In the Public Interest
Government Relations Update
July 2009
APA's Public Interest Government Relations Office (PI-GRO) Continues to Advance Association Priorities for National Health Care Reform
With Congress moving at breakneck speed to complete an overhaul this year of the nation's health care system, PI-GRO continues to work diligently to ensure the inclusion of APA's priorities. What follows is an update on some of these activities.
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Senate Health, Education, Labor, and Pensions (HELP) Committee. On June 12, 2009, APA's Public Interest and Education Government Relations Offices sent a letter to Senators Edward Kennedy (D-MA) and Mike Enzi (R-WY) in response to draft Health Care Reform legislation, the Affordable Health Choices Act. APA applauded Senator Kennedy's leadership, the bill's aims, and provisions of the legislation that address many important and needed reforms, including efforts to:
- End the practice of denying health coverage, due to pre-existing medical conditions and disabilities;
- Promote improved nutrition and physical activity;
- Expand the School-Based Health Clinic infrastructure;
- Create standards for accessible medical diagnostic equipment;
- Promote integrated care;
- Protect vulnerable populations and address health disparities;
- Involve professional associations in federal efforts related to health care;
- Emphasize cultural and linguistic competence, and others.
In addition, APA made a number of critical recommendations related to longstanding Association priorities.
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Health Disparities. PI-GRO staff was invited to the White House June 9 to participate in a Health Care Reform Stakeholder Roundtable Discussion moderated by Secretary of Health and Human Services, Kathleen Sebelius, and Director of the White House Office of Health Reform, Nancy-Ann Deparle. Discussion focused on how health reform can reduce health disparities and address problems associated with the current system. APA, as the only mental health organization represented, emphasized the reduction and elimination of mental health and mental health care disparities as integral to health care reform. PI-GRO staff also advocated for robust data collection, a culturally and linguistically competent workforce, and psychology's role in eliminating health disparities.
Furthermore, PI-GRO convened a working group formed by organizations and coalitions with membership exceeding 400 separate organizations and several million individuals to create a cohesive, coordinated mechanism advocating for HCR to address health disparities impacting a diverse group of vulnerable populations. The working group also works to help create a workforce pipeline that increases the number of minority health professionals and other professionals working in underserved areas. PI-GRO also urged increased emphasis on cultural and linguistic competence in health curricula. The special edition of the Communiqué journal produced jointly by OEMA and PI-GRO continues to play a significant role in the recognition of APA's expertise and emphasis on this critical issue.
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Older Adults. APA worked as a member of the Eldercare Workforce Alliance (EWA) to coordinate a federal advocacy day to urge Congress to expand and enhance the health care workforce for older adults as part of HCR. EWA represents 29 national organizations, joined together to address the immediate and future workforce crisis in caring for an aging America. Advocacy activities included visits with key congressional offices responsible for health reform. Each of these congressional visits included an interdisciplinary team of EWA experts and advocates, representing both the professional and direct care workforce, who focused on the EWA health reform priorities, including several bills and legislative provisions that APA was instrumental in drafting and securing in the HELP Committee draft bill. In addition, EWA purchased a full page color advertisement in Roll Call, a trade newspaper for legislative matters, highlighting collective health reform priorities and encouraging congressional support for these initiatives. Furthermore, EWA coordinated a national congressional call-in day for grassroots advocates from around the country.
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Children's Mental Health. PI-GRO spearheaded outreach to the White House to advance much-needed priorities involving children's mental health in HCR. In collaboration with the Carter Center and the National Center for Children in Poverty, PI-GRO crafted a letter, signed by 61 organizations, calling for HCR to focus on this issue and include specific provisions for:
- Family-centered infant and early childhood mental health services;
- A comprehensive financing strategy;
- A public health approach to children's mental health;
- Enhancing service delivery to transition age youth;
- Eliminating health disparities in mental health status and mental health care; and
- Investing in health professions training and education.
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Senate Finance Committee. PI-GRO spearheaded APA's comments to Chairman Baucus (D-MT) and Ranking Member Grassley (R-IA) of the Senate Finance Committee in response to a Committee document concerning health care reform, titled Expanding Health Care Coverage: Proposals to Provide Affordable Coverage to All Americans.
