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AN
ACT to Expand "Religious" Exemption form
Immunization
Memo
of Opposition for A. 592
Contact: May 4, 2011
Elie Ward
Director of Policy & Advocacy
eward@aap.net
518-441-4544
The American Academy of
Pediatrics, District II, New York State, representing
almost 6,000 pediatricians across the state, opposes
A592. This bill will expand the ability of parents to
claim a "religious" exemption to avoid
immunizing their children.
New York State already
has religious exemption legislation and a functional
regulatory structure. Families who have true religious
issues with immunization, can, and do meet the tenets
of their religious beliefs within the context of
current law. If there are problems with the
implementation of the current law and regulation in
specific school districts, then those problems should
be addressed and resolved.
This bill however, has
very little to do with religion. Rather it provides an
option for an exemption without clearly stating the
decision basis for such an exemption. It is to all
extents and purposes a philosophic exemption, since a
parent need only state that they are opposed to
immunization for "religious" reasons. Every
state that has implemented a philosophic exemption has
seen a reduction in the percent of children immunized.
Taken in any other
context, this bill would allow a person to say that
their "religion" doesn't allow speed limits
therefore they don't need to obey the speed limit; or
their "religion" provides for carrying a
concealed weapon at all times and therefore they can
do that. And all they would have to do, if this
legislation was more broadly applied, is self attest
to their "religious" belief re speed limits
or concealed weapons.
Civil liberties are an
important part of our lives, but civil liberties and
social responsibility are always held in balance by
the concept of public good. That is why, although we
have free speech, we cannot yell "Fire" in a
crowded public place, unless, of course, there is a
fire.
Universal immunization
is a public good. Families who participate in other
public goods, such a public school, day care, summer
camp, play groups need to take the responsibility to
immunize their children so that all children are
protected. Immunization works to protect all children
through the concept of herd immunity. No vaccination
is 100% effective in every child. Protection is
afforded through universal immunization which offers
protection because most children are immunized,
therefore disease cannot spread. If we allow parents
who are afraid of vaccination, those who are persuaded
by anti-scientific information on the internet, those
who believe that somehow vaccines cause all kinds of
problems, to decide that their "religion"
allows them to reject immunization, then children who
are medically fragile and cannot be immunized for
medical reasons, or children who are the younger
siblings of those in groups and have not yet been
immunized will be open to infection. We will allow
herd immunization to be breached.
Public and private
efforts over the last two decades have resulted in the
eradication of most childhood diseases from our state
and our country. Parents who chose not to immunize
their children have every right to make that decision.
But they do not have a right to include that child in
public school or group day care, where their lack of
immunization has the potential to cause harm to other
children. Parents who chose not to immunize can also
chose to home school. Or if they are part of an
unrecognized religion that rejects immunization, they
can come together with other families who are of the
same faith and start a school to educate their
children.
Here in New York State
we have had recent outbreaks of measles and of
whooping cough. All of our children are just one plane
ride away from infection if we do not assure that all
children are appropriately immunized against childhood
diseases which in the past have maimed and in fact
killed our children.
We are firmly opposed
to this insidious and yet dangerous legislation and
urge you to soundly reject it.
Immunization has been
one of this country's greatest public health
successes. We cannot allow overconfidence to weaken
our children's safety net and once again have to care
for children disabled by measles and polio, and other
crippling childhood diseases. The children of New York
are depending on you to help keep them safe.
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Eliminate
the Requirement that NP's have a Cooperative Practice
Agreement with a Licensed Physician
Memo of
Opposition for A. 5308/S. 3289
Contact: June 4, 2011
Elie Ward
Director of Policy & Advocacy
eward@aap.net
518-441-4544
The American Academy of
Pediatrics, District II, New York State, representing
5,500 pediatricians across the state, opposes
A5308/S.3289. This bill will eliminate the current
requirement that all NP's have a Cooperative Practice
Agreement with a licensed physician.
