Bill would fund children’s psychiatric residencies

U.S. Sen. Sheldon Whitehouse last week unveiled legislation that would allow children’s psychiatric hospitals that train residents – including Bradley Hospital – to qualify for federal payments to cover the extra costs associated with taking residents.
Bradley is one of the few children’s psychiatric hospitals that train residents in child and adolescent psychiatry, pediatrics and general psychiatry. But as a psychiatric facility, it’s excluded from the Children’s Hospitals Graduate Medical Education Payment Program.
At a roundtable discussion with Bradley residents and medical faculty last week, Whitehouse, a Rhode Island Democrat, said he’s introduced a bill, the Children’s Hospitals Education Equity Act, to change that. U.S. Rep. Patrick J. Kennedy, D-R.I., is doing the same in the House of Representatives.
“Teaching hospitals offer new doctors invaluable experience working with patients, and the federal government has long recognized that additional funding helps make these residency programs possible,” Whitehouse said in a statement. “At a time when we’re facing a shortage of psychiatrists trained to work with children and young people, we can’t afford to let programs like Bradley’s fall through the cracks.”
The federal government has estimated that 12,624 child and adolescent psychiatrists will be needed by 2020, far exceeding the projected supply of 8,312. There are now about 6,300 child and adolescent psychiatrists nationwide, with particular shortages in poor and rural areas.
Bradley trains 10 psychiatry residents per year through a partnership with the Hasbro Children’s Hospital and the Warren Alpert Medical School at Brown University. The hospital supports a residency program in child and adolescent psychiatry; a “triple board” program that trains residents in pediatrics, general psychiatry, and child and adolescent psychiatry; and postdoctoral fellowships in clinical psychology and a National Institutes of Health-funded research training program.
Bradley is one of only four hospital-based programs in the United States that is affiliated with a medical school and that specializes in serving children with both psychiatric disorders and developmental disabilities.
Most teaching hospitals get graduate medical education funds from Medicare, but children’s hospitals get funds from a separate program, the Children’s Hospitals Graduate Medical Education Payment Program, created in 1999. The latter, which includes about 75 hospitals, had $301.6 million to dole out in fiscal 2008.
To qualify, hospitals must meet the Social Security Act’s definition of a “children’s hospital,” which is “a hospital whose inpatients are predominantly individuals under 18 years of age,” among other qualifications. The new legislation would expand the definition to include “a freestanding psychiatric hospital with 90 percent or more inpatients under the age of 18.”
The bill has been endorsed by the American Academy of Child & Adolescent Psychiatry, the Association for Behavioral Health and Wellness, the National Alliance on Mental Illness, the National Association for Children’s Behavioral Health, and the National Association of Psychiatric Health Systems.
Had Bradley qualified for program funds in fiscal 2008, it would have received as much as $390,000. Dr. Gregory K. Fritz, academic director at Bradley, said he was “grateful” that Whitehouse and Kennedy “have taken the lead to help correct this glaring example of unintentional but serious stigmatizing of children with psychiatric disorders.”
Founded in 1931, Bradley Hospital, a Lifespan health system member, was the nation’s first psychiatric hospital for children and adolescents. It is a nationally recognized center for children’s mental health care, training and research, and a teaching hospital for the Warren Alpert Medical School of Brown University. For more information, go to www.bradleyhospital.org.