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AMERICAN ACADEMY OF PEDIATRICS

CHAPTER ANNUAL REPORT

January 1, 2008 – December 31, 2008

10/24/08

All AAP chapters should use this report format. The District Vice Chairpersons Committee will

review all submitted reports to determine nominees for and winners of the Outstanding

Chapter Awards, Awards of Chapter Excellence and the Special Achievement Awards. The

template is a Word document and can be saved and shared between the chapter president, vice

president, and executive director. The final report should be emailed to pstien@aap.org, with

copies to the respective district chairperson and vice chairperson.

Name of Person Preparing Report:

D. Michael Foulds, MD, FAAP

Chapter:

Texas Pediatric Society, The Texas Chapter of the

American Academy of Pediatrics

District:

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GOALS

Please briefly describe your goals (up to a maximum of 5), and include information on how they

were developed (for example, part of your strategic plan).

GOAL #1: ADVOCACY: Advocate for children and the profession of pediatrics. Provide a

forum to educate physicians on ways to advocate in their community and at the state level and encourage participation in advocacy activities.

Measurable Objectives tied to Texas Pediatric Society, the Texas Chapter of the AAP (TPS/Chapter) Strategic Plan

Advocate with legislators on issues pertinent to the health and safety of children.

Support current, and develop new mechanisms to promote pediatricians and TPS/Chapter accomplishments and advocacy to the membership, the medical community and the general public.

Work as part of the Primary Care Coalition to promote the importance of primary care and address issues that impact primary care physicians through legislative action.

Activities tied to Advocacy A. Legislative Briefings The Texas Pediatric Society, in collaboration with the Children’s Hospital Association of Texas (comprised of 8 non-profit, free-standing children’s hospitals), provided issue-specific briefings to legislative staff in preparation for the 81

st Legislature set to convene in January 2009. Hosted during the

lunch hour, in walking distance from the state capitol, the briefings targeted key staff for legislators serving on committees pertaining to health, human services and appropriations as well as individuals from the offices of the Governor, Lieutenant Governor and Speaker of the House. The briefings were led by physicians representing the best of their field as well as the leadership of both associations. Presentations were given forty-five minutes to an hour and additional time was paid to questions and answers as well as open dialogue during the shared lunch time. The topics were drawn from our joint legislative priorities and included:

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Child Abuse and Neglect Nancy Kellogg, MD (San Antonio) and Matt Cox, MD (Dallas), both pediatricians specialized in child abuse, led a discussion of the medical needs of children who have been sexually and/or physically abused as well as the best system of care for delivering services to this fragile population. Included was a discussion of the development of a statewide network of pediatric centers of excellence by which children receive comprehensive diagnosis, treatment and follow-up.

Children in Disasters Ben Raimer, MD (Galveston) and Lori Upton, RN (Houston) discussed the unique needs of children during each stage of a disaster. They shared child-specific strategies that were employed while the Galveston-Houston corridor prepared for Hurricane Ike and the challenges identified. Also discussed, was the number of outstanding health-related concerns for children that have returned to Galveston.

Childhood Injury and Trauma Todd Maxson, MD (Austin), a pediatric trauma surgeon, explained how children are not little adults when it comes to traumatic injuries and the unique needs tied to providing them medical treatment, in some cases lifesaving treatment. Information about optimal booster seat laws was included.

In addition to basic issue education and identification of our joint legislative priorities the briefings have provided an excellent forum for establishing expert physician resources that staff may call on for guidance during the legislative session. Approximately 15 to 20 legislative staff have attended each briefing.

B. Advocacy Training The TPS/Chapter Executive Legislative Committee researched and developed The Pediatrician’s Role as an Advocate an educational tool in presentation form aimed at assessing an individual’s political activity and awareness, providing case examples of community and state level advocacy (including a “How To” section) and outlining issues identified and on the horizon that will require future advocacy. The presentation is now a core component of the advocacy section of the residency training program located at Dell Children’s Medical Center in Austin as of this summer/fall. It has been presented in several large forums including an October Grand Rounds at Texas Children’s Hospital in Houston. Further, upon request it has been altered slightly to cover the individual’s role as a child advocate and presented to community leaders interested in engaging legislators on behalf of children. The presentation is available in electronic form on the TPS/Chapter website to allow TPS/Chapter members to use the presentation with their colleagues or other community leaders and will be routinely updated.

