MCAAP Committee/Initiative Updates – 5/2010
The following reports have been submitted by MCAAP Committee Chairs:
The Committee on Adolescence addresses issues that affect teens and young adults and thos who care for them. Recent efforts have focused on obesity, medical care and services for teens in DYS, access to pediatric medical and mental health consultations for the judges in the juvenile courts, psychopharmacology and mental health access for adolescents, "free care", new vaccination recommendations, increasing advocacy for teens within the Chapter, and participating in the Pediatric Council to represent the needs of adolescents and young adults. Liaison with other organizations that advocate for adolescents such as the Massachusetts state adolescent health coordinator and the New England Regional Chapter of the Society for Adolescent Medicine occurs regularly.
Chair - Dr. Carl Rosenbloom
Anti-tobacco Advocacy Initiative - Tobacco-related accomplishments
We continue to represent the Chapter on the Tobacco Free Mass Coalition (tobaccofreemass.net), a group of advocates who are working toward eliminating tobacco use and, in the meantime, minimizing its harmful effects. Dr. Megan Sandel, representing the Chapter, is working with the Boston Public Health Commission on a Smoke Free Housing Policy campaign to increase smoke free building options
The Chapter has become of a partner of a DPH program called "Quitworks". The goals of the program are the following:
• Create awareness of the issue of child exposure to second-hand smoke
• Encourage child and family practitioners to focus on family tobacco use
• Provide a “go-to” resource to help practitioners to help families to quit smoking
• Adaptation of the QuitWorks free fax-referral program as a solution for all child and family practice settings in Massachusetts.
Through this partnership, the Chapter will participate in a variety of promotional events with the DPH and other organizations.
If you have an interest in preventing tobacco addiction and exposure to secondhand smoke, please contact us at HYPERLINK "mailto:msandel@mcaap.org" msandel@mcaap.org or HYPERLINK "mailto:callen@mcaap.org" callen@mcaap.org. There are plenty of ways you can contribute to this effort and we welcome your help.
This year the Chapter received a grant from the AAP Healthy Peoples Grant “Using Technology to Support Pediatricians in Tobacco Management" in the amount of $20,000.
Dr. Mona Sharifi and Dr. Renee Boynton Jarrett also work with Dr. Sandel on tobacco-related activities.
Co-Chairs - Dr. Carole Allen, Dr. Megan Sandel
The Committee on Breastfeeding works to promote breastfeeding via education, advocacy, and legislative efforts. Through the Massachusetts Breastfeeding Coalition (www.massbfc.org), the Committee provides statewide resource guides, lectures to hospital and office staff, community awards, and the organization of conferences for medical professionals. The Coalition has formed strong affiliations with the DPH and WIC to further goals and provide families with the benefits of human milk. We have worked to help produce the Annual Breastfeeding Conference in September 2009 organized by the Mass Breastfeeding coalition. We also participated in a session for the Breastfeeding Chapter Coordinators at the 2009 Academy of Breastfeeding Medicine in October. We have worked to promote breastfeeding friendly regulations and legislation through DPH and the legislature giving testimony and working with other groups such as Mass ACOG. Currently we are still working to promote further legislation supporting workplace lactation support for working mothers. We are also working to promote the Baby Friendly Hospital Initiative in the Breastfeeding Collaborative to bring together Massachusetts birthing hospital staff and community resources to help hospitals progress together that are working to become Baby Friendly. The AAP has endorsed the Ten Steps for Successful Breastfeeding. We participated in the recent state-wide Mother Baby Summit of Maternity Hospitals. We supplied the group through the Mass Breastfeeding Coalition a PowerPoint presentation regarding methods to work with the new Joint Commission on Hospitals Breastfeeding Exclusivity Measure.
Coordinator - Dr. Susan Browne
The Committee on Bylaws submits revisions of chapter bylaws as the need arises. The Committee does not have regular meetings. The bylaws were revised with input from the Executive Board for approval at the 2007 Annual Meeting. They were approved at the 2009 Annual Meeting.
