Children's Hospital GME Support Reauthorization Act of 2013

Mr. Speaker, I move to suspend the rules and pass the bill (H.R. 297) to amend the Public Health Service Act to reauthorize support for graduate medical education programs in children's hospitals.

Mr. Speaker, I ask that all Members may have 5 legislative days to revise and extend their remarks and insert extraneous material into the Record.

Mr. Speaker, I yield myself such time as I may consume.

Mr. Speaker, Pennsylvanians are fortunate to have several excellent children's hospitals in the State. One of these hospitals is the Children's Hospital of Philadelphia, the country's first hospital to exclusively care for children, and they have remained one of the best for over 150 years.

In a recent survey, the hospital was rated number one in six separate pediatric specialties and ranked no lower than fourth in another four specialty categories.

Other children around the country aren't so fortunate to have access to excellent doctors. A study in the journal Pediatrics found that more than 8 million children have no pediatrician in their area. Many other sick children have to drive hundreds of miles to see a doctor who specializes in treating their condition.

Children aren't just miniature adults, and treating them isn't just a matter of working on a smaller scale and shrinking the equipment. A doctor who is experienced in treating adults may not be able to apply that same expertise to a child. Treating children is both a medical and an emotional challenge. Often, doctors have to correctly diagnose an illness in little patients who haven't even learned to speak. It takes a special person to go into pediatrics.

For a time in the 1990s, our Nation was facing an acute shortage of pediatricians. With much of government assistance to train doctors being funneled through the Medicare program, it was becoming significantly more expensive for a doctor to choose to be trained in pediatrics.

To help correct this imbalance, Congress created the Children's Hospital Graduate Medical Education program. This is a program that was created, and has been sustained, with bipartisan support.

Unfortunately, the program is facing elimination. President Obama's budget for the 2012 fiscal year called for elimination of the program, despite the positive results.

I support getting rid of programs that are duplicative, unproven, or unnecessary, especially with the budget pressures we are facing now; however, CHGME has a proven track record. Over 40 percent of pediatricians in the United States are trained through CHGME.

Forty-three percent of those in subspecialities are trained through the program.

The Children's Hospital of Philadelphia runs the largest pediatric residency program in the country. Their residents will treat children in my community and then move across the country to practice in other communities. We need their expertise now more than ever.

Last Congress, I worked with my Democratic counterpart on the Energy and Commerce Health Subcommittee, Representative Frank Pallone, to introduce legislation to renew the program. Our legislation passed the House of Representatives twice in the 112th Congress, both times by voice vote.

Unfortunately, the bill was tied up in the Senate and was not considered. Congressman Pallone and I wasted no time in reintroducing the bill this year, and I'm proud to say that in the very first meeting of the Energy and Commerce Committee, on January 22, the bill was reported out unanimously. The bill is a very simple, 5-year reauthorization of the CHGME program at current funding levels.

H.R. 297 is supported by the Children's Hospital Association, the American Hospital Association, the Academic Pediatric Association, the American Academy of Pediatrics, the American Pediatric Society, the Association of Medical School Department Chairs, the Society for Pediatric Research, the

Association of American Medical Colleges, the American Osteopathic Association, and the American College of Surgeons, among others.

Far too many children in our Nation already lack access to a pediatrician or doctor trained in a pediatric subspecialty. Without CHGME, we will once again be discouraging medical residents from choosing pediatrics.

On a personal note, nearly 2 years ago, I met Anna Lipsman, who was receiving treatment for leukemia at the Children's Hospital of Philadelphia. Today, thanks to the excellent care she received, she is happy, energetic and in school full time. She continues to remind me about what is really at stake.

I urge all of my colleagues to vote ``yes'' on H.R. 297 and reserve the balance of my time.

Mr. Speaker, I urge Members to support this legislation. It has tremendous bipartisan support, and, with that, I yield back the balance of my time.

Mr. Speaker, on that I demand the yeas and nays.

Mr. Speaker, I rise today in support of H.R. 297 the ``Children's Hospital Graduate Medical Education

(GME) Support Reauthorization Act of 2013'' This legislation would authorize the appropriation of $110 million a year for 2013 through 2017, for payment toward the direct costs of graduate medical education in children's hospitals.

As the Founder and Co-Chair of the Congressional Children's Caucus, I understand the important of this vital program. The Children's Hospital Graduate Medical Education Program (CHGME) trains 40 percent of our Nation's pediatricians and more than half of our Nation's pediatric subspecialists. Each year, over 5,000 residents take part in this program.

