Advocacy Archives – New York State American Academy of Pediatrics (District II)

The American Academy of Pediatrics, District II, New York State, representing almost 6,000 pediatricians across the state, enthusiastically supports S.6500/A.9381. This legislation requires any hospital with a newborn nursery to offer new parents, and others who may be regular caregivers in the household of a newborn, immunization against pertussis (whooping cough).

Newborns are at very high risk of serious illness or death should they contract the pertussis. Most recently, nine babies in California died of complications from pertussis. Here in NYS, we have had several outbreaks of pertussis in various parts of the state including on Long Island and in several areas upstate. We have also had to treat some very sick babies.

For clinical reasons, it is not advisable to vaccinate newborns. Therefore the parents and caregivers in the home of newborns need to be immunized. They are the primary pathway through which newborns are exposed to pertussis. Offering parents and other key caregivers the opportunity to be immunized by the birthing hospital prior to newborn’s discharge will go a long way to protecting infants across the state from life threatening dangers of pertussis.

Families who are dealing with the challenges of birth and the needs of a newborn are often overwhelmed with new and complicated responsibilities. Requiring hospitals with newborn nurseries to offer immunization to parents and caregivers will lessen the burden of potential serious illness in highly vulnerable infants. It will also allow parents to take the most responsible action on behalf of their babies without adding additional scheduling and travel requirements to already overstressed families.

This approach, termed, cocooning, is an effective public health approach to protect infants too young to receive their own protection through immunization. This legislation will also help New York address the current breakthrough episodes of pertussis in the general population.

We encourage the legislature to pass, and the Governor to sign this bill, as soon as possible so that we may begin to help protect our vulnerable infants across the state of New York.

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Memo of Support
A.02474A/S.3186
January 17, 2012

Contact: Elie Ward, Director of Policy & Advocacy
eward@aap.net
518-441-4544

The American Academy of Pediatrics, representing more than 5,500 pediatricians across the state supports A.02474/S.3186 providing legal support for physicians to negotiate with insurers for fair service and reimbursement contracts.
Due to the current imbalance of negotiating power in favor of the managed care plans, physicians are offered take-it-or-leave-it contracts by health plans that can significantly hamper their ability to provide quality patient care. These contracts often permit burdensome processes and unjustifiably long wait times for obtaining pre-authorization to provide needed patient care; impose limitations on whom a physician or other health care provider may refer a patient for necessary care; permit demands for refunds of payments long after the time that such payments were originally made; permit health plans to make major changes to key elements of a contract without physician consent; and cede to physicians and other health care providers the legal consequences for patients harmed by health plan utilization review decisions.
Right now, the playing field in health care contract negotiations strongly favors large managed care plans and disempowers physicians to represent the needs of their patients.
By allowing independent contractor physicians and health care providers to conduct some collective negotiations while being closely monitored by the state, this bill would give physicians greater ability to advocate for patients in contract negotiations. This bill would also create a system under which the state could closely monitor those negotiations, and any negotiations involving fee-related matters would only be permitted when an individual managed care plan controls a substantial share of the managed care market. This legislation would not authorize strikes or boycotts of health benefit plans by physicians.
We fully support A.0274/S.3186 because we believe it will not only help improve health care, it will also create an equitable partnership between health care service providers and large managed care insurers across the state. This legislation will have the ultimate effect of improving patient care and keeping more highly skilled physicians in New York State.

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Memo of Support
A.7285B
February 9, 2012

Contact: Elie Ward, Director of Policy & Advocacy
eward@aap.net
518-441-4544

AN ACT to amend the Public Health Law to prohibit smoking in private passenger cars, vans and trucks where a minor less than 14 years of age is a passenger in such vehicles; provides for rebuttable presumption; provides that violations of such provisions shall be subject to a fine of not more than $100.
The American Academy of Pediatrics, District II, NY representing 5,500 pediatricians across the state and the millions of New York children we care for, enthusiastically supports A.07285B.
The AAP has had a consistent and strong policy on tobacco control and cessation. It has also been in the forefront of research on the negative health impacts of second hand smoke (SHS) on children through the work of its Julius B. Richmond Research Center.