C. Retail Health Collaboration TPS/Chapter in collaboration with the Texas Medical Association and the Texas Academy of Family Physicians established an Ad Hoc Committee on Retail Health (spring 2008) chaired by Gary Floyd, MD, a Fort Worth pediatrician, to provide a forum for dialogue with leaders of the retail health entities operating in the state of Texas. The need for the Committee grew out of physician opposition to efforts led by retail health to loosen the physician oversight requirements of Advance Practice Nurses and Physician Assistants during the 2007 legislative session. At the heart of their proposal was an attempt to expand the number of allied health providers a physician could oversee and loosen the requirements for onsite supervision and chart review. Looming in the background was the completion (December 2007) of the collaborative practice agreement between physicians and APNs and PAs a 5-year moratorium on scope of practice discussions in the regulatory and legislative arenas and a pledge on behalf of the APNs to push for autonomous practice. Physician collaboration with retail health, if achievable, could ensure their hands were tied when the allied health practitioners came calling for support.

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Representatives from CVS/Caremark (Minute Clinics), Redi Clinic, Walmart and Walgreens joined physicians at the discussion table in mid-spring and met face-to-face on at least two occasions. Physician-only conference calls took place routinely to vet the various options. As of early December, a tentative agreement is in the works and bill language is being drafted. The collaborative agreement will commit physicians and retail health to maintaining delegation of authority to three APNs or PAs (current rule) with a waiver process for up to six. The waiver will be applicable if the procedures are limited in nature, duration and scope. The agreement also expands onsite requirements for alternate sites allowing for 10% chart review within 30 days (instead of 20% for sites in urban areas with no time requirements – 10% in rural areas).

D. The Primary Solution In early-October, the Primary Care Coalition, comprised of TPS/Chapter, the Texas Academy of Family Physicians and the Texas Chapter of the American College of Physician Services prepared and released The Primary Solution: Mending Texas’ Fractured Health Care System, a document outlining the current status of primary care in the state and advocating for specific reforms. The document describes a sicker, uninsured population that lacks access to affordable preventative care in their primary care medical home. This is due to a dwindling pool of physicians choosing primary care because of long hours, high debt and low pay. It outlines solutions including loan repayment strategies, funding of graduate medical education, investment in health information technology, ensuring access to affordable health insurance options and reinvestment in Medicaid and CHIP. The document was distributed to members of the Legislature and a media tour is set for the start of 2009.

GOAL #2: PUBLIC HEALTH: Children shall have access to appropriate health care in Texas. Measurable Objectives tied to the TPS/Chapter Strategic Plan

Educate pediatricians in all types of practices and residents in training about current knowledge of disasters and emergency preparedness in pediatrics.

Ensuring 90% of Texas children will reach and maintain full immunization by 2010.

Activities tied to Public Health A. United Healthcare RSV Policy In mid-October of 2008, TPS/Chapter began to hear from physicians that they were unable to provide RSV prophylaxis to patients because United Healthcare had set national policy recognizing RSV season as beginning on November 1. Since 2006, the TPS/Chapter Infectious Disease and Immunizations Committee has served as a policy arm for the state Medicaid program by gathering and tabulating statewide data determining the beginning and end of RSV season. Based on several years of data it is clear that the RSV season in Texas begins October 1. The chair of the TPS/Chapter RSV surveillance project, Don Murphy, MD (Fort Worth), reached out to United Healthcare, providing the necessary data and within a matter of days, United Healthcare opted to revise their policy allowing physicians to begin administering RSV prophylaxis in October with special attention paid to covering physician cost incurred from October 1 until the policy was corrected. Based on the data collected by TPS/Chapter, United Healthcare has formally set October 1 as the official start date for RSV coverage nationwide.

B. Immunization Summit TPS/Chapter, after receiving grant funding from the AAP to host a dialogue on vaccine cost, approached the St. David’s Community Health Foundation to co-host the Texas Immunization Summit 2008. St. David’s is a non-profit foundation that supports projects addressing the uninsured and underinsured through hospital care in the six St. David’s hospitals in Austin and primary care in local safety-net clinics. In 2006, St. David’s hosted a conference on immunization registry systems and has continued to focus on vaccine-related issues in their community work. The collaboration between TPS/Chapter and St. David’s

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Community Health Foundation ensured that additional resources would be directed to the Summit, allowing for an expanded agenda and setting the stage for future partnerships. The Summit, hosted in November, allowed interested stakeholders including physicians, nurses, public health workers, legislators and public policy makers to hear firsthand from expert panels of nationally renowned speakers as well as representatives of the Centers for Disease Control and the Texas Department of State Health Services. The Summit Planning Committee developed the following mission; to advance a shared vision of a community protected from vaccine preventable diseases by providing a forum for exchanging ideas, promoting innovation and galvanizing partnerships. In order to advance the mission of the Summit, panels focused on the costs associated with vaccine administration, immunization registry enhancements and addressing vaccine safety concerns with patients. Break-out discussions were then held on the second day of the Summit based on topics identified during the panel presentations and question and answer sessions. Several themes arose:

Promoting Available Resources There was general agreement that many tools exist to assist physicians in improving their vaccine purchase and payment levels as well as tools to increase the vaccination coverage of their patients but that too few are aware of their existence. For example, ImmTrac, the state immunization registry, includes reminder recall tools but too few physicians know of this free resource to participating physicians.

