• Talking Points
  • February 8, 2021

COVID-19 Crisis in Children's Health and Children's Hospitals - 2021 Congressional Relief Request

Congressional action on the next COVID-19 relief package is ongoing. Our asks for this package, sent in a Feb. 8 letter to Congress, highlight the immediate needs of children and children's hospitals, including additional provider relief funding and direct support through Medicaid and other funding streams to address children's mental, emotional and behavioral health needs. For this bill, we are focusing on adding intentional language to include children and children's providers in funding directed to existing programs and proposals in President Biden's American Rescue Plan.

Ask of Congress

The COVID-19 pandemic impact continues to tear away at children’s health and the financial sustainability of their pediatric providers. Revenue shortfalls plagued children’s providers before COVID-19 and the added stresses of the pandemic on their care systems has hampered our national disaster response capability. Further, children’s mental, emotional and behavioral (MEB) health is in crisis stage in communities with emergency departments seeing increases in suicide attempts, self-harm and violent outbursts. This crisis is exacerbated by issues of race and health equity. Children and children’s health care providers need federal assistance in any additional relief legislation. We ask for help.

Provide additional PRF funding and ensure PRF funding specifies support to pediatric providers including children’s hospitals as disproportionate providers of care to children who rely on Medicaid by including specific intent language.

“Provided further, that the Secretary shall ensure payments to eligible providers that serve at-risk individuals, including children, pregnant women and the elderly (as described in 42 USC 300hh-1(b)(4)(B)), and eligible providers that serve large volumes of low-income individuals requiring specialized care (such as patients with comorbidities, chronic conditions, and social risk factors) who may be especially vulnerable to complications from COVID-19.”

Strengthen children’s access to mental, emotional and behavioral (MEB) treatment through Medicaid.

  • Provide an overall FMAP increase of a further 5.8% (bringing cumulative increase to 12%).
  • Enact specific FMAP increase for pediatric MEB services.
  • Provide a specific provider payment rate increase for pediatric MEB services, similar to Section 1202 of ACA.
  • Enact specific FMAP increase for pediatric MEB telehealth services to 100% of Medicare rates.

Within $4 billion for behavioral health called for in American Rescue Plan, designate immediate disaster relief for all children in MEB crisis to support emergent care in children’s hospitals and in the community.

  • Within funds for SAMHSA and HRSA, specify congressional intention for “children,” “pediatricians,” “pediatric behavioral health providers” and “children’s hospitals” to receive immediate support.
  • Create a designated pool of funding under HRSA specifically intended to target the MEB needs of children with flexibility to fund a range of activities, e.g., navigators providing coordination and continuity, funding to support telehealth treatment, pediatric training for crisis response, mental and behavioral health urgent care, community-based initiatives such as school-based partnerships, and initiatives to decompress emergency departments, including partial hospitalization, step down residency programs and intensive outpatient programs.
  • Provide additional funding to existing programs to support pediatric MEB, including the Behavioral Health Workforce Education and Training (BHWET) program and the Pediatric Mental Health Care Access Program.

Ensure workforce provisions clearly call out MEB training and staffing for children.

  • Specify congressional intent for all ARP provisions (e.g., 100,000 new health care workers) to consider and include “children,” “pediatrics,” “pediatric behavioral health providers” and “children’s hospitals” as priorities, to supplement MEB workforce.
  • Support expanded MEB pediatrician training by increasing CHGME program support of children’s MEB trainees to 100% of comparable GME.