Children's Mental Health Task Force (CMHTF) is a coalition of pediatricians, child psychiatrists, psychologists, social workers, insurance representatives, policy advocates, various commissioners, legislators, employer groups, nurses, and groups from the education and correctional services community in an effort to improve children's mental health in Massachusetts. The Task Force has been successful in obtaining reimbursement for non face-to-face care, increasing payments for child psychiatrists, helping in establishing a Special Governor's Commission on Children's Mental Health, facilitating funding for the Parent Advocacy League from HMO's, and facilitating the creation of various local children's mental health programs. The Child Psychiatry Access Project has been launched in six regional sites around the state and is enabling pediatricians to get training and consultations in psychopharmacology and managing patients with mental health problems. Recent activities include:
● Getting health plans to reimburse for formal developmental/mental health/substance abuse screening using CPT code 96110 with annual preventative care visits. After extensive lobbying with Senator Kerry’s staff, the federal Blue Cross FEP program has begun reimbursement as well. A coding fact sheet from AAP may be found at http://www.aap.org/moc/reimburse/DevelopmentalScreeningTestingCodingFactSheet.doc.
· The Massachusetts Child Psychiatry Access Program (MCPAP) has expanded across the state to make child psychiatrists available for timely pediatric consultation and make pediatricians aware of the mental health resources in their communities. MCPAP may be reached at 617-790-5670. In view of budget cutbacks, the Academy has advocated for full funding of MCPAP services.
· There has been a lawsuit against the state, where the judge ruled that the state is not doing enough to offer mental health community resources for MassHealth children. The state has established the Children’s Behavioral Health Initiative (CBHI) to implement the court order and the plan includes universal pediatric behavioral screening at well visits, a standardized assessment for children referred to mental health providers (the CANS), and an array of emergency and community-based mental services for children.
· The Task Force continues to advise the CBHI on implementation by serving as the MCAAP’s representative on the advisory board and providing ongoing advice on pediatric screening including modifications to the birth-6 month measures, substituting a parental depression screen in the early months of life. The Task Force also serves as the Academy’s representative on the new advisory board established legislatively by the Children’s Mental Health Bill which became law this past summer. The Task Force continues to monitor and advocate for full implementation of this legislation particularly in light of budget cuts and their impact on early intervention services and child mental health services.
· In keeping with the MCAAP’s decision to focus on early childhood, the Task Force has been particularly focused on pediatric efforts at prevention of mental health problems in early childhood. Pediatricians presented various approaches to clinical management and the need for an expanded workforce of consultants with expertise in infant mental health was identified. Various agencies presented training and supervision models (UMass, JFCS, DPH). The need for an expanded role of Early Intervention in working with socioemotional risk and parent infant interaction was encouraged. The need for universal parent support in the first few months was emphasized and various parent support groups/community schools presented their programs to the task force as potential models. The Task Force is working with DPH to create a registry of parent support groups throughout the commonwealth (available to pediatricians, obstetricians and nurseries), to identify best practices, and to encourage the creation of such support groups in every community in the Commonwealth.
· The Task Force testified before the legislature in support of parental depression screening. A subgroup of the task force led by Ellen Perrin is working on a member survey to assess the utilization of co-located or collaborative mental health care.
· A major effort has been underway to expand participation by pediatricians in the Task Force. We welcome new members and can make participation available by conference call. Our initial planning meeting for next year will be focused on the agenda of our pediatric members.
If people have questions about any of this or wish to join the CMHTF, they can email me at myogman@massmed.org.
Chair – Dr. Michael Yogman
The Committee on Continuing Medical Education (CME) is committed to providing the highest quality educational programs for MCAAP members. MCAAP maintains certification to provide Category 1 credits through the Massachusetts Medical Society. The 2009 Annual Meeting, “Asking the Tough Questions: How to Screen for High Risk Adolescent Behaviors in the Pediatric Office " presented our members with updated results from the “Massachusetts Youth Risk Behavior Survey and challenged them to recognize teen behaviors that should be discussed at length in office visits. A panel consisting of parents of GBLT youth and advocates allowed our members to develop effective and sensitive communication strategies to serve families coping with questions on sexuality. Attendees also learned how to implement validated and simple screening toolkits for adolescent substance use and depression. Our 2009 Edward Penn Lecturer Dr. Michael Rich presented “The (Inter)Active Child: Facebooking, Sexting, and the Electronic Bully”.
