HOW TO BE A CHAMPION FOR
CHILDREN’S HEALTH
WHEN ADVOCATES DEDICATED TO CHILDREN’S HEALTH AND WELL-BEING RAISE THEIR VOICES,
great t hings happen
Photo by Justin Kelley, Women and Children’s Hospital University of Missouri Healthcare, Columbia, MO
Raise your voice and join the Children’s Hospital Association and activists
from children’s hospitals across the country as we work together to advocate
for policies that improve access to quality care for kids everywhere. With
your help, we can ensure our elected officials put forth policies that support
children’s unique health care needs.
TOGETHER WE:
Representing more than 220 hospitals, the Children’s Hospital Association
is the voice of children’s hospitals nationally. The Association works hard to
promote policies that enable hospitals to better serve kids, and is the premier
resource for pediatric data and analytics. Formed in 2011, the Association
brings together the strengths and talents of three organizations: Child Health
Corporation of America (CHCA), National Association of Children’s
Hospitals and Related Institutions (NACHRI) and National Association of
Children’s Hospitals (N.A.C.H.).
• Worked to pass legislation that would help alleviate the record
number of drug shortages that hamper quality pediatric care
• Halted Medicaid cuts that would harm children’s access to health care
• Secured funding to train more than 6,000 pediatric specialists at
nearly 60 independent children’s teaching hospitals
But the fight for quality health care for all kids is far from over.
WE NEED TO ENSURE THAT CHILDREN HAVE ACCESS TO
THE RIGHT CARE AT THE RIGHT TIME.
AND WE NEED YOUR HELP TO DO IT.
1
IT’S EASY TO BE A CHAMPION FOR CHILDREN’S HEALTH
The children we serve depend on champions like you to be their advocates and
to support policies that improve the well-being of all children. Whether you’re
a patient, parent, staff member, or just concerned about our kids’ health, you
can raise your voice to influence local, state, and federal policies. We need to
educate our elected officials on how their decisions impact children’s health.
It is important that champions for children’s health work within the law to
change the law. Federal and state governments limit the amount of legislative
advocacy in which nonprofit organizations may engage, but there are no such
limits on concerned private citizens. Legislative advocacy by private citizens
is constitutionally protected by the Bill of Rights, just like freedom of speech
and freedom of religion. In fact, elected officials encourage petitioning the
government; they want to hear from the people who elect them. As jazz great
Wynton Marsalis once said, “We always hear about the rights of democracy,
but the major responsibility of it is participation.”
Follow these simple recommendations to increase your effectiveness as a
champion for children’s health:
n FIND YOUR LEGISLATORS
n WRITE TO YOUR LEGISLATORS
CONTENTS
LEARN ABOUT THE LEGISLATIVE PROCESS................................................... 4
Find your legislators........................................................................................................................ 5
WRITE TO YOUR LEGISLATORS......................................................................... 6
When to write....................................................................................................................................8
ADVOCATE THROUGH SOCIAL MEDIA.......................................................... 10
Facebook.............................................................................................................................................11
Twitter..................................................................................................................................................12
Send a video message...................................................................................................................14
When making your video.............................................................................................................15
MAKE TIMELY PHONE CALLS............................................................................18
VISIT YOUR LEGISLATORS................................................................................20
Prepare for your visit....................................................................................................................22
The powerful 90-second prepared speech.........................................................................22
During your visit..............................................................................................................................23
After your visit.................................................................................................................................24
RESOURCES.......................................................................................................... 26
Glossary of terms...........................................................................................................................26
Common policy priorities for children’s health.................................................................. 27
Additional resources.....................................................................................................................28
nP
ROMOTE YOUR POSITIONS THROUGH SOCIAL MEDIA
n MAKE TIMELY PHONE CALLS
n MEET YOUR LEGISLATORS
2
3
INTRODUCTION
HR 1 Introduced in
House
➧
TAKE ACTION
COMMITTEE
ACTION
Referred to House
Committee
➧
REFERRED TO
SUBCOMMITTEE
➧
REPORTED
BY FULL
COMMITTEE
➧
RULES COMMITTEE
ACTION
➧
TAKE ACTION
FLOOR ACTION
House debates, vote on
passage
HOUSE
➧
➧
HOUSE
THE LEGISLATIVE PROCESS
➧
This chart is meant as a general overview –
most legislation follows this process.
