Kansas Pediatrician: November 2023 Updates

Welcome to the November 2023 updates from the Kansas Pediatrician, the quarterly eNewsletter from the Kansas Chapter of the American Academy of Pediatrics. This edition includes:

• President’s Perspective: From KAAP President Gretchen Homan, MD, FAAP
• Executive Director Update: From Denise Cyzman
• One-On-One Visits with the Executive Director
• Vaccine Liason Update: From Mallory Laur
• Kansas Pediatric Foundation Updates
• Kansas CARE Network Updates
• CATCH Updates
• KanQuit Resources & doctor’s Note
• KAAP Employment Opportunities

President’s Perspective

By Gretchen Homan, MD, FAAP

Something my dad said a few weeks ago really made me smile and pause to think. He proudly reported that at his regular doctor’s visit, his physician said he is the most vaccinated patient he has! I smiled with joy because I think I had a role in this, I am a passionate supporter of vaccines, and even my family knows that. But then I thought about the other adult patients and wondered, why don’t they have the same vaccines as my dad?

I want the very best for my family and I make decisions every day to help work towards that. My time away from my family is a big deal and I spend it working to get the very best for my patients and the children of Kansas. I do this through teaching, advocacy work, patient care, and staying curious – always learning. I think we are all very similar in these things and how we work to help people and that is what I love about Kansas pediatricians.

I want to thank you and let you know how much you are appreciated. You make a difference for so many people and in so many ways. In fact, I’m sure you will never begin to know how many people you help and influence just by being you and doing your everyday things. It might feel like you are only taking care of children but really you are helping their parents, extended families, friends, and entire communities. Your voice and ideas are being heard and are helping and this is something we can all be thankful for.

I wish you all Happy Holidays! Please remember that KAAP is here for you. Any questions you have, ideas to share, or support to request, please let us know. We are thankful for you! I think pediatricians are the people who do the right things, even when it’s hard. Be sure to tell all the kids that you are officially awesome!

Executive Director Update

by Denise Cyzman

Thanksgiving holds a special place in my heart – an occasion to pause and reflect on blessings and opportunities. As I do this, I am reminded of a quote from John F. Kennedy. “We must find time to stop and thank the people who make a difference in our lives.”

This year, I have something new to be grateful for. You. Your love for children. The care you provide. The difference you make every day. And I am also thankful for the trust you place in us, the KAAP team. Your support motivates us to do our very best and gives us energy to do the hard work.

I ask that you join me in celebrating the power of gratitude, the strength of community, and the results of our collective efforts. Together, we will give Kansas children the chance to grow up safe and strong, with faith in the future and in themselves. Wishing you and your loved ones a Thanksgiving season full of joy.

An Adventure Awaits: Let’s Chat One-on-One!

I’m gearing up for an exciting road trip across the beautiful state of Kansas.  I’m hitting the road with one mission in mind – to connect with members and hear stories, insights, and perspectives that can help shape the future of KAAP.  With your permission, I’d love to swing by and meet with you.

Here’s what you need to know about the one-on-one meetings:

• I’ve blocked out specific times over the next few months, and I’ll be in touch to coordinate a time that suits you best.
• Each meeting will last 30-45 minutes, giving us ample time for a meaningful chat. You’re more than welcome to invite colleagues from your practice to join in the conversation.
• We could meet in your office or another location that is convenient for you.  Just let me know when we’re scheduling your meeting.
• This is your opportunity to share, ask, and discuss anything about KAAP that’s on your mind. Whether it’s the latest projects, our organization’s strategies, or your personal experiences and innovative ideas – I’m all ears.  I can also share some of KAAP’s member benefits and upcoming activities.

If you’ve got specific topics or burning questions you’d like to dive into during our meeting, please don’t hesitate to mention them when scheduling your appointment.  I look forward to getting to know you better. 

Let’s create something extraordinary – starting with our one-on-one chat!  Please RSVP by clicking below or scanning this QR code.

AAP Medicaid & CHIP Vision

by Dena Hubbard, MD, FAAP; Chair, KAAP Public Policy Committee

“It is easier to build strong children than to repair broken men.” This quote by Frederick Douglass was shared in the address by Secretary Xavier Becerra of the Department of Health and Human Services at the 2023 AAP National Conference and Exhibit.

Likewise, pediatricians know that it is not only easier, but an excellent return on investment, to build healthy children through preventative healthcare, support early growth and development, and provide access to early intervention rather than treating disease. KAAP aligns with AAP in their commitment to all children to have access to health care that supports their optimal growth, development, and well-being.

The AAP recently outlined a new vision for Medicaid and CHIP in their policy Medicaid and the Children’s Health Insurance Program: Optimization to Promote Equity in Child and Young Adult Health. This policy statement calls for combining Medicaid and CHIP into a broad national program supporting the provision of individualized, family-centered, equitable and comprehensive care. It focuses on three areas: eligibility and duration of coverage, standardization of covered services and quality of care, and program financing and payment.

