DOCUMENT RESUME ED 414 009 PS 025 891 TITLE Improving the Healt.J. Status of Children. Hearing on Examining Proposals To Improve the Health Status of Children, Including S. 435 and S. 525, Focusing on Pediatric Care, Public Healt)., lntal Health, and Substance Abuse Issues. Committee Labor and Human Resources. United States Senate, One undred Fifth Congress, First Session. INSTITUTION Congress of the U.S , Washington, DC. Senate Committee on Labor and Human Resources. REPORT NO Senate-Hrg-105-39 ISBN ISBN-0-16-055175-7 PUB DATE 1997-04-18 NOTE 112p. AVAILABLE FROM U.S. Government Pri' :ing Office, Superintendent of Documents, Congress,clnal Sales Office, Washington, DC 20402. PUB TYPE Legal/Legislative/Rc rulatory Materials (090) EDRS PRICE MF01/PC05 Plus Postc DESCRIPTORS Adolescents; Child A vocacy; *Child Health; Child Welfare; Childhood Needs; Children; Dental Health; Diseases; Health Insurance; *Health Needs; Health Programs; Health Promotion; Health Services; Hearings; *Mental Health; Pediatrics; *Physical Health; Prenatal Care; Preventive Medicine; *Substance Abuse IDENTIFIERS Congress 105th ABSTRACT These hearings transcripts present testimony befcre the Senate Committee on Labor and Human Resources to address the question of how to improve the health care status of American children. The hearings addressed a range of issues relating to children's health from witnesses with expertise in pediatric care, public health, mental health, and substance abuse. Each witness addressed the following four questions: (1) "What are the health-related needs of children that we should work to fulfill?"; (2) "How can we better address children's health needs through improvements to federally-funded public health programs?"; (3) "How do you propose we address the problem of ensuring health coverage to children who are currently uninsured, and what should be the Federal role in that endeavor?"; and (4) "How might we encourage the private sector to participate in partnerships with our Government and community organizations to address the needs of children?" Specific child health issues addressed by a variety of witnesses included pediatric illness, children not covered by health insurance, quality care, substance abuse, care delivery systems, child and adolescent psychiatric services, oral health, and prenatal care. Speakers included Senators Orrin G. Hatch (Utah), Edward M. Kennedy (Massachusetts) and Barbara A. Mikulski (Maryland); Secretary of Health and Human Services Donna Shalala; hospital administrators and other administrators of organizations concerned with child health. (Author/SD) ******************************************************************************** Reproductions supplied by EDRS are the best that can be made from the original document. ******************************************************************************** S. HRG.105-39 IMPROVING THE HEALTH STATUS OF CHILDREN U.S. DEPARTMENT OF EDUCATION Office of Educational Research and Improvement EDUCATIONAL RESOURCES INFORMATION CENTER (ERIC) NiThis document has been reproduced as eceived from the person or organization originating it. Minor changes have been made to HEARING improve reproduction quality. Points of view or opinions stated in this OF THE document do not necessarily represent official OERI position or policy. COMMITTEEON LABOR AND HUMANRESOURCES UNITED STATESSENATE ONE HUNDRED FIFTHCONGRESS FIRST SESSION ON EXAMINING PROPOSALS TO IMPROVE THE HEALTH STATUS OF CHIL- DREN, INCLUDING S. 435 AND S. 525, FOCUSING ON PEDIATRIC CARE, PUBLIC HEALTH, MENTAL HEALTH, AND SUBSTANCE ABUSE ISSUES APRIL 18, 1997 Printed for the use of the Committee on Labor and Human Resources BEST COPYAVAILABLE U.S. GOVERNMENT PRINTING OFFICE 40-171 CC WASHINGTON : 1997 For sale by the U.S. Government Printing Office Superintendent of Documents, Congressional Sales Office, Washington, DC 20=102 ISBN 0-16-055175-7 2 COMMITTEE ON LABOR AND HUMAN RESOURCES JAMES M. JEFFORDS, Vermont, Chairman DAN COATS, Indiana EDWARD M. KENNEDY, Massachusetts JUDD GREGG, New Hampshire CHRISTOPHER J. DODD, Connecticut BILL FRIST, Tennessee TOM HARKIN, Iowa MIKE DeWINE, Ohio BARBARA A. MIKULSKI, Maryland MICHAEL B. ENZI, Wyoming JEFF BINGAMAN, New Mexico TIM HUTCHINSON, Arkansas PAUL D. WELLSTONE, Minnesota SUSAN M. COLLINS, Maine PATTY MURRAY, Washington JOHN W. WARNER, Virginia JACK REED, Rhode Island MITCH McCONNELL, Kentucky MARK E. POWDEN, Staff Director SUSAN K. HATTAN, Deputy Staff Director NICK LITTLEFIELD, Minority Staff Director and Chief Counsel 3 CONTENTS STATEMENTS FRIDAY, APRIL 18, 1997 Page Jeffords, Hon. James M., Chairman, Committee on Labor and Human Re- sources, opening statement 1 Prepared statement 2 Kennedy, Hon. Edward M., a U.S. Senator from the State of Massachusetts, opening