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

In This Report
AAP District II (NYS) Strategic Plan
Policy and Advocacy Update
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Dear District II Member, Danielle Laraque, MD, FAAP

It's been several months since my last report to you, but that is because the District, the State of New York and the City of New York have all been very busy working on issues that directly impact the health and well-being and children and the work of pediatricians.


Please read on for details.


Danielle Laraque, MD, FAAP
Chair, AAP District II, New York State
AAP District II (NYS) Strategic Plan

The District has been an active in a Strategic Planning process to help take us forward in this time of change. District leadership has also been working with the State of New York and with the City of New York and our external partners on initiatives designed to improve the health and well-being of infants, children, adolescents and young adults.


The District's Strategic Planning Process began with Focus Groups in each Chapter. All Chapters invited members to participate in Focus Group phone calls. The input from members who called in and discussed the topics was collated and presented to a small group of active members representing all Chapters who convened for a day of Retreat. Those who attended the retreat spent the day reviewing the main topic areas and creating goals and objective for the three areas of concern, Membership, Health Care Delivery Systems and Policy & Advocacy. The District's leadership will review the work of the Retreat and continue to work with all members to refine the Strategic Plan, prior to finalization.


In addition, the national AAP is offering Districts non-competitive grants to help them design and implement specific and targeted membership recruitment and retention activities. District II plans to submit an application and work very hard over the next year to build, maintain and engage our membership.


The District leadership has also made a firm, District wide commitment to identify and operationalize new ways to reach out to young physicians and engage them in the work of the District. We look forward to your input and your active participation in these efforts.



Policy and Advocacy Update

Legislative Session


Our work with the State during the legislative session has included efforts aimed at improving the wellbeing of children and strengthening the practice of pediatrics. We were able to get our Tdap legislation passed. This bill would require all hospitals with newborn nurseries to offer parents and caregivers of newborns Tdap immunizations on site.


We were also able to stop two anti-immunization bills and stop a scope of practice incursion that would have eliminated the requirement that all nurse practitioners maintain a practice agreement with a physician. We also succeeded in stopping a Retail Clinic bill that had the potential to disrupt our efforts to maintain children in a medical home. We did get the tanning booth age raised to 16 in New York. We supported raising the minimum wage, but that did not happen yet. We also supported legislation that raises the age of children who could be tried as an adults, but that legislation also did not move in this session. We will continue to advocate for these two issues in a Special Session if one is called this fall. Regardless, we will certainly call for both child supportive policy and legislative changes next year. We did not succeed in getting the physician negotiation legislation passed, but we knew that would be almost impossible with the lack of support by legislators in both houses. We do have an alternative option to propose for next session. You will be hearing more detail from the District on that after the summer.


Justice Center


The District also participated in supporting the Governor's proposal for the Justice Center to strengthen and broaden protections for vulnerable people in state care. District representatives were invited to attend the Governor's announcement ceremony for the Justice Center. They were also in attendance at the Governor's Press Conference highlighting the importance of the Center. We posted information about the Justice Center on our website. The goal of the Justice Center, to better protect and advocate for the needs of those in State care, is consistent with the historic position of the District on behalf of children in State care in the mental health, health, special education, child welfare and juvenile justice systems.


State Health Insurance Exchange


We remain vigilant as New York continues to take steps toward creating a Health Insurance Exchange.


Pediatric Councils


Your District and your Chapter Pediatric Councils continue to work together to try to improve understanding between insurers and pediatricians about coverage issues and payment decisions. They have been engaged with various insurers regarding payment for vaccine administration and payment for developmental screening. Their work continues on your behalf.


Work with New York City


Our work with New York City, in partnership and on behalf of our members in the five boroughs in Chapters 2 & 3, has included participation in the NYC Breastfeeding Support initiative, Latch-On NYC. We are currently working with the City in its ongoing work with NYC private and public hospitals. The second phase of the initiative will be to work with pediatricians in clinic and office setting. All activities will be voluntary, and much of what we are discussing is already AAP policy. We will be in touch with Chapter 2 & 3 leadership as we learn more and will be asking for member participation going forward.


We are also working with the City on a Teen Health Initiative. Our meetings with representation from Chapter 2 & 3 have been focused on how to develop more teen friendly practices, and how to keep adolescents attached to health care through their "Medical Homes." We will share more information as this initiative develops. We are also partnering with the City on the complex statewide issue of protecting adolescent confidentiality in the world of electronic health records and electronic billing.


Adolescent Health Webinars


The District is also working an on producing a series of webinars for our members highlighting specific information and techniques to help pediatricians improve their knowledge and skills on the areas of adolescent reproductive health care. We anticipate having the webinars available within the next several months.


Federal Health Care Reform


As you are all aware, the Supreme Court has ruled on the federal health care reform legislation, ACA, and has upheld the constitutionality of the individual mandate. The one provision not upheld was a proposed penalty to states who did not expand Medicaid. The implications are nil for NY which has moved steadily to expand coverage for children and adults. The changes implemented through the MRT (Medicaid Reform Team) process are going forward. The initiatives to create health homes, couple behavioral health with physical health, support care management, reduce re-hospitalizations, enhance targeted, evidence based preventive services, build medical homes, and incentivize quality through payment for NCQA level certification, are all going forward. The number of hospital mergers building bigger and bigger systems continues. Also ongoing are efforts by service networks to buy up practices in various parts of the state. In fact, this process appears to be accelerating. Our state is moving toward full implementation of Managed Care in all state supported programs, Medicaid, Child Health Plus and Family Health Plus. Currently the state expects to phase out of fee for service in all state subsidized programs by 2014.


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The agenda for children is broad and challenging. In this most fluid environment it is imperative that we all work together to define the high value of insuring children's health and well-being to our state and national leaders and clearly articulate the importance of accessible, quality pediatrics to attain that high value goal.

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