Our committee continues to work with other AAP Chapters and collaborates with other child health organizations in presenting CME programs throughout the state. We will be continuing to evaluate the use of e-learning and community learning groups to extend CME opportunities to members who are not able to attend live programming at our headquarters. We also would like to aid our members in clarification and implementation of their personal Maintenance of Certification requirements. We are in great need of new committee members to keep our programming fresh. All medical students, residents, young and senior physicians, and practicing and academic pediatricians are invited to contact us to join our next meeting. Our committee also relies greatly on member physicians to complete evaluations and needs assessments to develop programs that meet our members’ needs. We continue to incorporate the expertise of MCAAP committees in educating the general membership on clinical issues, pediatric practice administration, and child advocacy.
Chair – Dr. Mary Beth Miotto
MCAAP Committee on Disabilities (COD) is committed to increasing awareness and capacity among pediatricians to better care for children and youth with special health care needs (CYSHCN) within the medical home. Areas of focus for the COD over the past several years have included medical education, developmental screening, and transition of CYSHCN to adulthood.
The COD has collaborated with the Consortium for Children with Special Needs (Consortium) on a number of projects, including the CSHCN Medical Education Project, which involved interviews of faculty and residents at each of the pediatric training programs in Massachusetts to identify what and how residents are taught about CYSCHN and medical home. A summary report “Preparing for Practice” can be found online at http://www.neserve.org/neserve/pub_pfp.htm.
The COD’s current area of interest is transition of youth with special needs. We have been focusing on how to increase physician awareness of transition issues, and in particular how to support physicians who care for adults in the transition process.
The MCAAP COD generally meets every three months, and includes primary care pediatricians, developmental specialists, and others. We hope to continue to expand our membership, and always welcome new members and new ideas. We would also like to
increase participation of medical students, residents, and fellows. Please email me nazariab@ummhc.org for more information on the COD.
Chair – Dr. Beverly Nazarian
The MCAAP Committee on Environmental Health
The Committee looks forward to the next year to have regular meetings again to discuss a wide range of topics, including many updates from the national AAP Committee on Environmental Health, which Dr. Megan Sandel now serves. Topics of interest include plasticizers like BPA and the new proposed DPH regulation on BPA, built environment and healthy food in hospital settings among others. Also in Fall of 2010, the new revised Green Book will be coming and will be an exciting update.
As always, we welcome feedback from committee members, and are open to suggestions for changes and/or additional topics. We are also looking for volunteers who would like to help with writing the short pieces for MCAAP's quarterly newsletter. Please feel free to extend an invite to MCAAP members who are interested in environmental health issues. We always welcome new energy, new ideas!
Co-Chairs - Dr. Megan Sandel, Boston Medical Center and Pediatric Environmental Health Specialty Unit at Children's Hospital, Boston and Dr Siobhan McNally, who remained as co-chair until recently!
*The Committee on Fetus & Newborn is committed to early discharge
issues, specifically the need for hyperbilirubemia monitoring prior to discharge and appropriate follow-up. The committee will also be involved in work related to prevention of preterm birth. The committee will was closely involved in the rewriting of the MA DPH Perinatal Regulations which were approved this year and will continue to be involved in their implementation over the coming year.
Chair – Elizabeth Brown
Update from 2006
The Forum
The MCAAP Forum continues to provide timely and practical information on various topics of interest to the membership four times per year. During this past year, which has been filled with local and national activities in health care reform legislation, the Forum has published both information and editorial articles on this all important topic. Reoccurring columns from the Reach out and Read Program as well as the Watch Your Mouth Campaign have been a well-received addition to each issue. Most recently the Immunization Initiative has brought back the Shot Clock, a monthly series of articles and information surrounding vaccines. The Shot Clock is a joint project between the MCAAP, the Immunization Initiative, and the Massachusetts Department of Public Health. In addition to the print version of the newsletter, which is mailed to all members, an online edition is available at no-charge to the public.
Submissions for the quarterly newsletter continue to fill an 8-12 page publication each issue. We continue to encourage medical students and residents to contribute articles and have been successful at obtaining high quality content written by those in training across the state.