Occasionally, however, a piece of legislation
will skip one or even many steps to be passed
➧
➧
TAKE ACTION
COMMITTEE
ACTION
Referred to Senate
Committee
➧
REFERRED TO
SUBCOMMITTEE
➧
REPORTED
BY FULL
COMMITTEE
As a champion for children’s health you want to be in the know when it comes
to understanding the legislative process. Creating and passing legislation is
complicated. This chart will help you understand how a bill becomes a law.
Remember that at every step in this process, you have the power to influence
your legislators. Some sit on committees that craft legislation before it
reaches the full House or Senate. And all of them will ultimately vote on any
legislation considered by Congress. There is no bad time to reach out to your
legislators, but some steps in the process allow for more influence from the
public (indicated by TAKE ACTION above). This guide will show you how to
maximize your effectiveness in communicating with lawmakers.
4
➧
PRESIDENT
SIGNS OR
VETOES
➧
SENATE
more quickly.
INTRODUCTION
S2 Introduced in Senate
➧
CONFERENCE
ACTION
TAKE ACTION
FLOOR ACTION
Senate debates, vote on
passage
SENATE
➧
FIND YOUR LEGISLATORS
There are multiple resources available to find your elected officials at each
level of government. For starters, visit www.speaknowforkids.org and click
TAKE ACTION . You’ll be given contact information on all your lawmakers,
from the president all the way down to your city council. You can also find
information about important bills Congress is considering that may have an
impact on children’s health care. And, as you’ll see next, we give you the tools
you need to contact your legislators.
5
WRITE TO YOUR LEGISLATORS
Elected officials respond to constituent outreach
in a number of different ways. In-person visits carry
the most weight with legislators, but of course it’s
not always convenient to visit your legislator in
Washington, or even while they’re at home in their
district offices. Luckily, more than 90 percent of
congressional staffers say that written communication
from a constituent can influence their bosses.
write
Now that you know who your legislators are, let’s talk about the best way to
contact them. As a constituent, you carry a lot of power with your elected
officials – remember, they work on your behalf. Simply visit our Legislative
Action Center at www.capwiz.com/nach. There you’ll find pre-written letters
to your legislators you can personalize with your thoughts on why quality
health care for all kids is so important. Many congressional staffers say a
personalized letter carries more weight since it illustrates that the constituent
took the time to tell his or her story.
While our pre-written letters will cover most of the basics, here are some more
tips on writing to legislators:
• Begin by introducing yourself as a constituent. Many legislators won’t
accept letters or emails from folks outside their district.
6
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ake the ask. Within the first paragraph, specify what action you want
taken and, if possible, refer to bills by name or number.
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Follow this approach for a successful email
communication with your elected official.
• Briefly explain the issue you are referencing – this is your chance to educate
legislators on how the policy will affect you.
•M
ake it personal. Briefly share your story about how your legislator’s
actions will directly impact you, your community, your job, and your family.
•A
sk for your legislator’s view on the issue. If they agree with your opinion,
you can hold them accountable if they don’t vote your way.
• I nclude your name, home address, email address and phone number.
It is important to include your home address so you can be identified as a
constituent.
• Include a link to your CarePage or blog if you have one.
• Keep the length of your email to three or four paragraphs, and
less than 500 words.
7
WRITE TO YOUR LEGISLATORS
“
Kyler Quincy from Vermont
visits Capitol Hill. Kyler is in
Washington, DC with Boston
Children’s Hospital.
”
“Political action is the highest
responsibility of a citizen.”
— John F. Kennedy
WHEN TO WRITE:
There is no wrong time to communicate your concerns to your legislator, but
there are key times in the legislative process where legislators may be most
receptive to your point of view (these are indicated by TAKE ACTION on the
chart on page 4 and 5):
• When a legislator acts favorably on your request, follow up with a thank
you note regardless of whether or not the end result of the vote is consistent
with your position. The thank you note strengthens the constituent/legislator
relationship and helps reinforce that constituents pay attention and are
engaged in the entire legislative process.
• After a bill is introduced and assigned a number it is sent to the appropriate
committee. This is a great opportunity to educate your elected official on the
impact that the new legislation may have on children’s health. Committees
are always seeking input from the public, and sending an email can provide
just the right amount of detail and personal touch.
