In order to provide quality pediatric care, children’s hospitals in the U.S. need government funds to address the children’s mental health emergency, more members of the pediatric workforce and safeguards for children’s health coverage, according to a recent letter sent to Congress by Children’s Hospital Association CEO Mark Wietecha.

Children’s Hospital Association is an organization with more than 220 children’s hospitals as members. Wietecha wrote his letter on behalf of these members, asking Congress for “long sought-after, bipartisan, bicameral policies” that will enable pediatric hospitals to better care for the country’s children.

“At a time when our children’s hospitals are flooded with children dealing with respiratory illnesses, mental health crises and other healthcare needs, congressional action is urgently needed before the end of the year to ensure children’s hospitals have the resources and capacity they need to best take care of our nation’s children. Our children cannot wait for needed federal support,” he wrote.

Tackling the pediatric mental health emergency

In October 2021, the Children’s Hospital Association, along with the American Academy of Pediatrics and the American Academy of Child and Adolescent Psychiatry, declared a national emergency for child and adolescent mental health. In their declaration, the organizations said the crisis was “inextricably tied” to the pandemic-induced stress, as well as the country’s ongoing struggle for racial justice.

A year has passed, but the situation has not improved. Children’s hospital visits for suicide attempts and eating disorders have drastically increased, and pediatric suicide rates are rising, especially among Black children, according to Wietecha’s letter.

To address this worsening problem, Wietecha called for “meaningful Medicaid investments to enhance the low reimbursement rates that pediatric behavioral health providers currently receive.”

He pointed out that Medicaid is the country’s largest payer for pediatric behavioral health services, yet access issues persist. For example, in 2018, just 54% of non-institutionalized children covered by Medicaid and the Children’s Health Insurance Program who went through a major depressive episode received treatment for their mental health condition.

Protecting children’s health coverage

Wietecha recommended that Congress enact 12-month continuous eligibility for children covered by Medicaid or CHIP. This would decrease coverage gaps — he pointed out that fluctuations in household income and paperwork errors often cause coverage gaps, meaning that children lose their access to medical care. The letter also called for the permanent authorization of CHIP. 

“This will be particularly important as we look ahead to the eventual unwinding of the public health emergency and to the Medicaid eligibility redetermination process,” Wietecha wrote. “No children should mistakenly lose critical Medicaid and CHIP coverage.”

Investments to expand the pediatric workforce

In his letter, Wietecha asked Congress to allocate $718.8 million for fiscal year 2023 to address the disparity in federal investments for physician training in adult care versus pediatric care. He asked that this amount be funneled into the Children’s Hospitals Graduate Medical Education program, which helps train more than half of the U.S. pediatric physician workforce.

The letter also called for $200 million one-time increase in funding to help grow the pediatric workforce, saying “we simply do not have enough pediatric specialists to staff the beds in our children’s hospitals.”

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