The newsletter could not be produced without the excellent coordination of services from the New England Journal of Medicine. Advertisers continue to find the Forum a useful means of disseminating their message to pediatricians across Massachusetts, and as a result have produced a small amount of revenue for the Chapter.
Dr. Lloyd Fisher, Editor of the Forum
The Committee on Foster Care, comprised of pediatricians and representatives from the Massachusetts Department of Children and Families, continues its commitment to improve the health care of children in foster care.
In September of 2008 our chapter was awarded a grant from the Task Force on Foster Care, an ad hoc committee of the national AAP that has met biannually since 2007. The TFOFC awarded grants to five state chapters to facilitate the development of systems of care within the state. With the support of this grant, we have visited several medical clinic sites throughout Massachusetts to discuss ways to increase access, communication, and appropriate care for children in DCF custody. Since March of this year we have been working with North Central DCF and medical providers in that area to develop a medical evaluation clinic in the Leominster/Fitchburg area, similar to the FaCES model in Worcester, described below. The recent federal “Fostering Connections” legislation has provided added impetus to develop a statewide system and collaborative meetings with physicians, the Massachusetts Child Advocate, and DCF leadership are scheduled for spring and summer.
In Worcester, the FaCES Clinic (Foster Children Evaluation Services) continues to provide screening, procurement of past medical records, comprehensive evaluation, updating of immunizations, laboratory tests as needed, and necessary referrals for all children from birth to 18 years of age. At completion of these visits, all medical information is sent to child's Medical Home while in foster care. All interested pediatricians are welcome to join our committee. - Chair – Dr. Linda Sagor
The Immunization Initiative continues to advocate for universal distribution of all recommended childhood immunizations, advise the Massachusetts Department of Public Health (the MDPH) on vaccine issues, and educate health care providers, legislators, public health advocates and the general public about the importance, effectiveness and safety of vaccines.
Funding of immunizations continues to be a major challenge, and the passing of the immunization Bill “An Act Establishing the Massachusetts Childhood Vaccines Program and the Massachusetts Immunization Registry”, is a top priority of the Immunization Initiative (and one of the chapter’s legislative priorities this year).
The legislation will establish a Vaccine Purchase Trust Fund to cover the costs of purchasing and distributing vaccines for childhood immunizations and to cover the costs of a Massachusetts Immunization Registry.
It will require to every health insurer provide benefits for routine childhood immunizations for Massachusetts residents (until age 19) and recommended immunizations for Massachusetts residents who are 19 and older.
By using the “American Recovery and Reinvestment Act” (ARRA) funds, the MDPH resumed the development of the State's Immunization Registry (MIIS). The Immunization Initiative supports the registry development and provides feedback on the current version of the immunization registry IT system. However, the ARRA funds are limited (one time deal), thus passing of the Immunization Bill (S2195) is essential to the roll out and maintenance of the MIIS. The bill stipulates that providers would be required to report immunization information to the registry and permit disclosure on an as needed basis to health care provider groups. Otherwise, the information would be confidential. A parental consent will not be required, but parents will be able to opt-out of the registry.
Last May, the bill was heard by the Joint Committee on Health Care Financing, and was favorably referred to the Senate Committee on Ways and Means where it resides now.
The Immunization Initiative and the MCAAP chapter leadership HAVE mobilized an large coalition of support for this legislation. At this time, we are calling upon the members of the coalition to communicate to the legislators the importance of the bill and the urgency of moving it for a vote during the current legislative session.
Unless there is a change in the funding for the universal immunization for children in the general laws of Massachusetts, we will need to continue to advocate each year with state legislators for the appropriation of adequate funds to buy and distribute vaccines for all children in the state, a task that becomes more difficult as more and more costly vaccines are developed and recommended.
The 2009/2010 influenza season was the year of the Flu Pandemic. The Immunization Initiative assisted in the MDPH work by disseminating timely and credible information to pediatric providers.
We continue to meet at least quarterly to discuss current immunization issues to advise the Massachusetts Department of Public Health on issues of purchasing and distributing vaccines for children.
