PUBLIC
POLICY COUNCIL LEGISLATIVE REPORT OVERVIEW Congress returned to Washington on late January to begin the second session of the 106th Congress anxiously awaiting the President’s final State of the Union address, the release of the President’s FY 2001 budget proposal and most importantly preparing for the congressional and presidential elections in November. This report represents a summary of congressional and regulatory activity from the conclusion of the first session of the 106th Congress and a summary of the pressing issues for the coming months. Members of the American Pediatric Society, Society for Pediatric Research and the Association of Medical School Pediatric Department Chairs are urged to make their voices heard in Congress during the coming months. This report contains the following information:
****************** National Institutes of Health (NIH): The NIH was not reauthorized in the first session of the 106th Congress and it is not expected to be reauthorized in this second session. Unfortunately, the important discoveries in 1998 of human pluripotent stem cells, the concerns around human cloning and the ongoing fetal tissue research debate, have made reauthorization of the NIH at this time too controversial. As anticipated, the NIH received a 14.7% increase over previous year’s funding, bringing the total funding for FY 2000 to $17.9 billion. [Please note: As part of the FY 2000 spending agreement reached by Congress and the White House, $3 billion of this amount is unavailable to the NIH until September 29, 2000.] This increase is the second step towards doubling the NIH by FY 2003. The Academy continues to work with the research community to advocate for these important increases in funding but has emphasized that these increases should not come at the expense of other vital public health programs and services. In a press statement released by the White House on January 16, the President indicated his intent to recommend a $1 billion increase for the NIH in FY 2001. The biomedical research advocacy community will recommend a 15% increase for NIH in FY 2001 - the third step in doubling the NIH budget in five years. Pediatric Research Initiative: The Pediatric Research Initiative (PRI) provides money to fund new NIH extramural research devoted to the illnesses and conditions of children. The money has been located in the Office of the Director. Despite the support of Senators Mike Dewine (R-OH) and Arlen Specter (R-PA), there was no funding level specified for the Initiative in the FY 2000 appropriations. The pediatric academic societies working in partnership with the National Association of Children’s Hospitals as well as the AAP and congressional staff to implement and increase the federal investment in pediatric research. Staff will advocate for a funding level of at least $50 million in FY 2001. During the first session of the 106th Congress, the pediatric community continued to work with the offices of Senators Kit Bond (R-MO) and Mike Dewine (R-OH) to authorize specific funds to promote pediatric research and meet the training needs of pediatric researchers. Staff anticipates a continued commitment by these offices to the creation of a pediatric research initiative statutory provision at the NIH. In addition, the pediatric community will continue to seek authorization for a new loan repayment program for pediatric researchers and for institutional and career development training grants in pediatrics. Working with the National Association of Children’s Hospitals, the March of Dimes, the Juvenile Diabetes Foundation, among others, the pediatric academic societies will continue its advocacy efforts to raise the visibility of pediatric research at the NIH. Stem cell research: In December the NIH published for public comment in the Federal Register its draft stem cell guidelines. Comments were due by January 31, 2000. [Please note: at the time of this writing the comments on the guidelines are running two to one against the proposed guidelines.] As written, the draft guidelines indicate that the NIH will fund research using human pluripotent stem cells from early human embryos only if investigators use cells derived from frozen embryos that were created for purposes of infertility treatment and were in excess of clinical need. The guidelines also state that the NIH also will support research to derive or use human pluripotent stem cells from fetal tissue. The draft guidelines identify areas of research that are ineligible for funding and also state that no NIH funds will be used to derive pluripotent stem cells from human embryos. The draft guidelines also propose the creation of a Human Pluripotent Stem Cell Review Group (HPSCRG) that will hold public meetings