The data is clear, second hand smoke has significant negative impacts on infants, toddlers, young children and pre-adolescents. In fact, SHS has a negative impact on the health of all people, but the outcomes for children are especially concerning. Children who are exposed to SHS have more respiratory and bronchial infections and irritations. They are more prone to develop asthma and other breathing challenges. Additionally, children who are already at risk of poor health outcomes because of asthma and other chronic illnesses are especially vulnerable to SHS.

Passing this legislation will put New York squarely in favor of protecting children’s health. Protecting children from SHS within the confines of a car will go a long way to reducing negative health impacts of SHS across the state. In addition, passage of this legislation provides an opportunity to mount a focused public education campaign about the dangers of second hand smoke. Not smoking in cars can be equated with securing your child in a child seat or a seat belt. It is the safe and smart thing to do.

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Position Statement on Legislation Before the Assembly Health Committee
February 7, 2012

Contact: Elie Ward, Director of Policy & Advocacy
eward@aap.net
518-441-4544

The Academy of Pediatrics, representing more than 5,000 pediatricians across the state
Supports:

- - A. 3621 This bill has the potential to push landlords to do appropriate lead abatement in housing units in a more timely manner. The increased fines may reduce childhood exposure to lead, while at the same time providing additional resources to government. AAP supports this bill.
  - A. 3815 This bill can impact on the availability of toxic candies and toxic child specific products. We firmly support the goals of this legislation, but believe for the State Department of Health to do a credible job in interdicting toxic candies and child specific products, it would need resources to hire more inspectors and more public educators to help parents in targeted communities understand the dangers that these products pose to their children.
  - A.04285 This bill provides parity for the state’s Child Health Plus and Family Health Plus programs. It is imperative that this legislation is passed to assure that children and parents in state subsidized health insurance programs have access to the same mental health benefits as those covered by Medicaid and by private insurance. This is a bill that guarantees equity and should be supported.

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American Academy of Pediatrics, District II, New York State
Supportive Positions on Pending Initiatives in New York City

Memo of Support
May 31, 2012

The American Academy of Pediatrics, District II, NYS representing more than 3,000 pediatricians working in the five boroughs, enthusiastically supports and endorses New York City’s initiative Supporting Women’s Choice to Breastfeed. The Academy has been on record in support of breastfeeding as the best choice for babies and for mothers. Most recently the AAP released clear recommendations in its professional journal Pediatrics detailing its specific support for breastfeeding and citing the overwhelming scientific evidence to support breastfeeding as the best option unless medically contraindicated.

In support of the City’s Breastfeeding Initiative the District will:

- - Stand with the Department leadership to call for hospitals voluntary commitment to support breastfeeding and reduce infant formula promotion in hospitals and pediatric offices
  - Participate with the Department in a public awareness campaign in support of Breastfeeding
  - Link our website to all Department materials in support of Breastfeeding
  - Link our website to the State’s Breastfeeding Bill of Rights and encourage members to print it out and make it available to all patients with newborns.
  - Work with our members to assure that they all support Breastfeeding as the best option for their patients.
  - Work with our members to help them help their patients get the support they need to sustain their commitment to breastfeeding, such as Lactation Counseling.
  - Prepare and disseminate our own Press Release detailing AAP’s support for the City’s Supporting Women’s Choice to Breastfeed initiative.

