September 2011

In This Report
NYS Budget Decisions Impacting Children
Fair Payment for Pediatricians
Mental Health Training for Pediatricans
Legislative Efforts: Looking Forward
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District II Chair
    
    
Dear AAP District II Member, 

Welcome back from what I hope was a good summer for all of you.  The past year was a busy one with both federal and state children's health policy, program and legislation challenges.  Here in NY we had a very good year despite some very hard budget decisions.  Please read on for details.

 

Henry Schaeffer, MD, FAAP
Chair, AAP District II, New York State
 
New York State Budget Decisions Impacting Children

 

Health Care Coverage and EI 

 

With your help, the children in New York were able to keep all of their health care coverage. There were no budget cuts to children's health. Early Intervention Programs were challenged to save dollars, but there were no large program cuts. The state and its partner localities may be shifting resources and priorities, but there is a commitment to maintain high quality and accessible early intervention services for those very young children assessed to truly need the additional services and supports EI provides.

 

Child Care, Foster Care & Juvenile Justice System

 

Children were able to keep access to affordable child care and critical health and mental health supports for foster care. The juvenile justice system was finally able to move on closing some old and unworkable upstate residential facilities that really did not help rehabilitate young people, and certainly were not able to provide important health and mental health services. Many of these young people will be moved into supervised community based programs which have been demonstrated to provide more targeted and more effective services.

 

Educational Services 

 

One of the biggest unanswered questions we have, as people most interested in the well being of children, is how the local tax caps will impact children's educational and support services connected to their public schools. Each community will be making its own decisions, so the impacts will be variable. We encourage all of you to keep an eye on what happens in your communities. Special concerns should focus on the services for special needs children, the work of CPSE (Committee on Pre-School Special Education) and CSE (Committee on Special Education) and the actual provision of services to children to help them succeed in school and in the least restrictive settings. It would also be important to be aware of budget impacts on after school activities and school sports since the availability or reduced availability of these activities can have a direct effect on the quality of life for children and families in your practice.

 
Fair Payment for Pediatricians
  

For pediatricians, the State Department of Health has continued to support Primary Care Enhanced Payments including higher rates paid for NCQA certification. However, we still have the challenges of contractual relationships with insurers and getting fair payment for our services to children. Our expanding service package in pediatric primary care, including required autism screenings, renewed focus on newborn hearing screening follow-up and encouragement to provide mental health services and psychotropic medication management to children with mental health challenges remains an ongoing discussion with the State Department of Health, the State Department of Insurance and various insurers across the state to get statewide fair payment for our members.

 

Creating and maintaining a true Children's Medical Home reflecting the Bright Futures Model remains elusive in the current payment environment. But the state continues to encourage our work in this area and is hopeful that some of the work of the MRT (Medicaid Redesign Team) and the implementation of ACA (Federal Health Care Reform) will result in target financial support for enhanced primary care services and the evidence based Bright Futures Medical Home Model. 

 
Mental Health Training for Pediatricans
 

One of our challenges is to work with you, our members to encourage you to use the valuable resources we have garnered to help strengthen your practices and bring in more revenue. As a result of our ongoing participation in the Office of Mental Health's TEACH Project, more than 200 pediatricians across the state have been trained to provide mental health services to children in the pediatric primary care setting. These pediatricians have had access to case review and telephone consultation with child psychiatrists from the five participating academic medical centers.

 

Now, all AAP NY Chapter members and their practices have access to the consultation service.  So, if you have questions or need some help with a particularly challenging patient with mental health issues, please feel free to access the CAPPC consultation service at www.cappcny.org or call them at 1-855-227-7272. The CAPPC Consultation Service offers information about assessment, diagnosis, treatment, medication management, referral, community resources, and other supportive services for children and families. The Service is staffed by child psychiatrists, social workers and case management specialists. Their goal is to help you manage your patients while keeping them in your practice.

 

AAP District II has worked hard to make this service available to our members.  We hope that you will use it as you need it.

 
Legislative Efforts: Looking Forward
 

AAP District II Representatives on NYS MRT Subcommittees 

 

Looking forward to the next year, the AAP has two representatives on the state's MRT (Medicaid Redesign Team) subcommittees. This group will be making recommendations to the Governor and the Legislature on how to reform the state's Medicaid program. The recommended changes will also impact on the work of the state's implementation of the state designed Health Insurance Exchange as part of ACA (Federal Health Care Reform). Danielle Laraque is our representative on MRT's Children' Mental Health Work Group and Bob Corwin is our representative on the MRT's Basic Benefit Package Work Group. Both Work Groups will submit their recommendations to the full MRT before Thanksgiving. It is anticipated that the MRT will forward all recommendations to the administration for inclusion in the 2012 state budget plan and state plan submission to CMS.

 

Governor will Sign Autism Insurance Bill 

 

We are also looking forward to Governor signing the Autism Insurance legislation that passed last session. We anticipate the signing will take place soon. Recent weather emergencies have absorbed the full attention of the Governor's Office. But eventually other work will resume and we'll get news of a bill signing ceremony.

 

Continue to Raise Your Voice for Children 

 

Recent meetings with key administration officials indicate that this will be another challenging year for the state budget and for health care reform implementation. There are also large federal budget cuts looming for many key children's programs. Our work to protect and strengthen children's health care services, and our efforts to ensure the continuation of programs that contribute to children's health and well being, will be tested. I invite you to join me, as always, to raise your voices for the children we all care for and care about.

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