when a funding request proposes the use of a newly derived line of human pluripotent stem cells. The NIH will not fund research using human pluripotent stem cells until final guidelines are published in the Federal Register and an oversight process is in place. In addition to encouraging the members of the Public Policy Council [and their colleagues] to submit their own comments on the draft stem cell guidelines, the PPC submitted its own formal comments. The PPC comments highlighted the following points:
It is the PPC’s staff’s understanding that Senators Arlen Specter (R-PA) and Tom Harkin (D-IA) are planning to introduce legislation in the early days of the second session of the 106th Congress to allow federal funds to be used for the derivation of human stem cells for further research into this potential field. Although it is anticipated that the legislation will make little progress in this Congress it will be an important and positive discussion vehicle on this critical research issue. We anticipate that stem cell research may be a hotly debated issue in Congress in the months to come. Staff will continue to closely monitor this issue. [Note: Background information is available on the NIH web-site at www.nih.gov.] Clinical Research: Prior to adjournment, on November 19, the Senate approved by unanimous consent the Clinical Research Enhancement Act (S. 1813) sponsored by Senator Edward Kennedy (D-MA). This is a companion bill to H.R. 1798 introduced last spring by Representative Jim Greenwood (R-PA). The legislation is designed to help reverse the pattern of "the clinical investigator as an endangered species" by authorizing funds to improve the peer review process for clinical research grants, to establish general clinical research centers, to make new training awards focused on clinical investigators, and to expand the existing intramural loan repayment program. The Public Policy Council will continue to work with other clinical research advocates to correct the disincentives that guide physicians away from much-needed clinical research careers and work to ensure that the House approves and sends the bill to the president for his signature early in the second session of the 106th Congress. Agency for Healthcare Research and Quality: Congressional support for the Agency for Healthcare Research and Quality (AHRQ, pronounced "arc"), formerly the Agency for Health Care Policy and Research, remained strong through the first session of the 106th Congress. In FY 2000, the AHRQ received a 16% increase to $200 million. The pediatric academic societies will continue its advocacy, individually and as part of the Friends of AHRQ, to push for a significant increase for health services research in FY 2001. President Clinton signed reauthorizing legislation for the agency on December 6, 1999. Known as the Healthcare Research and Quality Act of 1999 (PL 106-129), the law reauthorized the Agency through the end of FY 2005 and renamed it the Agency for Healthcare Research and Quality. Under the new law, the agency will coordinate, conduct and support research related to measurement and improvement of health care quality, annually report on trends in health care disparities, advance the use of technology to improve patient care and continue its commitment to health services research. The legislation also eliminates a requirement that the agency support the development of clinical practice guidelines. The issues of patient safety and the elimination of medical errors gained momentum at the end of 1999 and are likely to draw the attention of several policymakers during this session of Congress. Two senate hearing have been held to date. AHRQ will have a critical role in this debate. On November 29, the Institute of Medicine released a report citing medical errors as one of the leading causes of deaths in the U.S., To Err is Human: Building a Safer Health System. In response, President Clinton called on the Quality Interagency Coordination Task Force to implement the recommendations of the IOM. AHRQ will continue to take the lead in improving patient safety as the lead quality agency and the chair of the Task Force. Adequate funding in FY 2001 will be necessary to ensure that AHRQ fulfills this charge. Research data availability under the Freedom of Information Act – OMB Circular A-110: The Omnibus Appropriations from the 105th Congress included statutory language that instructed the Office of Management and Budget (OMB) to amend Circular A-110 (Uniform Administrative Requirements for Grants and Other Agreements with Institutions of Higher Education, Hospitals, and other Non-Profit Organizations) "to ensure that all data produced under a [research] award will be made available to the public through the