Contact: Elie Ward, Director of Policy & Advocacy
eward@aap.net
518-441-4544

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American Academy of Pediatrics, District II, New York State
Opposing Positions on Pending Legislation in New York State

Memo of Opposition for A.592
Expanded “Religious” Exemption from Immunization
January 17, 2012

Contact: Elie Ward, Director of Policy & Advocacy
eward@aap.net
518-441-4544

The American Academy of Pediatrics, District II, New York State, representing almost 6,000 pediatricians across the state, opposes A592. This bill will expand the ability of parents to claim a “religious” exemption to avoid immunizing their children.
New York State already has religious exemption legislation and a functional regulatory structure. Families who have true religious issues with immunization, can, and do meet the tenets of their religious beliefs within the context of current law. If there are problems with the implementation of the current law and regulation in specific school districts, then those problems should be addressed and resolved.
This bill however, has very little to do with religion. Rather it provides an option for an exemption without clearly stating the decision basis for such an exemption. It is to all extents and purposes a philosophic exemption, since a parent need only state that they are opposed to immunization for “religious” reasons. Every state that has implemented a philosophic exemption has seen a reduction in the percent of children immunized.
Taken in any other context, this bill would allow a person to say that their “religion” doesn’t allow speed limits therefore they don’t need to obey the speed limit; or their “religion” provides for carrying a concealed weapon at all times and therefore they can do that. And all they would have to do, if this legislation was more broadly applied, is self attest to their “religious” belief re speed limits or concealed weapons.
Civil liberties are an important part of our lives, but civil liberties and social responsibility are always held in balance by the concept of public good. That is why, although we have free speech, we cannot yell “Fire” in a crowded public place, unless, of course, there is a fire.
Universal immunization is a public good. Families who participate in other public goods, such a public school, day care, summer camp, play groups need to take the responsibility to immunize their children so that all children are protected. Immunization works to protect all children through the concept of herd immunity. No vaccination is 100% effective in every child. Protection is afforded through universal immunization which offers protection because most children are immunized, therefore disease cannot spread. If we allow parents who are afraid of vaccination, those who are persuaded by anti-scientific information on the internet, those who believe that somehow vaccines cause all kinds of problems, to decide that their “religion” allows them to reject immunization, then children who are medically fragile and cannot be immunized for medical reasons, or children who are the younger siblings of those in groups and have not yet been immunized will be open to infection. We will allow herd immunization to be breached.
Public and private efforts over the last two decades have resulted in the eradication of most childhood diseases from our state and our country. Parents who chose not to immunize their children have every right to make that decision. But they do not have a right to include that child in public school or group day care, where their lack of immunization has the potential to cause harm to other children. Parents who chose not to immunize can also chose to home school. Or if they are part of an unrecognized religion that rejects immunization, they can come together with other families who are of the same faith and start a school to educate their children.
Here in New York State we have had recent outbreaks of measles and of whooping cough. All of our children are just one plane ride away from infection if we do not assure that all children are appropriately immunized against childhood diseases which in the past have maimed and in fact killed our children.

We are firmly opposed to this insidious and dangerous legislation and urge you to soundly reject it.

Immunization has been one of this country’s greatest public health successes. We cannot allow overconfidence to weaken our children’s safety net and once again have to care for children disabled by measles and polio, and other crippling childhood diseases. The children of New York are depending on you to help keep them safe.

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Memo of Opposition
A593
January 17, 2012

Contact: Elie Ward, Director of Policy & Advocacy
eward@aap.net
518-441-4544

The American Academy of Pediatrics, District II, New York State, representing more than 5,000 pediatricians across the state, opposes A593. This bill is not required. We have no reports of physicians being overruled or challenged by school districts in the rare instances where they request a medical exemption from immunization requirements for child patient. If pediatricians are not asking for or supporting this legislation, a good question would be, who is supporting this bill and why are they doing so.
New York State already has adequate protections for physicians who have child patients for whom immunization is not medically appropriate.
If there are problems with the implementation of the current law and regulation in specific school districts, then those problems should be addressed and resolved. But, again, we have not gotten any reports from our members across the state that this is a problem.
Universal immunization is a public good. Immunization works to protect all children through the concept of herd immunity. No vaccination is 100%. Protection is afforded through universal immunization which offers protection because most children are immunized, therefore disease cannot spread.
Here in New York State we have had recent outbreaks of measles and of whooping cough. All of our children are just one plane ride away from infection if we do not assure that all children are appropriately immunized against childhood diseases which in the past have maimed and in fact killed our children.
This is not a problem across the state. And it does not require legislation redress.

