January 2011

In This Report
Medicaid Redesign Team Holding Public Forums
Working to Address Pediatricians' Concerns
State Budget Proposal
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Dear AAP District II Member,  

We have a new Governor.  We have new Commissioner of Health.  We have a new statewide group called the Medicaid Redesign Team.  We are awaiting a Governor's Budget, due February 1 which will attempt to close a $9-$10 billion budget deficit with the biggest cuts to health care and education.


In this most challenging environment, I want to encourage you to participate in the various opportunities for input into the Governor's planning process, most especially as the problems defined and the solutions proposed, will most definitely impact on the health and well being of New York State's children.  Please read on for more details.


Henry Schaeffer, MD, FAAP
Chair, AAP District II, New York State
Medicaid Redesign Team Holding Public Forums


The Medicaid Redesign Team is holding public forums across the state.  The District and your Chapter encourage you to attend the Forum in your area.  We have created a short AAP Talking Points document that can help guide your comments if you wish to speak at your community forum.  If you can attend, but do not wish to speak, please copy the document and leave it with the forum members, so it becomes part of the public record. 

Although pediatrics is not a big cost driver in Medicaid, it is important to remind the Medicaid Redesign Team that Medicaid is very important to children and that the needs of children and of pediatricians must not be compromised as other large cost drivers are addressed. 

AAP District II's Talking Points for
Medicaid Redesign Team Forums

We are all agreed that changes need to be made to New York State's Medicaid Program.  But the changes proposed and adopted not only have to save scarce dollars, they also need to help our state build a stronger and better Medicaid program that provides high quality, accessible health care for all eligible New Yorkers.  The cost drivers of the system are not its core services of primary and preventive health care, therefore primary and preventive care should not be part of cost cutting.


The members of American Academy of Pediatrics, District II, NYS, care for more than 85% of the 4.8 million children in our state.  The 5,500 members of the AAP across New York know how very important Medicaid is to our children. 


  • More than 55% of New Yorkers on Medicaid are children.  Yet children's health care services cost less than 18% of Medicaid dollars.
  • Children's primary and preventive health care as provided by Medicaid helps keep more than a million children healthy.
  • Strengthening children's access to high quality primary and preventive care in a Medicaid supported Medical Home program has the potential of reducing high cost medical services in emergency rooms and specialty services.
  • Supporting Bright Futures, a high quality model of a child specific Medical Home can and will improve the services provided to children in the Medicaid program and reduce costs going forward.
  • Driving dollars toward children's primary and preventive care, even in these difficult economic times is a smart budget and smart health policy decision.
  • Pediatricians have been asked to provide more and earlier child development assessments to help identify children who may need extra services as soon as possible.  This approach allows children to have access to needed services sooner and improves outcomes for children with special needs. It also saves health care dollars by reducing the child's need to require  additional services from the special needs health care systems.
  • Pediatricians are being trained to provide children's mental health services in the primary care setting for children with mild to moderate mental health needs.  This growing primary care sited service will reduce children's dependence on the high cost and overburdened children's mental health system.  It also has the potential to reduce the utilization of high cost residential and psychiatric care.
  • As our health care system requires more and more services of primary care providers, that same system must be ready to pay for those services.  The costs of a high quality Children's Medical Home services, like Bright Futures, is actually a cost avoidance investment.  The better we manage care for children, the healthier adults will be.  Even those children with complex medical needs can be more effectively managed in a Medical Home.
  • It is imperative that as we agree to build and support Medical Homes for Children that each community has the pediatric specialty and subspecialty care it needs to adequately serve its children. A Bright Futures Children's Medicaid Home can only be effective if pediatric specialty and subspecialty care is available when and where it is needed.

We look forward to working with the Medicaid Redesign Team and all other partners in health to help New York create a strong, effective and affordable health care system that serves children and families across the state. 


State Budget Proposal

On February 1, the Governor will release his State Budget Proposal.  We are already hearing about the potential for very large cuts to health care, education and children and family services.  Our advocacy this year will focus on maintaining access to high quality vital services for children and families.  We want to build and have the support to maintain a Bright Futures Medical Home of every New York Child no matter who is paying the health care bill.  We want children to have access to the health, mental health, and specialty and subspecialty care that they need when and where they need it.  We want children assessed for developmental delays early and we want needed quality, evidence based services available early and at a level of intensity that can and will make a positive difference.  We want children supported in healthy homes and communities and safe and effective schools where they can breathe clean air, drink clean water and get enough outside exercise without fearing for their safety.


These are the things we want for our own children and for all children.  But we need to make our voices heard if we hope to help ensure the health and well being of New York's children in these most difficult times. 


District II (New York State), American Academy of Pediatrics
408 Kenwood Avenue, 2nd Floor | Delmar, NY 12054
518/439-0892 | Fax:  518/439-0769 | www.aapdistrictii.org