Engaging in the Public Policy Process Much discussion focused on legislatively-required improvements (i.e. elimination of the 1% tax assessed on vaccine purchase, requiring transparency within contracts so physicians know how much they are being paid for vaccines by state-regulated insurance companies) and the need to engage and educate public policy makers in a way that empowers them to make decisions that improve public health and the practice of pediatrics.

ImmTrac Improvement The state registry is only as useful as the data included and too few physicians submit data in part because of the time required and the administrative hassles associated with the system. Discussion focused on the need to make ImmTrac a more attractive tool by encouraging participation while improving the data submission process.

Practice Tools A repeated concern was the physician’s ability to address parental concern about the safety of vaccines in a timely yet thorough manner. Various strategies were discussed such as community outreach and pro-vaccine media involvement. Other issues raised included the use of bar-coding to improve the efficiency and safety of vaccine administration and tracking.

Approximately 150 people were in attendance. Continuing Medical Education credits were available to participants.

C. Disaster and Emergency Preparedness Training A Basic Disaster Life Support Course was offered in conjunction with the 2008 TPS/Chapter Annual Meeting. This program is one of the National Disaster Life Support (NDLS) courses based on nationally standardized educational and training curricula to educate first responders (with emphasis on those in healthcare and public health) concerning disaster and catastrophic events and the recognition of the issues surrounding management of the victims, healthcare facilities and the scene itself during an event. The Annual Meeting provided an inviting forum to promote the pediatrician’s role in public health and incident management systems, community mental health, and in understanding the special needs of underserved and vulnerable populations during a disaster or emergency. Approximately 20 individuals were in attendance.

D. Pediatric Disaster Response to Hurricane Ike In 2007 a plan was developed by the TPS/Chapter Subcommittee on Disaster Preparedness for the evacuation of hospitalized patients (NICU, PICU and general admissions) in the event of disaster. Point people in each major hospital were identified and this list was available to all pediatricians and emergency medical physicians. The plan was put into effect in the days leading up to Hurricane Ike’s

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landfall in September of 2008. Easy access to key contact information ensured efficient and effective transport of pediatric patients from the Galveston/Houston area, greatly improving the transfer process.

GOAL #3: ACCESS AND QUALITY: All Texas children should have access to the highest quality of care throughout the state

Measurable Objectives tied to the TPS/Chapter Strategic Plan

All children with disabilities and children with special health care needs shall have access to physicians best trained to care for them. TPS/Chapter will work with state health authorities (Health and Human Services) to help ensure resources for CSHCNs are used responsibly.

Work to provide all Texas children (including CSHCN) with improved access to oral health care by acting as a liaison with Texas dentists/pedi-dentists to support common issues, improving access to preventive dental education, providing wider access to early dental prophylaxis in primary care offices, and evaluating application of dental varnish in the pediatric office.

Ensure access to mental health services

Activities Tied to Access and Quality A. Quality of Care for Children with Special Health Care Needs In October, the TPS/Chapter Children with Special Health Care Needs Committee hosted a meeting in Austin to discuss the statewide implementation of quality of care measures for children with special health care needs in all state programs. Stakeholders representing different medical specialties, key program and decision makers from a variety of health and human service programs and family advocates were brought together to delineate a core set of high priority health outcome measures. The goal was to identify health outcome measures that are evidence-based, best practices as well as feasible for implementation in the state of Texas. Through the help of a trained facilitator, the group reviewed the available measurement tools and their core components. The group was able to come to a consensus that quality measures were warranted and that the National Survey of Children with Special Health Care Needs (NS-CSHCN) was an ideal measurement that should be formatted for Texas and implemented statewide in conjunction with certain HEDIS measures. A second measurement tool, the PEDS-QL (Pediatric Quality of Life Inventory), was also identified in the event the NS-CSHCN proved cost prohibitive. A white paper summarizing the conclusions reached and identifying roles for each group of stakeholders is being formalized. It will be disseminated in early 2009 with a request for endorsement from the various agencies and organizations in attendance.

