AAP District II is funded by your NY Chapter dues                                                  July  2013

In This Report
Working on a National, State & Local Level
Legislative Victories
Challenges Remain
Collaborations & Committees
Get Involved
Quick Links 
Who are We?

AAP District II (NYS)

District II is the New York State District of the AAP. We work on behalf of you, our members, on state-wide issues to improve the well-being of pediatricians and children in NYS.

AAP NY Chapters

District II contains 3 local AAP Chapters.

Your NY Chapter dues support both Chapter & District efforts.

NY Chapter 1:
All remaining counties in NYS that are not listed below

NY Chapter 2:
Brooklyn, Queens, Nassau & Suffolk counties

NY Chapter 3:
Manhattan, the Bronx, Staten Island, Westchester, Dutchess, Orange, Putnam & Rockland counties

Dear District II Member, Danielle Laraque, MD, FAAP

As I began to think about this report to you, I was both excited and challenged by the huge amount of work that the NYS AAP has done and still needs to do. I would like to recap these endeavors, but first start off with the following, the status of the NYS AAP, District II, and the need for a cohesive and unified voice for children.


Please read on for details.


Danielle Laraque, MD, FAAP

Chair, NYS AAP, District II

The AAP - Working on a National, State, and Local Level


The NYS AAP, District II is one of 10 Districts composing the national AAP. Similar to California, District IX, our district is unique in encompassing a single state. (Most Districts are composed of multiple states.) This reality has forged a strong and unified approach to addressing local, regional and national efforts to support child health. Members of the AAP should fully understand the importance of paying both their national and chapter dues. Your chapter dues represent a clear investment in the advocacy and educational efforts at the state level; they help support the function of the NYS AAP, District II, and the District represents NYS at the national level. With the increasing complexity of health care, the absolute necessity of a unified message through local, regional and federal affairs is critical to the survival of the NYS AAP's efforts and the national AAP's efforts.

Legislative Victories


Now, shifting to the important work at hand. We achieved many of our goals during this state legislative session.



  • helped to raise the minimum wage which will eventually pull many children out of poverty
  • helped pass a comprehensive gun control law, one of the first and most far reaching in the nation.
  • in the budget, we were able to hold all children's health programs harmless from state cuts, and were able to help secure additional funds for home visiting programs and high quality child care and early education
  • moved legislation to make pulse oximetry testing part of universal newborn testing, making New York the 13th state to have this requirement.
  • after much targeted advocacy, we were also successful in getting the maternal depression legislation passed by both houses. This legislation now supports pediatricians to do screening for maternal depression in the pediatric office during well baby visit in the first year.
Challenges Remain in a Changing Health Care System


Despite these victories, we continue to be challenged by the changes in health care services and delivery structures at the federal and the state levels, and, in some instances, at the local level as well. More and more practices are affiliating or partnering with large health care systems and hospitals. Insurers are merging and consolidating. The NYS Health Insurance Exchange is moving forward while many questions remain unanswered. There has been a proliferation of urgent care centers, some with physician ownership, and a significant increase in the number of retail based clinics, clinics within well-known chain stores.


With all of these pressures there are also pushes by insurers to reduce payments to pediatricians. Some insurers have started to refuse payment for historically supported services, tests and treatments. As we continue to advocate for high quality medical homes for children, many of our members are being pressured to accept reduced payments and external decisions that result in fragmented care.


In this environment of challenge and change, we, as New York pediatricians, have an obligation to continue to talk with our state leaders and with insurers about the value of a child-focused medical home, high quality coordinated care, and how children's health and well-being are inextricably related. It is possible that our conversations have to be more public and more formal than they have been in the past, but they must continue.


We know that children who live in families with financial stresses and in communities suffering from inadequate infrastructure and inadequate services have more health stressors which can and do lead to more chronic childhood disease. We also know that children can be supported to develop resiliency even in hard times and hard places if we can help them and the adults around them access the hard and soft services and supports they need.


We also know that providing a true medical home for children is an intensive and difficult challenge. It is hard in the current health care environment to offer comprehensive and integrated services to the average child in an average family. It is incredibly difficult to do the job of providing a high quality medical home to children in families struggling with poverty, substandard housing, poor educational opportunities and other social and economic stressors. It is also very hard to provide a high quality medical home to children with special health care needs. But because it is hard doesn't mean that we stop trying to do the right thing for the children and families who need our services and support.


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NYS AAP Initiatives - Collaborations & Committees


As a District we are reaching out to other child serving systems and organizations to help craft integrated interventions for children's mental health. We are also working with external partners to help support services for children with significant social, emotional and economic challenges. We are exploring closer relationships with child care and the public education system. We also continue to work with the environmental community to assure safe places for children to live and to learn.


As we continue to advocate for our children and their families, we must also continue to advocate for pediatricians. We need to secure pediatric practices for the future. We need to understand the millennium morbidities of mental health, learning difficulties, obesity, violence both in the family and in the community, poor nutrition, substance use and abuse, and support the core values of population based health care. And we need to find ways to get insurers to pay for the level of care that we know our children and families need and deserve.


To help us address all the challenges we face, the NYS AAP supports the Pediatric Councils at the Chapter level as well as a District Pediatric Council for those issues that require a statewide intervention. The NYS AAP has recently created several District-wide committees to identify issues, explore solutions and make recommendations to the NYS AAP leadership to pursue with our state leadership. We currently have committees on Public Policy & Advocacy, Early Childhood Development, Health Care Services Delivery, Membership and Structure. All committees have representation from all Chapters, and all committees address both the needs of children and the needs of pediatricians.


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Get Involved!


We encourage you to become active in your Chapter and the NYS AAP, District II so that we can learn from you about the problems you and your patients are encountering, as well as the solutions that have worked for you.  For more information, contact our Director of Policy & Advocacy, Elie Ward, at eward@aap.net.


Have great and safe summer!

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