The Initiative sponsored 12 Grand Rounds this year throughout Massachusetts and co-sponsored (with MDPH) the 14th Annual Massachusetts Immunization Conference. The program maintains a web page within the MCAAP web site and is publishing the Shot Clock as a part of the MCAAP’s publication, the Forum.
In collaboration with the Pediatric Council, the Immunization Initiative works on clarifying issues related to CPT coding and reimbursement for vaccines and their administration. We publish results of our periodical surveys of the HMOs on their reimbursement policies.
Program Director - Sean Palfrey, MD, FAAP & Program Manager - Hadassa Kubat, DSc, MPH
The Committee on International Child Health was formed in 2004 and welcomes pediatricians with an interest in issues related to global child health. The Committee has developed a relationship with a hospital in Zumbahua, Ecuador, a remote town in the high Andes. This site provides an opportunity for residents and pediatricians from both academic and practice settings to work in clinical care, teaching and collaborative research. We are working with local health care providers on a program to both research and treat existing malnutrition as well as provide general medical care in this high, indigenous region.
The Committee also reviews applications for six $500 International Health travel grants awarded yearly. We also allocate money in small grants for international health projects being done by committee members. Money in the past has been used to purchase scales for Zumbahua and buretrols and related supplies for a project in Ghana. Finally, all of the pediatric residency programs in Massachusetts are developing interest groups and curricula in international child health.
The Committee is providing a forum for these groups to share what they are learning, and foster the growing interest in global health issues among physicians in training. We also meet on occasion with the MMS Global Medicine Committee to share speakers as well as ideas.
Anyone interested in being added to the International Committee listserv should contact Cathleen Haggerty at 781-895-9852 or via e-mail at chaggerty@mcaap.org. We meet roughly five times a year at 6:30 pm in Waltham, on varying evenings.
Co-Chairs – Dr. Jane Cross and Dr. David Norton
The Injury Prevention Committee Section on Injury and Poisson Prevention
It has been a busy year in injury prevention. There have been four main legislative issues to which we have been devoting time. Two of these involve car safety: these are the ban on texting/limits on cell phone use while driving, and the primary enforcement of seatbelt laws. The other two issues are the proposed ban on All Terrain Vehicle Use by children, and the bill mandating concussion training for high school coaches
The texting/cell phone bill has passed both chambers, and is currently in conference committee. It is coupled with the controversial elder driving regulations, which seems to have slowed progress. We remain optimistic that a law will be in place before the end of the session.
The primary enforcement of seatbelt laws has been a hard issue for many years. I have served as co-chair of the Belts Ensure a Safer Tomorrow (BEST) coalition for the last 2 years. We have grown to 35 members, and in addition have developed an email network of several hundred individuals known as the “Mass Auto Safety Action Network”. Despite strong leadership by Sen. Jehlen on the issue, the bill was referred out to “study”. Barring a last minute change, we anticipate having to continue this important battle in the next session.
The ATV bill is doing better. This would ban use under age 14, and regulate use over this age. Named after 8 year old Sean Kearney off Plymouth, Sean’s Bill has passed the Senate and is showing some momentum in the house, where it awaits clearance from House Ways and Means Committee.
The Concussion training Bill also shows hopeful signs. This issue has received considerable attention at both a State and National Level, and the Bill received a positive release from Committee.
We have built on many relationships with partners around the State. This includes the Department of Public Health and the Executive Office of Public Safety and Security, as well as many other groups. We have participated in the Mass Prevent Injury Now Network (PINN), and the Partnership for Passenger Safety. Special note should be made of Inta Hall of the Brain Injury Association, who co-chairs the BEST Coalition, Jeff Larson and the SafeRoads Alliance and AAA on cell phones and Seatbelts, Chris Nowinski from Sports Legacy for his concussion work and Lewis Howe and Colleen McGuire from the DPH.
In the year to come, we hope to wrap up as many of these legislative issues as possible. I am also putting together an email network of Mass SOIVPP members, trying to grow the network of people involved in injury prevention and hope to focus more attention on prevention of poisoning and intentional injury.