Milestone Reached with Introduction of LGBT Health Disparities Legislation
On June 23, Representatives Tammy Baldwin (D-WI), along with several original co-sponsors, introduced H.R. 3001, the Ending Health Disparities for LGBT Americans Act (EHDLA), the first-ever comprehensive legislation addressing health disparities experienced by sexual and gender minorities in the United States. PI-GRO, in close collaboration with APA's Lesbian, Gay, Bisexual, and Transgender Concerns Office and a number of coalitions, including the National Coalition for LGBT Health, was actively engaged in the drafting process of this important bill, which contains APA's key LGBT health priorities Among its many critical provisions, EHDLA:
- Lays out plans for additional research and data collection on the health and the health disparities experienced by LGBT individuals and their families;
- Provides a comprehensive approach to eliminating the barriers to health care access for all sexual and gender minorities; and
- Includes new infrastructure support for LGBT health services, including a new office of LGBT Health within in the Department of Health and Human Services.
PI-GRO, in conjunction with a range of organizations and advocacy groups, continues to press for the inclusion of provisions from H.R. 3001 in HCR efforts
APA Takes Lead Role in Developing Congressional Resolution Introduced on African American Youth Resilience
On May 7, Congressman Alcee Hasting (D-FL) introduced a Resolution on Fostering Resilience in African American Youth. PI-GRO staff led the efforts developing this legislation, which reflects the work of APA's Task Force on Resilience and Strength in Black Children and Adolescents. The resolution promotes a number of steps related to research on resilience, well-being, and health in African American children and adolescents, including coordination among federal research agencies and the inclusion of culturally relevant guidelines in related requests for proposals. Furthermore, the resolution emphasizes the need for interdisciplinary partnerships to adapt, disseminate, and implement culturally relevant, evidence-based practices that focus on resilience in African American communities. PI-GRO will continue to advocate for passage of this important legislation, which has also received the endorsement of a number of organizations, including the American Academy for Child and Adolescent Psychiatry, the Bazelon Center for Mental Health Law, and Mental Health America.
APA Urges Congress to Strengthen Outreach to Military Service Members and Veterans
In response to an invitation received by PI-GRO, Jeffrey Pollard, PhD, ABPP, testified on May 19 on behalf of APA before the House Committee on Veterans' Affairs Subcommittee on Health, at a hearing entitled, U.S. Department of Veterans Affairs' Medical Care: The Crown Jewel and Best Kept Secret. Dr. Pollard's testimony focused on the need for mental and behavioral health outreach to military service members and veterans on college and university campuses and highlighted his and his colleagues' work in this area at George Mason University. In addition, Dr. Pollard highlighted three key recommendations:
- Sufficient resources to support targeted efforts on campus to address mental and behavioral health needs among service members and veterans, including risk of suicide;
- The need for readily available continuing education and training opportunities for college and university mental and behavioral health professionals regarding the unique deployment, reintegration, and readjustment issues faced by service members, veterans, and their families; and
- The development of mechanisms to conduct appropriate outreach to service members and veterans who are beginning their post-secondary education online while deployed or upon their return from service.
PI-GRO Provides Critical Input on Reauthorization of Child Abuse Law, Contributes to Provisions Addressing Adoption
In early June, PI-GRO sent comments to the Senate Health, Education, Labor, and Pensions (HELP) Committee on behalf of APA, responding to the draft legislation to reauthorize the Child Abuse Prevention and Treatment Act (CAPTA). The draft bill incorporated most of APA's proposed recommendations, including provisions addressing:
- Mental health and substance use issues;
- Research on approaches to assisting maltreated infants and toddlers;
- The intersection between child maltreatment and domestic violence;
- More attention to the prevention of child abuse and neglect;
- The needs of diverse populations, including children and families who are English language learners, individuals with disabilities, racial and ethnic minorities, and unaccompanied homeless youth
Responding to the Senate draft, PI-GRO staff commended Committee members for their attention to the importance of respite care services, the role of caregivers, and home visitation services. Furthermore, APA praised the Committee for the legislation's strong attention to research, evaluation, and prevention. APA's response also recommended:
- Appropriate funding to fully address critically needed research, training, technical assistance, information collection, and program innovations;
- That mental health be considered an integral part of the term "supportive services," which appears several times in the draft bill; and
- That the legislation recognizes successful initiatives addressing child abuse and neglect prevention and screening conducted by other entities, such as the Centers for Disease Control and Prevention and federally qualified community health centers.
As part of CAPTA, the HELP Committee also plans to take up reauthorization of the Adoption Reform Act, which establishes the critical Adoption Opportunities Program. PI-GRO submitted several critical recommendations pertaining to this law and urged the Committee to fund prevention and early intervention services for individuals transitioning from foster care to adoption, especially for families adopting children with special needs, including those experiencing mental health problems.
The significant time and expertise offered by APA's membership, particularly the Interdivisional Task Force on Child Maltreatment Prevention, made possible the original set of recommendations regarding CAPTA reauthorization, as well as PI-GRO's timely response to the draft legislation.
