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.
- 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 a few weeks ago, 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). The Chapter has partnered with Nassau County’s Office of Emergency Management to assist with distribution of Personal Protective Equipment. The Chapter has already distributed ~300 masks and other PPE to pediatricians across Long Island. Through our strong partnership with legislators across New York, the Chapter obtained a small amount of standard (non-N95) facemasks for outpatient, private pediatric practices. The Chapter has stepped in to distribute about ~100 masks which general pediatricians can use to see children who require in-person visits in the office, thereby reducing the burden on emergency rooms. Contact Jessica Geslani if you require a portion of this allotment. Pediatricians that provide care in Nassau can complete the short online form available here: https://app.nassaucountyny.gov/OEM/supply-request/ to request equipment. As we receive more, we will be distributing it accordingly.
- The Chapter has also sent letters to all 11 of the Chapter’s federal representatives outlining the dire need for personal protective equipment, faster roll-out of point-of-care testing for COVID-19, a national stay-at-home order, and increased enforcement of current regulations.
- At the onset of the COVID-19 pandemic, pediatricians in Chapter 2 realized that health plans covered under the Employee Retirement Income Security Act (ERISA) were NOT uniformly paying for telehealth visits, financially impacting pediatricians and reducing healthcare access during a time of public health crisis for up 5-8% of children in our Chapter. Within TWO WEEKS, Chapter leaders brought this to the attention of Representative Tom Suozzi of New York 3rd Congressional District. As a member of the powerful House Ways and Means Committee, he was closely involved in reviewing pending COVID legislation. Based on discussions with Chapter 2, Rep. Suozzi urged members of the House Education and Labor Committee to ensure that federal legislation REQUIRED these plans to cover telehealth services for both adults and children. The measure passed into law on March 27, 2020 as part of the “Coronavirus Aid, Relief, and Economic Security Act” or CARES Act. Chapter members should be proud of our role in detecting a loophole in federal policy and working expeditiously to close it in close partnership with our legislators. Read the letter congratulating our Chapter on influencing national policy.
- 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.
- Chapter 2 member and Pediatric Pulmonologist Dr. Melodi Pirzada from NYU Winthrop Hospital has 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/
- The NYS DOH’s COVID-19 Weekly Healthcare Provider Update Compilation provides healthcare providers in New York State with a consolidated update of guidance released by the New York State Department of Health (NYSDOH) related to the COVID-19 pandemic response. Click Here for this week’s update.
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Raise the Age NY put out a call for help in urging NY Governor Cuomo and NYC Mayor de Blasio to act quickly to reduce the risks to young people and families posed by the COVID-19 pandemic. Learn more and spread the word by using their social media toolkit.
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