• Congress still accepts snail mail, and many legislators say they appreciate
hand-written letters. But keep in mind that because of security restrictions it
can take more than three weeks for your letter to arrive.
• Just before a committee takes action or votes is another ideal time to reach
out to your legislators with a clear request to vote for or against proposed
legislation.
8
9
INTERACT WITH LEGISLATORS ON FACEBOOK AND TWITTER
A survey conducted by the Congressional
Research Service in late 2011 found that
legislators sent more than 30,000 Tweets
and posted more than 16,000 times on
Facebook in just two months.
connect
Social media has radically increased the number of venues and opportunities
constituents have to communicate with lawmakers. Legislators continue to rely
on traditional means such as their own websites and email, but have begun
using blogs, YouTube, Twitter, and Facebook to be more accessible to those
that elect them. Additionally, electronic communications are less expensive
than sending postal mail, and allow legislators to respond much more quickly.
10
Finally, social media allows you to break down geographical barriers to
communicating with Congress. Normally, legislators only want to hear from
constituents – the people that live in their district, vote for them and keep
them in office. Social media, of course, is not tethered by these restrictions;
you can communicate through Twitter and Facebook with a legislator in a
position of leadership, or who has jurisdiction over a key health committee,
even if they aren’t your legislator. (You can learn more about congressional
committee jurisdiction on page 28.)
FACEBOOK
More than 90 percent of legislators in the 113th Congress have a Facebook
page and use it for sharing information with constituents. Legislators are most
frequently using Facebook to communicate their opinion on pending issues or
legislation. However, they also use Facebook to talk about what is going on in
their states or districts, including events they’re holding or attending – this is a
good way to find out about where you can meet your legislator in person.
In addition, legislators read comments and posts on their Facebook pages. In
a study by the Congressional Management Foundation, nearly two-thirds of
House and Senate social media managers said Facebook is an important tool
for understanding constituent views and opinions. Keep track of what they
post and add your thoughts; these are great ways to make your voice heard.
11
INTERACT WITH LEGISLATORS ON FACEBOOK AND TWITTER
Photo by Dana Johnson, Monroe Carell Jr. Children’s Hospital at Vanderbilt, Nashville, TN
TWITTER
Twitter has become a favorite tool of legislators to release press statements,
photos, and short news items. In the 113th Congress, 100 percent of senators
and more than 90 percent of representatives use Twitter. Every state has at
least 70 percent of its delegation on Twitter.
There are two easy ways to find your legislator’s Twitter handle:
1) Visit www.tweetcongress.org and enter your home address. You’ll be given
information about your legislators as well as their Twitter handles.
2) Visit www.govsm.com, a Wiki page devoted to legislators’ social media
usage. You’ll need to know the names of your legislators in advance, but
you’ll see the full range of social media platforms they are currently using.
12
Reaching your legislators through Twitter is easy; simply begin your tweet with
their Twitter handle (user handles begin with an @ sign). You’ll also want to
include relevant hashtags, (which begin with a # sign). Hashtags are a way of
branding your tweet and making it easier to track conversations. For example:
@SpeakerBoehner Please support children’s health by providing funding for
#Medicaid and #CHGME.
Other common hashtags used by the Children’s Hospital Association include:
#speaknowforkids
#medicaid4kids
#dontcutkids
#healthcare
#congress
13
SEND A VIDEO ADVOCACY MESSAGE
“
“One of our office’s top priorities is
”
maintaining a high quality of dialogue
with the people we represent.”
— Senate Correspondence
Manager, “Communicating
with Congress,” report
by the Congressional
Management Foundation
Video messages are an important and personal way to share with legislators
how you feel about a topic or policy.
While there’s no substitute for face-to-face interaction with your elected
officials, recording and sharing a video advocacy message explaining how
an issue affects you personally is a close second. If you’d like, you can let
the Children’s Hospital Association know you are planning to send
your legislators a video advocacy message. Just send an email to
[email protected]. We can provide you with the most
immediate policy concerns affecting children’s health which will enhance
the effectiveness of your message (also be sure to visit our website,
www.childrenshospitals.net). We can also post your video to our YouTube
page to increase your visibility. And of course, don’t forget to post your
video to your social media and on your legislators’ Facebook wall.
