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California Chapter 4, AAP has partnered with the
Children and Families Commission of Orange County
to hold a community campaign focusing on increasing
awareness of the importance of immunizations for
children, specifically targeting the 2 year-olds, and
encouraging the establishment of a medical home.
The AAP has participated in eight Health Fairs in the
months of May and June at the School Readiness
Partnership School Districts (Capistrano, Garden
Grove, Magnolia, Newport Mesa, Ocean View,
Placentia/Yorba Linda, Santa Ana, and Westminster).
Community resources and information on oral health,
literacy, child safety, health insurance enrollment,
and other health topics would be available. The Los
Angeles-Orange Immunization Network (LINK), an
internet-based computerized database system that is
in use in Orange County, and one of the 10 Regional
Immunization Registries in the State of California, will
be used to enter immunizations given. Attached is
the list of dates in May and June and the locations of
the Health Fairs. Two additional health fairs are
scheduled for July and August and if you are
interested in supporting this campaign, please note
the date you can attend and what your interest is.
ï July 15, 2006, The Friendly Center, 147 W.
Rose Avenue Orange, CA -- 9am to 1pm
ï August 24, 2006, Centralia School District, 320 Danbrook, Anaheim, CA -- 10am to 2pm The Chapter is also offering its assistance in
involving interested pediatricians in Orange County to
join in this Immunization Campaign.
(Please check box of choice. You may choose
more than one.)
May attend one of the Health Fairs and
If unable to attend any of the Health Fairs
California Chapter 4, AAP would like to acknowledge
pediatricians participating in any of the above by
giving out tokens of appreciation, gift coupons for
the AAP Online Bookstore, and by recognizing them
as Physician Champions in our E-Newsletter. A
number of grant proposals to help provider offices to
start LINK will also be accepted.
Please print this form and complete with your
name and contact information and fax to (714) 971-
0652, or email Dian Milton at
dianmilton@sbcglobal.net. For
further information please call the Chapter office at
(714) 971-0695. Thank you.
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The Chapter will be participating at the Children and
Families Commission booth at the upcoming Orange
County Fair on July 19 and July 26. We will be
distributing Immunization information and educational
materials on the importance of nutrition and physical
fitness to the fair attendees. If you are available to
help at the booth with the distribution of this
information, please contact Dian Milton at AAP (714)
971-0695 or email (dianmilton@sbcglobal.net). The
AAP will be covering the booth from 12pm to 3pm or
2pm to 5pm on July 19 and July 26. If you can help
for any amount of time, we would appreciate your
support. For supporting AAP, you will receive a
complimentary OC Fair ticket and parking as well as
an appreciation gift from the chapter for your time.
Thank you for your support.
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June 2006
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A class action lawsuit was filed in federal court
Wednesday, challenging the validity of the citizenship
documentation requirement of the Deficit Reduction
Act of 2005 (DRA) for Medicaid applicants and
enrollees. Families USA, the National Health Law
Program, the National Senior Citizens Law Center,
and the Sergent Shriver Center on Poverty Law
worked to file this lawsuit on behalf of the over 50
million Medicaid enrollees who will be required to
provide documentation of citizenship and identity
starting July 1, 2006. A
press release on this lawsuit can be found online.
As indicated, the attorneys are seeking an immediate
hearing so that the law can be prevented from going
into effect. We will keep AAP chapters up-to-date
on the latest developments with this case.
As you know, July 1 is the deadline for state
implementation of the citizenship documentation
requirements of the DRA. While we had expected the
Centers for Medicare and Medicaid Services (CMS) to
promulgate regulations on the citizenship
documentation requirements before the deadline,
CMS has not done so. As such, the previous
guidance in the form of the Dear State Medicaid
Director Letter and Fact Sheet will stand until further
regulations are published. These and other DRA-
related materials can be found on the AAP Member
Center at www.aap.org/moc, under "State
Government Affairs" and "Deficit Reduction Act of
2005 (DRA): Resources." Again, we will keep
chapters apprized of any forthcoming regulations.
Finally, chapters are reminded that states are
publishing their individual state plans for
implementation of the citizenship documentation
requirements. You may check with your state
Medicaid office to see what your state has published
to provide further guidance on complying with the
law in your state.
Of note, Ohio and California have at least indicated
that they may not comply with the July 1 deadline
for implementation of the new citizenship
documentation requirements. The federal
government has stated the noncompliance will result
in a loss of federal funding for Medicaid enrollees who
do not provide documentation of citizenship.
We will continue to provide updates on the DRA to
AAP chapters. If you have any questions, need
information, strategy, or consultation on the DRA or
other state Medicaid advocacy, please contact Dan
Walter at 800/433-9016 ext. 4086 or
dwalter@aap.org. If you have questions or need
additional information or strategy on federal Medicaid
efforts, please contact Bob Hall, JD, in the
Department of Federal Affairs at (202) 347-8600, x.
