LEGISLATIVE UPDATE FROM ALBANY
(Posted:  3/12/07)

(posted September, 2006)
Dear AAP District II Member:

In hopes of keeping you more informed as to District activities, I plan on emailing periodic District progress reports like the one below.
 
POLICY AND ADVOCACY UPDATE

A.  Immunization Coalition

The Immunization Coalition, which is awaiting a new name, has taken its first steps. As you may know, the District decided to support the creation of a statewide Immunization Coalition that would bring together voices beyond medicine to design and deliver pro-immunization messages to the public and to our state decision makers.  We are currently meeting with key representatives of the State School Boards Association, the NYS Child Care Coordinating Council, which represents all child care providers across the state from centers to home based/family care, NYSUT/NEA, the union representing teachers across the state, and the PTA.  The response has been positive and everyone who has been visited has agreed to join the AAP coalition.  This is intensive, but important work.
 
We are also reaching out to HPA, which represents most HMO’s in the state, the PHSP organization, HANYS, which represents hospitals outside of NYC and Greater New York HA and HHC for inner city hospitals and health care providers. So far the response has been positive. 
 
We are planning a first meeting some time in the fall.  At that time, we will bring our non-medical organizational partners together with our medical allies, like the NYS Public Health Association, NYSNA, ACOG, MSSNY, Family Physicians, etc.   Staff has met with or spoken with key representatives of many of these organizations.  Once the group has its first meeting, we will chose a name together and begin to set our agenda.  The State Department of Health was updated on our progress on 9/11/06.
 
B.  Campaign for Healthy Children

We have set the Annual Meeting for the Campaign for Healthy Children for November 6th, 12:00-5:00 at Pfizer, 435 E. 42nd St, NYC.  We will be inviting the children’s health and child serving organizations who have worked with us in the past.  This year, it is most important that we present our Agenda for Children’s Health as a broadly supported policy agenda for children.  With a new Governor and all new Commissioners, we have a chance to get our issues supported from the very beginning of the new administration if we can present a cogent, broadly supported and easily understood program to improve children’s access to quality health care and the other supports they need to develop into healthy, positive adults.
 
Basic planks of our Agenda will reflect the work we have been doing for the last two years.  There will be an emphasis on access to and quality of children’s health care.  A focus on meeting children’s mental health needs, their needs in the area of learning differences, and an exploration of best ways to meet children’s oral health needs.  We will also address issues to target childhood obesity, the availability of sub-specialists and the challenges of meeting the health care needs of special needs children.
 

Respectfully submitted,

Henry Schaeffer, MD, FAAP
Chair
American Academy of Pediatrics, District II

New York Governor Outlines Plan to Reform New York Health-care Industry.
(Posted:  2/2/07)

The New York Times (2/1, A1, Hakim) reports on its front page that "among several ambitious proposals," New York Gov. Eliot Spitzer (D) "proposed to radically restructure aid to New York's sprawling health-care industry in his first budget Wednesday, saying that the system props up failing hospitals and too often overlooks patients' needs, while consuming roughly a third of the state's budget." The Times continues, "To control health-care spending, Mr. Spitzer would hold the growth of Medicaid to 1.7 percent, compared to 8-percent growth rates in recent years, by cutting subsidies to hospitals and nursing homes, slashing Medicaid reimbursement rates and by stepping up efforts to combat fraud. Conversely, he outlined a plan to make low-cost, health-insurance coverage available to the state's 400,000 uninsured children."
      In a separate article in the paper's metro section, the New York Times (2/1, B5, Pérez-Peña) reports that the plan "contains the seeds of an epic battle -- $1.2 billion a year in cuts -- that could make everything else he wants harder to attain." The Times continues, "The proposed cuts, mostly in Medicaid, the health plan for the poor, pit the governor against the Legislature, health-care workers and the hospital industry -- powerful camps that welcome some of his ideas, but that fiercely protect their share of Medicaid spending."
      The Utica Observer-Dispatch (2/1, Roy) reports, "[Spitzer's] plans brought instant skepticism from the Republican-led Senate. Majority Leader Joseph Bruno (R-Brunswick, Rensselaer County) opened his news conference by calling Spitzer's ideas 'bold, imaginative and creative,' then proceeded to criticize most of its major components. He didn't like the new education formula, the freeze on hospitals and nursing homes, the closing of corporate tax loopholes, the lack of a small-business tax cut, the expansion of the beverage-container deposit law and, if that wasn't enough, the overall size of the budget."
      In an analysis, the New York Times (2/1, B5, Cooper) comments, "Now the new governor will need the cooperation of the Assembly and the Senate to pass his budget proposals, which take aim squarely at two of the holiest of Albany's sacred cows, health care and education. Past governors have tried, and failed, to enact some of his proposals. Other requests are new. Many, though, are sure to face strong opposition from powerful interests -- and lawmakers -- bent on preserving the status quo." The Times continues, "Governors typically have a honeymoon period when they can get things approved by a recalcitrant Legislature. ... Mr. Spitzer's political honeymoon, by contrast, is proving very short indeed."
      The New York Sun (2/1, Gershman) adds, "After a brief period of political accord, Governor Spitzer is readopting the aggressive style he wielded as attorney general, releasing an executive budget that butchers several of the Legislature's sacred cows." The Sun continues, "While calling for an infusion of billions of dollars for education aid and property tax reductions, Mr. Spitzer also is proposing a fundamental change in the way the state distributes dollars for education, Medicaid, and tax relief, a shift that will likely provoke fierce resistance from lawmakers."
      The New York Times (2/1) editorializes, "Unions, hospital advocates and politicians have already begun to raise the alarm" over Spitzer's health-care proposals, "[b]ut the governor is right to fight for a fairer, more cost-effective distribution of public funds."