14
Best practices for recording a video advocacy message:
Try to think of your video advocacy message as a quick face-to-face meeting
with a decision-maker. You are in complete control of the content of this video
“meeting.” The ideal length for your video advocacy message is less than 90
seconds.
When making your video, address these important details:
• The decision-makers who watch your video will want to know your name,
city, and state. Do not include your home address as this video will be
accessible to the public
• If you are recording a message for your senator, it is appropriate to
address her as senator and use her last name. If you are contacting your
representative, you can address him as congressman or her as congresswoman
and use his/her last name.
15
SEND A VIDEO ADVOCACY MESSAGE
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Use this example e-mail containing your
video advocacy message.
Follow this example for an introduction:
“Congresswoman Johnson or Senator Cornyn, my name is Jennifer Smith
from Houston, Texas, and I want to tell you why Medicaid is so important in
my child’s life and how it addresses his special health care needs.”
• If you are or your child is a current or former patient, or if you work at a
children’s hospital, mention the name of your hospital.
•B
e prepared with what you want to say – it’s always okay to prepare a script
in advance.
•S
peak slowly and clearly. A helpful tip is to address the elected official
directly by looking straight into the camera.
• Remember, this video is your opportunity to share with decision-makers
your personal interest and passion about this issue.
•C
learly state what action you want taken and mention the bill name and
number if you know it.
16
17
MAKE TIMELY PHONE CALLS
Communication from constituents is
crucial. A well-timed phone call can have
a big impact on influencing legislation.
call
A personal phone call to your legislator’s office is always an effective and
timely advocacy tool. It’s quicker and more personal than an email, and your
legislators will appreciate your input.
When calling your legislator’s office:
•P
rovide your name and address so you are recognized as a constituent.
• I dentify the bill or issue you are calling about by its name and/or number if
you have it.
• Ask to speak to the staff member who handles health issues. You won’t be
able to speak directly to the legislator, but the health staffer will relay your
comments and concerns.
• Briefly state your position and how you would like your legislator to vote.
18
• Ask for your legislator’s stance on the bill or issue and for a commitment to
vote for your position. Remember to make the ask.
•D
on’t guess at answers to questions. If the elected official’s office requests
information you don’t have, tell them you will gladly follow up with
requested information.
•F
ollow up with a note restating your
position and thanking the legislator or
staff member for his or her time.
It is important to keep your phone calls
quick and simple since most offices are
flooded with phone calls. For the most
effective phone conversation, follow
this example:
“
“Hello, this is Tiffany Smith at 123
Main Street in Hartford, CT. As your
constituent, I am calling to let you
know that I fully support H.R. 1234,
which would expand health care
”
coverage for children. I urge you to
vote yes. Thank you.”
19
VISIT YOUR LEGISLATORS
Amauri Bowman from South Carolina meets with Rep. James
Clyburn (D-SC) on the steps of the U.S. Capitol. Amauri is in
Washington, DC with The Children’s Hospital of the Medical
University of South Carolina.
visit
Photo by Ken Cedeno
20
Visiting your legislator connects the issue you care about to the people your
legislator was selected to serve. While less convenient than using email,
social media, or calling by phone, it is by far the most effective means of
conveying your message.
Building a positive face-to-face relationship requires that you to plan ahead.
If you would like to visit your legislator, you may want to consider contacting
your children’s hospital government relations department to ensure that your
efforts and messages are coordinated.
The more personal the interaction you have with your legislators, the more
attention your request will receive, and nothing is more personal than an
face-to-face meeting. In a recent survey, 77 percent of congressional staffers
said that an in-person visit carried the most weight in terms of delivering a
constituent message. Visiting your legislators may sound intimidating, but
remember: their offices are open to the public; they are elected to work for
you; and they need to hear your story and opinions in order to vote on issues
that will benefit the communities that they serve.
Please note that legislators often can’t control their calendars and frequently
ask their staff to handle meetings with constituents. These meetings are just
as effective; the staff member will relay your concerns and comments to the
legislator, and will frequently advise them on how to proceed.
21
Zeb Garvey-Knapp from Vermont talks with
Sen. Patrick Leahy (D-VT) at the Russell Senate
Building on Capitol Hill. Zeb is in Washington,
DC with Boston Children’s Hospital.
