplace.  The law gives FDA additional regulatory mechanisms to track pediatric device needs as well as provide increased post-market surveillance for adverse events in children as recommended by IOM. 

PEDIATRIC WORKFORCE 

GME Financing for Children’s Hospitals (CHGME)–Appropriations:  Current funding (FY 2008) for the CHGME program is $301.65 million a modest – 3% - increase above FY 2007. However, heavy lifting from the pediatric advocacy community will be needed once again because the president’s FY 2009 budget proposal calls for completely eliminating funding for CHGME. The PPC will continue its collaborate with the leadership of the National Association of Children’s Hospitals (NACH) in conjunction with the Academy and others to urge the House and Senate Appropriations Committees to include funding for the CHGME at the authorized level of $330 million in FY 2009. 

Title VII Health Professions Program and Title VIII Nursing Professions Program – Appropriations: As rumored, the president’s FY 2009 budget proposal eliminates funding for Title VII and calls for a significant cut in funding for nursing education. The APS, SPR, and AMSPDC will continue to work with the Health Professions and Nursing Education Coalition (HPNEC), led by the AAMC, to urge Congress to add back as well as increase funding. The coalition’s request is $550 million for both Titles VII and VIII in FY 2009. 

The coalition supports adequate funding for the Title VII Health Professions Training Programs and the Title VIII Nursing Programs.  This has been a particularly challenging task over the past several years as Title VII has received substantial funding cuts as well as elimination year after year.  Funding for FY 2008 was approved at the level of $194 million for Title VII, an increase of 5.0 % and $156 million for the Nursing Programs, Title VIII an increase of 4.3 percent.  

Title VII Health Professions Program—Reauthorization: It remains to be seen what action, if any, will take place during the second session of the 110^th Congress on reauthorizing Title VII.  However, there has been recent interest in the Senate. The pediatric community has already begun a dialogue with congressional staff to discuss how the Title VII program should look in the future. A letter, outlining specific issues for consideration, was submitted to the Senate HELP Committee hearing record by the Federation of Pediatric Organizations, which includes the APS, SPR, and AMSPDC. The letter included the following recommendations:  

• Enhancing pediatrics in Title VII;
• Training primary care physicians in the workforce, especially those serving disadvantaged/underserved populations;
• Training all physicians in the workforce about primary care, care of underserved populations, and emerging health care needs;
• Training minority physicians and minority faculty; training primary care researchers and leaders to address: Healthy People 2010 objectives, disparities in health and health care, and primary care practice and health outcomes; and,
• Research and innovations in primary care training and health care delivery with demonstrated impact on health care quality.

Higher Education Act Reauthorization: On September 27, 2007, the President signed the "College Cost Reduction and Access Act" (CCRAA, HR 2669, H. Rpt. 110-317), the budgetary provisions of the current HEA reauthorization. Among the most notable changes, the measure includes a change to the definition of economic hardship deferment. The bill also creates a new income-based repayment and "public service" loan forgiveness program. In a December letter to the AAMC from the Assistant Secretary of Post Secondary Education in the U.S. Department of Education, the letter confirms that the debt-to-income ratio (20/220) qualifying pathway for economic hardship has not been changed. Furthermore, the letter notes that changes in the economic hardship poverty line requirements will expand eligibility for the program. The letter does not indicate any end date for the debt-to-income ratio pathway or the Department of Education's intentions for the upcoming round of negotiated rulemaking. Lenders currently should be offering - and should never have stopped accepting applications for the economic hardship deferment from medical residents that qualify under the debt-to-income ratio.  

EMERGENCY MEDICAL SERVICES FOR CHILDREN 

EMSC—Reauthorization: The EMSC program’s authorization expired in late 2005, but the program has yet to be reauthorized.  On the first day of the first session of the 110^th Congress, Senators Inouye (D-HI) and Hatch (R-UT) introduced an EMSC reauthorization bill, S. 60, the Wakefield Act.  It currently has 11 cosponsors. The House version, HR 2464, introduced by Representatives Matheson (D-UT), Capps (D-CA) and King (R-NY) has 72 cosponsors.  No floor action has occurred in either chamber although efforts are being made at all levels to move the bill forward as soon as possible. 