(Posted:  6/29/06)

This update focuses on: a new primer for legislators on child health finance; an analysis of
state budgetary conditions; and an overview of state laws regarding fireworks.

Guidance on Children's Health Insurance
The National Conference of State Legislatures (NCSL), the bipartisan professional society for the nation's 7,382 state legislators and their staff, has issued a new paper reviewing the issues related to children's health insurance coverage. The document is intended to educate lawmakers
about the various problems states encounter in providing health coverage for all children and the extent of the uninsured status of children across state lines, and offers steps that states can take to improve health care access for children.  Although many of these issues are familiar to pediatricians, this document can provide valuable insight into how state lawmakers approach this issue and offers a framework for your discussions of this topic with your legislators.  The report can be retrieved from NCSL's Web site at http://www.ncsl.org/programs/health/forum/childinsprimer.htm

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States See Budget Surpluses, but Medicaid Budget Shortfalls Cause Concerns for Children's Health Advocates
According to an article on Stateline.org, for the first time since 2000, most states expect budget surpluses this year. Only Indiana, Louisiana, New Jersey, and Rhode Island have budgets that continue to fall short of current spending. Surprisingly in this election year, governors are not calling for tax cuts, and 11 governors are actually calling for tax increases. Driving this hesitancy to commit to lowering taxes are concerns about the cost of complying with the new federal standards on driver's licenses, increases in spending on state pensions, and with health care costs expected to continue skyrocketing, the cost of funding Medicaid. During an economic downturn, states have a hard time determining how much to spend on the Medicaid program because economic uncertainty brings with it an untold number of new enrollees.  Though the overall budget surplus of states is good news for children because early childhood programs or school funding often times get cut during lean budget years, the continued pinch on the Medicaid budget is troubling.  Currently, Medicaid makes up 22% of state's total budgets. 18 states had Medicaid budget shortfalls in 2005, and even with overall budget surpluses, 15 states expect Medicaid budget shortfalls in 2006.  If spending stays at the current pace, according to a National Conference on State Legislatures (NCSL) survey, expenses will exceed
revenue in FY 2007 in 10 states and in 18 states in FY 2008.  This article can be found at
http://www.stateline.org/live/ViewPage.action?siteNodeId=136&languageId=1&contentId=119510 

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Overview of state laws regarding fireworks
As the Fourth of July holiday approaches, AAP chapters may receive inquiries about the sale
and use of fireworks.  Consumer fireworks of all kinds are responsible for hundreds of injuries to children and cause millions of dollars in fire damage annually. The Division of State Government Affairs has compiled a summary of state laws on consumer fireworks, which you may find useful in response to these inquiries.  The AAP policy statement "Fireworks-Related Injuries to Children" is available on the Academy's Web site at: 
http://pediatrics.aappublications.org/cgi/content/full/108/1/190 

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Session Recap
As of this writing, eight states (California, Delaware, Massachusetts, Michigan, North Carolina, New Jersey, Ohio and Pennsylvania) and the District of Columbia remain in regular legislative session. In addition to these, Virginia is in special session this week.  24,054 bills have been enacted or adopted so far in 2006, creating more than 1.9 million pages of bill text.  For more information on the issues contained in this e-mail update, please contact Ian Van Dinther at 800-433-9016, ext 7092 or at ivandinther@aap.org.

The Division of State Government Affairs sends the e-mail update to the Academy's Executive Committee, Board of Directors, District Vice-Chairs, Chapter Presidents, Chapter Vice Presidents, Chapter Legislative Contacts, Committee on State Government Affairs, Committee on Federal Government Affairs, Chapter Executive Directors, and other interested AAP members and staff.  For additional advocacy information, log in to the Academy's Web site
(http://www.aap.org) and select either Advocacy (for more information about the Academy's State Government Affairs program) or the Member Center (for strategy suggestions and more in-depth information on issues of pediatric interest). Previous e-mail updates are also available on the Academy's Member Center.