Although we understand
the current challenge the state faces in providing
high quality primary care to all New Yorkers, removing
the requirement that Nurse Practitioners have a
Cooperative Practice Agreement with a licensed
physician is not the solution to the problem. In fact,
such action has the potential to reduce quality of
care, most especially for poor and disenfranchised New
Yorkers. We support training and certifying more
pediatricians, family physicians and nurse
practitioners to meet anticipated increased need for
primary care and care management. A doctor attends
four years of Medical School, serves an internship and
successfully completes residency, and then must meet
the requirements of licensing in New York and maintain
their status in their professional organization. An NP
takes a very different academic and training track.
The requirement for a Cooperative Practice Agreement
is simply a way to help insure quality patient care.
If there are issues of
equity in these relationships across the state, or if
there are problems related to establishing and
maintaining Practice Agreements, then the SDOH and SED
should address those issues to assure quality,
accessible primary care for all New Yorkers.
The best way to
preserve and enhance access to high quality primary
care is to strengthen, not weaken the relationship
between nurse practitioners and primary care
physicians.
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AN
ACT to Amend the Public Health Law to Prohibit Smoking
in Private Passenger Cars, Vans and Trucks Where a
Minor less than 14 Years of Age Is a Passenger in Such
Vehicles; Provides for Rebuttable Presumption;
Provides That Violations of Such Provisions Shall Be
Subject to a Fine of Not More than $100
Memo of Support
for A. 07285/S.
03082
Contact: June 9, 2011
Elie Ward
Director of Policy & Advocacy
eward@aap.net
518-441-4544
AN ACT to amend the
Public Health Law to prohibit smoking in private
passenger cars, vans and trucks where a minor less
than 14 years of age is a passenger in such vehicles;
provides for rebuttable presumption; provides that
violations of such provisions shall be subject to a
fine of not more than $100.
The American Academy of
Pediatrics, District II, NY representing 5,500
pediatricians across the state and the millions of New
York children we care for, enthusiastically supports
A.07285/S.03082.
The AAP has had a
consistent and strong policy on tobacco control and
cessation. It has also been in the forefront of
research on the negative health impacts of second hand
smoke (SHS) on children through the work of its Julius
B. Richmond Research Center.
The data is clear,
second hand smoke has significant negative impacts on
infants, toddlers, young children and pre-adolescents.
In fact, SHS has a negative impact on the health of
all people, but the outcomes for children are
especially concerning. Children who are exposed to SHS
have more respiratory and bronchial infections and
irritations. They are more prone to develop asthma and
other breathing challenges. Additionally, children who
are already at risk of poor health outcomes because of
asthma and other chronic illnesses are especially
vulnerable to SHS.
Passing this
legislation will put New York squarely in favor of
protecting children's health. Protecting children from
SHS within the confines of a car will go a long way to
reducing negative health impacts of SHS across the
state. In addition, passage of this legislation
provides an opportunity to mount a focused public
education campaign about the dangers of second hand
smoke. Not smoking in cars can be equated with
securing your child in a child seat or a seat belt. It
is the safe and smart thing to do.
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High
Schools to Include CPR Instruction as Part of Their
Existing Health Curriculum
Memo of Support
for S. 2491/A.
3980A
Contact:
Elie Ward
Director of Policy & Advocacy
eward@aap.net
518-441-4544
The American Academy of
Pediatrics, representing more than 5,500 pediatricians
across the state supports S.2491/A.3980A. This
legislation would require all high schools to include
CPR instruction as part of their existing Health
Curriculum.
Research has shown that
effective bystander CPR, provided immediately after
sudden cardiac arrest, can double or triple a victim's
chance of survival.
The American Heart
Association recommends that hands-on CPR training be a
requirement for graduation. Several studies have
demonstrated that trainees, including school children,
can achieve an acceptable level of skill in adult CPR
in 30 minutes or less. This legislation does not
require students to become certified in CPR, it simply
requires the training.
The American Heart
Association's 2010 revised CPR guidelines require
hands-only CPR, (chest compression). This new approach
makes it easier for any bystander to perform CPR and
survival rates are similar to that of conventional CPR
(with both compressions and breaths).
Learning CPR can
provide high school students with the knowledge
necessary to save lives. This bill will ensure that
all lessons meet the established standards of
professional organizations such as the American Heart
Association and the American Red Cross. Adding CPR
training as part of the high school health curriculum
will increase all students' awareness of important
life saving techniques and it could ultimately save
lives.
