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Advocacy Report (9/8/2018)
By William J. Swift, MD
I spent time this Spring working with Eileen Hirsch, a supervising attorney at the UW Law School. The issue was mandatory Life Without Parole (LWOP) sentences for teenagers in Wisconsin who commit murder. I started to write an amicus brief arguing that sentences for adolescents who commit capital crimes should not be automatic (like LWOP) but should be thoroughly deliberated, looking at factors such as the possibility of rehabilitation, circumstances of the offense, family and home environment, level of maturity, capacity to appreciate risks and consequences, etc. before sentencing.

It was expected that the Supreme Court of WI would be reviewing two teen LWOP cases this year. One was Curtis Walker who shot and killed a Milwaukee police office in 1994 when 17 y/o; the other is Omer Ninham, who at age 14 y/o (2000) murdered a 13 y/o.

Hirsch was going to argue before the Supreme Court that the lower courts did NOT adequately consider their youth and circumstances at the time of their sentences; that the judges, in essence, just conferred mandatory sentences without adequate review. I was writing an amicus to support Hirsch's case.

But the Supreme decided NOT to put these two cases on their review docket this year. Thus, my efforts and Eileen Hirsch's efforts were put on hold for the time being. Maybe next year these case will reach the high court.

On the legislative front, things have been quiet of late as the Senate and Assembly have not been in session. But both reconvene in January, 2019. Almost certainly the biggest issue for child psychiatry will be renewed funding for the Child Psychiatry Consultation Program (CPCP) for the next biennium. Hopefully, the existing funds will not only be renewed but further expanded. I will be working with MCW and Children's Hospital of Wisconsin (CHW) on this important issue as well as other advocacy and medical groups.

Following the November election, the state legislature will undoubtedly have some faces. If you want to be an effective advocate on the state level, the first step is to meet with your assembly representative and Senator. Get to know them and develop a working relationship over time. Then you are in a position to educate them and advocate for key issues which the WISCCAP and the AACAP will delineate for you. When it comes to child advocacy, you have to be prepared to play the "long game." It is slow work but patience frequently pays off. 

Update from AACAP (June 8, 2017)
1. Save-the-Date! October Legislative Program and Congressional Visits during AACAP’s Annual Meeting Announced: As discussed, AACAP is excited to announce a new lobby program with Congressional visit scheduled for 2017 AACAP Annual Meeting attendees on Monday, October 23, starting at 9:00 am in Washington, DC. The Annual Meeting hotel registration opens next week (conference registration opens in August) so, as you think about your travel plans, consider arriving in Washington, DC early to join this free event to gain advocacy experience and lobby your own members of Congress. Once conference registration opens, the Legislative Program will be limited to the first 150 AACAP members that select the event during their conference registration. If not sold out, registration will close early for this event on September 15. On the heals of the record-setting 2017 AACAP Legislative Conference, this new opportunity is certain to be popular.

But we need your help! We’re looking to have all Congressional meetings well-coordinated and scheduled by AACAP members, and we need volunteers to serve as a state or regional captain to communicate with AACAP members that register for this event from your state/region and to help schedule Congressional meetings, a natural role for advocacy liaisons. We promise it will not take much time to serve as a captain and AACAP staff will provide ample resources on how and when to schedule meetings with your Congressional Representatives to ensure this is a smooth and easy process. Scheduling Congressional meetings for this lobby event will not start until September, but we want to secure state captains before conference registration opens in August. If you’re interested in serving as a captain for your area, or want to find out more information, please email Emily Rohlffs at

2. In-person Advocacy Liaison Meeting in Washington, DC (Tuesday, October 24, 4:15-6:15 pm): You are invited to join the scheduled meeting for the Advocacy Liaisons Network at the 2017 Annual Meeting, on Tuesday, October 24, from 4:15-6:15 pm, immediately following the Fall Assembly Delegate meeting. This meeting will allow the Advocacy Liaison Network to hear from physician leaders and learn helpful strategies on several topics including grassroots advocacy, mental health as a bipartisan issue, advocacy v. lobbying, and coalition building. This meeting should also allow some time for you to ask questions and network with fellow physicians interested in advocacy.

3. Contact your U.S. Senator to save children’s mental health coverage: If you have not yet sent your U.S. Senator an email telling him/her to protect children’s mental health care and oppose the American Health Care Act, which is expected to move to the Senate at any moment, don’t wait. We’ve made it easy to do here, and considering what’s at stake, it’s important to take action now.

4. Regarding the Netflix series "13 Reasons Why," below is what is currently made available on AACAP’s homepage:

AACAP Facts for Families:
• Movies, Media, and Children
• Teen Suicide
• TV Violence and Children
• Video Games and Children: Playing with Violence
Other Resources:
• Thirteen reasons to be concerned about "13 Reasons Why" by AACAP Member Sansea L. Jacobson, MD
• "13 Reasons Why" is must-watch TV for parents of teenagers by AACAP Member Mirjana Domakonda, MD
• 13 Reasons Why: Talking Points for Viewing and Discussing the Netflix Series by the JED Foundation
Does someone keep forwarding this email to you, or do you know someone that should join the AL network? Email Emily Rohlffs, State Advocacy Manager ( to join.

