March 2020

Shetal Shah, MD, FAAP

Shetal Shah, MD, FAAP

Dear NYS AAP – Chapter 2 Member,

As we all adjust to the changes in our lives brought about by COVID-19, I wanted to update you on what our Chapter, the National American Academy of Pediatrics, and the state and local government have been doing to assist patients and pediatricians during this time.  Like you, we are learning as we go and dealing with an ever-shifting array of regulations in both our personal and professional lives.  However, this is what has been done so far.
  • The New York State Department of Health has created a single website for all information related to COVID-19:  https://www.health.ny.gov/diseases/communicablecoronavirus/providers.htm The website includes medical information for healthcare providers.
  • For more pediatric-specific information, the National AAP has created a web resource for members: https://services.aap.org/en/pages/2019-novel-coronavirus-covid-19-infections/ and established an email address COVID-19@aap.org for questions related to pediatrics.
  • Two weeks ago, Dr. Lenny Krilov, Chairman of Pediatrics and New York University Winthrop Hospital at a Pediatric Infectious Disease specialist, recorded a short video about the importance of social distancing and handwashing which is available from multiple sources in Nassau County.
  • Both AAP Chapters 2 and 3 were consulted about the decision and timing of closing New York City Public Schools. Advocacy by senior NYS and Chapter leaders, particularly Drs. Lisa Handwerker (President, NYS AAP – Chapter 3) and Warren Seigel (Chair, NYS AAP District II), helped assure that the city implemented a plan to make school meals available to eligible students prior to closing until April 20th.
  • New York State released a downloadable PDF of a sign to assist triage of patients who enter a healthcare setting and may be exhibiting possible symptoms of COVID-19: https://health.ny.gov/publications/13076.pdf
  • Within hours of the announcement that schools in Nassau and Suffolk County would be closed for 2 weeks, Chapter 2 submitted a list of questions/concerns to the County Legislatures concerning the need to ensure healthcare workers receive priority for childcare and school services. As of this writing, that plan is currently being created.
  • The Chapter has reached out to the Departments of Health of Nassau and Suffolk Counties, and New York City, on behalf of its members in an attempt to secure Personal Protection Equipment (PPE), particularly gowns and N-95 masks – which many private pediatric offices do not stock and are unable to obtain.  All 3 departments have relayed that the shortage of PPE requires prioritizing ERs and hospitals, particularly intensive care units and therefore no other PPE is available.  In fact, conservation of PPE is actively occurring within hospitals due to concerns of a potential future shortage.  That said, all of these departments are aware of the critical role pediatricians will play in assessing the status of children, particularly those with primary caretakers in higher risk groups.
  • New York City recently announced that small businesses may be eligible for no-interest loans or grants if they can demonstrate significant financial losses from COVID-19.  The Chapter is working with officials in New York City to ensure that small pediatric practices which voluntarily reduced well-child visits during the pandemic as a means of reducing community spread are eligible. More information on these programs is available here:https://www1.nyc.gov/site/sbs/businesses/covid19-business-outreach.page
  • As Nassau and Suffolk Counties consider similar programs, the Chapter is working to ensure that small medical practices are also included.
It’s now been another week that we’ve been living and dealing with COVID-19 24 hours a day.  As always, we at the NYS AAP – Chapter 2 are inspired by the efforts of all our pediatric members to keep children safe during this pandemic.
As I reiterated last week, I know you are getting deluged with emails, and that hospital regulations are changing (sometimes dramatically) daily.  Keeping up with all the information for yourself and your patients, adapting to new ways to delivering care, and just keeping our families together (and our kids from killing each other) is exhausting.  This is what your local AAP Chapter and the National AAP have been doing:
  • National AAP issued a “CALL TO ACTION” on behalf of pediatricians and other physicians to increase the availability/supply of Personal Protective Equipment (PPE).
  • Through information provided by Chapter members, we realized that ERISA health plans were not paying (nor obligated to pay) for telehealth visits.  As ERISA plans are overseen by the federal government, Chapter 2 led a coalition of Congressional Representatives, led by Congressman Tom Suozzi of Long Island, in calling for these plans to cover telehealth for at least 90 days.  This loophole was previously unrecognized by the federal government.  The House of Representatives Ways and Means and Education and Labor Committees are actively including this directive in legislation at the time of this email update.
  • We are in contact with Tanuja Mohapatra of the New York State Department of Financial Services to ensure compliance of state-regulated health plans with telehealth.  If you are denied payment for a telehealth visit during the pandemic, please contact us.
  • Last week, Chapter 2 member and Pediatric Pulmonologist Dr. Melodi Pirzada from NYU Winthrop Hospital answered questions from the public live on News 12 Long Island.
  • Dr. Eve Krief also participated in a “VIRTUAL TOWN HALL” on COVID-19 via Facebook LIVE.
  • Immediate Past President of New York Chapter 2, Dr. Steve Goldstein, made an appearance on MSNBC as one of several physicians calling for increased access to PPE.
  • Through our partnership with State Senator Jim Gaughran, our Chapter was THE STATE LEADER in ensuring that pediatric outpatient offices will qualify for Empire State Development and state Small Business Administration loans in New York. Until we brought this to the state’s attention, there was no consideration given to whether outpatient medical practices (themselves small businesses) would qualify.  Pediatric practices will be treated no differently than any other business and will be able to receive grants/loans based on their number of employees.
  • The Chapter partnered with local Girl Scout Troops and received donations of unsold Girls Scout Cookies which have been delivered to children’s hospitals within the Chapter.
  • We are considering starting a listserv, similar to the popular listserv on the National AAP’s Section on Practice Management, to help area pediatricians dealing with any COVID-19 issues.  If you are interested in having the Chapter pursue this, please contact me or Jessica Geslani at jgeslani@aap.org
  • Don’t forget to read our Pediatric Blog on COVID-19 by Dr. Asif Noor, available at: http://ny2aap.org/category/blog/
In the past few weeks, I’ve felt like the world is going crazy and tilting off its axis.  Then I think about the vital role we play in the lives of our patients and families as we show up each day to care for children, all of whom – either directly or indirectly – have been impacted by this virus.  It’s a quick way to rejuvenate yourself before the next encyclopedia of regulations/policies/procedures arrives in your inbox.
As always, if there is anything more the Chapter could be doing to help pediatricians in this demanding time, please do not hesitate to reach out to us.
Sincerely,
Shetal Shah, MD, FAAP
President, NYS AAP – Chapter 2