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Memo of Opposition
A654
January 17, 2012

Contact: Elie Ward, Director of Policy & Advocacy
eward@aap.net
518-441-4544

The American Academy of Pediatrics, District II, New York State, representing more than 5,000 pediatricians across the state, opposes A654.
This bill is not required. Nurse Practitioners currently practice with agreements with physicians, usually pediatricians or family physicians. We have not received any indication that physicians and nurse practitioners disagree on medical exemptions from vaccination. In fact, in the last few years many prohibitions, especially egg based concerns, have been lifted as evidence based research has proven conclusively that many former contra-indications for immunization exemption or delay can and should be reversed. We have no reports of disagreements between nurse practitioners and the physicians with whom they work, in the rare instances where they request a medical exemption from immunization requirements for child patient.
If there are problems between certain physicians and nurse practitioners, then those problems should be addressed and resolved within the confines of their practice agreements.
Universal immunization is a public good. Immunization works to protect all children through the concept of herd immunity. No vaccination is 100%. Protection is afforded through universal immunization which offers protection because most children are immunized, therefore disease cannot spread.
Here in New York State we have had recent outbreaks of measles and of whooping cough. All of our children are just one plane ride away from infection if we do not assure that all children are appropriately immunized against childhood diseases which in the past have maimed and in fact killed our children.
This is not a problem across the state. And it does not require legislation redress.

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Legal Support for Physicians to Negotiate with Insurers for Fair Service and Reimbursement Contracts
Memo of Support for A.02474/S.3186

Contact: May 10, 2011
Elie Ward
Director of Policy & Advocacy
eward@aap.net
518-441-4544

Due to the current imbalance of negotiating power in favor of the managed care plans, physicians and other health care providers are offered take-it-or-leave-it contracts by health plans that significantly hamper their ability to provide quality patient care. These contracts permit burdensome processes and unjustifiably long wait times for obtaining pre-authorization to provide needed patient care; impose limitations on whom a physician or other health care provider may refer a patient for necessary care; permit demands for refunds of payments long after the time that such payments were originally made; permit health plans to make major changes to key elements of a contract without physician or other health care provider consent; and cede to physicians and other health care providers the legal consequences for patients harmed by health plan utilization review decisions.

Right now, the playing field in health care contract negotiations strongly favors large managed care plans and disempowers physicians to represent the needs of their patients.

By allowing independent contractor physicians and health care providers to conduct some collective negotiations while being closely monitored by the state, this bill would give physicians and health care providers greater ability to advocate for patients in contract negotiations. This bill would also create a system under which the state could closely monitor those negotiations, and any negotiations involving fee-related matters would only be permitted when an individual managed care plan controls a substantial share of the managed care market. This legislation would not authorize strikes or boycotts of health benefit plans by physicians.

We fully support A.0274/S.3186 because we believe it will not only help improve health care, it will also create an equitable partnership between health care service providers and large managed care insurers across the state. This legislation will have the ultimate effect of improving patient care and keeping more highly skilled physicians in New York State.

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AN ACT to amend the insurance law, to require health insurance coverage of the diagnosis and treatment of Autism Spectrum Disorders.
Memo of Support for A. 6305/S. 04005

Contact: April 14, 2011
Elie Ward
Director of Policy & Advocacy
eward@aap.net
518-441-4544

The American Academy of Pediatrics, District II, NY representing 5,500 pediatricians across the state and the millions of New York children we care for, supports A.6305/S04005.

This legislation amends Insurance Law to require every health insurance policy in the State of New York to cover diagnosis and treatment of autism spectrum disorders. Further, the legislation requires that treatment for autism spectrum disorders shall include psychiatric care, including direct, consultative, and diagnostic services; psychological care; habilitative or rehabilitative care; pediatric and developmental pediatric care, including behavioral, speech, occupational and physical therapies as well as social skills education training.