Emily Rohlffs
State Advocacy Manager
American Association of Child and Adolescent Psychiatry
American Academy of Child and Adolescent Psychiatry
Direct: (202)587-9668

Advocacy Update (5/1/2017)
The Wisconsin Legislature has been back in session since January 2017. Right now, the $76 billion state budget for the 2017-2019 biennium is the focus of the lawmakers' attention. Time is short because the budget must be finalized by June 30 as the new fiscal year starts July 1. The good news is that child and adolescent psychiatry is almost certainly to be a winner in these deliberations: MCOW's Child Psychiatry Consultation Program (CPCP) is slated to have its state funding increased to $1 million in each of the two biennium years. (Currently, the funding is $500,000 per year.) For those of you who are unfamiliar with the CPCP, this is a joint initiative of Wisconsin Department of Health and the Medical College of Wisconsin. CPCP provides telephonic consultation on all things child psychiatric to primary care providers (e.g., family medicine doctors, pediatricians, clinical nurse specialists, etc.) from two hubs in the state---Milwaukee and Wausau. This program has been running at full speed for almost two years now and has been extremely well received by the PCPs who have participated. Hundreds of Wisconsin's youth and their families have been helped by CPCP. The increased funding may allow the CPCP to open a new hub in the Fox Valley area. Bob Chayer (Milwaukee) and Gabi Hangiandreou (Wausau) are the two WISCCAP members most intimately involved with this project. The increased CPCP funding isn't a "done deal" until Governor Walker signs off on the final budget, but my sources tell me that it is a 99% certainty. CPCP was greatly helped by a huge turnout (450 physicians) on Doctor Day, March 29th at the State Capitol, in Madison. The assembled doctors lobbied the legislature on only 3 issues---efforts to counteract the opioid epidemic, improvements in Badger Care, and increased funding for the CPCP. As Donald Trump likes to say, that massive show of strength may have "closed the deal." The WISCCAP owes a huge debt of gratitude to the Wisconsin State Medical Society and our fellow physicians for their very public and very vocal support of the CPCP.

After a summer recess, the legislature will return in the Fall to consider non-budgetary matters. The Second Chance Initiative will be re-introduced then for legislative consideration. Wisconsin is one of only a handful of states that sends all 17-year-old youth automatically to adult court, no matter the nature of the crime. The Second Chance Bill would change the law so that 17-year-olds who commit minor crimes would be waived to juvenile court while those who commit major offenses would be remanded to adult court. This bill has had wide bipartisan support (e.g, former governors Doyle and Thompson have both endorsed it) in past legislative sessions but it has never gotten to the floor for a vote. Why? Because the juvenile justice system is financed by the counties while the state-funded Department of Corrections deals with adult offenders. As a result, county expenditures would increase if 17-year-olds enter the juvenile justice system, and the county executives have fought that with a fiscal vengeance. Sadly, this wonderful proposal has not passed because of political/fiscal venality. (That is the actual truth as best as I can divine it.) By the way, the WISCCAP has spoken in support of the Second Chance Initiative as well as the WI Chapter of the AAP, the WPA, & the State Medical Society. We will all continue our advocacy efforts for the Second Chance Initiative in the upcoming session.

Lastly, I would like to give you an update on the Slender Man Girls. They are scheduled to be tried in adult court this summer, three years after their attempted murder of a 12-year-old peer in Waukesha County. This case has been moving slowly through the court system because of multiple appeals. Both girls will face a bifurcated court proceeding. The first part of their trials will determine if they are indeed guilty of attempted, first-degree, intentional homicide. That is not in question, but the second part of trial will be much more complex as it will focus on whether they were "SANE" at the time of the crime or Not Guilty by reason of Insanity (NGI, in legal parlance). The advocacy interest of the WISCCAP is in ensuring that at the completion of the trial that the Slender Man Girls are placed in a developmentally appropriate facility for youth, NOT in an adult prison (if sane) and NOT in an adult mental hospital if NGI. My hopes are that the WISCCAP can influence the authorities to make a youth placement for these girls who are now 15-years-old.

Mike Witkovsky, Julie Nielsen, and myself will be watching the progress of the Slender Man Girls. If they are declared SANE at the time of the crime, they would be placed at the Copper Lake, the girls' juvenile correctional facility in Irma. However, Copper Lake and its male counterpart, Lincoln Hills, have been immersed in scandal the last few years (e.g., FBI criminal investigation of staff maltreatment of youth in their care; law suits brought by the ACLU and the Juvenile Justice Center in Washington, DC.). However, at the WISCCAP’s Spring Meeting in Delafield, we heard from Mr. John Paquin, the new Chief of Juvenile Justice/Department of Corrections, and the new Head of Mental Health Services, Dr. Tracy Johnson at the Irma facilities. Both of them reported that they are undertaking a thorough, rigorous reform of the Irma institutions. (We are all rooting that they will have enormous success.)