Freedom of Information Act" (FOIA). The scientific and academic communities advocated that the provision be repealed or substantially modified. The OMB issued its final policy on the data access provision on October 8, 1999 and it took effect November 8 (64 FR 54926). Recognizing the concerns of researchers, OMB narrowly interpreted the statutory language. The final revision limits FOIA requests to data cited by a federal agency in an "action that has the force and effect of law". In addition, regulations allow researchers and research institutions to determine what data could be released under a FOIA request. The burden now falls to the individual agencies within the federal government to develop administrative procedures for compliance. Staff anticipates that interim data release policies will be published in the Federal Register early in the year. In mid-December the NIH issued its guidance on OMB Circular A-110. It can be found at http://grants.nih.gov/grants/policy/a110/a110_guidance_dec1999.htm. In the meantime, the U.S. Chamber of Commerce filed a FOIA request with the Environmental Protection Agency, in an effort to overturn the OMB’s narrow interpretation of the statutory language. The medical research community including the pediatric community will continue to observe the impact of this provision and press for a repeal, if appropriate, in the coming session of Congress. PEDIATRIC WORKFORCE Graduate Medical Education/Independent Children’s Hospitals: The pediatric community joined the National Association of Children’s Hospitals in successfully seeking authorizing legislation for the financing of graduate medical education in independent children’s hospitals. Included as part of a larger legislative vehicle (the reauthorization of the Agency for HealthCare Research and Quality), Representative Nancy Johnson’s (R-CT) H.R. 1579 passed both the House and Senate in November and was signed by the President on December 6, 1999. This legislation would authorize a two-year fund for pediatric GME with $280 million in FY 2000 and $285 million in FY 2001. At the same time, the FY 2000 omnibus-spending bill appropriated $40 million for pediatric GME, funded with discretionary dollars through the Health Resources and Services Administration [HRSA]. Balanced Budget Act of 1997 Relief for Teaching Hospitals: The academic medical research community sought corrective legislation for the reductions in several education payments to teaching hospitals included as part of the Balanced Budget Act of 1997. Passed as part of the final omnibus spending bill, Congress provided a 2-year freeze in the Indirect Graduate Medical Education reductions – the adjustment rate would now be 6.5% in FY 2000, 6.25% in FY 2001, and 5.5% in FY 2002. Under the BBA, the IME adjustment would have been reduced to 5.5% in FY 2001. The corrections would also create a geographically-adjusted Direct Graduate Medical Education "corridor" – hospitals with per resident amounts below 70% of the national average would have their levels raised to 70%; hospitals with per resident amounts above 140% would have their levels frozen at current levels for FY 2001 and 2002 and updated by market basket minus two in FY 2003 through 2005. The legislation freezes disproportionate share hospital payments (DSH) at FY 2000 levels and reduces payments to 4 percent in FY 2002, providing $100 million to hospitals. In addition, for cost report periods beginning on or after July 1, 2000, residents enrolled in a child neurology residency training program will be counted as the initial residency period for board eligibility for pediatrics plus two years. Finally, MedPAC is required to in its March 2001 report to Congress to included recommendations on the appropriateness of Medicare initial residency period policy for other residency training programs in a specialty that requires preliminary years of study in another specialty. Council on Graduate Medical Education (COGME): COGME continues to draft its 15th Report, which will address the current method of graduate medical education financing and the system’s impact on training in ambulatory settings. The report will also discuss several alternative GME financing mechanisms, including but not limited to the Medpac model. COGME hopes to publish this report in the fall of 2000. Medicare Payment Advisory Commission (MedPAC): The Medicare Payment Advisory Commission (MedPAC) submitted its report to Congress on Medicare’s participation in the federal financing of graduate medical education in the summer of 1999. The report recommends that Medicare payments to teaching hospitals only reflect the added patient care costs of those institutions and not their education costs. The commission will continue to expand