Chair - Greg Parkinson, MD - gparkinson@massmed.org
The Committee on Legislation tracks legislation relevant to children's health care and related issues, provides testimony on bills, and updates the Executive Board on the state budget process and the specific ways in which it may impact children's health care. The Committee works in collaboration with other AAP subcommittees and groups who are invested in children's health care. The goals of the Committee are to consider issues of importance to the children of Massachusetts that have been affected by local, state, and national legislative action; to research and discuss such issues as they are brought to the attention of the Committee by its members, Chapter members, and others; and to recommend appropriate actions to the Executive Committee after such study and discussion.
Some highlights of the last legislative session (2007-2008):
Some highlights of the current legislative session (2009-2010):
· The Chapter, under the guidance of Sean Palfrey, MD, brought forth legislation creating a Vaccine Trust Fund to cover the costs of purchasing and distributing vaccines for childhood immunizations and to cover the costs of a Massachusetts immunization registry. The bill is entitled An Act Establishing the Massachusetts Childhood Vaccines Program and the Massachusetts Immunization Registry. The Chapter's bill was filed by Senator Moore in the Senate and Rep. Wolf in the House
· The Chapter continues to advocate for passage of a School Nutrition Bill.
· The Chapter continues to support legislation regulating the use of off-highway and recreation vehicles (ATVs) by Children
· The Chapter continues to oppose bills allowing for independent licensure and practice for midwives
· The Chapter is closely monitoring initiatives to “reform” the health care payment system
· The Fifth Annual "Residents' Day at the State House" took place on Thursday, April 15th. Approximately 60 pediatric residents, fellows, and others were in attendance. Participants supported the immunization bill, the bill regulating all-terrain vehicle use by children, and opposed legislation licensing and independent practice by midwives.
Co-Chairs Drs. Karen McAlmon and Michael McManus
The Committee on Membership
· The Chapter currently has 1,763 members. This number includes all dues-paying, board certified, board-eligible pediatricians, and pediatric residents whose membership dues are covered by their respective training programs and medical students whose dues are covered by AAP/MCAAP.
· The Committee has requested and obtained financial support from the MCAAP for the fifth resident organized and directed Resident Legislative Day which occurred on June 15th. The 2010 Residents day was very successful with representation from all the residency programs. Many of the resident participants came away from their meetings with senate and house leaders with a strengthened knowledge that one person can make a difference if communication exists between different arenas interested in similar issues. Many of these residents are now actively involved in Chapter activities.
· As part of advocacy training, Children’s Hospital Boston has sent residents to Executive Committee, Pediatric Council, Children’s Mental Health Task Force and Obesity Committee Meetings. This has increased awareness of opportunities to be involved in the Chapter throughout the residency community.
· Drs. Chelsea Gordner and Walter Rok have been appointed as co-chairs of the membership committee. Cathleen Haggerty and Chelsea Gordnor had a preliminary meeting in March and a follow up conference call will take place in June that will include Dr. Rok.
For more information, contact Cathleen Haggerty at chaggerty@mcaap.org.
The Nominating Committee consists of six (6) members who shall be appointed by the Executive Board every two years to coincide with the term of the President. The Nominating Committee prepared a slate of candidates for offices to be filled starting in July 2010. A candidate's name may be submitted to the Nominating Committee for consideration by any member or placed on the ballot by a petition of fifteen (15) voting members. All nominations must be received by the Nominating Committee one month after the call for nominations is mailed. The Nominating Committee is currently identifying board members for the newly formed 501c3 Foundation.
Chair – Open
The Obesity Committee was established in 2003 in response to the alarming increase in prevalence of overweight among children in the United States. The Committee has worked on developing strategies to identify, prevent, and control the problem, and meeting approximately every 3 months.
In order to gain a broader perspective of the problem and a better understanding of current programs that address childhood obesity, members from various state organizations were invited to join the Committee. Participants include both community and academic pediatricians, nutritionists, psychologists, and representatives from the Department of Education, the Department of Public Health (including WIC), the Massachusetts Public Health Association, and some health insurers. The Committee thus serves as a sounding board, providing a setting for the exchange of viewpoints between the pediatric community and public and private-sector institutions which play a central role in promoting the health of the children of the Commonwealth.