Autism is the fastest growing disabling disorder affecting American children. In New York State, the autism rate for children has been increasing by approximately 15% per year. Recent studies have shown that close to 1 in 90 children are affected. Currently, there are 17,000 students age 4 to 21 classified by New York schools as having autism. The number of adults with autism has not been well studied,

To date families have had difficulty getting coverage for autism and autism spectrum disorder diagnosis and treatment from their health insurers. However, recent discoveries of co-morbidities in autism including gastro-intestinal issues, seizures, immune disorders, allergies, asthma, chronic inflammation and metabolic complications which require medical treatment to insure the highest function of those with autism.

Studies have also shown that specific evidence based intensive behavioral therapies can result in significant improvement in the cognition, communication and functionality of people with autism.

Children denied intensive early evidence based psycho/social and medical treatment will have a lower level of functionality and are much more likely to need life-long support services. Cost analyses show that every dollar spent on early treatment will save $5 to $7 in long-term costs. In the absence of adequate health insurance coverage, the families of those affected bear the costs of treatment. Many of them do not have the resources to provide adequate treatment (out-of-pocket costs often run as high as $2,000 to $4,000 per month), and the Autism Society of America estimates that the lifetime cost of caring for a child with autism ranges from $3.5 to $5 million. Alternatively, the taxpayers pay these costs through Medicaid and increased demand for services through schools. Information on the real costs for mandatory autism coverage from Aetna in Texas shows an increase of less than .01%, and an actuarial analysis of legislation introduced in Massachusetts showed an estimated worse case scenario cost increase of .08% per policy holder.

New York State Insurance Law was significantly changed in 2006, by requiring insurers to provide all medical services to people with autism that would be provided to people without autism. This law has helped ameliorate the problem, but it does not specify coverage for health services specific to the treatment of autism. Nor does Timothy’s Law provide adequate provisions, pertaining only to specified psychiatric disorders co-morbid with autism.

California, Texas, Pennsylvania, Florida, Illinois, Montana, Indiana, Louisiana, Oregon, South Carolina and Arizona, all have laws requiring health insurers to cover autism. Similar legislation is under consideration in many other states. In early 2009, legislation was introduced in the United States Senate calling for modifications to federal insurance law that would require autism coverage with no annual spending caps or age limits. New York needs to join other states and provide coverage to children and adults with autism and autism spectrum disorder. To do less would be shirking our responsibility to provide high quality accessible medical care to all children.

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Exemption from Immunization
Memo of Opposition for A. 593

Contact: May 4, 2011
Elie Ward
Director of Policy & Advocacy
eward@aap.net
518-441-4544

The American Academy of Pediatrics, District II, New York State, representing almost 6,000 pediatricians across the state, opposes A593. This bill is not required. We have no reports of physicians being overruled or challenged by school districts in the rare instances where they request a medical exemption from immunization requirements for child patient.

New York State already has adequate protections for physicians who have child patients for whom immunization is not medically appropriate.

If there are problems with the implementation of the current law and regulation in specific school districts, then those problems should be addressed and resolved. But, again, we have not gotten any reports from our members across the state that this is a problem.

Universal immunization is a public good. Immunization works to protect all children through the concept of herd immunity. No vaccination is 100% effective in every child. Protection is afforded through universal immunization which offers protection because most children are immunized, therefore disease cannot spread.

Here in New York State we have had recent outbreaks of measles and of whooping cough. All of our children are just one plane ride away from infection if we do not assure that all children are appropriately immunized against childhood diseases which in the past have maimed and in fact killed our children.

This is not a problem across the state. And it does not require legislation redress.

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AN ACT to Expand “Religious” Exemption from Immunization
Memo of Opposition for A. 592

Contact: May 4, 2011
Elie Ward
Director of Policy & Advocacy
eward@aap.net
518-441-4544

New York State already has religious exemption legislation and a functional regulatory structure. Families who have true religious issues with immunization, can, and do meet the tenets of their religious beliefs within the context of current law. If there are problems with the implementation of the current law and regulation in specific school districts, then those problems should be addressed and resolved.