We are all aware that we must continue to support the development and training of all medical professionals. Me must do more to ensure that we have enough qualified medical professional choosing to specialize in key fields in order to address the growth in both our baby boomers and child populations. I believe this legislation is a step in the right direction.

In the early 90's, we witnessed a thirteen percent decrease in the amount of qualified graduate medical students entering into pediatrics. Upon the enactment of the Children's Hospital Graduate Medical Education program we saw a significant increase in the amount of qualified medical school graduates choosing to enter into pediatrics, their numbers increased by 35 percent.

In 1999, Children's Hospital Graduate Medical Education, CHGME, was enacted as part of the Healthcare Research and Quality Act to provide freestanding children's hospitals with discretionary federal support for direct and indirect expenses associated with operating medical residency training programs. Since few children's hospitals receive Medicare funds, the program is designed to correct the exclusion of pediatric training in the Medicare Graduate Medical Education, GME, program.

Under the Children's Hospital Graduate Medical Education Program, direct medical education funding is designed to cover costs associated with stipends for residents, salaries, salaries for faculty, overhead and other costs of running a training program. The CHGME also provides indirect medical education funds that are designed to assist in expenditures such as reduced productivity of staff training residents and the processing of additional diagnostic tests those residents may order.

Graduate Medical Education, GME, begins upon graduation from medical school and passed the examination needed to obtain general board certification. GME in a specialty field (residency) and further specializations in a specific clinical field (fellowship) are generally provided in hospital settings with additional clinical experiences in non-hospital site. This can take between three and seven years to complete, depending on the medical, dental or podiatric specialty track chosen.

Freestanding children's hospitals receiving Federal GME funds have increased the number of residents and fellows that they are training since 2000:

The number of residents and fellows claimed for Federal support for the 2000 Federal fiscal year (FY) was about 4,263.

In the latest Government Performance Results Acts, GPRA, report for Federal FY 2009, the hospitals described training 5,631 pediatricians, pediatric subspecialists, and other physicians in the clinical care of children within the U.S.

Of the 5,631 resident FTEs being trained, about 48 percent were in general pediatrics, 24 percent were in pediatric subspecialties, and 28 percent were non-pediatric residents.

In FY 2009, 56 children's hospitals located in 30 states and Puerto Rico had nearly half a million inpatient discharges. Children's hospitals vary in size and service mix. The number of available beds at these hospitals varies from 30 to 456.

These freestanding children's hospitals provide services ranging from outpatient ambulatory care to inpatient critical care.

Mr. Speaker, I yield myself such time as I may consume.

I rise today in support of the Children's Hospitals GME Support Reauthorization Act, which reauthorizes the Children's Hospital Graduate Medical Education Program through 2018.

The Children's Hospital Graduate Medical Education Program provides vital funding to support the training of pediatricians and pediatric specialists in our children's hospitals.

Continued strong support for CHGME is essential to maintain this investment in our children's health care. Reauthorizing the Children's Hospital Graduate Medical Education Program represents a commitment to ensuring that children throughout the country have access to the quality care they need.

Since its creation in 1999, this program has increased the number of pediatric health care providers, addressed critical shortages in pediatric specialty care, and improved access to necessary care.

The CHGME recipient hospitals represent less than 1 percent of all hospitals, yet train half of all the Nation's pediatricians and pediatric specialists.

As a cosponsor of the House bill that passed in 2013 and a long advocate for the Children's Hospital Graduate Medical Education Program, I applaud this bipartisan, bicameral effort to preserve and strengthen this important program.

I want to recognize and applaud the leadership of Ranking Member Frank Pallone and Chairman Pitts on this legislation in the House.

I also want to acknowledge the sponsors of the measure we are considering today, Senators Casey and Isakson. I also commend Chairman Upton, Chairman Harkin, and Ranking Member Alexander for making it possible for the House to consider this bipartisan legislation today.

I urge my colleagues to join me in supporting S. 1557 and sending this legislation to the President for his signature.

I yield back the balance of my time.

Mr. Speaker, I rise today in support of the Children's Hospitals GME Support Reauthorization Act, which reauthorizes the Children's Hospitals Graduate Medical Education (CHGME) program through 2018.

The CHGME program provides vital funding to support the training of pediatricians and pediatric specialists in children's hospitals.

Continued strong support for CHGME is essential to maintain this investment in children's health care. Reauthorizing CHGME represents a commitment to ensuring that children throughout the country have access to the quality care they need.

