July 2009  

In This Report
Flu Shots in the NICU
Mental Health Services
NYS Medical Home
NYS Immunization Coalition
Additional DII Activities
Dear Anthony,

As many of you know, the NYS Senate has been embroiled in an internal power struggle which has interrupted most legislative action.  We have waited to release this report in the hope that the Senate would have solved its problems and that the AAP could provide a full report of its legislative activities.  Recognizing that there is little hope of a timely solution to the impasse, this report will give you the latest update of what the District has been doing over the last several months.
 
Henry Schaeffer, MD, FAAP
Chair, AAP District II, New York State
 
Legislative Victory! Flu Shots in the NICU 
 
We are very pleased to announce that after much hard work, we have been able to secure passage of our legislation requiring all hospitals with a NICU to offer parents and caregivers of NICU infants, immunization against flu on site.  We have been working on this legislation for several years, and this year, with some hard negotiations with HANYS (Hospital Association of New York State), we were able to secure passage.  We are now waiting for the Governor to sign the bill and to begin to help the SDOH and the HANYS with implementation. This is not only a significant legislative victory for the District it also has the potential to assure a healthy start for some of the most vulnerable infants in our practices.  Congratulations to all who worked so hard, for so long to secure passage of this important legislation.
 
Children's Mental Health Services in Primary Care
 
The District has been in serious discussion with the New York State Office of Mental Health and the State Department of Health on how to best provide training and support for those pediatricians who want to offer a level of children's mental health services in the primary care setting.  These discussions are anticipated to produce a pilot project. Several possible programs models will be discussed, including one offering interested pediatricians training and support from a panel of child psychiatrists. We will also explore the feasibility of creating and supporting regional panels to provide telepsychiatry consultations and case management work for specific patients.  The discussion will absolutely include ways to include specific payments to cover the time both in office and in consultation to make the approach viable.  Both Managed Care in the public and private sectors, and Fee for Service in the private and public sectors are being invited to join the discussion to help design appropriate payment for the service from various payer groups. Discussions are just beginning. We will provide regular updates as progress is made.
 
New York State Medical Home
 
The District has been very active in the SDOH discussions on creation and implementation of a New York State Medical Home in the Medicaid, Child Health Plus and Family Health Plus programs.  The District representatives have two main issues they continue to raise.  One is that children are not just small adults, and therefore a children's Medical Home is somewhat different from one for adults. We are working on gaining state acceptance of a Bright Futures NY model.  Also, we are adamant that the Medical Home discussion not be allowed to devolve into only a money saving approach to care for high end, chronically ill adults, those with heart disease, diabetes and obesity complications.  Our second issue is that it makes no sense to establish a Children's Medical Home only for those children who are covered by the public or subsidized health insurance.  It is more reasonable to set a statewide standard of care, Bright Futures NY, and provide payment to support that level of care for all children. Any other approach would produce more complications and an inequity in care across various coverage options.  We are also waiting to better understand how any legislation and coverage requirements included in the federal health care reform initiative will impact on New York's current children's health insurance options and future plans for expansion of eligibility and benefits.
 
NYS Immunization Coalition
 
The District's Immunization Coalition had its June meeting in New York City.  The Immunization Bureau of the New York City Department of Health and Mental Hygiene hosted the meeting in their offices at
125 Worth St. The meeting was well attended by representatives of a broad array of organizations who are working with AAP on immunization issues. The group reviewed the legislative work of the Coalition this session.  All groups were pleased with the work they were able to do together to stop anti-immunization legislation, including an expansion of the "medical exemption" and a bill to create an easily obtainable "philosophic exemption."  Groups representing child care and teachers joined this year in submitting Memos of Opposition for anti-immunization legislation and Memos of Support for legislation the AAP and the Coalition supported.

The coalition also discussed recent media coverage of immunization issues.  There was considerable focus on the recent Newsweek magazine coverage of Oprah Winfrey's off the wall health advice.  Her hosting of anti-vaccine advocates like Jenny McCarthy was part of the coverage.  In general, the coverage in Newsweek and other general media during the last quarter has been more positive about vaccines.  Major media have covered outbreaks of preventable disease from an objective perspective. And media seemed to be quoting more science and less "opinion" in their pieces.
 
We also reviewed the first design draft of our bookmark for parents.  All groups were very pleased with the design.  We will be meeting with the groups individually to discuss dissemination in various sites that serve children and families.  The bookmarks will also be available to all members who may wish to have them available in their offices, clinics or other service sites.
 
We also discussed reaching out to additional service groups like Rotary, Lions, Elks, etc. Staff will explore the feasibility of such an effort.
 
Additional District Activities
 
Other District activities during this period include:
  • continued negotiations on the legislation creating a Breastfeeding Bill of Rights;
  • ongoing involvement in the state's efforts to expand and enhance its efforts to ensure that all age appropriate children are tested, and if necessary, treated for lead poisoning;
  • presentation of the Western NY Vaccine Summit;
  • continued work on building the strength and capacity of the Chapter based Pediatric Councils;
  • ongoing work to follow and provide input to our representatives on federal health reform initiatives, including the implementation of a soda and sugar tax;
  • continued work with state government staff on school nutrition issues and work on other components of the state's anti-obesity agenda. 
Again, our success depends on the hard work of our members.  The hours you spend volunteering to advocate for issues important to children's health and well being and to improve the practice of pediatrics is what gives the AAP its strong voice for children.
District II (New York State), American Academy of Pediatrics
1325 Franklin Avenue, Suite 255 | Garden City, NY 11530
516/326-0310 | 516/326-0316 fax |
www.aapdistrictii.org