This bill however, has very little to do with religion. Rather it provides an option for an exemption without clearly stating the decision basis for such an exemption. It is to all extents and purposes a philosophic exemption, since a parent need only state that they are opposed to immunization for “religious” reasons. Every state that has implemented a philosophic exemption has seen a reduction in the percent of children immunized.

Taken in any other context, this bill would allow a person to say that their “religion” doesn’t allow speed limits therefore they don’t need to obey the speed limit; or their “religion” provides for carrying a concealed weapon at all times and therefore they can do that. And all they would have to do, if this legislation was more broadly applied, is self attest to their “religious” belief re speed limits or concealed weapons.

Civil liberties are an important part of our lives, but civil liberties and social responsibility are always held in balance by the concept of public good. That is why, although we have free speech, we cannot yell “Fire” in a crowded public place, unless, of course, there is a fire.

Universal immunization is a public good. Families who participate in other public goods, such a public school, day care, summer camp, play groups need to take the responsibility to immunize their children so that all children are protected. Immunization works to protect all children through the concept of herd immunity. No vaccination is 100% effective in every child. Protection is afforded through universal immunization which offers protection because most children are immunized, therefore disease cannot spread. If we allow parents who are afraid of vaccination, those who are persuaded by anti-scientific information on the internet, those who believe that somehow vaccines cause all kinds of problems, to decide that their “religion” allows them to reject immunization, then children who are medically fragile and cannot be immunized for medical reasons, or children who are the younger siblings of those in groups and have not yet been immunized will be open to infection. We will allow herd immunization to be breached.

Public and private efforts over the last two decades have resulted in the eradication of most childhood diseases from our state and our country. Parents who chose not to immunize their children have every right to make that decision. But they do not have a right to include that child in public school or group day care, where their lack of immunization has the potential to cause harm to other children. Parents who chose not to immunize can also chose to home school. Or if they are part of an unrecognized religion that rejects immunization, they can come together with other families who are of the same faith and start a school to educate their children.

We are firmly opposed to this insidious and yet dangerous legislation and urge you to soundly reject it.

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Eliminate the Requirement that NP’s have a Cooperative Practice Agreement with a Licensed Physician
Memo of Opposition for A. 5308/S. 3289

Contact: June 4, 2011
Elie Ward
Director of Policy & Advocacy
eward@aap.net
518-441-4544

The American Academy of Pediatrics, District II, New York State, representing 5,500 pediatricians across the state, opposes A5308/S.3289. This bill will eliminate the current requirement that all NP’s have a Cooperative Practice Agreement with a licensed physician.

Although we understand the current challenge the state faces in providing high quality primary care to all New Yorkers, removing the requirement that Nurse Practitioners have a Cooperative Practice Agreement with a licensed physician is not the solution to the problem. In fact, such action has the potential to reduce quality of care, most especially for poor and disenfranchised New Yorkers. We support training and certifying more pediatricians, family physicians and nurse practitioners to meet anticipated increased need for primary care and care management. A doctor attends four years of Medical School, serves an internship and successfully completes residency, and then must meet the requirements of licensing in New York and maintain their status in their professional organization. An NP takes a very different academic and training track. The requirement for a Cooperative Practice Agreement is simply a way to help insure quality patient care.

If there are issues of equity in these relationships across the state, or if there are problems related to establishing and maintaining Practice Agreements, then the SDOH and SED should address those issues to assure quality, accessible primary care for all New Yorkers.

The best way to preserve and enhance access to high quality primary care is to strengthen, not weaken the relationship between nurse practitioners and primary care physicians.

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AN ACT to Amend the Public Health Law to Prohibit Smoking in Private Passenger Cars, Vans and Trucks Where a Minor less than 14 Years of Age Is a Passenger in Such Vehicles; Provides for Rebuttable Presumption; Provides That Violations of Such Provisions Shall Be Subject to a Fine of Not More than $100
Memo of Support for A. 07285/S. 03082

Contact: June 9, 2011
Elie Ward
Director of Policy & Advocacy
eward@aap.net
518-441-4544

The American Academy of Pediatrics, District II, NY representing 5,500 pediatricians across the state and the millions of New York children we care for, enthusiastically supports A.07285/S.03082.

