Friday, May 9th 2003

The Honorable Arlen Specter
Chairman, Labor-HHS Subcommittee
U.S. Senate
Washington, DC 20510
The Honorable Tom Harkin
Ranking, Labor-HHS Subcommittee
U.S. Senate
Washington, DC 20510
The Honorable Ralph Regula
Chairman, Labor-HHS Subcommittee
U.S. House of Representatives
Washington, DC 20515
The Honorable David Obey
Ranking, Labor-HHS Subcommittee
U.S. House of Representatives
Washington, DC 20515

Dear Mr. Chairmen and Ranking Members:

On behalf of the American Hospital Association, representing more than 5,000 hospitals across the country, the Association of American Medical Colleges, representing more nearly 400 teaching hospitals and 126 accredited medical schools, and the National Association of Children's Hospitals representing more than 120 children's hospitals, we write in support of making the federal Children's Hospitals Graduate Medical Education (CHGME) Payment Program a priority in the FY 2004 Labor-HHS-Education Appropriations Bill.

In the last four years, Congress has taken important steps to secure federal GME support for the nation's independent children's hospitals, because they are indispensable to the health care of all children.  In 1999, Congress authorized the establishment of CHGME, including $285 million for FY 2001.  In 2000, it reauthorized the program through FY 2005 for such sums as necessary.

Because of your leadership, Congress appropriated $292 million for FY 2003 - the full authorization for the program adjusted for the consumer price index.  This year, there is strong, bipartisan support for an appropriation of $305 million in FY 2004, which would continue the authorization adjusted for inflation.

This funding is essential not only to the independent children's teaching hospitals but also to future of pediatrics overall.  Because they care for children, not the elderly, children's hospitals are unable to qualify for significant support from the one reliable source of GME funding - Medicare.  This created an unintended gap in federal GME support for independent children's hospitals that in 1998 amounted to an estimated $285 million.   In an increasingly price-driven market place, this gap in federal support put the ability of children's hospitals to sustain their core missions of caring for all children, teaching, and research at risk.

Although they represent less than one percent of all hospitals, the independent children's teaching hospitals train almost 30 percent of all pediatricians, almost half of all pediatric subspecialists, and two-thirds of pediatric critical care physicians.  They are the major pipeline for future pediatric researchers.  Together, they and their affiliated pediatric departments are among our nation's leading centers of pediatric research.  Congress enacted CHGME to close the gap in federal GME support and help to secure the future of our pediatric workforce and advancements in children's health care.

GME funding for children's hospitals is a sound investment in the future of pediatric medicine and children's health.  Please provide $305 million for the federal Children's Hospitals' GME Program in the FY 2003 Labor-HHS Appropriations Bill.  Thank you very much for your consideration.


Rick Pollack
Executive Vice President
American Hospital Association
325 Seventh St., N.W.
Washington, DC  20004
Richard K. Knapp, Ph.D.
Executive Vice President
Association of American Medical Colleges
2450 N Street, NW
Washington, DC  20036
Lawrence A. McAndrews
President and CEO
National Association of Children's Hospitals
402 Wythe Street
Alexandria, VA  22314


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