EMSC—Appropriations:  Similar to the past several years, the president’s FY 2009 budget once again zeroed-out funding for the EMSC program. Current funding (FY 2008) for the EMSC program is $19.454 million. The FY 2009 request for funding by supporters of the EMSC program including the PPC is $25 million. 

ACCESS TO HEALTH CARE 

Reauthorization of the State Child Health Insurance Program (SCHIP): On August 1, the House voted 225-204 to approve legislation, H.R. 3162, the Children’s Health and Medicare Protection Act, which would reauthorize the State Child Health Insurance Program (SCHIP) and make changes to the Medicare program.  The legislation would increase SCHIP funding by $50 billion over five years.  On August 2, the Senate passed, by a vote of 68-31, the Children’s Health Insurance Program Reauthorization Act (CHIPRA) of 2007, S. 1893/ H.R. 976.  The 5-year, $35 billion reauthorization package preserves the enrollment of 1.9 million beneficiaries who would likely lose overage under current funding levels, enrolls 1.6 million SCHIP-eligible children not yet in the program, and expands SCHIP eligibility to 1.1 million more children.  The funding increase is offset by 61 cents per pack increase in federal tobacco taxes and a series of SCHIP cuts beginning in FY 2014.   

Veto and Veto Override: The President vetoed CHIPRA on October 3^rd.  The $35 billion reauthorization was a compromise between the House-passed $50 billion proposal and the Senate-passed $35 billion proposal. The additional money was funded by a 61-cent per pack increase in tobacco taxes. The bill received a veto-proof margin in the Senate (67-29), but was approximately 13 votes short of a two-thirds majority in the House (265-159). The House failed an attempt to override the veto on October 18.  

House Speaker Nancy Pelosi, D-CA, said the House would immediately begin work on another SCHIP bill to send to the Bush and on October 25, House leaders brought up a modified SCHIP bill that they hoped would attract several more Republicans in order to achieve a veto-proof majority. The bill included stricter limits on federal poverty level eligibility, stricter coverage of childless adults, and stricter citizen documentation requirements. The bill passed but failed to sway any additional Republicans. It moved on to the Senate, which passed the bill November 1. The president vetoed the bill on December 12 and another veto override failed on January 23, 2008. 

From October 1 through December, SCHIP was funded through a Continuing Resolution (CR) until Congress finally passed an extension of SCHIP through March 2009. It included an additional $1.6 billion to ensure that those states that may have a shortfall with be funded. The president signed this extension on December 29. It is anticipated that this additional funding will cover the currently enrolled children in SCHIP but will not provide any additional funding to enroll any new children.  

FY 2009 BUDGET 

The president’s FY 2009 budget proposal was released on February 4, 2008. This is the final budget proposal for the Bush Administration. The budget proposal includes some surprises such as an increase in funding for the State Child Health Insurance Program (SCHIP)—though it still falls short of the $35 billion needed to cover additional eligible low-income children and some serious disappointments slashing more than $2 billion from discretionary health and human services programs, including many for children and adolescents In addition, Bush has proposed trimming costs in Medicaid, the health safety net for the nation’s poorest children, by $18 billion over the next five years. The budget proposal maintains current level funding for several key programs aimed at children and adolescents, including child welfare and abuse prevention programs, child care and development grants, and crucial medical research at the National Institutes of Health. The president’s budget proposal also goes further and eliminates funding for the National Children’s Study, Emergency Medical Services for Children, Title VII, health professions training including primary care medicine and dentistry, the Children’s Hospitals GME program, and universal newborn hearing screening. 

The PPC joined with over 440 organizations to ask Congress to increase funding for all aspects of public health in FY 2009 that will 1) restore funding to public health programs cut in FY 2006; 2) restore lost purchasing power that flat-funding for at least five years has eroded; and, 3) provide investments that begin to meet the health challenges currently facing the nation. The estimate to meet this goal is an additional $5.3 billion.

