March 2011

In This Report
Advocacy Day Update
Mental Health Training for Pediatricians
Medicaid Redesign Team
NYS Budget
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May 13, 2011 

Pediatric Nutrition


8:00am - 4:30pm
The New Yorker Hotel
sponsored by:
AAP Districts II & III


Dear AAP District II Member,  

As I think about reporting to you about the work of the District and the state's health care environment, I am hard pressed to know where to start.  There is so much going on and all of it has the potential to impact directly on your practice of pediatrics here in New York. What I can tell you is that the current health care service delivery budget and policy environment is in upheaval.  Please read on for more details.


Henry Schaeffer, MD, FAAP
Chair, AAP District II, New York State
Advocacy Day Update

The District had a very successful Advocacy Day in Albany on February 15th.  We had almost 100 pediatricians in attendance. Our presenters included the State Commissioner of Mental Health, Chairs of the Health Committees in the Assembly and the Senate and the Medical Director of the State's Office of Health Insurance along with a pediatrician working in the state's Medical Home Project.


Those in attendance not only had an opportunity to talk with our presenters, they also, for the most part, had appointments with their state representatives and key leaders in the legislature.  All attendees were provided with the District's 2011 Budget, Program & Legislative Priorities.  The participant evaluations were very positive.  I urge you to try to join us next year.


Mental Health Training for Pediatricians
& Other Initiatives

I am pleased to report that even in this very difficult budget environment, the State Office of Mental Health is continuing to support training primary care pediatricians in children's mental health through the CAP PC program and the CAPES program.  The District is currently working on registrations for the second phase of training.  Visit the District website for details and contact information if you are interested in registering for this very intensive free training. We are working with the Department of Health and the Department of Mental Health to try to get increased payment to pediatricians who take this training and then provide mental health services to children in their practices.


AAP District II is also working on these initiatives:

  • with the State Department of Health, we are working to provide training and support to pediatricians to help them effectively implement early developmental screening and follow up, and early hearing screening and follow up. You will be hearing shortly about training opportunities in your area.
  • improving the participation in and functionality of the Immunization Registry as the Registry expands to include lead screening and explore the addition of early hearing and metabolic screening data.
Medicaid Redesign Team

In the broader world of health care policy and budget, the recommendations from the Governor's Medicaid Redesign Team were presented on Feb 24th, a few days earlier than their deadline.  The 79 recommendations range from system wide impact, such as the 2% across the board spending cut and medical liability reform, to targeted cuts or investments in specific components of program.  There has already been much discussion and debate in the media and from political pundits and politicians.  But this is just the first step.  The Governor included the recommendations in his 30 day budget amendments.  This means that they are now part of the state budget that will be negotiated with the legislature.


For pediatricians, most of the financial changes, if adopted, have the potential to drive more dollars toward primary care and to support Medical Homes and care management for medically complex patients, which includes children with co-morbidities.  Other proposals, such as allowing physicians to collectively negotiate with insurers and to form Accountable Care Organizations, as well as proposed liability reforms, can strengthen practice.  Recommendations which include moving all Medicaid patients into a form of care management may present challenges for some of our patients, such as children with significant mental health challenges, complex medical needs and those in the foster care system.


But we are a long way from any of the positives or the perceived negatives becoming state law.  We will try to keep you informed as the budget negotiations move forward.

NYS Budget

The State Budget itself, aside from the MRT recommendations, proposes some cuts, realignments and changes that, if accepted, will impact the lives of some of our most vulnerable children.  The budget eliminates all funding for Home Visiting Programs, proposes some cuts and structural changes to the Early Intervention Program, proposes changes and cuts in the juvenile justice and foster care programs, and barely funds child care at current levels.  Of course, we all know about the proposed cuts to education and the possible school closings, teacher layoffs, cuts to art, music, libraries and sports and increases in class size.


In this challenging budget environment the District continues to support renewal of the Millionaire's Tax and adoption of the Sugared Drink Tax to raise needed revenues to support vital programs for vulnerable children.


Here is a tidbit of information to help you better understand the workings of Albany and state decision making.  Last year, the bottling industry alone spent $12.8 million fighting the sugared drink tax. This doesn't mean we stop fighting for what is right.  It just helps us understand what we are up against on some of our key issues.


We ask that you join our advocacy efforts.  We encourage you to call, e-mail or visit your state Assemblyperson and your Senator.  Legislators are in their home districts, in your community, at least four and sometimes five days every week. Call them, meet with them, talk to them about what is important to children and those of us who care for children. Use the District's priority list to choose the topics or issues that seem most important to you.  Your voice can and does make a difference.  Join us in bringing the needs of children and of pediatricians to the state's decision makers. 


We can and do make a difference, even if we don't have $12.8 million to spend.


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