July 1, 2020

The Honorable Alex Azar Secretary U.S. Department of Health and Human Services 200 Independence Avenue, SW Washington, DC 20201

Dear Secretary Azar:

We thank you for your efforts to swiftly and fairly distribute funding from the Provider Relief Fund to the facilities caring for individuals infected with COVID-19. However, we are very concerned that a disproportionately low amount of this funding has been distributed to children’s hospitals, including those in . The recent disbursement of $25 billion in COVID-19 relief funding to Medicaid providers and safety net hospitals delivered much-needed support to many providers, yet only a handful of children’s hospitals were eligible for those funds. Children’s hospitals are the “pediatric safety net,” serving as the provider of first response and last resort for children. In Pennsylvania, for example, 55% of children with special health needs rely on Medicaid for their care. Yet children’s hospitals have received less than 1% of the more than $190 billion in COVID-19 relief funding allocated to health care providers to date.

The impact of COVID-19 on all children’s hospitals has been far greater than one might assume given the relatively lower number of children subject to significant, direct harm from the virus. Social distancing protocols resulted in thousands of deferred surgeries and even more decreased face- to-face outpatient visits in both primary and specialty care. The fiscal and health consequences of this are of historic proportion. With childhood vaccinations down dramatically, creating a risk of other outbreaks, and children with complex and chronic conditions deferring care, many children’s hospitals have nonetheless been forced to consider furloughs and lay-offs. At the same time, children’s hospitals have had to increase expenditures in personal protective equipment to keep patients and staff safe.

Caring for children is not the same as caring for adults. Children’s hospitals are unique institutions with highly specialized expert knowledge about health and disease at all stages of child development. All children need this expert care, and during this unprecedented time, children’s hospitals need our support to continue providing the exceptional care our children require. We request that you move quickly to release a tranche of the remaining provider relief dollars that is formulated to include Medicaid providers, including all children’s hospitals.

Thank you again for your leadership during this difficult time.

Sincerely,

Brian Fitzpatrick Member of Congress Member of Congress

Daniel P. Meusuer Member of Congress Member of Congress

Mike Kelly Member of Congress Member of Congress

Chrissy Houlahan Member of Congress Member of Congress

Conor Lamb Dwight Evans Member of Congress Member of Congress