FY 2008 BUDGET/APPROPRIATIONS 

Continuing Resolution(s): Fiscal year 2008 began on October 1, 2007, with a continuing resolution (CR) – a short –term, stopgap funding bill - to fund the federal government at the same level as FY 2007. Congress passed and the President signed a total of four CR’s to keep the federal government open through December 19 when a final Omnibus Spending bill was approved. The CRs were necessary because Congress was able to complete only one (Defense) of the 12 appropriations bills by the start of the new fiscal year. This included a veto by the president and a failed veto override despite a large advocacy campaign involving hundreds of health and education organizations, including the pediatric community.  

Consolidated Appropriations Act of 2008: On December 19, 2007, the House voted, 272 – 142, to send President Bush a year-end-spending bill. The total funding for the 11 appropriations bills that were funded under the four Continuing Resolutions was $555 billion. The prior day, the Senate, by a vote of 76 – 17 completed its work on the omnibus bill, adding $70 billion funding for the wars in Iraq and Afghanistan, to avoid another veto by the President. The president signed the omnibus-spending bill – the Consolidated Appropriations Act, 2008, on December 26, 2007 (P.L. 110-161).

The total funding for the Labor/HHS/Education provision in the omnibus spending bill is $144.8 billion, $316 million (0.2%) above FY 2007 and $3.9 billion (+2.8%) above the President’s FY 2008 Budget proposal released in February 2007.  An additional $307 million is included for Emergency Funds with $250 million for Low Income Heat and Energy Assistance Program (LIHEAP) and $57 million for World Trade Center responders, residents, and workers.  

The final spending bill includes $65.4 billion for the Department of Health and Human Services, an increase of $1.3 billion (+2%) over FY 2007 and $2.8 billion (+5%) over the President’s FY 2008 Budget proposal.  .

PANDEMIC INFLUENZA 

One-Year Progress Report— National Strategy for Pandemic Influenza Implementation Plan: In July 2007, one year after the Bush Administration’s release of its federal pandemic influenza preparedness plan, the National Strategy for Pandemic Influenza Implementation Plan, the White House Homeland Security Council reported that 86% percent of the plan tasks that were to be completed by 2007 were finished.   The remaining 14% were expected to be completed by the end of the year.  The White House reported that the federal government still has limited capacity to detect a disease outbreak and track its progress across the country.  The nation also has little extra capacity in its hospitals and other health care facilities to deal with a huge surge in need that would accompany a mass disease outbreak. Further, the government has little ability to ensure that during an outbreak, when many workers would stay home, limited Internet capacity would go to essential work and not to children playing video games.  A White House spokesperson also said that a decision had been made to keep U.S. borders open if a pandemic flu outbreak occurs somewhere in the world.  The Administration noted that a significant remaining challenge is that the country has grown tired of pandemic flu warnings.  More information on the National Strategy for Pandemic Influenza can be found at: http://www.whitehouse.gov/homeland/pandemic-influenza-oneyear.html. 

At-Risk Populations Listening Session: Also last summer, the Interagency Committee on Pandemic Influenza’s Work Group on Pandemic Influenza and At-Risk Populations hosted a listening session for non-governmental organizations to seek information about gaps, barriers and best practices for addressing the needs of at-risk populations in State and local Pandemic Influenza plans.  The session was moderated by Dr. Daniel Dodgen, Human Services Policy Coordinator in the Office of the Assistant Secretary for Preparedness and Response.  Staff from the Washington Office attended the meeting and relayed some of the pediatric community’s concerns regarding children and pandemic influenza, such as the need for further testing on the use of N95 masks by children and the ramifications of prolonged school closure on children’s emotional and physical health and well-being. 

Pandemic Influenza: Warning, Children at Risk – am issue brief from the Trust for America’s Health and the American Academy of Pediatrics: The Trust for American’s Health (TFAH) is a non-profit, non-partisan organization dedicated to saving lives by protecting the health of every community and working to make disease prevention a national priority. (http://healthyamericans.org/). TFAH works on a number of public health related issues including immunizations, obesity, pandemic influenza to name just a few. In late April, TFAH approached the American Academy of Pediatrics to discuss the possibility of doing a report focused on children and pandemic influenza. The intent of the report is to look at a number of issues that have been raised related to children and pandemic influenza but little has been done, such as the use of Tamiflu, N-95 masks, closing schools and child care etc. The outcome of this report was to develop a set of policy recommendations. The report was issued in October 2007. 