VISIT YOUR LEGISLATORS
An example of a good introduction/90-second speech:
“Hi, I’m Chuck Jenkins. I am a constituent of yours and I am here to
talk with you about health care coverage for children. I am asking
you to vote yes on H.R. 1234, which reauthorizes the Children’s
Health Insurance Program. CHIP provides health insurance
to children who do not qualify for Medicaid and can’t afford
to purchase private insurance. Here’s a sheet with some more
information. My phone number and e-mail address are included if
you have any questions. Thank you for your time today.”
Photo by Ken Cedeno
Prepare for your visit:
•M
ake an appointment in advance. Expect to get about 15 minutes with
your legislator or their staff, but be prepared to deliver your message in as
little as 90 seconds.
• Be on time.
• Be prepared by knowing where your legislator stands on the issue by doing
some research on his or her website. You can also contact the Children’s
Hospital Association at [email protected] to get your
legislators’ voting history.
• The Children’s Hospital Association frequently posts fact sheets on its
website; download the relevant fact sheets to share with your legislators and
their staff.
22
• Use this meeting to explain how the bill or issue will affect you personally, as
well as other voters in your district or state.
• Dress in business attire for an appointment with your legislator.
During your visit:
• Firstly, summarize in a 90-second speech who you are and why you are
meeting with the legislator by doing the following:
· Identify yourself as a constituent
· Identify your relationship to your children’s hospital (if any)
· Highlight the issue you came to discuss
· Be specific about the action you want taken
•M
ake the ask. You can’t know if the legislator will support (or oppose) a
given piece of legislation if you don’t ask.
•S
tick to the issue and avoid political attacks on your legislator or staff (or
even his opposition).
23
VISIT YOUR LEGISLATORS
Photo by Julie Stefaniak, Women and Children’s Hospital of Buffalo, Buffalo, NY
•S
hare a personal story by providing context for why you care about the
issue.
• Before leaving, ask how you can be of help on this issue. Position yourself
as a resource.
• Give your legislator or staff the fact sheet on your issue and briefly highlight
your points.
•T
hank the legislator or staffer for his time.
After your visit:
Follow up with a thank you letter or email and include any information that
was requested by the legislator. This will strengthen your relationship and leave
a positive impression with the legislator’s office.
24
25
GLOSSARY OF TERMS
Glossary adapted from “Congress at Your
Fingertips,” copyright 2013, CQ-Roll
Call, Inc. Publishing: Newington, VA.
Filibuster — Tactic used in the Senate
whereby a minority intentionally delays
a vote
Act — Legislation that has passed both
Houses of Congress and becomes law
Lame Duck — Senator or representative
(or the president) who has not been
reelected but whose term has not yet
expired
Amendment — A change in a bill or
document by adding, substituting or
omitting portions of it
Appropriations Bill — Legislation that
provides funds for authorized programs
Authorization Bill — Legislation
establishing a program and setting
funding limits
Lobbying — The process of attempting
to influence the passage, defeat or content
of legislation by individuals or a group
other than legislators
Bill — Legislation introduced in either
the House or Senate
Majority Leader — Chief spokesman
and strategist for the majority party,
elected by members of the majority party.
In the House, the majority leader is the
second-ranking lawmaker, behind the
Speaker of the House
Budget Resolution — Concurrent
resolution that establishes spending and
revenue targets for the upcoming fiscal year
Minority Leader — Chief spokesman
and strategist for the minority party,
elected by members of the minority party
Chamber — Place where the
entire House or Senate meets to
conduct business; also, the House of
Representatives or the Senate itself
Omnibus Bill — Bill regarding a single
subject that combines many different
aspects of that subject
Cloture — Method of limiting debate or
ending a filibuster in the Senate. At least
60 Senators must vote in favor before
cloture can be invoked
26
COMMON POLICY PRIORITIES FOR CHILDREN’S HEALTH
Quorum — The number of senators
or representatives who must be present
before a legislative body can conduct
official business
Committee — A group of legislators
assigned to give special consideration to
certain bills
Ranking Members — The members
of the majority and minority party on
a committee; next in seniority after the
chairman
Conference Committee — Meeting
between representatives and senators to
resolve differences when two versions
of a similar bill have been passed by the
House and Senate.