on their August recommendations in preparation for their March 2000 report to Congress. However, the commission’s rejection of explicit payments for education will no doubt shape the political landscape for graduate medical education in the coming months. Title VII – Health Professions Training Grants – Reauthorization: The Advisory Committee on Primary Care Medicine and Dentistry met for the first time in November. This committee, created under the reauthorization of Title VII in 1998 (PL 105-392), is charged with examining the Title VII programs and reporting to Congress with their recommendations by fall 2001. Three pediatricians and one pediatric dentist currently serve on the 23-member advisory committee. This committee will continue to meet twice a year and has identified health disparities as an area on which to focus. Title VII – Appropriations: Working with the Health Professions and Nursing Education Coalition, throughout this session of Congress, the PPC, the Academy and the APA advocated for a modest 4% increase above FY 1999 funding for Titles VII and VIII. The final FY 2000 omnibus spending legislation provides $344 million for these programs, of which $40 million is for the new pediatric graduate medical education provision. The primary care medicine and dentistry training grants is funded at $79.9 million. In its FY 2001 advocacy efforts, the pediatric academic societies, as active members of the Health Professions and Nursing Education Coalition, will advocate for a 10% increase for the Title VII programs, to $335 million. Staff anticipates that the Administration, as in past years, may recommend a substantial cut in the program as part of the President’s FY 2001 budget recommendations to Congress, including recommending the elimination of the primary care training grants (that includes pediatric training grants). HEALTH DISPARITIES During the first session of the 106th Congress, Representative Jesse Jackson, Jr. (D-IL) introduced H.R. 2391, the National Center for Research on Domestic Health Disparities Act with 79 cosponsors. The bill would establish a national center for research on domestic health disparities at the National Institutes of Health. The Center would also be crucial to promoting research endowment programs through the centers of excellence and the legislation will establish an Advisory Council to the Center Director. Despite a growing number of cosponsors, H.R. 2391 did not move forward in 1999. However, according to a January 16, White House press release, it is anticipated that the President’s FY 2001 budget will include "$20 million to establish a new Center for Research on Minority Health to coordinate new research on this issue and explore the relation of health status to differences in culture, diet, language, and occupational hazards. This research will be used to develop prevention strategies and other interventions for affected populations." In addition, the recently released Healthy People 2010 objectives for the nation include an important focus on health disparities. Appropriations: The FY 2000 omnibus appropriations bill (P.L. 106-113) included $30 million for health disparities demonstration projects through the Centers for Disease Control, $5 million less than the President’s initial proposal to Congress. FY 2000 BUDGET/APPROPRIATIONS: Unable to complete the appropriations process by the October 1 start of fiscal year 2000, Congress combined the five remaining unsigned appropriations bills into one omnibus spending measure. President Clinton signed the "Consolidated Appropriations Act for Fiscal Year 2000," [PL 106 – 113] on November 29. Congress employed a number of so-called budget "gimmicks" in an attempt to avert using the Social Security surplus and to avoid surpassing the spending limits imposed by the Balanced Budget Act of 1997. The Congress imposed a .38% across-the-board spending cut for all discretionary programs [except military personnel], to be administered with substantial flexibility by the White House. In addition, there are also so-called "delayed obligations" of $3 billion of NIH funds; $450 million of HRSA funds; $500 million of CDC funds; $200 million of SAMHSA funds; $450 million of Social Services Block Grant Funds; and $400 million of Children and Families Services until September 29, 2000. In other words these sums will not become available until just a day before the end of the fiscal year. However, despite these "gimmicks," according to the Congressional Budget Office, the omnibus-spending bill exceeds the budget caps by $31 billion and dipped into Social Security surpluses by $17 billion. The omnibus-spending bill provides for the majority of federal health discretionary spending. Several federal programs and