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Child Psychiatry Faces Workforce Shortage: Page 5 of 6

Child Psychiatry Faces Workforce Shortage: Page 5 of 6

"That was actually a more traumatic thing for our kids long-term than Flight 93," Kashurba said.

Pending Legislation

The Child Healthcare Crisis Relief Act would help address some of these issues. The legislation, currently being considered in the U.S. House and Senate, would provide scholarships and loan forgiveness as incentives for people to train as children's mental health care professionals--not only as psychiatrists, but as psychologists, social workers and counselors in school settings, and as psychiatric nurses.

The bill was introduced last year in the House by Reps. Patrick Kennedy (D-R.I.) and Ileana Ros-Lehtinen (R-Fla.) and in the Senate by Sens. Jeff Bingaman (D-N.M.) and Susan Collins (R-Maine). As of January, the legislation had 44 co-sponsors in the House and five co-sponsors in the Senate.

"This is one of the key bills that would increase access to treatment for children and adolescents with mental illnesses," Nuala S. Moore, AACAP's assistant director of government affairs, told PT. "We hope to see action in 2004 on the bill."

The goal, Moore said, is to increase bipartisan support in both chambers of the U.S. Congress and have it attached to the reauthorization bill for the Substance Abuse and Mental Health Services Administration (SAMHSA). However, SAMHSA reauthorization bills have a tendency to get delayed, and it appears unlikely that the 108th Congress will take action before it adjourns at the end of this year.

But Moore said she is optimistic that the Crisis Relief Act can get passed as awareness grows about the work force shortages. Work force issues are sure to be part of the Senate's SAMHSA subcommittee hearings on children's mental health issues this year, and the topic received attention last year from the Senate Governmental Affairs Committee during hearings on the Keeping Families Together Act, which would try to put an end to families relinquishing custody of their children in order for them to receive mental health services.

The Crisis Relief Act would allow for changes in the residency training sequence and provide more appropriate reimbursements from Medicare for that training, Anders said. As it stands now, Medicare will reimburse hospitals only for the full cost of residents through their first specialty. While a hospital is fully reimbursed for residents in adult psychiatry training, it receives only 50% reimbursement for the additional two-year residency in child and adolescent psychiatry.

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