To avoid any additional
costs to the schools, we would encourage all local Red
Cross and Heart Association organizations to work
closely with their school districts to implement this
CPR addition to the Health Curriculum.
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Legal
Support for Physicians to Negotiate with Insurers for
Fair Service and Reimbursement Contracts
Memo of Support
A.02474/S.3186
Contact:
Elie Ward
Director of Policy & Advocacy
eward@aap.net
518-441-4544
The American Academy of
Pediatrics, representing more than 5,500 pediatricians
across the state supports A.02474/S.3186 providing
legal support for physicians to negotiate with
insurers for fair service and reimbursement contracts.
Due to the current
imbalance of negotiating power in favor of the managed
care plans, physicians and other health care providers
are offered take-it-or-leave-it contracts by health
plans that significantly hamper their ability to
provide quality patient care. These contracts permit
burdensome processes and unjustifiably long wait times
for obtaining pre-authorization to provide needed
patient care; impose limitations on whom a physician
or other health care provider may refer a patient for
necessary care; permit demands for refunds of payments
long after the time that such payments were originally
made; permit health plans to make major changes to key
elements of a contract without physician or other
health care provider consent; and cede to physicians
and other health care providers the legal consequences
for patients harmed by health plan utilization review
decisions.
Right now, the playing
field in health care contract negotiations strongly
favors large managed care plans and disempowers
physicians to represent the needs of their patients.
By allowing independent
contractor physicians and health care providers to
conduct some collective negotiations while being
closely monitored by the state, this bill would give
physicians and health care providers greater ability
to advocate for patients in contract negotiations.
This bill would also create a system under which the
state could closely monitor those negotiations, and
any negotiations involving fee-related matters would
only be permitted when an individual managed care plan
controls a substantial share of the managed care
market. This legislation would not authorize strikes
or boycotts of health benefit plans by physicians.
We fully support
A.0274/S.3186 because we believe it will not only help
improve health care, it will also create an equitable
partnership between health care service providers and
large managed care insurers across the state. This
legislation will have the ultimate effect of improving
patient care and keeping more highly skilled
physicians in New York State.
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AN
ACT to Amend the Education Law, in Relation to the
Sale of Certain Foods in Vending Machines on School
Grounds or Property
Memo of Support for A. 6900/S. 4552
Contact:
Elie Ward
Director of Policy & Advocacy
eward@aap.net
518-441-4544
The Academy of
Pediatrics, District II, New York State, representing
more than 5,500 pediatricians across the state,
strongly supports this bill.
Each year more and more
New York children are burdened with the physical and
emotional challenges of being overweight and/or obese.
What children eat has a lot to do with how much they
weigh. Because children spend many hours in school,
and in fact, school is their workplace, it is
imperative that their food choices in the school
setting are healthy choices.
Most children
supplement their lunch with food from vending machines
during and after school. Many children in the upper
grades create their lunches from the school vending
machines and continue eating from machines during
after school activities. Therefore, it is imperative
that the food and beverage choices provided to
children in the school vending machines are healthy
choices.
When Connecticut
instituted a healthy foods school vending machine
policy, a peer reviewed research study indicated that
not only did students make better food choices in the
school setting they also did not increase their intake
of junk food in out of school time.
We support this
legislation because it has the potential to be a
significant component of a public health initiative to
fight childhood and adolescent obesity.
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American
Academy of Pediatrics, District II, New York State
2011 NYS Budget, Program and Legislative Priorities
Revenue:
The
State is facing an enormous budget challenge.
The Governor & the Legislature have to close a $9
billion deficit. To mitigate cruel and
unsustainable cuts to vital programs for children and
families, the AAP supports two key revenue options
- Pass the Sugared
Drink Tax
- Maintain
Millionaire's Tax
Budget:
Maintain and Support Initiatives to Build
Bright Futures NY Medical Homes for all children.
