December 2009  

In This Report
National Health Care Reform
NYS Deficit Reduction Plan
Annual Legislative Day
Other Legislative Issues
Mental Health Services
NYS Immunization Coalition
Foster Care
Quick Links 
Save the Date! 
February 23, 2010
AAP District II's
Annual Legislative Day 
 * Hear presentations from legislative & government leaders
* Be a voice & advocate for NYS's children & pediatricians
* Meet with your Assembly member & Senator
Come and Make a Difference!
Free Immunization Bookmarks 
available in 4 colors
To order batches of 100, email George Dunkel at:

Dear District II member,

In the constantly changing legislative, budget and policy environments at the national and state levels, we, as pediatricians, need to take care of and raise our voices for the children and families we serve as well as all children.
Although this is a rather exhaustive report, your District leadership believes it is important for members to have information about what we are doing and the key issues that dominate our work for and with you.

I would like to take this opportunity to wish each of you a happy and healthy holiday season. It is my hope that working together we can make 2010 the best year yet for children and for pediatricians in our state.
Henry Schaeffer, MD, FAAP
Chair, AAP District II, New York State
National Health Care Reform Update
At the federal level, the health care reform debate continues its circuitous path through the congressional process.  The struggle between cost, quality and access bedevils the discussion.
The National AAP has taken a position not to engage in the specifics of any current debate or any specific bill.  This is reasonable, since there is a long way to go before all sides actually sit down and try to negotiate a bill that can pass both houses of Congress and be signed by the President.  But the Academy has taken a series of positions during the ongoing debate that reflect the needs of children and of our members in terms of insuring an appropriate array of services for children and an adequate supply of pediatricians and other primary care physicians.  The five core issues to assure quality children's health care remain central to our discussions with our federal leaders.  These are:
  1. All children are entitled to health insurance coverage regardless of income
  2. There should be comprehensive age appropriate benefits based on Bright Futures
  3. Children deserve quality care delivered in a medical home
  4. Children must have access to pediatric specialists
  5. There must be appropriate payment for necessary services
Recently, the National AAP has retargeted its effort to a position which focuses on the need to pay primary care physicians, especially pediatricians, fees that reflect the work they do. The new target includes support for the development of a more focused federal investment in primary care at the medical school and residency levels. It includes a tuition payback model similar to New York State's Doctors Across NY program. It also proposes federal support for the development of patient centered medical homes, which, for children, would be built on the foundation of our Bright Futures Medical Home model. 
The ongoing federal debate on health care reform holds many potential pitfalls for pediatricians and the children and families we serve, but it also offers incredible opportunities.  It is imperative that we continue to communicate with our federal representatives about the importance of supporting the AAP's pediatric priorities in the final federal health reform legislation that goes to the President's desk.
NYS Deficit Reduction Plan Update
At the state level the environment is just as chaotic and uncertain.
The Governor's recent Deficit Reduction Plan, which passed the state Assembly and the state Senate, spared most of office based health care, and especially children's health care, from any significant cuts. But other programs of importance to the well being of the children we care for have been cut to the bone:
  • after school programs
  • home visiting programs
  • many community based child focused programs
  • children's mental health, foster care, juvenile justice and community based prevention programs
  • adolescent reproductive health care services
  • school based health care programs
There are also cuts to hospitals which are yet to be clearly outlined, but they do include cuts to graduate medical education.

And this is only the beginning.  The cuts that are being put in place at this time are cuts to this year's ongoing budget.  The state budget that the Governor will propose on January 20th for the state's next fiscal year, 2010-2011, is anticipated to have even larger cuts to state programs across the board.  We know that the next state budget proposal will propose even larger cuts to all programs that are not legally required, but we do not know exactly where the cuts will fall or how deep they will be.
AAP District II's Annual Legislative Day:  2/23/10 
On a more optimistic level, there are economists who are suggesting that New York State's current budget problems will resolve over the next few months as revenues to the state increase based on the profits of Wall Street and the banks.  Time will tell.  But we need to prepare our advocacy as we get ready to protect vital programs for children in health, mental health, education, family supports, child care and community based child well being.
This year our Advocacy Day on February 23rd in Albany will be one of the most important times for pediatricians to learn about the latest state budget and policy issues in children's health and well being and to show their state representatives that they care about what happens to children in our communities across the state.  Mark February 23rd on your calendar and plan to join us in Albany as we advocate for children's health.
Other Legislative Issues
Beyond national Health Care Reform and the challenges that the New York State budget may present, there are many other issues directly involving District leadership and staff: 
  1. The New York State Assembly is exploring legislative authority to develop more retail clinics.  The District was invited to the first legislative Roundtable to discuss the issue. Legislation may be proposed this session.
  2. There is legislation proposing the expansion of all payer health care demonstration programs.
  3. The State Health Department is competing for a federal grant to work on the development and implementation of Children's Medical Homes for the state's Medicaid program.
  4. It is also anticipated that legislation impacting the state's current Early Intervention Program will be proposed this year.
Children's Mental Health Services in Primary Care
Our work with the State Office of Mental Health and State Health Department to create a training and support pilot program to work with pediatricians in providing children's mental health services in the primary care office setting continues to move forward.  We expect to hear who the Department of Mental Health has chosen as the principal by the end of this month.

Our members also continue to work with the State Health Department on training and implementation of newly required developmental screening in the pediatric office.
NYS Immunization Coalition
The District's work on immunization issues remains a policy and legislative priority.  The NYS Immunization Coalition has distributed more than 75,000 Immunization Bookmarks to pediatricians, child care providers, school based programs, and other advocate organizations over the last several months. These very attractive bookmarks are available at no cost to all members.  Those who have used them have reported that parents love them and they are important tools in the immunization discussion with families.
We are currently exploring the best ways to get the Bookmarks into ob/gyn offices to be available to pregnant women who are making decisions about immunization for their new babies. The Coalition is exploring more media work once the current H1N1 focus abates.  We also continue to work with the Department of Health to assure attention to pediatricians' concerns regarding administration payment and vaccine supply.
Foster Care Efforts
The District has joined the efforts of national AAP to become involved in the implementation of the federal Fostering Connections legislation. AAP National worked at the federal level on the details of the Health Oversight and Coordination Plan (HOCP) of Public Law 110-351.
Our work at the state level focuses on helping the state develop the required Health Oversight and Coordination Plans for children in foster care.  We are working with both the state Office of Children and Families, the agency providing foster care oversight in New York, and the State Department of Health, Medicaid Office, the arm of SDOH responsible for the health care of children in care.  This work dovetails with national AAP's core commitment to improved health care and child well being for children in foster care.

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 |