The AAP has had a consistent and strong policy on tobacco control and cessation. It has also been in the forefront of research on the negative health impacts of second hand smoke (SHS) on children through the work of its Julius B. Richmond Research Center.

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High Schools to Include CPR Instruction as Part of Their Existing Health Curriculum
Memo of Support for S. 2491/A. 3980A

Contact:
Elie Ward
Director of Policy & Advocacy
eward@aap.net
518-441-4544

The American Academy of Pediatrics, representing more than 5,500 pediatricians across the state supports S.2491/A.3980A. This legislation would require all high schools to include CPR instruction as part of their existing Health Curriculum.

Research has shown that effective bystander CPR, provided immediately after sudden cardiac arrest, can double or triple a victim’s chance of survival.

The American Heart Association recommends that hands-on CPR training be a requirement for graduation. Several studies have demonstrated that trainees, including school children, can achieve an acceptable level of skill in adult CPR in 30 minutes or less. This legislation does not require students to become certified in CPR, it simply requires the training.

The American Heart Association’s 2010 revised CPR guidelines require hands-only CPR, (chest compression). This new approach makes it easier for any bystander to perform CPR and survival rates are similar to that of conventional CPR (with both compressions and breaths).

Learning CPR can provide high school students with the knowledge necessary to save lives. This bill will ensure that all lessons meet the established standards of professional organizations such as the American Heart Association and the American Red Cross. Adding CPR training as part of the high school health curriculum will increase all students’ awareness of important life saving techniques and it could ultimately save lives.

To avoid any additional costs to the schools, we would encourage all local Red Cross and Heart Association organizations to work closely with their school districts to implement this CPR addition to the Health Curriculum.

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Legal Support for Physicians to Negotiate with Insurers for Fair Service and Reimbursement Contracts
Memo of Support A.02474/S.3186

Contact:
Elie Ward
Director of Policy & Advocacy
eward@aap.net
518-441-4544

Right now, the playing field in health care contract negotiations strongly favors large managed care plans and disempowers physicians to represent the needs of their patients.

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AN ACT to Amend the Education Law, in Relation to the Sale of Certain Foods in Vending Machines on School Grounds or Property
Memo of Support for A. 6900/S. 4552

Contact:
Elie Ward
Director of Policy & Advocacy
eward@aap.net
518-441-4544

The Academy of Pediatrics, District II, New York State, representing more than 5,500 pediatricians across the state, strongly supports this bill.

Each year more and more New York children are burdened with the physical and emotional challenges of being overweight and/or obese. What children eat has a lot to do with how much they weigh. Because children spend many hours in school, and in fact, school is their workplace, it is imperative that their food choices in the school setting are healthy choices.

Most children supplement their lunch with food from vending machines during and after school. Many children in the upper grades create their lunches from the school vending machines and continue eating from machines during after school activities. Therefore, it is imperative that the food and beverage choices provided to children in the school vending machines are healthy choices.

When Connecticut instituted a healthy foods school vending machine policy, a peer reviewed research study indicated that not only did students make better food choices in the school setting they also did not increase their intake of junk food in out of school time.

We support this legislation because it has the potential to be a significant component of a public health initiative to fight childhood and adolescent obesity.

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American Academy of Pediatrics, District II, New York State
2011 NYS Budget, Program and Legislative Priorities

Revenue:
The State is facing an enormous budget challenge. The Governor & the Legislature have to close a $9 billion deficit. To mitigate cruel and unsustainable cuts to vital programs for children and families, the AAP supports two key revenue options

- - Pass the Sugared Drink Tax
  - Maintain Millionaire’s Tax

Budget:
Maintain and Support Initiatives to Build Bright Futures NY Medical Homes for all children.

