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AAP leaders vote on top priorities; call for action on equity, trauma-informed care

August 24, 2021

Foundational change to the Medicaid program, including national standards and federal funding, was voted as the No. 1 resolution at the 2021 AAP Leadership Conference.

Calls for more intense action on equity, diversity and inclusion; wellness; and trauma-informed care approaches for children, families and AAP members also resonated throughout the combined Annual Leadership Forum and District meetings.

The conference, held virtually Aug. 5-8, brought together AAP chapter, committee, council and section leaders. They drew on their diverse perspectives and expertise to advise the AAP Board of Directors.

AAP leads throughout pandemic

The pandemic has brought dramatic ups and downs, scientific triumphs, and uncertainty, but pediatricians have supported each other through it, AAP President Lee Savio Beers, M.D., FAAP, told attendees.

“While we are all in the same storm, we are not all in the same boat, and some subpopulations of children and families are impacted more significantly, with higher rates of food insecurity, increased risk of child abuse and neglect, significantly increased impact on children and immigrant families, and we're also seeing an impact on youth around nutrition and obesity,” she said.

In his remarks, AAP CEO/Executive Vice President Mark Del Monte, J.D., described how the Academy has been working to guide pediatricians, children and families through the pandemic. Among priorities were the development of policies and clinical guidelines, and advocacy for vaccines, financial support for pediatricians, reopening schools safely and children’s mental health.

The AAP also spoke in support of mandatory vaccination of health care workers and has developed a plan to guide the return of AAP staff to the office that includes mandatory COVID-19 vaccination and masking. (At press time, 92% of AAP staff had been vaccinated.) Staff will shift from remote work to a staged return to the offices beginning Oct. 4.

Del Monte lauded the efforts of members who speak up for children’s health, while facing attacks and combating misinformation and disinformation.

“It is your acts of truth-telling and sense of purpose and compassion that will ultimately lead us to the other side of this pandemic,” Del Monte said. “The AAP stands behind our evidence-based recommendations. And we stand behind every pediatrician member who is working to promote them.”

Need for trauma-informed care

Pediatricians have never practiced in a post-COVID-pandemic world, and trauma-informed care will need to be part of the solution. This will involve discerning which patients need safe, stable, nurturing relationships and identifying and appropriately treating patients with mental illnesses, according to plenary speaker Brooks R. Keeshin, M.D., FAAP, liaison from the American Academy of Child and Adolescent Psychiatry to the AAP Council on Child Abuse and Neglect.

Dr. Keeshin noted that the trauma-informed approach goes beyond the response to the pandemic and urged pediatricians to consider it alongside impacts of structural racism and divisiveness on families.

“If we're not starting to get ready … we’re going to be caught flat-footed,” Dr. Keeshin said. “We also need to be doing it for ourselves. We're recognizing how potentially impactful our clinical experience is. You're walking this path with your families together; (think about) how much of an emotional burden that can have.”

Voting on resolutions

AAP leaders ranked the resolution calling for foundational change to the Medicaid program as the top priority (see below). It urges the Academy to build on existing policy and advocacy work to promulgate minimum national standards to ensure that those ages 26 years and younger who need publicly funded health insurance have equitable access to affordable, timely, quality and comprehensive health care through Medicaid and related programs. It also calls for the AAP to advocate for foundational changes in federal law to require states and territories to adopt minimum national standards and provide full federal funding for direct health care and related activities.

Members discussing the resolution said it would remove barriers and ensure equitable benefits, quality and access.

Leaders prioritized a related resolution (No. 3) that calls on the Academy to develop a comprehensive rights and equity-based framework for child health and well-being that can be applied at federal, state and local levels. This would include developing, promoting and tracking minimum equity-based standards for child health and well-being; ensuring that these minimum standards are realized for all children; and advocating for funding mechanisms.

Recordings from the 2021 Leadership Conference will be available shortly at PediaLink.aap.org (login required).

2021 top resolutions

Leaders from AAP chapters, committees, councils and sections selected 11 resolutions as priorities, due to a tie at No. 10. Resolutions are not official policy. They are referred to areas of the AAP for review and potential action.

  1. The Medicaid Program for Children and Young Adults Requires Foundational Change: National Standards and Full Federal Funding
  2. Formation of a National Bureau for Firearm Injury Prevention
  3. Establishing the United States as a Global Leader in Child Well-Being
  4. Combatting Racism in Graduate Medical Education Through Accreditation Council for Graduate Medical Education (ACGME) Curriculum Changes
  5. Developing Healthcare Effectiveness Data and Information Set (HEDIS) Measures to Reflect all Aspects of Preventive Care According to Bright Futures
  6. Accountability through Measurement — Improving Diversity and Inclusivity in Pediatrics Through Metric-Driven Data to Better Address Members’ Needs
  7. AAP Support for Gender Pay Equity for its Members
  8. A Toolkit to Address Pediatric Mental Health Needs Resulting From Pandemic
  9. Advocate for Federal Reporting Requirements of Adverse Pediatric Firearm Events
  10. Promotion of Early Evidence-Based Screening Tests for Reading and Systematic Reading Instructional Interventions in Elementary School to Promote Life-long Literacy
  11. 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 (login required).

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