July 2011

In This Report
New Legislation for Children & for Pediatricians
Stopping Legislation We Opposed
Legislative Priorities for Next Year
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Dear AAP District II Member, 

As most of you know this was a very active and newsworthy legislative session.  The media covered the timely passage of the state budget, Medicaid reform initiatives and the work of the Medicaid Reform Team, the passage of the 2% property tax cap, extension of rent control, and of course, marriage equality.  Coverage also focused on state worker layoffs and struggles between the state and New York City on budget and education policy issues.

 

What the media did not cover, were the many legislative initiatives, positive and negative, that have the potential to significantly impact the practice of pediatrics for both pediatricians and for children and families.  Please read on for more details.

 

Henry Schaeffer, MD, FAAP
Chair, AAP District II, New York State
 
New Legislation for Children & for Pediatricians
 

Autism Insurance Coverage Bill

In the plus column, this year, after three years of hard work in partnership with the families and supporters of Autism Speaks, we were able not only to get an autism insurance coverage bill passed, but were able to get a firm commitment from the Governor's office to sign the legislation.  We are waiting for a date for the signing ceremony.  This is milestone legislation which supports families in their efforts to access evidence based and peer reviewed behavioral services and physical health services for their children struggling with autism.

"Back to Play" Protocols 

Another bill which passed with our active support and is awaiting the Governor's signature is a school health bill that directly speaks to "back to play" protocols for students sustaining head injuries during sports competitions. The legislation requires the Department of Health and the Education Department to work together to develop regulations to guide school districts in creating and supporting medically sound "back to play" protocols and school based Concussion Management Teams. 

Incarcerated Youth Consenting to HepB Immunization

 

Legislation giving incarcerated youth the right to consent to HepB immunization is awaiting the Governor's signature.  This legislation will help protect some of the most high risk youngsters from HepB infections.  Because these teens are involved in the juvenile justice system, they often have poor or non-existent relationships with their parents and other adult family members.  There are also often complicating factors around substance abuse and sometimes sexual orientation that these teens do not want to share with their parents.  Allowing them to consent to their own immunizations while incarcerated will help protect them during their time in residential care and in the often chaotic life that follows them back into their home communities.

OMIG Reform Legislation 

Many of you will be happy with the passage of the OMIG (Office of the Medicaid Inspector General) reform legislation.  This bill, also awaiting the Governor's signature, clearly limits and defines the work that OMIG can do.  It eliminates fines for purely technical errors.  The legislation states that OMIG's work and its investigations, audits, fines and recovery actions must be based on intent to defraud, not purely technical errors and errors in documentation.  Fair hearing options are expanded. In general the legislation improves the process and makes it possible for providers to represent alternatives to previous unfair and unreasonable OMIG processes and procedures. 

 
Stopping Legislation We Opposed
  

Protecting Pediatric Practice 

 

In addition to helping get legislation important to pediatricians and families passed, your District, with your help, also worked to stop several bills that had the potential to significantly compromise or weaken pediatric practice:

  • Legislation codifying the establishment of retail clinics in New York was stopped after considerable staff work and a strong partnership with the Academy of Family Physicians.
  • We were also able to stop a bill that would have eliminated the requirement for a collaborative practice agreement between nurse practitioners and physicians.  The District felt that these practice agreements really do improve quality of care and are not an impediment to access to primary care.

Fighting Anti-Immunization Bills 

 

This year we fought against three anti-immunization bills:

  • One bill would have established a philosophic exemption to immunization.*
  • The second would have made it easier for parents to get a "religious" exemption.* 
  • The third bill would have allowed non physicians to determine whether or not it was medically safe for a child to be immunized.

* Research has clearly demonstrated that in states where philosophic and religious exemptions are easy to get, rates of immunization do go down, over time.  And it has been shown time and again, most recently in the schools of Illinois, that those schools with the highest levels of unimmunized children are in districts with highly educated and economically secure families.  Parents choosing easily available exemptions in other states have been identified as those who are internet savvy and college educated.  Making it too easy to opt out of immunization allows these frightened and misinformed parents to keep their children from being immunized without much difficulty.

 

Again, this is just another attempt to end run good science and good medicine.  Our ongoing vigilance on anti-immunization legislation goes a long way to ensure that New York remains a state that can limit the number of un or under-immunized children. 

 

 
More Work Ahead

Legislative Priorities for Next Year

 

As proud as we can be of our victories, there are several legislative priorities that we did not succeed in getting passed this year.  But, as many of you know, legislative work is incremental.  What you don't get one year, you continue to work on until it is possible to move the issue forward.  The autism insurance bill is a good example.  We have been working on passage for three sessions.  This was the time it could move and it did.  

 

For next year:

  • One of our priorities will be passage of the physician negotiation bill.  This legislation passed the Senate, but did not make it to the floor in the Assembly.  We will begin our advocacy very early this year with a hope of passage during the 2012 legislative session.
  • We will also revisit a ban on smoking in cars,
  • We will work on the creation and passage of legislation that would require birthing hospitals to offer parents and caregivers Tdap to protect newborns through cocooning.

And we will, of course, stay very close to Medicaid Reform Initiatives from the MRT and to legislation moving New York State further along the federal health care reform road.  At this time, the Governor's bill to create a Health Insurance Exchange for New York passed the Assembly, but did not make it through the Senate.  There is an expectation that the legislature may return this fall, prior to October 1, to take care of this and several other key pieces of legislation that were left undone.  If so, we may use that time to begin our work on reintroducing and passing the physician negotiation bill.

Although this may be a longer report than usual, it is only because the District is deeply involved in the legislative processes in our state and we want to share our work with you.  What the legislature creates as state law directly impacts on our practices and on the children and families we all serve.  As always I encourage you to participate with us in our state based advocacy.  Your voices can work to make New York a better place to be a pediatrician and a better place to be a child.

 

REMEMBER THAT IT IS YOUR CHAPTER DUES WHICH ALLOW US TO DO THIS DISTRICT WORK.

THANK YOU!

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