- - Support the requirement to offer Child Specific full benefit package for all health insurance offered in NYS
  - Maintain and Support all financial and programmatic supports for early screening for developmental and socio-emotional milestones in the primary care setting
  - Create and maintain universal financial support for trained pediatricians to provide assessment, diagnosis and treatment to children with mild to moderate mental health challenges
  - Explore additional supports to keep immunizations as a viable part of pediatric care

Other Issues:

- - Support proposed Juvenile Justice Reforms:
    - Bring young people closer to home for services;
    - Close outdated institutions;
    - Reinvest savings in community care
  - Maintain evidence based services for vulnerable children in fragile families; support quality respite and family support services, like the Nurse Home Visiting Program.
  - Support quality services for children in the foster care system and invest in real permanency for all children.
  - Maintain support for high quality Child Care and Pre K programs. These are key investments that have been proven to prepare children for success in school.

Education:

- - Maintain adequate funding so that every child can and will receive a quality education. We accept that cuts must be made in these difficult times. Therefore, we encourage state leadership to provide guidance and support to school districts to help them make decisions that direct resources to quality instruction for all students.
  - Maintain support for early education services, Early Intervention, Parent as Teacher programs and Reach Out & Read programs

Legislation:

- - We support:
    - Back to Play Concussion legislation that includes the appropriate involvement of a physician in the decision matrix.
    - Legislation that encourages all birthing hospitals to offer parents & caregivers of newborns Tdap immunization in the hospital setting. The recent outbreak of Whooping Cough has clearly demonstrated that we must do more to protect vulnerable infants from a resurgent disease that can kill them California recently had 10 infant deaths from Whooping Cough. One of the best ways to protect babies is “cocooning,” that is, vaccinating the people who will be around the baby the most.
    - Legislation that continues to reduce children’s and teen’s access to cigarettes and other tobacco products.
    - Legislation that improves adolescent’s access to all domains of reproductive health care and pregnancy prevention
    - Legislation that increases nutritional value of food offered to students in the school setting
    - Legislation that contributes to a healthy environment for children by improving the quality of our air and water
  - We Oppose Legislation:
    - That works to reduce universal immunization, including expansions of “religious” or introduction of philosophic exemptions.
    - Creates additional barriers to adolescent’s access to Reproductive Health Care and Pregnancy Prevention Services
    - Weakens Environmental Protections
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The American Academy of Pediatrics, District II New York State
Statement on Medicaid Redesign Team Recommendations & 30 Day Amendments

The Academy of Pediatrics, District II, NYS, representing nearly 6,000 pediatricians across the state supports the majority of the recommendations recently presented by the Medicaid Redesign Team, and included in Governor Cuomo’s 30 Day Amendments to the New York State Budget.

We believe reforming Medicaid and in fact, reforming health care in New York is an enormous challenge, but reform is imperative if we hope to provide high quality, affordable health care to the family of New York.

We believe:

- - High Quality Medical Homes must be supported with adequate payment
  - Bright Futures New York should be the standard of Medical Home care for all children
  - Health System dollars must be targeted to evidence based primary and preventive care
  - Physicians need a level playing field to negotiate with insurers
  - Care Management cannot just be another name for “old and ineffective” managed care
  - Medical Malpractice Liability Reform should be part of any program of health care reform
  - The special needs of medically complex children must be taken into consideration in the design and implementation of care management systems
  - Behavioral Health Organizations, as defined in the recommendations, must be directly connected to and communicate with primary care providers and Medical Homes.
  - Children in foster care must have special services available to meet their special needs in any move toward care management or managed care for this population. These services must be designed and delivered in partnership with the agency caring for the children.

We reject the 30 Day Amendment/ MRT recommendation, which allows pharmacists to immunize children from age 11. This is unnecessary. There is no lack of capacity for immunizing children in pediatric care. The recommendation supports fragmented care and is antithetical to the principles of a Medical Home.

We look forward to working with the Administration and the Legislature to reform, strengthen and improve health care for children and families across New York.

For additional information please contact:
Elie Ward
Director of Policy & Advocacy AAP, District II
eward@aap.net

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