by Dena K. Hubbard, MD, FAAP
KAAP Public Policy Chair
Thank you to all the Kansas pediatricians who have been vocal child health advocates in clinics, schools, and communities regarding the need for mask mandates and vaccines. KAAP resources include KAAP statement on back to school and mask guidance for school aged-children. In addition, the AAP communications toolkit shares AAP’s guidance for how to allow children to safely return to school in person. AAP published its latest advocacy report with updates on COVID-19 and many other child health priorities at the federal and state level.
As COVID-19 cases resurge with the highly contagious Delta variant, Governor Laura Kelly will retain authority to issue a state of emergency and local health officials to mandate business closures, capacity limits, and masks. These sanctions were originally constrained by the Kansas Legislature in April when Senate Bill 40 passed subjecting many of the Governor’s emergency orders to legislative review, required public health officers to first gain approval from local governing bodies before issuing orders, and established a process for residents to challenge public health measures in court (including mask mandates.) However, recently Johnson County District Judge David Hauber declined a request by Attorney General Derek Schmidt to set aside his ruling that the changes made by lawmakers were unconstitutional. The Attorney General is directly appealing to the Kansas State Supreme Court with briefings due next month.
AAP recently joined with leading sports and medical organizations encouraging COVID-19 vaccine conversations to be part of all preparticipation exams as part of the White House effort to prioritize adolescent COVID-19 vaccination. We know that vaccination prevents widespread disease, hospitalizations and deaths due to COVID-19 and will help keep students in the classroom, athletes in the game, and teams on the field, all while protecting our communities and those that are ineligible for the vaccine.
A Win for Medicaid in Missouri, Will Kansas Be Next?
In late July, the Missouri Supreme Court unanimously deemed the state’s 2020 voter-approved ballot initiative that authorized Medicaid expansion to eligible adults constitutional. After the initiative passed with 53% of the vote and support of the AAP Missouri Chapter, the Legislature refused to provide funding to implement the program, and the state rescinded the federal paperwork to begin enrollment. A coalition of advocates filed suit, arguing that these moves blocked implementation of the program as approved by voters.
The Supreme Court decision ruled that as the Legislature appropriated money in its fiscal year 2022 budget for MO Health Net (the state’s Medicaid program), it was bound under existing law to provide coverage to those who are eligible. The decision will result in 275,000 more individuals eligible for Medicaid in Missouri. So don’t lose hope for Kansas!
Kansas Medicaid is considering the addition of ten months of Medicaid coverage for postpartum coverage that currently expires after sixty days. The pandemic has allowed continuous coverage and several other states have data on the positive impacts, particularly related to behavioral health services. It’s likely the plan will be included in the Governor’s Medicaid budget. KAAP has been actively advocating for this over the past 3 years and will continue to do so.
Another approach might be standardizing Medicaid at the federal level. A call for foundational change to the Medicaid program for children and young adults topped the list of resolutions prioritized by AAP leaders during the Leadership Conference, a combined meeting of the Annual Leadership Forum and the District meetings.
“Whereas, all children deserve equitable access to affordable, timely, quality, and comprehensive health care; and whereas, the Medicaid program, as enacted in 1965 as a voluntary federal-state partnership, has allowed states substantial discretion in defining Medicaid standards for eligibility, benefits, provider payment, networks, and reporting requirements for children less than 19 years of age, resulting in geographic disparities for children; and whereas, the Centers for Medicare & Medicaid Services, through administrative actions, have enabled states to reduce Medicaid standards for eligibility, benefits, provider payment, networks, and reporting requirements, thereby exacerbating disparities to the further detriment of children, therefore be it RESOLVED: that the Academy build on its existing policy and advocacy work to promulgate minimum national standards to ensure that US children and young adults (age 26 years and younger) in need of publicly funded health insurance have equitable access to affordable, timely, quality, and comprehensive health care through Medicaid and related programs, and be it further resolved, that the Academy advocate for foundational changes in federal law that (1) will require all states and territories to adopt these minimum national 35 standards for children and young adults insured by Medicaid and related 36 programs and (2) will provide full federal funding for direct health care and related activities in children and young adults insured by Medicaid.”
The virtual conference brought together AAP chapter, committee, council and section leaders from around the country, drawing on their diverse perspectives and expertise to advise the AAP Board of Directors. Resolutions afford AAP members the opportunity to provide input regarding AAP efforts to address important child health issues, relate to the mission of AAP, and are advisory to the Board of Directors. The mission of the American Academy of Pediatrics is to attain the optimal physical, mental, and social health and well-being for all infants, children, adolescents, and young adults. These resolutions were chosen from 60 submitted by AAP groups and members for consideration.
Due to a tie at No. 10, there are 11 top resolutions for 2021. Following are the top resolutions they approved, which will be referred to areas of the Academy with related expertise for a review and potential action.
