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

In This Report
Upcoming AAP Events (Nov. 2013 Vaccine Summit)
Call for AAP Resolutions
Changes in Health Care
Childhood Immunization
Creating Partnerships
Fair Compensation
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

Upcoming Events

Oct 7

Hot Topics in the Care of Hospitalized Children: Safety & Quality Issues

Location: The Children's Hospital at Montefiore, Bronx, NY

Register / More Info


Nov 15 - 17

Vaccine Summit

(2 nights at Hotel / 6 meals included)

Location: The Thayer Hotel, West Point, NY

Register Now

More Info


Call for AAP Resolutions
With summer (unfortunately) behind us, it is now time to start putting together resolutions that you would like to be presented to the National AAP's Annual Leadership Forum in March 2014. Seems a long way away, but the deadline for submission is the beginning of December. If you have any pressing, or not so pressing, issues relating to any aspect of pediatrics, please consider putting them forth as a resolution.
If you have any questions, please feel free to contact me.
Edward Lewis, MD, FAAP


Dear District II Member, Danielle Laraque, MD, FAAP

As we cycle out of summer and into the changes of autumn, we will all be challenged by the many changes in health care that this new season will bring.


Please read on for details.


Danielle Laraque, MD, FAAP

Chair, NYS AAP, District II

Changes in Health Care


Some of us are already experiencing changes in payment, or new systems of care. Many offices are affiliating with larger practices, joining new networks, or exploring invitations by hospitals and emerging community health systems to join population based health care consortiums. The federal government is expanding options for ACO's, more hospitals are merging or changing their scope of services, insurers are also merging and changing the kinds of coverages they are offering. Employers large and small are looking at new coverage options that the New York State Health Insurance Exchange, called New York State of Health, can offer, and some are already deciding to purchase coverage through the Exchange or provide for their employees to purchase through the Exchange.


New York State's Medicaid Reform Initiatives started with the MRT (Medicaid Reform Task Force) and are moving forward on several levels. Health Homes for medically complex adults are being created, supported and evaluated. Models for Health Homes for Children are being explored by various state work groups. Behavioral Health services are being integrated into primary care, either as contract ancillary services or co-located attached to primary care. Population health approaches are also being explored by larger health systems. Many of these new initiatives have the potential to impact on your practice and the practice of pediatrics in New York.


Several communities are already experiencing significant changes in how and where they will access all levels of health care. School based health care services for children in all settings from Buffalo to the tip of Long Island, are on schedule to be integrated in Medicaid Managed Care as part of the MRT process. This initiative opens up many questions about coordination of care, communication, responsibility of the PCP, and even more basically who is the PCP for a particular child. But it also offers opportunities to explore the notion of an expanded Medical Home to care for children and families. There are many questions and many concerns, but change is the constant that all health care systems and those delivering health care to children will be facing. The implemented and proposed changes are or will affect everyone, from the solo practitioner to the largest hospital based pediatric network practices.


In concert with all these changes, October 1st will bring the official opening of New York State's Health Insurance Exchange, New York State of Health. It is imperative that all pediatricians have information about the Exchange available to share with families in their practices. Research has shown that families who have health insurance for parents and children access more regular health care for their children. Therefore, family coverage can and does improve children's health. We have provided access to New York State specific information about the Exchange for you on our website (under "Current News" on the homepage: www.aapdistrictii.org). In addition, here is a link to the New York State of Health web portal that you can share with families who bring their children to you: www.nystateofhealth.ny.gov. We are bringing this to your attention because it is possible that many families who currently have some level of health insurance through their employers, especially small employers, will be asked to now purchase insurance through the Exchange. If parents have questions, or families are confused about their health insurance options, it is important that you help them choose an insurer that will allow them to continue to bring their children to you for pediatric care.