services for children and adolescents supported by the pediatric community fared favorably. For example, section 317 childhood immunizations received an increase of $40 million from last year’s funding level ($489 million), the National Health Service Corps received an appropriation of $116.9 million, an increase of $1.5 million over FY 1999, the Maternal and Child Health (MCH) Block Grant received $710 million, the funding for family planning initiatives was increased 11% ($238.9 million), the Agency for Healthcare Research and Quality [formerly AHCPR] was increased 16% ($200 million), and $40 million of new funding was included for graduate medical education in independent children’s hospitals. The NIH was appropriated $17.9 billion, a 14.7% increase and NICHD funding is $862.8 million [an increase of 14.5%]. [Please note these numbers do not reflect the .38% cut in funding included in the omnibus spending bill. However, the Office of Management and Budget announced on January 10, that several programs would be "protected" naming such programs as, family planning, childhood immunizations, WIC and several others.] FY 2001 BUDGET/APPROPRIATIONS On February 7, 2000, the President will present his FY 2001 budget proposal to Congress. In preparation for the release of his Administration’s last budget, the President has identified several funding priorities in FY 2001, including funding for biomedical and technology research, family planning programs, school construction and maintenance, enhancing the security of the nation’s cybertechnology in the face of terrorist assaults, the addition of a prescriptive drug benefit to Medicare, expanding the earned income tax credit for working families and protecting the Social Security surplus. The Public Policy Council will continue to maintain its high level of involvement in the budget and appropriations process. MANAGED CARE House Action on Managed Care: On October 7, 1999, the House passed the managed care legislation introduced by Reps. Charlie Norwood (R-GA) and John Dingell (D-MI), H.R. 2723, "The Bipartisan Consensus Managed Care Improvement Act." Despite the House leadership’s efforts to pass an alternate bill, which failed by a vote of 193 to 238, 68 Republicans broke ranks. The Norwood-Dingell bill passed 275 to 151. This legislation contains several of the pediatric-specific provisions that the pediatric community supports. For example, the bill includes access to pediatric specialists, and provides for choice of a pediatrician as the primary care provider. Specifically, the bill states, "If a group health plan, or a health insurance issuer in connection with the provision of health insurance coverage, requires or provides for an enrollee to designate a participating primary care provider for a child of such enrollee, the plan or issuer shall permit the enrollee to designate a physician who specializes in pediatrics as the child’s primary care provider." The Norwood-Dingell bill would allow patients to sue health plans for damages over delayed or denied benefits but would exempt the health plans from punitive damages if they follow the recommendations of external reviewers. The bill emphasizes its external appeals process, which would allow patients to appeal benefit denials to independent medical reviewers. The bill does not include the legal definition of "medical necessity" that Democrats included in their bill, opting instead to leave the final decisions on medical necessity to the physicians who conduct the external reviews. Unfortunately, the House passed a rule that automatically attached the Norwood-Dingell bill to a measure (H.R. 2990) that included tax breaks and insurance marketing mechanisms to help small-business people and others that do not have access to corporate health plans. This measure would allow all taxpayers to establish Medical Savings Accounts, which are tax-exempt accounts that can be used for medical expenses. The bill also would allow creation of "health marts," which are regional alliances of employers, insurers, and health care providers that band together to develop insurance packages for their employees. It would also allow creation of "association health plans," in which church groups or trade associations could pool together to buy insurance at more affordable rates than if they tried to buy it on their own. This provision must be opposed because it would ultimately harm children by splitting insurance pools between the sick and the healthy, limit application of state-mandated benefits, and provide a disincentive for preventive care. Senate Action on Managed Care: Last July, the Senate approved, by a vote of 53-47, S. 1334, the Republican "Patients’ Bill of Rights Plus Act." President Clinton promised