Among the report’s key policy recommendations for reducing the impact of pandemic flu on children are:   

• The Federal government should ensure that the Strategic National Stockpile includes sufficient pediatric doses of antiviral medications to ensure treatment of 25 percent of the nation’s children and adolescents, or about 18.4 million individuals. 

• HHS should conduct additional studies on vaccine efficacy in young children, support the development of additional flu vaccine products, and conduct more studies of antiviral agents for infants.
• HHS should immediately convene an independent task force to study and make specific recommendations about the use of surgical masks, N95 respirators, and other personal protective equipment by children.
• HHS should conduct further studies on the feasibility of prolonged school and childcare center closures, including a more precise assessment of the long-term interruption of the school meals program and how to mitigate the impact on students who rely on them.

·        Educators and school administrators should be encouraged to get an annual influenza vaccination and should remind families that public health experts recommend annual flu vaccines for 1) all children with high risk conditions who are 6 months of age and older, 2) all healthy children ages 6 months through 59 months, 3) all household contacts and out-of-home caregivers of children with high risk conditions and of children younger than 5 years if age, and 4) all health care professionals.

• CDC and state and local health departments should encourage and support seasonal flu vaccination clinics in school settings to maximize flu vaccine coverage rates.

This report can be accessed at http://www.aap.org/new/KidsPandemicFlufnl.pdf. 

·        The 15^th annual joint PPC/APA public policy state of the art plenary session and legislative breakfast will be held during the PAS meeting in Hawaii. The plenary session, is entitled, “Election 2008: A National Agenda for Children and Adolescents.”  The panel format will include the presidents of the AAP, APS, APA, SPR, and AMSPDC. The chair of the Public Policy Council, Mike Genel, MD and the chair of COFGA, Mary Anne McCaffree, MD will moderate this session. The intent is to develop a set of principles (perhaps 5 to 7) that can be utilized by the entire pediatric community throughout the 2008 election cycle – platform committee hearings, party conventions, candidate forums etc. that reflects for example, the importance or prevention, an adequate pediatric primary care and pediatric subspecialist workforce, adequate pediatric biomedical and health services research, medical home, the role of the retail clinic and other related issues. 

·         The 22^nd annual legislative breakfast will be led by Jennifer Puck, MD, of UCSF who with discuss "CTSAs and Pediatric Research: Opportunities & Pitfalls."  

·        For the fourth year An Update on the National Children’s Study also will be provided. Participants are: NIH staff Drs. Peter Scheidt, Duane Alexander and the pediatric department chair at the University of Utah, Ed Clarke, MD, one of the seven vanguard sites. 

2008 CONGRESSIONAL CALENDAR (110^th Congress – Second Session)
March 17 – 21                          District Work period – recess
May 26 - 30                              District Work period – recess
June 30 – July 7                        District Work period – recess
August 1 – Sept. 8                    District Work period – recess
August 25 – 28                         Democratic Convention
September 1 – 4                       Republican Convention
September 26                           Target Adjournment 

HOW TO CONTACT YOUR MEMBER OF CONGRESS: 

Write: The letter remains the most popular choice of communication with congressional offices.  However, due to increased security on Capitol Hill, you must fax or e-mail your letter, in lieu of using traditional mail, in order to avoid extensive lag-time in the receipt of your correspondence.  If you decide to write a letter, remember to be courteous, to the point, and include key information and personal examples to support your position.  Address only one issue in each letter and, if possible, keep the length to one page. 

To a Senator:                                         To a Representative:
The Honorable (name)                             The Honorable (name)
United States Senate                              United States House of Representatives
Washington, DC 20510                           Washington, DC 20515 
Dear Senator ________:                          Dear Representative ____: 

Fax:  Fax numbers are available through the Capitol Hill Switchboard (202) 224-3121, or you can look up your members of Congress on “Thomas” the official website for Congress, available at http://thomas.loc.gov/, by going to “House Directory” or “Senate Directory” from the front page.   