Childhood Immunization


Autumn also brings an increased focus on childhood immunization. This is the time that parents become more acutely aware of the immunization status of their children, and school, child care and recreational activity requirements. It is also the time that many families bring their children in for school and sports physicals. All visits are opportunities for immunization. Although our track record for compliance with mandated immunizations on the ACIP/AAP schedule is reasonable, we as pediatricians are not doing as well on non-mandated vaccines. Our City and statewide influenza coverage remains subpar. Only 65% of the youngest and most vulnerable children in NYC received influenza vaccine last year. The statewide figure is similar. The numbers are even worse for those over five and into their teen years. The older cohort of those over the age of nine had only 35% influenza vaccination rate. We can and must do better. If we want to continue to be perceived by the health care system as the most effective immunizers of children, we need to make sure all of our kids are immunized against influenza. And we need to work harder to get young patients immunized against HPV.


The stakes for pediatricians are high. Not only are we fighting off Retail Based Clinics, we are also holding off allowing children to be immunized in pharmacies and other community based sites. But we cannot simply say we don't want other points of services for childhood immunizations, we have to decide that this is part of what we do and we must find ways to do it better. There are experts in your local AAP NY Chapters and in the NYS AAP. If you are having difficulties, or if you are exhausted trying to work with parents who continually refuse or delay immunization for their children, you are not alone. There are human and material resources to help. Please reach out and get whatever help you may need to assure that we can and will immunize more children against influenza this year. And please, let's all work to be a positive force to help young people and parents understand the importance and protections that HPV vaccine offers. We are the immunizers. Let's make sure that we immunize children in a timely fashion. One additional point, please help assure that you and your colleagues have taken the time to be vaccinated this influenza season. This simple step will help protect your patients, their families, you and your own family!


The NYS AAP remains committed to working with the State Health Department and the Department of Financial Services to pass legislation or create regulation that sets a fair statewide immunization administration fee and requires all commercial insurers to pay pediatricians 27% above the CDC retail cost of vaccines for all vaccines. Yes, we have to work harder to get our child patients fully immunized, but we also have to be able to keep our pediatric practices afloat.

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Partnering with Community Based Child Serving Systems


The NYS AAP is also exploring ways we can partner with other community based child serving systems in a focused way to help children and families achieve and maintain higher levels of health and well-being. Finding effective and efficient ways to work with child care, teachers and schools, recreation and sports programs, and children's mental health services will help all of us better serve and support our patients. The new concepts of population based health and Medical Homes as community engaged teams pushes us to expand the walls of our offices and accept that we need to work with people who spend many hours a day every day with our patients.


We are also clear in our support of services that contribute and help sustain the development of healthy children and stable healthy families. The NYS AAP supports expanded high quality affordable infant and child care, the expansion of the evidenced based Nurse Family Partnership for all families caring for a new baby in challenging circumstances and Universal Pre-K. Recognizing the importance of brain development in the early years, we are committed to building services and supports that can and will create and maintain resilient children and supportive nurturing families and communities.


Our commitment to children also reflects our commitment to pediatricians and to pediatrics. We want to be the physician that parents see as a partner in the healthy development of their children. We also want to be the expert on children who knows what a child needs and knows how to get them what they need. We are physicians, but we are also care managers and referral services. We know that we have to take care of the whole child in their environment if they are to be and stay healthy.


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Fair Compensation for Pediatricians


Recognizing our complex role and needing to be fairly compensated for what we do and should be doing, we need to be able to negotiate with health insurance companies on a level playing field. One way to level that playing field is to allow physicians to create groups to collectively bargain with insurers. The NYS AAP remains committed to the concept of allowing physicians to collectively bargain with insurers for fair compensation. We will once again advocate for collective bargaining legislation this year. 


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Get Involved!


We urge you to become active in the work that we are all doing. There are many ways you can advocate for the services that children and families need, and there are many ways you can advocate for pediatricians and for pediatrics in New York State. There are simple short actions like a phone call or e-mail on a specific subject or issue, or there are longer, deeper involvements such as working on legislation or meeting with legislators. We urge you to do whatever you can. What New York State decides about how to deliver health care to children and how to pay for it, directly impacts what you do in your office and how you can treat and advise your patients. Join us, and add your voice to those that care deeply about children and the physicians who care for them.

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