Strong AAP-CA Chapter advocacy has never been more important than during this era of state budget cuts and implementation of federal health care reform.
The District Chapter of the AAP (AAP-CA) advocates at the state level on priority issues that affect the health and well-being of California children and the viability of California primary care and subspecialty pediatric practice.
District priorities include:
1. Protection of publicly funded health care programs for children
* The California Children Services program provides care for acutely and chronically ill children with special health care needs. With AAP-CA support it has remained a “stand-alone program”, carved-out from Medi-Cal managed care. That carve-out is scheduled to end December 31st of this year. If it does, CCS services will be stripped of independent, specialized case management and absorbed into the massive Medi-Cal plan system, with fees to physicians capitated. AAP-CA is sponsoring and strongly advocating for legislation that will extend the carve-out to protect access to care for these vulnerable children and support the pediatricians that see them.
* The Healthy Families Program (HF) was slated for elimination under this year’s budget. 900,000 children would have been moved out of HF into Medi-Cal managed care all at once, without thoughtful stakeholder input or benchmarks to evaluate the move. AAP-CA was successful in urging legislators to delay the decision until there can be a policy analysis and review.
Advantages to a move into Medi-Cal for these children, if done correctly, include their new eligibility for Vaccines for Children, as well as streamlined eligibility and administration through a single public plan for children of all ages. Concerns include lower reimbursement rates in Medi-Cal than Healthy Families, and care management/quality issues. AAP-CA continues to engage aggressively with the state to demand that publicly-funded care structures be guided by the goal of access to a quality medical home to comprehensive services, rather than simply short-term state cost savings.
* Current Healthy Families funding is also at risk, with two significant funding sources (a hospital tax and managed care organization tax) both set to expire. AAP-CA is engaging with legislators to educate them about the critical need for these funds.
2. Support for immunization access and reimbursement
* AAP-CA joined the California Immunization Coalition (CIC) last year to successfully enact legislation that requires a Tdap booster for California youth entering middle school and high school this year. We also supported successful passage and signing of a companion bill to permit schools to allow a 30-day grace period in which students can get the booster without the school having to ban attendance and lose education funds. AAP-CA takes a holistic view of the child and his or her needs, and works with our partners in education and social services to make sure that important health policy decisions like this one are implemented in a way that is feasible and practical.
* AAP-CA successfully passed a bill to require appropriate administration fees from health plans to physicians for all childhood vaccines. Unfortunately, the measure was vetoed by the Governor. AAP-CA continues to strategize with our partners and those in the private and public sector to address the pressing need to establish secure and adequate vaccine funding at the practice level.
3. Development of clear policies to support families of children diagnosed with autistic spectrum disorders and to appropriately reimburse pediatricians for that care.
* For several years bills have been introduced in the California Legislature to require insurance companies to cover various treatments for autistic spectrum disorders. Working with private sector plans through the AAP-CA Pediatric Council, the AAP-CA is reviewing and evaluating the evidence on these treatments. The goal is to develop recommendations that guide policymakers and insurance companies to make decisions that utilize limited resources to most benefit children and their families
For a complete list of AAP-CA priority issues, updated weekly, please go to www.aap-ca.org