- Support the
requirement to offer Child Specific full benefit
package for all health insurance offered in NYS
- Maintain and Support
all financial and programmatic supports for early
screening for developmental and socio-emotional
milestones in the primary care setting
- Create and maintain
universal financial support for trained
pediatricians to provide assessment, diagnosis and
treatment to children with mild to moderate mental
health challenges
- Explore additional
supports to keep immunizations as a viable part of
pediatric care
Other Issues:
- Support proposed
Juvenile Justice Reforms:
- Bring young
people closer to home for services;
- Close outdated
institutions;
- Reinvest savings
in community care
- Maintain evidence
based services for vulnerable children in fragile
families; support quality respite and family
support services, like the Nurse Home Visiting
Program.
- Support quality
services for children in the foster care system
and invest in real permanency for all children.
- Maintain support for
high quality Child Care and Pre K programs. These
are key investments that have been proven to
prepare children for success in school.
Education:
- Maintain adequate
funding so that every child can and will receive a
quality education. We accept that cuts must be
made in these difficult times. Therefore, we
encourage state leadership to provide guidance and
support to school districts to help them make
decisions that direct resources to quality
instruction for all students.
- Maintain support for
early education services, Early Intervention,
Parent as Teacher programs and Reach Out &
Read programs
Legislation:
- We support:
- Back to Play
Concussion legislation that includes the
appropriate involvement of a physician in the
decision matrix.
- Legislation that
encourages all birthing hospitals to offer
parents & caregivers of newborns Tdap
immunization in the hospital setting.
The recent outbreak of Whooping Cough has
clearly demonstrated that we must do more to
protect vulnerable infants from a resurgent
disease that can kill them California recently
had 10 infant deaths from Whooping
Cough. One of the best ways to protect
babies is "cocooning," that is,
vaccinating the people who will be around the
baby the most.
- Legislation that
continues to reduce children's and teen's
access to cigarettes and other tobacco
products.
- Legislation that
improves adolescent's access to all domains of
reproductive health care and pregnancy
prevention
- Legislation that
increases nutritional value of food offered to
students in the school setting
- Legislation that
contributes to a healthy environment for
children by improving the quality of our air
and
water
- We Oppose
Legislation:
- That works to
reduce universal immunization, including
expansions of "religious" or
introduction of philosophic exemptions.
- Creates
additional barriers to adolescent's access to
Reproductive Health Care and Pregnancy
Prevention Services
- Weakens
Environmental Protections
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The
American Academy of Pediatrics, District II New York
State
Statement on Medicaid Redesign Team Recommendations
& 30 Day Amendments
The Academy of
Pediatrics, District II, NYS, representing nearly
6,000 pediatricians across the state supports the
majority of the recommendations recently presented by
the Medicaid Redesign Team, and included in Governor
Cuomo's 30 Day Amendments to the New York State
Budget.
We believe reforming
Medicaid and in fact, reforming health care in New
York is an enormous challenge, but reform is
imperative if we hope to provide high quality,
affordable health care to the family of New York.
We believe:
- High Quality Medical
Homes must be supported with adequate payment
- Bright Futures New
York should be the standard of Medical Home care
for all children
- Health System
dollars must be targeted to evidence based primary
and preventive care
- Physicians need a
level playing field to negotiate with insurers
- Care Management
cannot just be another name for "old and
ineffective" managed care
- Medical Malpractice
Liability Reform should be part of any program of
health care reform
- The special needs of
medically complex children must be taken into
consideration in the design and implementation of
care management systems
- Behavioral Health
Organizations, as defined in the recommendations,
must be directly connected to and communicate with
primary care providers and Medical Homes.
- Children in foster
care must have special services available to meet
their special needs in any move toward care
management or managed care for this population.
These services must be designed and delivered in
partnership with the agency caring for the
children.
We reject the 30 Day
Amendment/ MRT recommendation, which allows
pharmacists to immunize children from age 11.
This is unnecessary. There is no lack of
capacity for immunizing children in pediatric
care. The recommendation supports fragmented
care and is antithetical to the principles of a
Medical Home.
We look forward to
working with the Administration and the Legislature to
reform, strengthen and improve health care for
children and families across New York.
For additional
information please contact:
Elie Ward
Director of Policy & Advocacy AAP, District II
eward@aap.net
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