to veto the bill. The Republican bill rejected the Democrats effort to allow patients to sue health plans in state court if they are injured as a result of denied or delayed benefits. The Senate bill also does not let physicians to decide what medical care is medically necessary. The bill limits most of its protections to the 48 million Americans who cannot be helped by state patient protection laws because they are self-insured health plans. President Clinton and the Democrats believe that any bill must cover all 161 million Americans with private health insurance. S. 1334 does not include a number of important pediatric provisions such as the ability to choose a pediatrician as a primary care provider and access to pediatric specialists. Outlook: Given the stark differences between the House and Senate versions of managed care reform, it remains unclear how the pediatric-specific reforms will fare in the House/Senate Conference. The managed care provisions passed by the House are far superior to the product passed by the Senate during the summer. It will now be up to a House/Senate Conference to craft a final set of protections and rights for American families. However, in mid-January, House Majority Leader Dick Armey (R-TX) indicated his interest in seeing a patient’s bill of rights passed before this Congress adjourns in early October. STATE CHILDREN’S HEALTH INSURANCE PROGRAM (SCHIP) The State Children’s Health Insurance Program (SCHIP), part of the Balanced Budget Act of 1997 (PL 105-33) gives grants to states to provide health insurance coverage to uninsured children through age 18 up to 200% of the federal poverty level (FPL). States may provide this coverage by expanding Medicaid, expanding or creating a state children’s health insurance program, or doing a combination of both. Fifty-six programs are approved to date in the states and U.S. territories. In addition, DHHS has also approved 37 state amendments to existing plans. On January 11, 2000, the Department of Health and Human Services announced that the number of children enrolled had increased to nearly 2 million children. Of the 2 million children, 1.2 million children were enrolled in separate state programs and almost 700,000 were enrolled in Medicaid expansions. The Congressional Budget Office has projected SCHIP enrollment of 2.5 million children three years after the program is fully implemented. As part of President Clinton’s budget and legislative agenda for the coming year, the White House also plans to pursue several new initiatives to improve Medicaid and SCHIP coverage of eligible children, including the following:
White House staff anticipates that these programs would cost $2.7 billion over 5 years. The pediatric community continues to work actively at the Federal level to implement and continue to improve the State Children’s Health Insurance Program. Staff have worked closely with Rep. Diana Degette to build support for her legislation, the "Improved Maternal and Children’s Health Act" (H.R.827). This legislation now has 120 cosponsors in the House of Representatives. Additionally, in October 1999, Sen. Blanche Lincoln (D-AR), Sen. Gordon Smith (R-OR), Sen. Mary Landrieu (D-LA), Sen. Evan Bayh (D-IN), and Sen. Dianne Feinstein (D-CA) introduced S.1646, the Senate version of the bill. This legislation provides states with additional options for utilizing SCHIP resources and provides incentives for states to implement best practices for outreach and enrollment. Additionally, the PPC is monitoring other measures to enhance the SCHIP program, such as:
IMMUNIZATIONS During the first session of the 106th Congress the House Government Reform Committee held three hearings on childhood immunizations. The first hearing focused on the Hepatitis B vaccine, the second was entitled "Finding the Balance Between Public Health and Personal Choice" and the third hearing focused on the national vaccine injury compensation program. In 2000, the House Government Reform Committee has indicated its intent to hold hearings on vaccine safety, vaccine research, the education of health care clinicians on vaccines, and vaccines and autism, among other topics. The pediatric community also has been actively pursuing additional funding for the Section 317 [Public Health Service Act] childhood immunization program. For FY 2000 Congress included $489.9 million for Section 317. As part of this advocacy effort, the PPC will continue to participate in a new ad hoc coalition facilitated by the Academy and including the American Public Health Association, the American Medical Association, American Academy of Family Medicine, the National Association of WIC Directors and the Association of State and Territorial Health Officials, to name a few. In