Since its creation in 1999, CHGME has increased the number of pediatric health care providers, addressed critical shortages in pediatric specialty care and improved access to necessary care.

The CHGME recipient hospitals represent less than one percent of all hospitals, yet train half of all the nation's pediatricians and pediatric specialists.

As a co-sponsor of the House bill that passed in February 2013 and a longtime advocate for the CHGME program, I applaud this bipartisan, bicameral effort to preserve and strengthen this important program.

Mr. Speaker, I move to suspend the rules and pass the bill (S. 1557) to amend the Public Health Service Act to reauthorize support for graduate medical education programs in children's hospitals.

Mr. Speaker, I ask unanimous consent that all Members may have 5 legislative days in which to revise and extend their remarks and insert extraneous materials in the Record on the bill.

Mr. Speaker, I yield myself such time as I may consume.

I am glad that, today, we will pass a bill that will help keep American children healthy. Today, the House considers S. 1557, the Children's Hospital GME Support Reauthorization Act of 2013. This is companion legislation to my own bill, H.R. 297, which passed the House at the beginning of this Congress. I am pleased that we have worked out the slight differences between the bills and that we can now reauthorize an important program that makes sure our Nation has enough doctors trained to treat children.

The Children's Hospital Graduate Medical Education Program helps encourage more young doctors to pursue this important specialty. Without it, we would certainly see fewer medical professionals enter pediatrics and pediatric subspecialties.

Children need doctors trained just to treat them. Nationwide, this program supports the training of more than 5,000 doctors. Locally, in my area of Pennsylvania, the Children's Hospital of Philadelphia participates in the program.

I have had the privilege of visiting the hospital a number of times and meeting with the young patients and the doctors learning how to treat them.

I am proud to have worked on this legislation with Energy and Commerce Health Subcommittee Ranking Member Frank Pallone. We originally introduced this bill in the 112th Congress. It has been a long road. I am glad we can finally send this bill to the President for his signature.

This is yet another bipartisan bill that we have successfully moved through the Health Subcommittee. It is proof that, despite our differences, we can find common ground and work together on legislation in a bipartisan way to help Americans stay healthy.

I would like to especially thank Monica Volante on my staff, as well as the staff of the Health Subcommittee, especially Brenda Destro and Katie Novaria, who worked tirelessly on this legislation.

I urge all of my colleagues to support this bill, and I reserve the balance of my time.

Mr. Speaker, I am very pleased to ask all Members to support S. 1557, very important legislation with bipartisan support, and I yield back the balance of my time.

Mr. Speaker, I yield myself such time as I may consume.

Mr. Speaker, I'm pleased to rise in support of H.R. 297, the Children's Hospital Graduate Medical Education Support Reauthorization Act of 2013.

As every parent knows, it's very important to have a trusted doctor to turn to when their child gets sick. Since its inception in 1999, the Children's Hospital Graduate Medical Education program, known as CHGME, has helped to make sure that the doctor is there and prepared to diagnose any symptoms that our children face.

In fact, the program has been a true success. In the 1990s, declines in pediatric training programs threatened the stability of the pediatric workforce, and CHGME helped to reverse these dangerous declines. Even then, Congress, in a bipartisan way, recognized that if we didn't create and fund programs that would train doctors to treat these children, there won't be anyone left to take care of them.

That's why the House overwhelmingly supported reauthorization of the program in the 112th Congress, passing stand-alone legislation in September 2011 and also including the reauthorization in broader legislation in December 2012.

With this Federal CHGME support, children's hospitals can play a key role in ensuring the continued growth of our Nation's pediatric workforce. In 2009, the program supported the training of 5,361 resident physicians nationally. The program will also help to enhance hospitals' research capabilities and improve hospitals' ability to provide care to vulnerable and underserved children.

Reauthorizing CHGME continues to be one of my top health priorities, and I want to thank Congressman Pitts, the chairman of our Health Subcommittee, for working with me on this bill. Together with his help and leadership, we were able to move this bill again swiftly through our committee and to the floor upon convening this Congress.

Mr. Speaker, this program has proven results, and it's past time that we finally reauthorize CHGME so that we can provide certainty to hospitals, doctors, and their patients. Children in our communities are counting on this program to train a future generation of pediatricians, and I urge my colleagues to vote ``yes'' on the bill. I reserve the balance of my time.

Mr. Speaker, I would like to now yield 3 minutes to my colleague from Rhode Island (Mr. Cicilline).

I have no additional speakers. I yield back the balance of my time.