Sequestration — The permanent
cancellation of budgetary resources by
a uniform percentage, applied to all
programs, projects and activities within a
budget account
Continuing Resolution — A joint
resolution to appropriate funds, usually
for a short period of time and often in the
absence of a regular appropriations bill
Speaker — The presiding officer of the
House, elected by members of the House
Cosponsor — Legislator who joins in
sponsoring legislation but who is not
the principal sponsor or the one who
introduced the legislation
Medicaid
Medicaid is a federal-state program that covers 40 percent all children in the U.S.
While a quarter of the population, children are roughly half of all Medicaid recipients.
Children’s hospitals provide about 45 percent of the hospital care required by children
covered by Medicaid and almost all the hospital care for Medicaid-covered children
with complex medical conditions.
Medicaid, on average, pays for 56 percent of all inpatient days of care provided
by independent children’s hospitals. However, Medicaid payments for services are
inadequate, resulting in barriers to care for children covered by Medicaid. On average,
Medicaid pays only 78 percent of the cost of care, even after hospitals account for
supplemental payments, such as disproportionate share hospital payments, that provide
financial help to hospitals that treat a large number of Medicaid and uninsured
patients.
Get the facts on Medicaid in your state by visiting
www.childrenshospitals.net/statebystate.
CHIP
The Children’s Health Insurance Program (CHIP) provides health insurance to
children who do not qualify for Medicaid and do not have access to private health
insurance. It provides federal matching funds for states that put up funds of their own
to expand Medicaid to uninsured children of low-income families, create alternative
insurance programs for them or both.
The Affordable Care Act authorizes and funds CHIP through Sept. 30, 2015. After
that date, states may enroll CHIP-eligible children in qualified health plans that have
been certified by the Secretary of Health and Human Services. Beginning on Oct. 1,
2015, states will receive a 23 percentage point increase in their CHIP federal matching
rate. Congress will revisit CHIP, as the program’s funding and authority will need to
be extended beyond 2015, providing another opportunity for children’s hospitals and
Congress to ensure public policies strengthen children’s health care coverage.
Children’s Hospitals Graduate Medical Education or CHGME
Children’s Hospitals Graduate Medical Education (CHGME) program was created
in 1999 to provide children’s hospitals with federal graduate medical education
(GME) support comparable to the GME support the federal government provides to
adult teaching hospitals through Medicare. CHGME supports the training of 6,000
residents at nearly 60 independent children’s teaching hospitals. Hospitals receiving
CHGME funds train nearly half of all pediatricians and pediatric specialists.
Sponsor — The representative or senator
who introduces a measure
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TRICARE
TRICARE is the Department of Defense military health system for active duty
military, guard and reservists, and their families, serving more than 9.6 million
beneficiaries, including almost 2 million children. TRICARE is the only health
insurance plan for children that is consistent in policy and payment across all 50
states. The Children’s Hospital Association TRICARE Project seeks to optimize the
military health system’s understanding of children’s health care needs, and the ability
of children’s hospitals to best serve military children.
ADDITIONAL RESOURCES FOR CHILDREN’S HOSPITAL
ADVOCATES TO STAY INFORMED
The Children’s Hospital Association website provides more details on policies affecting
children’s health and how you can get involved as a champion for children’s health
www.childrenshospitals.net.
Take action and find bills, voting records and other legislative activity at our
Legislative Action Center at www.capwiz.com/nach.
Contact us at [email protected]
Relevant Congressional Committees
House Energy and Commerce Committee
energycommerce.house.gov
Maintains principal responsibility for legislative oversight of drug safety, Medicaid, and
the Children’s Health Insurance Program (CHIP).
Senate Finance Committee
www.finance.senate.gov
Has jurisdiction over Medicaid.
Senate Health, Education, Labor and Pensions (HELP) Committee
www.help.senate.gov
Handles most issues relating to public health, medical research, and individuals with
disabilities.
Other resources:
U.S. House of Representatives: www.house.gov
U.S. Senate: www.senate.gov
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401 Wythe Street
Alexandria, VA 22314
703-684-1355
6803 West 64th Street
Overland Park, KS 66202
913-262-1436
W W W.CHILDREN SHOS P I TA L S .ORG