3009 or rhall@aap.org.
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On June 16, the Centers for Medicare and Medicaid
Services (CMS) released a Dear State Medicaid
Director letter ("DSM Letter") and two State Plan
Amendment preprint forms ("preprint forms"),
providing guidance on premiums and cost sharing as
allowed under the Deficit Reduction Act of 2005
(DRA). The DRA gives states new opportunities to
impose or raise premiums and cost sharing for certain
populations, including children.
This June 16 DSM Letter largely reinforces the
guidelines set forth in the DRA itself related to
premiums and cost sharing, including special rules for
cost sharing for prescription drugs. The June 16 DSM
Letter does not address cost sharing for non-
emergency use of a hospital emergency room as
established by the DRA - a subsequent DSM Letter
will specifically address this issue. The DSM Letter
does not set any new guidelines and largely
reiterates and reinforces the premium and cost
sharing rules established by the DRA. Specifically,
the DSM Letter:
* Reiterates specific premium and cost sharing rules
for each eligibility category, including rules
for "preferred" and "non-preferred" prescription
drugs. Please see the attached AAP chart on
premiums and cost sharing, from the AAP analysis of
the DRA previously sent to chapters. "Mandatory"
children, including those with family incomes under
100% of the federal poverty level (FPL), are still
subject to this new cost sharing option.
* Indicates that states may choose to make cost
sharing "enforceable", meaning that physicians and
other providers may deny care if cost sharing is not
provided. Providers may still waive cost sharing on a
case-by-case basis if this occurs.
* Requires states to reduce payments to physicians
and other providers by the amount of cost sharing.
The DSM Letter reiterates that states may raise
Medicaid payments to providers when cost sharing is
implemented.
* Indicates that states may exempt entire
populations from cost sharing, such as all children,
and may impose more limited cost sharing than is
allowed by the DRA.
The DSM Letter is accompanied by State Plan
Amendment preprint forms that states can use to file
amendments to their Medicaid State Plans,
implementing cost sharing.
AAP chapters are encouraged to seek exemptions
for all children if your state seeks to impose cost
sharing. More information on the negative effects of
cost sharing can be found in the following reports on
the subject:
We will continue to provide updates on the DRA to
AAP chapters as more information becomes
available. If you have any questions, need
information, strategy, or consultation on the DRA or
other state Medicaid advocacy, please contact Dan
Walter at 800/433-9016 ext. 4086 or
dwalter@aap.org. If you have questions or need
additional information or strategy on federal Medicaid
efforts, please contact Bob Hall, JD, in the
Department of Federal Affairs at (202) 347-8600, x.
3009 or rhall@aap.org.
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California Chapter 4, AAP is excited to announce a
collaboration which will bring the Reach Out and Read
message to many more Orange County families.
Reach Out and Read (ROR) is a national program that
promotes early literacy in pediatric exam rooms
across the nation by giving new books to children
and advice to parents about the importance of
reading aloud. ROR makes early literacy a standard
part of pediatric primary care.
Through funding from National Reach Out and Read
and the Children and Families Commission of Orange
County, the Chapter in collaboration with the Early
Literacy Network will be able to supply interested
practices with training and books for their offices.
We are especially interested in bringing the ROR
message to children living in poverty, but welcome
interest from any office, no matter what the
demographics
The ROR Model: Pediatricians and other
clinicians are trained in the three part model in an
effort to promote pediatric literacy:
For more information about bringing ROR to
your office, contact Nancy Donnelly, MEd at (714)
971-0695.
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Phyllis F. Agran, MD, MPH, Craig Anderson, PhD,
DrSc, Diane G. Winn, RN, MPH Department of
Emergency Medicine, Center for Trauma and Injury
Prevention Research, University of California Irvine,
Orange, California The authors have indicated they
have no financial relationships relevant to this article
to disclose.
(Modified from the study)
High rates of use of child safety seats have been
achieved. A remaining challenge in child passenger
safety is to reach the Healthy People 2010 objective
of child safety seat use to 100%. Several factors
have been reported to influence child safety seat
use. We developed a child safety seat Hassles Scale
to explore these hassles.
In this low-income largely Latino population of
violators of the California Child Passenger Safety
Law, only 59% reported that they always use a child
safety seat. Child safety seat nonuse was related to
hassles that are associated with child behaviors and
vehicle crowding/inconvenience. Clinicians who
provide counseling and those who teach child
passenger safety classes need to address the
hassles of consistent use and stress the life saving
benefit.
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Practitioner's Guide to Children's Exercise in Health
and
Disease: July 27-29, 2006
Quarterly BREAKFAST Meeting and
Connected Kids Implementation Workshop:
September 9, 2006:
Current Advances in Pediatrics: October 20-22,
2006
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Deborah Monfea
California Chapter 4, American Academy of Pediatrics
email:
ca4aap@sbcglobal.net
phone:
714/971-0695
website:
http://www.aapca4.org
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