Briefly, the statement recommends the following:

• Combine the Medicaid and CHIP programs into a single program to allow for consistency between programs.
• Provide major increases in the federal share of funding for these programs with continued state flexibility for innovation.
• End decades of underpayment, with program payments at least in parity with Medicare rates.
• Enroll all newborns and maintain continuous enrollment until an individual is 26 years old or opts out of the program.
• Strengthen EPSDT and enforce it as a national standard of care and quality.
• Conduct health equity assessments of Medicaid-CHIP that create a system of accountability to help avoid introducing new harms or perpetuating existing damage and to close equity gaps.

Access to health care is part of setting up our children for success for today and their tomorrows into adulthood. The current Medicaid and CHIP programs have critical opportunities for improvement. The foundational and stepwise changes outlined in the policy statement should help guide policymakers to strengthen the Medicaid and CHIP programs with the goal of improving health care and access for all children.

Vaccine Liason Update

by Mallory Laur

One of the most effective ways to protect the health of Kansas kids is through on-time vaccination for preventable diseases. Through a KAAP-designed quality improvement project, we partnered with 26 pediatricians across the state to increase childhood immunizations. From April to October, physicians made significant improvements to immunization rates from birth to teens – including an 18% increase in HPV vaccination, an 80% increase in NICU rotavirus administration, and 100% compliance on HepB, IPV, Meningococcal and Tdap. Physicians received 25 MOC Part 4 credits and a $1,000 stipend for their participation. We’re proud to work alongside Kansas pediatricians in important work like immunizations that ensure the well-being of every Kansas child.

If interested in participating in future KAAP-led QI projects, reach out to Mallory Laur at mallory.laur@kansasaap.org. Read more for the project overview, results, and participating physicians.

Project Highlights

*A full report will be available soon.
Thank you to our physician leaders, Drs. Gretchen Homan and Grace Brouillette, and participating physicians!

• Dr. Masoud Noruzian, Cotton O’Neil Pediatrics
• Dr. Saeedeh Salmanzadeh, Cotton O’Neil Pediatrics
• Dr. Randy Schumacher, Cotton O’Neil Pediatrics
• Dr. Amanda Willis, GraceMed Downing Family Clinic
• Dr. Ellen Losew, Hutchinson Clinic Pediatrics
• Dr. Malani Kuiper, Lawrence Pediatrics
• Dr. Lori Ann Golon, Lori Ann Golan, MD, PA
• Dr. Peter Carter, Pediatric Partners
• Dr. Susan Ratliff, Pediatric Partners
• Dr. Lynn Beck, Pediatric Professional Association
• Dr. Barry Broeckelman, Pediatric Professional Association
• Dr. Rebecca Fahlgren, Pediatric Professional Association
• Dr. Delsie Filardi, Pediatric Professional Association
• Dr. Tom Heaphy, Pediatric Professional Association
• Dr. Alicia Daggett, Vibrant Health
• Dr. Jessica Howlett, Sunflower Neonatology
• Dr. Thomas Lancaster, Sunflower Neonatology
• Dr. Rebecca Verhaeghe, Sunflower Neonatology
• Dr. Sam Burns, Sunflower Neonatology
• Dr. Tiffany Simpson, Sunflower Neonatology
• Dr. Lisa Castro, Sunflower Neonatology
• Dr. Jamesia Donato, Sunflower Neonatology
• Dr. Chris Stapley, Sunflower Neonatology
• Dr. Robert Holcomb, Sunflower Neonatology

Project Measures (physicians chose at least one)

• Increase the percent of children who have all the Bright Futures recommended vaccines by their 3rd birthday.
• Increase the percent of adolescents who have all the Bright Futures recommended vaccines by their 13th birthday.
• Increase in first dose rotavirus vaccine administration for eligible NICU babies prior to discharge.

Process

• Four virtual meetings with quality improvement education.
• Four Plan, Do, Study, Act data cycles to measure effectiveness of the intervention.

Interventions

• Reconciling records to know who is due for vaccination ahead of the visit.
• Vaccinate at every visit, including sick visits.
• Patient recall, including calling those that are due.
• Starting to vaccinate for HPV at ages 9 and 10.

Childhood Immunization Results

• Dtap was 93% at baseline and rose to 99% on the last cycle
• PCV was 92% at baseline and rose to 99%
• HepB and IPV were both at 100% on cycle 4.

Adolescent Immunization Results

• Tdap rose from 97% to 100%
• Meningococcal rose from 96% to 100%
• HPV rose from 70% to 88%.

NICU Rotavirus Results

• Rotavirus went from 0% at baseline to 80% on the last cycle.

KPF Update

Empowering Kansas Children: TAP-TAM Soars in 2023

The Kansas Pediatric Foundation continues to impact child health in the state of Kansas. The bright star of the KPF, Turn a Page. Touch a Mind.® TAP-TAM  is projected to distribute over 180,000 books in 2023, totaling over $250,000 in value. TAP-TAM operates in 160 medical sites across 79 out of 103 Kansas counties with over 800 medical providers impacting child literacy daily. TAP-TAM serves a high Medicaid population, with over 50% of sites serving at least 30% Medicaid patients in their practice. This ensures that children from all economic backgrounds have access to quality literature.