- The Medicaid Program for Children and Young Adults Requires Foundational Change: National Standards and Full Federal Funding
- Formation of a National Bureau for Firearm Injury Prevention
- Establishing the United States as a Global Leader in Child Well-Being
- Combatting Racism in Graduate Medical Education Through Accreditation Council for Graduate Medical Education (ACGME) Curriculum Changes
- Developing Healthcare Effectiveness Data and Information Set (HEDIS) Measures to Reflect all Aspects of Preventive Care According to Bright Futures
- Accountability through Measurement—Improving Diversity and Inclusivity in Pediatrics Through Metric-Driven Data to Better Address Members’ Needs
- AAP Support for Gender Pay Equity for its Members
- A Toolkit to Address Pediatric Mental Health Needs Resulting From Pandemic
- Advocate for Federal Reporting Requirements of Adverse Pediatric Firearm Events
- Promotion of Early Evidence-Based Screening Tests for Reading and Systematic Reading, Instructional Interventions in Elementary School to Promote Life-long Literacy
- Every Child Deserves Good Pain Control – Ending Structural Racism in Pediatric Pain Management
To view the full text of the resolutions, visit https://collaborate.aap.org/alf/Pages/2021-Resolutions.aspx.
Stay tuned for further details on the strategic plan for the 2022 Kansas legislative session and the KAAP Blueprint for Children. Please reach out with any questions or concerns.
Federal Advocacy News from the AAP
The following information is from recent editions of the Federal Advocacy Capital Check-Up.
Update on Infrastructure Package – Lead exposure and broadband access
The U.S. Senate passed the Infrastructure Investment and Jobs Act on August 10, and will now continue to the U.S. House of Representatives for consideration. Of particular interest to pediatricians, it includes funds to 1) replace the nation’s lead pipes and service lines to protect children from lead exposure in drinking water and 2) expand broadband infrastructure nationwide – key to expanding telehealth services and a critical priority for children and families who increasingly rely on the internet for virtual school, work, and other activities.
Need Permanent Solution for DACA Recipients
The Deferred Action for Childhood Arrivals (DACA) program allows more than 700,000 young people who were brought to the United States as children to live and work here. The children who were protected under DACA have now grown into young adults. They have served our country in uniform, graduated from colleges and universities and have invested their lives and work in our cities and communities. The U.S. House of Representatives has already passed the American Dream and Promise Act (H.R. 6), but the Senate has yet to act.
A federal judge recently issued a ruling limiting the Deferred Action for Childhood Arrivals (DACA) program and declaring it unlawful. As a result, U.S. Citizenship and Immigration Services is prohibited from approving any new DACA applications. While new applications will no longer be approved, those who have DACA will be able to maintain their protected status and renewals will continue to move forward. Now is a critical time to tell your senators to pass a permanent solution for DACA recipients. To contact your senators, visit federaladvocacy.aap.org and go to “Pass a Permanent Solution for DACA Recipients” under Key Issues.
Limited Ban on Evictions
After the recent expiration of the CDC eviction moratorium, the Biden administration announced a new ban on evictions in parts of the US experiencing “high” and “substantial” levels of coronavirus and remains in effect through October 3.
Child Tax Credit Resources
The American Rescue Plan expanded the Child Tax Credit, so families can qualify for more money and can receive payments monthly, rather than having to wait until the end of the year. Eligible families will receive $3,600 per child younger than 6 and $3,000 per child ages 6 to 17. Payments started to automatically arrive in mid-July, but families who did not receive a payment may need to take additional steps to receive the benefit. Pediatricians can play an important role in making sure families know about this credit through sharing a handout, available in English and Spanish, with parents and families, which explains the credit, who is eligible and what next steps parents need to take, if any. Information is also available on HealthyChildren.org webpages in English and Spanish.
August is Civic Health Month
KAAP would like to introduce you to Vot-ER — a nonprofit, nonpartisan organization that works to provide patients with the opportunity to register to vote in healthcare settings. Vot-ER’s mission is to create healthier communities by empowering more voices to address the social determinants of health.
In August, Vot-ER will be hosting Civic Health Month — a national, nonpartisan initiative dedicated to focusing the nation’s attention on the strong connections between health care, healthy communities, and civic participation. The month aims to make voting and civic participation more accessible to all — particularly those underserved by America’s healthcare system.
American Academy of Pediatrics is a proud partner in the diverse and growing movement of organizations, institutions, and individuals that are promoting civic health in their work. Members are invited to join Civic Health Month to take action in supporting healthy communities, driving voter registration, and amplifying civic voices in healthcare. Learn more at this link or email firstname.lastname@example.org for additional information.
So far, more than 175 organizations (including AAP) have signed up to be either a Civic Health Month partner or champion. As a proud partner, AAP has committed to taking at least one action to advance these aims, such as featuring voter registration information on our organizational website or social media pages. We are sharing this information and inviting you to join in this growing movement of groups promoting civic health in our work.
You can find more detailed information about Civic Health Month in this two-pager and, if you’re interested, sign up to be a partner here. Please contact Vot-ER’s Civic Health Month Director, Dana (email@example.com), if you have any questions.