February 28, 2007

Dear Chairman Baucus and Senator Grassley:

The undersigned organizations urge you to ensure that the State Children's Health Insurance Program (SCHIP) provides equitable coverage of mental health services that are key components of the full range of services needed for healthy childhood development. Reauthorization of the program offers a critical opportunity to rectify discriminatory limits on mental health care that exist in SCHIP plans across the nation.

Many states have imposed restrictive limits on mental health services that would not be permissible in Medicaid, including caps on both inpatient and outpatient care, annual cost restrictions, and limits on diagnostic services. These limits are not based on the medical needs of beneficiaries or best practice guidelines and result in coverage that is wholly inadequate for children with mental disorders. One study found that children with complex mental health needs would have access to full coverage of needed services in only approximately 40 percent of states due to limited benefits in the SCHIP plans. Thus, these children have essentially moved from being uninsured to underinsured in this Federal-State partnership program.

It is obvious that the fundamental purpose of the SCHIP program is yet to be achieved.

Children in separate SCHIP plans deserve comprehensive coverage for their mental health needs. For these children to have access to the appropriate range of services, the law must be amended to ensure that all SCHIP plans provide mental health coverage that is equivalent to the coverage provided for physical conditions.

We commend you for your ongoing leadership on children's mental health policy. We look forward to working with you to eliminate these disparities in mental health care under SCHIP so that children enrolled in the program who need mental health services can appreciate the comprehensive health insurance benefits Congress intended for our next generation. If you have any questions, please contact Laurel Stine with the Bazelon Center for Mental Health Law at 202-467-5730 x-134 or Kirsten Beronio with Mental Health America at 202-675-8413.

Sincerely,

American Academy of Child and Adolescent Psychiatry
American Academy of Pediatrics
American Association for Marriage and Family Therapy
American Association of People with Disabilities
American Board of Examiners in Clinical Social Work
American Counseling Association
American Federation of State, County and Municipal Employees (AFSCME)
American Group Psychotherapy Association
American Mental Health Counselors Association
American Psychological Association
American Psychiatric Association
American Public Health Association
American Therapeutic Recreation Association
Anxiety Disorders Association of America
Association for the Advancement of Psychology
Association of University Centers on Disability
Bazelon Center for Mental Health Law
Children and Adults with Attention Deficit/Hyperactivity Disorders
Children’s Defense Fund
Children’s Law Center (DC)
Children’s Law Center of Los Angeles
Clinical Social Work Association
Depression and Bipolar Support Alliance
Eating Disorders Coalition for Research, Policy and Action
Foster Family-based Treatment Association
Kidsave
Mental Health America
National Alliance on Mental Illness (NAMI)
National American Council on Adoptable Children
National Association for Children’s Behavioral Health
National Association for Rural Mental Health
National Association of Psychiatric Health Systems
National Association of School Psychologists
National Association of Social Workers
National Council for Community Behavioral Healthcare
National Health Law Program
National Indian Child Welfare Association
National Network for Youth
National Respite Coalition
Orphan Foundation of America
Suicide Prevention Action Network USA
Tourette Syndrome Association, Inc.
United Jewish Communities
United States Psychiatric Rehabilitation Association