Call: You can contact your Senators and Representative's offices by calling the U.S. Capitol Hill Switchboard at (202) 224-3121.  If you do not know who your Representative is, the switchboard operator will be able to direct you to the proper office. Ask to speak to the staff member who works on health care issues. Be prepared to leave a very short message as well as your name and address.  You can also call your legislators in their home districts; if you are a member of the American Academy of Pediatrics, information about local offices is available on the AAP Member Center website, www.aap.org/moc. You can also go directly to www.senate.gov or www.house.gov for this information. 

E-mail: All of members of Congress now have e-mail addresses, but there is no set format for them. On some members web sites there is a mechanism to directly email most notably if you are a constituent.  We suggest calling the congressional office to get an accurate e-mail address or www.senate.gov or www.house.gov for this information.  Be sure to identify, in the subject line, that you are a constituent along with the legislative topic of the email correspondence. 

HOW TO CONTACT THE PRESIDENT 

Write: The Honorable George W. Bush
The White House
1600 Pennsylvania Avenue
Washington, DC  20500
Call: 202-456-1414 Fax:  202-456-2461
E-mail: president@whitehouse.gov 

AAP FEDERAL ADVOCACY ACTION NETWORK (FAAN) 

The Federal Advocacy Action Network (FAAN) is comprised of all AAP members for whom the Academy has an email address.  FAAN alerts are sent when federal legislative efforts require large-scale advocacy efforts by the Academy’s entire membership.   

Coordinated by the AAP Department of Federal Affairs, FAAN is a network of AAP members who help support federal legislative and regulatory activities from their position as constituents.  FAAN members play an important role in passing federal legislation that benefits children and pediatricians. 

The AAP Department of Federal Affairs gives FAAN members the information and tools needed to persuade their legislators. The Members Only Channel (http://www.aap.org/moc) has tools to make advocacy work easy.  Find the names of congressional representatives, contact legislators via e-mail, read about congressional activity, and register to become a Key Contact.   

If you have questions about the FAAN or if you have not been receiving FAAN alerts, please contact Priscilla Ring, AAP Department of Federal Affairs, pring@aap.org, or (800) 336-5475, ext. 3304.   

AAP KEY CONTACT PROGRAM 

If AAP members want to do more federal advocacy than responding to the FAAN alerts, we encourage pediatricians to join the AAP Key Contact program.  Key Contacts have an interest in developing a stronger working relationship with their congressional delegation, and usually work on several AAP legislative issues.  Key Contacts are contacted on a regular basis (approximately once a month when Congress is in session).  Key contacts receive all the latest information and news, advocacy tips and tools, suggestions for improving relationships with members of Congress and more sophisticated advocacy assignments, such as media work and congressional visits (all with help from AAP staff).   

To sign up to be an AAP Key Contact, log on to http://www.aap.org/moc (Member Login required, use your AAP member id, it can be found on the AAP News or Pediatrics mailing label) and click on “Federal Affairs."  For more information on the Key Contact program, contact Priscilla Ring, AAP Department of Federal Affairs, 800-336-5475, ext. 3304, or pring@aap.org. 

************* 

PUBLIC POLICY COUNCIL MEMBERS 

APS                 Myron Genel, MD; Jimmy Simon, MD
SPR                 Thomas Green, MD; Elena Fuentes-Afflick, MD, MPH
AMSPDC       Russell Chesney, MD; Jon Abramson, MD 

**********

Report Submitted By:
Myron Genel, MD, Chairman
Karen M. Hendricks, JD, Washington Coordinator
Becky Fowler, Legislative Assistant 

Additional information and resource material on these and other pediatric and child health issues are available from:  

Karen M. Hendricks, JD (KHendricks@aap.org).
Washington Coordinator
Public Policy Council
c/o American Academy of Pediatrics
601 13^th Street, NW
Suite 400 North
Washington, D.C. 20005
Phone: 800/336-5475 or 202/347-8600, ext. 3301
Fax: 202/393-6137 

Becky Fowler (bfowler@aap.org) 
Legislative Assistant
Public Policy Council
c/o American Academy of Pediatrics
601 13^th Street, NW
Suite 400 North
Washington, D.C. 20005
Phone: 800/336-5475 or 202/347-8600, ext.3302
Fax: 202/393-6137           

Please visit the Public Policy Council on the web at www.aps-spr.org 

March 1, 2008