statement 3 Hatch, Hon. Orrin G., a U.S. Senator from the State of Utah; and Hon Arlen Specter, a U.S. Senator from the State of Pennsylvania 6 Prepared statements of: Senator Hatch 9 Senator Specter 14 Mikulski, Hon. Barbara A., a U.S. Senator from the State of Maryland, prepared statement 21 Shalala, Hon. Donna E., Secretary, U.S. Department of Health and Human Services, Washington, DC 24 Prepared statement 25 Dodd, Hon. Christopher J., a U.S. Senator from the State of Connecticut, prepared statement 41 Harkin, Hon. Tom, a U.S. Senator from the State of Iowa, prepared state- ment 42 Dean, Hon. Howard, Governor, State of Vermont 50 Akhter, Dr. Mohammad N., director, American Public Health Association, Washington, DC; Dr. Antoinette Parisi Eaton, corporate director of govern- mental affairs, Children's Hospitals, Incorporated, Columbus, OH; and Dr. Judith S. Palfrey, chief, division of general pediatrics, Children's Hospital, Boston, MA 59 Prepared statements of: Dr. Akhter 61 Dr. Eaton 66 Dr. Palfrey 71 Copple, James E., president and chief executive officer, Community Anti- Drug Coalitions of America, Alexandria, VA; and Dr. Mary Jane England, president, Washington Business Group on Health, Washington, DC 82 Prepared statements of: Mr. Copple 84 Dr. England 90 American Academy of Child and Adolescent Psychiatry, Lawrence A. Stone, M.D., president, prepared statement 99 American Dental Hygienists' -Association, Stanley B. Peck, executive director, prepared statement (with attachment) 101 Council of Women's and Infants' Specialty Hospitals, Susan Erickson, presi- dent, prepared statement 103 IMPROVING THE HEALTH STATUS OF CHILDREN FRIDAY, APRIL 18, 1997 U.S. SENATE, COMMITTEE ON LABOR AND HUMAN RESOURCES, Washington, DC. The committee met, pursuant to notice, at 9:33 a.m., in room SD-430, Dirksen Senate Office Building, Senator Jeffords (chair- man of the committee) presiding. Present: Senators Jeffords, Collins, Kennedy, Dodd, Harkin, Mi- kulski, Wellstone, and Reed. OPENING STATEMENT OF SENATOR JEFFORDS The CHAIRMAN. The Committee on Labor and Human Resources will come to order. We have an excellent hearing for you this morning, and we want to get started right away. Senator Kennedy and I both will give our opening statements. Today, we will address the question of how to improve the health care status of our children. It is absolutely critical that we commit ourselves to giving our children the best possible start in life, thus ensuring a solid foundation for our country's future. Without good health, a child cannot learn and cannot thrive, and his or her op- portunity to contribute to a strong society is compromised. This hearing will address a range of issues relating to children's health. We will hear from witnesses with expertise in pediatric care, public health, mental health, and substance abuse. Speaking from his or her own particular area of expertise, each of the wit- nesses will address the following four questions: 1) What are the health-related needs of children that we should work to fulfill? 2) How can we better address children's health needs through improvements to federally-funded public health programs? 3) How do you propose we address the problem of ensuring health coverage to children who are currently uninsured, and what should be the Federal role in that endeavor?; and 4) How might we encourage the private sector to participate in partnerships with our Government and community organizations to address the needs of children? We will also hear from Senator Hatch and Senator Specter, each of whom has introduced a bill designed to address concerns about health coverage for children. Secretary Shalala is here. I know that she, too, is committed to addressing concerns about children's health. And, finally, I want to welcome Governor Dean from Ver- (1) 5 2 mont. He is a national leader in children's programs, and I am very pleased that he is here to share with the committee the successes of Vermont's programs. I want to thank both Senators Hatch and Specter for being here. Because of our lengthy agenda, I am going to ask that you take 5 minutes each and then be open for questions. But, first, I am going to turn to Senator Kennedy. [The prepared statement of Senator Jeffords follows:] PREPARED STATEMENT OF SENATOR JEFFORDS Today we will address the question of how to improve the health status of our children. It is absolutely critical that we commit our- selves to giving our children the best possible start in life, thus en- suring a solid foundation for our country's future. Without good health, a child cannot learn and cannot thrive, and his or her op- portunity to contribute to a strong society is compromised. This hearing will address a range of issues relating to children's health.