If the Slender Man Girls are declared NGI by the court, they would be placed on the adolescent unit at Winnebago Mental Health Institute in Oshkosh. This is a good unit, of course, but its average length of stay is 5-to-10 days. However, the Slender Man Girls would be remanded to Winnebago for years, at least until they are 18 years old. Clearly, a unit focused on lengthy, rehabilitative stays would be a better choice for them given the nature of their sentences. Does anyone know of a secure residential facility, in or out of the state, that might be a good fit for the needs of the Slender Man Girls? As I mentioned, Mike, Julie and I will working on this issue.

If you have questions or thoughts, we are welcome to contact me at I live only 2.5 miles from our State Capitol so it is easy for me to visit with legislators and to make known the concerns of the WISCCAP membership. On behalf of CPCP funding, I visited 6 lawmakers in 2017: Sen. Fred Risser (D--Madison); Rep. Teresa Berceau (D--Madison); Rep. Paul Tittl (R--Manitowoc), Chair of the Mental Committee; Rep. Joan Ballweg (R--Green Lake); Rep. David Considine (D--Baraboo); and Rep.Mike Rohrkaste (R--Neenah), member of the all-important Joint Finance Committee. All six were welcoming and all six prove to be strong supporters of childrens' mental health services.

Respectfully submitted,
Bill Swift, MD
Immediate Past-President, WISCCAP
Chair, WISCCAP Advocacy Committee 

2016 Advocacy: Wisconsin State Legislature
The Wisconsin State legislature reconvenes this fall to begin deliberations on the 2017-2019 biennial budget. The session is likely to be contentious one with Republicans prioritizing tax relief and Democrats aiming to strengthen social service programming. There are two prospective proposals that we will be following closely in this forthcoming session. First is state funding for the Child Psychiatry Consultation Program (CPCP) which is run by the Medical College of Wisconsin and Children's Hospital of Wisconsin. The CPCP now serves the Milwaukee Metropolitan Area and 16 northern Wisconsin Counties. This program allows primary care physicians to quickly access child psychiatry expertise, by phone and by E-Mail, to meet the pressing mental health needs of youth in their practices. CPCP is very worthwhile model because it is designed to compensate for the drastic shortage of child psychiatrists in Wisconsin by offering "at-a-distance," but very rapid response to consultation requests. The pilot CPCP program has been highly successful, but it will need a new infusion of state funding if it is to survive beyond the next year. We would like to see CPCP expanded to cover all 72 counties in the state.

The second initiative that we will be watching is the Second Chance Bill that would return first-time, nonviolent 17-year-old-offenders to the juvenile justice system. Currently, Wisconsin is one of only 9 remaining states that automatically prosecutes 17-year-olds as adults. Scientific studies have repeatedly shown that remanding 17-year-olds to adult prison fosters a "criminal identity" and leads to much higher rates of recidivism. We will have lots of help in lobbying for the Second Chance Proposal. Besides the WISCCAP, it is supported by the WI State Medical Society, the Wisconsin Psychiatric Association, the WI Chapter of the American Academy of Pediatrics, and the Wisconsin Council on Youth and Families.

From the judicial side of things, we will be keeping a close eye on the progress of the "SlenderMan" Girls. Right now, a state appellate court is deciding whether they will be tried as adults or juveniles. If these young girls are found "Not Guilty by Reason of Insanity," whether in juvenile or adult court, the WISCCAP is committed to ensuring that they receive "developmentally appropriate" psychiatric treatment. (WISCCAP Executive Committee Action, October, 2015.)

Members often ask me how can they be effective on behalf of children's mental health in the legislative arena. There is no easy answer, but the best bet is to meet with the Assembly Representative and State Senator representing you on the Capitol Square in Madison, and then (most importantly) to patiently cultivate a trusting relationship with them over time. Legislators love to hear from their constituents. And you can quickly become their "go-to" person when it comes to youth and family mental health issues. (To find out about how to identify and contact your state representatives, please go to Republicans currently dominate the state legislature: 64-to-36 in the Assembly and 19-to-14 in the Senate. So right now the GOP has the CLOUT. It is strongly recommend that WICCAP members in staunchly Republican counties like Waukesha, Washington, and Ozaukee make a special effort to reach out to their state representatives to educate them about the vast, unmet mental health needs of the children, teens and families of our state. Frankly, you are are likely to have a much greater impact than as a resident of ultra-liberal Dane County (home of "Mad-Town").

Wisconsin Council on Children and Families
WisKids Count Policy Brief
For more information, please contact