addition, the omnibus-spending bill also included an additional $20 million for polio eradication and $545 million for the Vaccines for Children (VFC) program. In FY 2001 the immunization community will advocate for $585 million for the section 317 program. PAS 2000 EDUCATIONAL SEMINAR – RESEARCH AND CHILD HEALTH ADVOCACY This educational seminar session is aimed at helping academicians to become more comfortable in approaching public officials as well as learning some techniques that enhance the odds of success for these encounters. It will be held on Friday, May 12, 2000, from 1:00 p.m. to 3:00 p.m. The Washington, DC "scene" will be reviewed with an update on issues relevant to academic pediatrics. We will also emphasize advocacy efforts at the local and state levels. Speakers include: Steve Berman, MD, Vice President, American Academy of Pediatrics, Myron Genel, MD, Chair, Public Policy Council, James Pawelski, MS, Director, Division of State Government Affairs, American Academy of Pediatrics and Karen M. Hendricks, JD, Washington Coordinator, Public Policy Council. LEGISLATIVE BREAKFAST - "MEDICAL SCIENCE AND THE BRAVE NEW WORLD OF ELECTRONIC PUBLISHING" The Public Policy Forum Legislative Breakfast is scheduled for Sunday, May 14, 7 a.m. – 8 a.m. The speakers are: Jerold Lucey, Editor-in-Chief of Pediatrics and Alvin Zipursky, Editor, Pediatric Research. James Perrin, MD, Editor, Journal of the Ambulatory Pediatrics Association will moderate this exciting legislative breakfast session. PLENARY SESSION – "PEDIATRICS IN THE NEW MILLENNIUM: COMPELLING ISSUES IN PUBLIC POLICY" The Public Policy Council in conjunction with the Ambulatory Pediatric Association is assembling a "state of the art" symposium entitled "Pediatrics in the New Millennium: Compelling Issues in Public Policy" that will be held Monday, May 15, 2000, from 10:15 to 11:45 a.m. This is the 7th year that this session will be held. Three broad topics have been selected: (1) Children's Access to Health Care –Removing the Financial Barrier; (2) Testing and Access of Children to Drugs and Devices; (3) The Pipeline for Pediatric Physician-Investigators and the Future of Academic Pediatrics. Our confirmed speakers are: Joel Alpert, MD, President American Academy of Pediatrics (1998 – 1999); Jane Henney, MD, Commissioner, Food and Drug Administration and Leon Rosenberg, MD, formerly dean of the Yale School of Medicine and president of the Bristol-Myers Squibb Pharmaceutical Research Institute. *************** HOW TO CONTACT YOUR MEMBER OF CONGRESS: The beginning of the second session of the 106th Congress provides an excellent opportunity to contact your members of Congress. The following provides you the necessary information to make these contacts. Also consider using the district work periods (Congressional recess) to invite your member of congress (and/or their staff) to your facility, office or community-based pediatric program. The upcoming district work periods are: February 11- 28, March 11 – 20 and April 17 – 28, 2000.
Be courteous, to the point, and include key information, using examples, if possible, to support your position. Address only one issue in each letter and, if possible, keep the length to one page. CALL YOUR MEMBER OF CONGRESS: You can contact your Senators and Representative’s office by calling the Capitol Hill Switchboard at (202) 224-3121. If you do not know who your Representative is, the switch board 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. Fax: Most offices have fax machines, so you can call and ask for the fax number if you would like to fax your letter. Some offices do not give out their fax numbers, however. E-mail: Most members of Congress have e-mail addresses, but there is no set format for them. We suggest calling the Member’s office to get an accurate e-mail address. This may not be the quickest or most effective mechanism to contact members offices because of the incredible volume of e-mails Congressional offices receive and each office’s response to e-mails varies greatly. HOW TO CONTACT THE PRESIDENT Phone: 202-456-1111 (You can enter by push-button your opinions on certain topics, or press ‘O’ to speak to an operator.) The Honorable William J. Clinton, The White House,
1600 Pennsylvania Avenue ****************** Additional information and resource materials on these or other issues related to child health are available from the Washington Coordinator for the Societies: Karen M. Hendricks, JD, (khendricks@aap.org) or Jennifer Stevens, Legislative Assistant (jstevens@aap.org) at 601 13th Street, NW, Suite 400 North, Washington, DC 20005; phone: 800/336-5475; fax: 202/393-6137. ****************** PUBLIC POLICY COUNCIL:
SUBMITTED BY: Myron Genel, MD, Chairman January 2000 |