The COVID-19 pandemic hit New York swiftly and severely.
N.Y. Chapter 3 President Lisa B. Handwerker, M.D., FAAP, described the dramatic turn. On March 3, pediatricians came together for a statewide advocacy day. “We had great successes in Albany, and then 10 days later our lives changed,” she said. “…There was tremendous success and then devastation.”
Led by their chapters, New York pediatricians have risen to the challenges posed by this unprecedented crisis.
All three chapters built on their relationships with government agencies, policymakers and health plans to respond. They advocated for children, families and pediatricians; provided clinical guidance and support to members; and consulted with state and local policymakers.
“From influencing the drafting of the CARES Act in the House of Representatives to providing boxes of critical personal protective equipment (PPE) to almost 150 pediatricians to keep them safe and their practices open, to hosting drives for local food banks, N.Y. Chapter 2 has been responding to the pandemic by meeting the personal and public needs of pediatricians and children,” said chapter President Shetal I. Shah, M.D., FAAP.
Advocating for children and families
Chapters 2 and 3 provided consultation to New York City (NYC) government agencies throughout the crisis, sharing information and access to webinars and educational resources. They were consulted on the timing of closing city schools. When multisystem inflammatory syndrome in children appeared, the NYC Department of Health consulted with Dr. Handwerker to plan how best to inform pediatricians on assessing and treating those potentially affected.
In the face of barren food pantries and exponential increases in food insecurity, chapter and district leaders advocated for food distribution to children and families. Now, anyone in New York City can receive three meals a day.
“Chapter 2 also received grant funding as well as private donations to support local food pantries in each of our chapter’s four counties,” Dr. Shah said.
Katie Keown, M.D., chair of Chapter 3’s Committee on Underserved Children, arranged delivery of PPE, hand sanitizer, masks and personal care packages to homeless shelters. Chapter 3 Committee on Adolescence Co-Chairs Chanelle Coble-Sadaphal, M.D., FAAP, Hina J. Talib, M. D., FAAP, and Tatiana Ndjatou, M.D., educated members about the needs of homeless youths and compiled a list of service providers in need of donations.
New York pediatricians also used the media to reassure and educate parents and to raise alarms about how the crisis was affecting children and youths. Chapter 2 leaders appeared in local and national media 28 times over 16 weeks. Nina A. Agrawal, M.D., FAAP, Chapter 3 Committee on Family Violence and Injury Prevention chair, wrote an op-ed for the New York Timestitled “The Coronavirus Could Cause a Child Abuse Epidemic.”
Advocating for pediatricians and pediatric practices
Initially, medical practices were excluded from relief through the Empire Small Business Development fund. Working with state legislators, Chapter 2 won eligibility of small pediatric practices for local financial relief. The chapters now are conducting a survey to assess the financial impact of the pandemic on pediatric practices throughout the state.
Leaders in Chapter 2 also discovered and helped to fix a miscalculation in the federal response.
“Our efforts made sure that across the country, kids in insurance plans governed by the federal Employee Retirement Income Security Act can get access to telehealth services for the duration of the pandemic,” Dr. Shah said. Prior to this, only adults were covered, and coverage for children was determined by individual plans.
Chapter 2 completed multiple applications to obtain the PPE and delivered over 2,500 pieces to practices representing over 148 pediatricians.
While the COVID-19 experience upstate has been different, the business impacts remain the same.
N.Y. Chapter 1 joined the upstate children’s hospitals to advocate for pediatricians, meeting with government representatives, payers and state representatives. “One of our most important goals has been equitable payment for telemedicine and phone visits,” said chapter President Edward D. Lewis, M.D., FAAP.
Communicating with members
Throughout the crisis, chapters have emailed members information on COVID-related resources and webinars, payer-related updates and information on testing recommendations and availability. They also provided emotional support as many members transitioned from outpatient to inpatient settings or from caring for newborns to caring for adults.
“The shift in our practices was really dramatic everywhere, from New York City to Utica,” Dr. Handwerker said. “The kind of information pediatricians needed was so vital. We were so vital in providing that information.”