Members of the Obesity Committee have continued to work with the MA DPH to coordinate and implement the BMI Screening regulations, particularly in relation to communications about BMI screening results between schools, families and health care providers. In addition, the Committee fielded a survey of the MCAAP membership this fall to determined MA pediatricians’ perspectives on BMI Screening. The results of this survey were presented at the annual meeting of the Pediatric Academic Societies in May, and a paper is currently in preparation for submission for publication in a peer reviewed journal. In addition, Dr. Goodman met with MA DPH Commissioner Auerbach and the DPH ‘s medical director, Lauren Smith, as well as Jewel Mullen, head of the Wellness Branch at DPH, to share the survey’s results.
Co-Chairs – Dr. Elizabeth Goodman and Dr. Alan Meyers
The Pediatric Council continues to meet with the major insurers, Masshealth, DPH, & the Immunization Initiative and serves both as an advocacy group for children and as an educational conduit to our member constituencies. The Council has confronted Immunization concerns and changes, CPT coding issues, realities related to Retail Based Clinics, streamlining of prior approval processes, issues related to the Medical Home, QA &QI, AND P4P. The Council has become the proverbial "canary in the coal mine" as an early warning mechanism for changes in the world of healthcare. We recruited a representative from Fallon which was a win for the group. We continue to look critically at vaccine issues, Medical Home issues, and we continue to serve as a venue to educate our colleagues from the managed care world.
I am extremely appreciative of the efforts put forward by this group of individuals, on an ongoing basis.
Chair, Dr. Peter Rappo
PROS —Pediatric Research in Office Settings
PROS offers the practicing pediatrician the opportunity to participate in meaningful hands-on clinical research. We have a large number of practices in Massachusetts who are actively participating in PROS studies, and there are a number of ongoing and evolving projects covering a variety of topics.
· Studies underway include the Clinical Effort Against Secondhand Smoke Exposure (CEASE), whose principal investigator is Jonathan Winickoff of Massachusetts General Hospital and the Secondary Sexual Characteristics in Boys (SSCIB) study, which completed data collection Dec. 31, 2009. Chapter members participated in both.
· Studies are being developed on topics such as obesity, oral health (principal investigator Paul Geltman of Boston Medical Center and Cambridge Health Alliance, teenage driving safety, adolescent smoking cessation, and improving mental health outcomes.
· Data from the PROS Febrile Infant Study will inform the new AHRQ clinical guideline, Evaluation and Management of Fever in Infants Less Than 3 Months. Many chapter members collected data for this study in the 1990s. Three PROS practitioners are members of the guideline development committee.
· Chapter member PROS practitioners who will be attending the AAP NCE in San Francisco in October are welcome to attend all or part of the PROS Coordinators meeting. Chapter members who are curious about PROS can attend, too.
· PROS can add a new dimension to your work. The studies are well designed and interesting. Practitioners are encouraged to be involved in data collection, and are welcome to work on study design, analysis and manuscript writing if interested. Our academic colleagues welcome the input of those of us in practice settings. Please contact one of the state PROS coordinators if you are interested or have questions about becoming a PROS practitioner.
MA State Co-coordinators - Drs. Ben Scheindlin and David Norton
Benjamin Scheindlin, M.D., F.A.A.P. Burlington Pediatrics, 281 Cambridge Street, Burlington, MA 01803, 781-272-2210, Fax 781-229-8324, Email: bscheindlin@yahoo.com
The Committee on School Health has two primary functions. The first function is to be a resource for the 351 public school physicians in Massachusetts, 54% of whom are not pediatricians. The Committee provides networking activities, didactic presentations, and legislative lobbying on areas of school health interest. The second function is to provide a forum for any pediatrician who has an interest in school health issues, whether they are school physicians or not.
Chair – Open
Suspected Child Abuse and Neglect Committee (SCAN) - The Committee continued to meet on a quarterly basis and was active on a number of different projects.
5. NETWORKING WITH OTHERS IN OUR FIELD: The committee has continued monthly WebEX on-line case reviews with our members and child abuse specialists in the New England area (RI, ME, CT, NH, VT) for professional development and support.
Respectfully submitted, Rebecca Moles, M.D., FAAP - Chair