In 2023, TAP-TAM trained several new sites, further extending its impact: Ashland Health Center, Community Health Center of Southeast Kansas-South Bicknell, Cotton O’Neil Care Clinic, Cotton-O’Neil – Manhattan Primary Care, Heart of Kansas Family Health Care, Meade County Health Department, Neodesha Family Practice (Including 3 sites)

TAP-TAM is focused on expanding and improving partnerships in 2023.

• Kansas Imagination Library (Dolly Parton): A collaboration to extend the reach of TAP-TAM and the Kansas Imagination Library, increasing the number of books in Kansas households.
• Russell Child Development Center: Partnering to educate medical sites about the benefits of TAP-TAM and expanding its presence in Southwest Kansas.

If you would like to give the gift of books to Kansas kids, click here.

If you are interested in becoming a Turn a Page. Touch a Mind.® site, download an application here.

CARE Update

Expanding the KS CARE Network for Child Abuse Victims

“I’m glad someone finally stood up for me.” These powerful words were spoken by a child to a DCF case worker after the child had been safely placed with a foster family thanks to the collaborative effort of DCF, Law Enforcement and a local CARE Provider. 

KAAP has been hard at work, expanding the KS CARE Network, ensuring comprehensive medical evaluations are accessible across all of Kansas for cases of child abuse. By expanding the network of qualified providers statewide, we aim to provide children in every Kansas community access to top-tier medical care.

In September, we hosted an intensive two-day training program in Wichita, with 28 physicians and medical providers in attendance. Following this training, one attending physician reported:

I used a lot of what I learned. . . on a baby who presented with a “nosebleed” and ended up having subconjunctival hemorrhages. I was able to start conversations with the family using the scripts discussed in the workshop and I printed out the forensic injury checklist and went through it with the family to capture a thorough history.

In the past year, the CARE project team has worked closely with the KU Center for Public Partnerships & Research to tailor the IRIS database and referral system to meet the program’s specific needs. This system facilitates secure and efficient information exchange between DCF and the Medical Resource Center (MRC).

Between June 1, 2023, and October 31, 2023, DCF transmitted a total of 1,344 referrals to the MRC through IRIS. Among these, 200 were for general medical examinations, 158 for CARE examinations, and 14 for evaluation by a child-abuse pediatrician.

Looking ahead to January 2024, KAAP will be hosting a child-abuse and maltreatment ECHO series, covering the following topics:

• Emotional Support for Children and Their Caregivers

• Needle in a Haystack: Using Clinical Decision Tools to Help Identify Possible Abuse
• Medical Child Abuse
• Introduction to the Evaluation of Child Sexual Abuse for the CARE Provider
• Physical Abuse Mimics
• Kids with Disabilities: Special Considerations and Challenges

If you’re interested in attending, please register using this link:

CATCH Update

Call for Proposals Now Open

The Community Access to Child Health (CATCH) program, a flagship initiative of the AAP, supports pediatricians who partner with community organizations to address a health issue impacting underserved children in a target community. The CATCH Call for Proposals invites pediatricians in training and in practice, from AAP chapters to apply by Jan. 22, 2024. The Resident Call for Proposals (grants up to $2,000) includes special funding from 11 AAP Sections and Councils for targeted child health issues. Pediatric residents should first review the trainee eligibility criteria. General pediatricians, pediatric medical subspecialists, pediatric surgical subspecialists, and fellowship trainees can apply for either a CATCH Planning or CATCH Implementation grant (up to $10,000).

KanQuit Doctor’s Note

Download and customize this editable doctor’s note to inform a patient’s school that they are under your care and have an excusable absence for treatment!

The Kansas Tobacco Quitline (www.KSquit.org or 1-800-QUIT-NOW) provides FREE one-on-one coaching for Kansans ready to quit using any form of tobacco. The Quitline is available 24 hours a day, 7 days a week, online and by phone. 

My Life, My Quit is a FREE quitline service for Kansas teens 13-17 years old who are interested in quitting vaping or other tobacco use. They can text or call My Life, My Quit at 855-891-9989 or enroll online.

In addition, providers can access the new Kansas Tobacco Cessation Help (KaTCH) FREE online training, which offers medical CME and nursing CNE. It is structured into 7 learning modules, each ranging from 15-30 minutes. Modules include information on vaping, tobacco treatment for behavioral health populations and Quitline programs and counseling call samples.

Click HERE for posters, rack cards, and additional resources available for you to download and use.

KAAP is Growing!

As we expand our services to KAAP members, we’re excited to announce we are currently seeking someone to join our KAAP Team as an Outreach and Event Coordinator. This role will focus on planning and executing a series of outreach events in collaboration with partner organizations, with a particular emphasis on supporting community events focused on re-enrollment in Medicaid for children.

Key responsibilities are:

1. Event planning
2. Partner collaboration
3. Coordinating education webinars and events
4. Assisting with applying for CME and other continuing education credits 

This position is full-time and fully remote.  The successful candidate must live in Kansas. 

We believe in the power of innovation, teamwork, and the pursuit of excellence.  If you know of someone who is dedicated, motivated, and ready to make a positive impact, please share this information with them. They may find out more information about this position and how to apply from our website or by emailing us at info@kansasaap.org.