AAP District II is funded by your NY Chapter dues                                                         April 2012   

In This Report
Our Changing Health Care System
Pediatric Councils
Strategic Planning
Legislative Advocacy
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Friday 
May 18, 2012

 

Pediatric
Nutrition Update: Challenges in 2012 and Beyond
Full day CME program 
New Yorker Hotel
New York, NY
Presented by:
AAP, District II (NYS)
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Thursday
May 17, 2012

 

Obesity and Pediatricians: 
The BIG Picture
6:30pm - 9:30pm 
dinner program
New Yorker Hotel
New York, NY
Presented by:
AAP, District II (NYS)
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June 28-30, 2012

 

Vaccine Summit
Multi day CME program 
 
Otesaga Resort Hotel
Cooperstown, NY
Presented by:
AAP, District II (NYS) &
AAP NY Chapter 1
    
     
Dear District II Member, Danielle Laraque, MD, FAAP

Reflecting on the current state of our health care system, it is clear that our system is in flux.  We are challenged daily at the federal, state and local levels.  No matter where or how you practice pediatrics, these are times of change and challenge  

 

Please read on for details.

 

Danielle Laraque, MD, FAAP
Chair, AAP District II, New York State
 
Our Changing Health Care System
  

Federal Level

 

At the federal level, the federal government and its agencies, e.g. CMS, continue to work with states to implement the ACA (Affordable Care Act), federal health care reform. At the same time the Supreme Court works on its decision to determine the constitutionality of the ACA.  What happens if the Supreme Court strikes down the whole law, or parts of the law?  How will it impact what we do in our offices, clinics or academic work? There are no real answers.  So, as we and our state leaders continue to plan to put all the pieces required by ACA in place, such as the Health Care Exchange, which was just created by Executive Order, and expansions in coverage, we are uncertain about how and how many of the options proposed by ACA will move forward.  

 

State Level 

 

At the state level, the state is struggling with its own Medicaid and Health Care Reform Agenda.  The recently passed state budget includes some good news for children and families.  Lactation counseling and support will now be a covered benefit for Medicaid.  It is our hope that this coverage will soon migrate to commercial insurance.  Also, the budget included additional investments in the Nurse-Family Partnership program which provides multiple health and socio-economic and parenting supports to at risk families with newborns.  This evidence based program has made significant positive impacts on the thousands of families it has served.

 

The state budget also provided support to current children's health programs in Medicaid, Child Health Plus and School Based Health Care. The budget also included support for the state to approve seven ACO's (Accountable Care Organizations).

 

The budget supported several key issues that we advocated for, including reforms to strengthen the Early Intervention Program, supporting New York City's Close to Home Initiative to bring most non-violent juveniles currently housed in non-secure upstate state facilities back to New York City for supervision, treatment and support.  Child care services did not experience cuts to services.  And education, always a contentious area, appears to have been funded at promised, if not adequate levels.

 

Health care reform efforts, centered in the work of the State's Medicaid Reform Team, the MRT, continue toward implementation. The state is in the process of implementing benefit coverage changes to reflect the most recent evidence based science.  There are also major decisions being made to identify and support county based coalitions to provide Behavioral Health Home Services.  Work is also accelerating on Health Homes for medically fragile adults and children.  The MRT recommendations can and will have an impact on children's health services.  Exactly how these new initiatives play out is still to be determined.  But we are involved in many discussions, working to keep the needs of children present in the ongoing planning.  It is imperative that you, in your communities also remain aware of what is happening around you.  Are you being asked to participate in new partnerships?  Have you been approached about participating in new networks or coalitions?  Are children's needs being considered as the health services in your communities begin to prepare for the "reforms" at the federal and state levels?  In that regard, one of the most important potential sources of community support created by ACA may the community benefit obligations of nonprofit hospitals that seek federal tax exempt status.  This requirement calls for community health assessments to engage hospitals in focusing on the specific health needs of child and adult populations.

 
Pediatric Councils
  

While working under the pressure of all of these megatrends and impacts, we are all also continuing to struggle to provide high quality care to children and families in very difficult times.  Your Pediatric Councils continue to engage health insurance companies around issues that remain problematic to pediatricians.  Pediatric Councils are working on securing fair payments for immunization, challenging unfair bundling of services, working to secure clear rates in contracting, and encouraging payment for children's mental health services in primary care setting.  At the same time Pediatric Councils are working with specific carriers to resolve specific problems experienced by pediatricians.

 

If you are having specific problems or have been frustrated in trying to solve a particular problem in your practice, we invite you to contact the District.  We may be able to help with information, contacts or connection to your Pediatric Council.

 

Bending the cost curve while maintaining access and quality, which is the goal of all reforms, requires a strong base of primary care providers. Pediatrics must continue to be a key player in primary care and care management as we move forward in this new and changing world.

 

Again, our goal, working with all of you is to keep children's health and well being central to the ongoing reform planning and implementation.

 
Strategic Planning 
 

To help the District continue to be most effective for its members both internally and externally, we have begun a process of strategic planning. Working with a key group of District members we will be meeting in early June to take some first steps to identify key goals and objectives of our planning process.

 

To further help inform our work, we are encouraging member participation through focus group conference calls for each Chapter.  If you received an e-mail inviting you to participate, please make every effort to be on the call and offer your input.  If you cannot be on the call for your Chapter we hope that you will take a minute to respond to the areas of question with a short e-mail to your Chapter Ex. Dir.  We really want to include as much member input as possible as we move forward into the process.

 
Legislative Advocacy 

 

To help support our policy and program work, we engage in targeted Legislative Advocacy.

 

This year we have four key legislative initiatives. Two are currently active bills that require your support.  We ask that you contact your legislators in the Assembly and the Senate and ask for their support for both bills.

 

A.02474/S.3186  Negotiation legislation which will help level the playing field between pediatricians and insurance companies.

 

A.9381/S.6500  *Tdap which requires all birthing hospitals to offer *Tdap immunization to parents and caregivers of newborns in the hospital setting.

 

Erratum:  *("Tdap" was incorrectly written as "TDaP" in the circulated version of this newsletter.  "Tdap" is correct.) 

 

We are on record in support of raising the age of juveniles tried in adult court to 18. Recent brain development research clearly indicates that the adolescent brain is not able to function at an adult level in terms of its executive function and decision/consequence matrix.  Recognizing this difference requires a different approach to adolescents who become involved in the criminal justice system.  Currently New York is only one of two states still trying 16 year olds in adult court.  We need to make a change to reflect the science that is very clear on this issue and we need to do it this year.

 

And we are on record as supporting the requirement that the state engage in a study of the potential health impacts on children before making a decision permitting hydrofracking.

 

You can get more information on these bills and the District's position on other legislation and policy issues at www.aapdistrictii.org and clicking on the Advocacy tab.

 

Your District remains engaged at the federal and state levels on behalf of children and pediatricians.  Our strength is your passion and your voice.  Once again we call upon you all to help us and our state leaders make New York an ever better place to be a child.

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