APA Urges Caution in FDA Consideration of Psychotropic Drugs for Minors
In a statement presented on June 9 by Ronald Brown, PhD, the APA outlined to an FDA panel its concerns related to the agency's possible approval of three additional atypical antipsychotics to treat bipolar disorders and schizophrenia in children and adolescents. PI-GRO coordinated the participation of Dr. Brown, who chaired APA's Working Group on Psychotropic Medications, and the Working Group's report provided the background for the statement. Dr. Brown presented information on the need for more long-term effectiveness and safety data on the use of psychotropic medications in children, both generally and specifically with regard to the three drugs in question—Geodon, Seroquel, and Zyprexa. The panel considering the applications, the Psychopharmacologic Drug Advisory Committee, ultimately voted to approve the three applications. While the FDA is not obligated to follow this decision, it frequently follows the recommendations of its advisory committees.
Congressional Briefing Emphasizes the Benefits of Workplace Flexibility
On Wednesday, May 20, PI-GRO staff organized a congressional briefing in partnership with Workplace Flexibility 2010 and the New America Foundation, and in conjunction with Representatives Grace Napolitano (D-CA) and Tim Murphy (R-PA), Co-Chairs of the Congressional Mental Health Caucus. Former APA President Diane Halpern, PhD, and APA member Joseph Grzywacz, PhD, were among the distinguished panelists at this important event. In her welcoming remarks, Public Interest Directorate Executive Director Gwendolyn Puryear Keita, PhD, stressed the importance of encouraging family-friendly work policies as a critical part of reforming the nation's health system. Dr. Halpern emphasized research findings showing that flexible workplace policies, such as the ability to work from home, four-day work weeks, and flexible leave to care for sick family members, are associated with less stress and job burnout and fewer missed workdays. Her remarks also noted that employees meet more deadlines and report more company loyalty, when working under flexible workplace conditions. Dr. Grzywacz spoke to the importance of incorporating workplace flexibility and work-life balance policies into employer efforts to advance the wellness of their workforce. He emphasized workplace flexibility as a way of doing business that companies must integrate into their human resources philosophy.
Obama Signs Homelessness Legislation into Law
On May 20, President Obama signed the Homeless Emergency Assistance and Rapid Transition to Housing (HEARTH) Act into law, as an amendment to mortgage foreclosure legislation (S. 896). The HEARTH Act aims to:
- Help reduce the amount of time families experience homelessness by using rapid re-housing programs that help them move quickly into permanent housing and provide services to ensure stability;
- Ensure that families with the greatest hardships aren't left behind, by establishing a federal goal that no family should be homeless for more than 30 days; and
- Prevent family separation by prohibiting shelters, transitional housing programs, and permanent supportive housing programs from discriminating against homeless families based on the age of their children.
PI-GRO worked with the APA Task Force on Psychology's Contribution to End Homelessness, led by APA President James Bray, PhD to promote policies which address the mental health effects of homelessness.
New Leadership for Push to End Military "Don't Ask, Don't Tell" Policy
PI-GRO continues to advocate for H.R. 1283, the Military Readiness Enhancement Act (MREA) of 2009, which would repeal the military ban of lesbian, gay, and bisexual service members and require the reinstatement of individuals dismissed under the policy. The original sponsor for this bill, Representative Ellen Tauscher (D-CA), recently accepted an appointment to serve as Undersecretary of State for Arms Control and International Security. Since then, Representative Patrick Murphy (D-PA) has taken the lead in advancing this critical legislation in Congress. PI-GRO continues its outreach efforts to garner support for this important proposal.
Critical Children's Mental Health Legislation Reintroduced
PI-GRO continues to provide critical leadership and support for efforts to advance legislation related to children's mental health, including:
- H.R. 2691, the Healthy Transitions Act, which would provide supports to individuals with serious mental illness, as they transition to adulthood;
- H.R. 2531, the Mental Health in Schools Act, which would expand the scope of Safe Schools/Health Students by ensuring that promotion, prevention, and treatment services are culturally and linguistically appropriate; and
- H.R. 2597, the Positive Behavior for Safe and Effective Schools Act, which would promote the adoption of school-wide positive behavior supports.
GET INVOLVED IN ADVOCACY!
We invite you to take part of our Public Policy Advocacy Network (PPAN) by visiting us at http://www.apa.org/ppo/ppan/homepage.html. Through PPAN, you can sign up for our timely action alerts and you stay informed about (and involved in) federal policy. In addition, if you are interested in becoming involved in PI-GRO'S legislative and regulatory initiatives, please contact our office at 202.336.6166.
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