B. Oral Health In September 2008, Texas Medicaid implemented a new fluoride varnish program that allows primary care physicians, physician assistants, and nurse practitioners to provide a limited oral health evaluation and application of fluoride varnish for children ages 6 months to 35 months based in part on recommendations from TPS/Chapter. Reimbursement for this service has been set at $34.16, which is paid on top of the Texas children’s well child exam. To receive reimbursement for providing this service, primary care physicians and mid-level practitioners must be certified by the state. TPS/Chapter, in conjunction with the Texas Department of State Health Services, has hosted a series of 5 webinars and 1 in-person training at the TPS/Chapter Annual Meeting (with additional in the planning stages) to train and certify Texas Health Steps providers to perform the oral evaluation and dental varnish application. Trainings are offered free of charge and in addition to state certification, 1.25 CME credits were offered upon completion of the session. Thus far, over 200 providers have been trained and certified to provide these services. The primary goal of the training is to improve access to dental health services for children by increasing physician and allied health provider knowledge and skills in performing these services, while encouraging referral collaboration between physicians and dentists.

C. Medicaid Access Frew vs. Hawkins, a class action lawsuit brought against the state to increase access to medical services for Medicaid recipients under 21, was settled in May of 2007. In addition to significant rate increases for medical providers and dentists, 150 million dollars was allocated to implement strategic initiatives to

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increase access to care. A technical advisory committee (TAC) was assembled to review proposals and is chaired by TPS/Chapter member Jane Rider, who is also chair of the TPS/Chapter Medicaid Subcommittee. Over the past year, TPS/Chapter has played a pivotal role in recommending initiatives, reviewing proposals, providing member expertise on specific topics, and participating in discussions to finalize decisions and begin the implementation process. Thus far, HHSC has requested expenditure for 17 strategic initiative projects based on input of state medical associations and recommendations of the TAC, and 5 have been implemented in 2008. Of the innovative projects underway, a pilot program has begun in 6 sites that links patients with mental health services through the collaboration of primary care physicians, mid-level behavioral health professionals, and psychiatrists. Mobile dental vans have also been commissioned to function in areas of great need, and oral evaluations and fluoride varnish application are being provided by pediatricians in the medical home. Of the proposals still pending expenditure approval, TPS/Chapter has provided guidance to HHSC on the following:

Loan forgiveness for primary care physicians and pediatric sub-specialists

Smart card

Promotoras (lay health advisors) in the ER

Migrant system interface which will expand flexible coverage to children of migrant workers

Study on vitamin and mineral coverage in the Medicaid program

Telemedicine pilot for provision of subspecialty care in underserved areas

Consultation and referral network for subspecialty care

Healthy lifestyles incentives

Telephone consultation reimbursement for subspecialists

Referral guidelines to help PCPs make appropriate referrals

GOAL #4: MEMBERSHIP SERVICES: Expand the role of TPS/Chapter to serve the ever changing needs of Texas pediatricians

Measurable Objectives tied to the TPS/Chapter Strategic Plan

Focus on young pediatricians to increase active participation in TPS/Chapter.

Increase membership by 50% over five years.

Activities tied to Membership Services A. Young Physician Section TPS/Chapter established a young physician section for all physicians and residents under the age of 40 to create a forum for increased dialogue and participation. Kim Edwards, MD (Austin) and Carl Tapia (Houston) were identified as co-chairs and Dr. Edwards was added to the TPS/Chapter Board for young physician representation. A survey was developed under their leadership to gage the activities, tool and resources of most interest to this section of physicians and is currently being distributed for feedback. TPS/Chapter received a grant from the AAP to provide 3 dinners to young physicians and residents – TPS/Chapter Annual Leadership Planning Session in Austin (April), TPS/Chapter Annual Meeting in Houston (October) and a stand-alone event in Dallas in December. At each gathering a co-chair of the section as well as TPS/Chapter staff and Chapter leadership have been available to discuss the core functions of the Society as well as listen to member concerns. Although it is in its infancy, the TPS/Chapter Executive Board hopes to soon be able to cater meeting content and member services to this group of physicians.

B. Increased Membership In the summer of 2008, the TPS/Chapter Member Services Manager, Crystal Zamarron, developed a comprehensive Membership Reference Guide to enhance member recruitment and retention efforts. The reference guide describes the host of membership services available to pediatricians, pediatric residents and medical students through TPS/Chapter. It also provides descriptions of the TPS/Chapter committees and sections as well as outlines the benefits and leadership opportunities available to TPS/Chapter

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members. The guide is included in every packet sent to new TPS/Chapter members and is available at all TPS/Chapter meetings so members have access to a simple way of encouraging non-TPS colleagues to become participants. In 2008, TPS/Chapter recruited 280 new members.

C. Disaster Relief Fund In October, the TPS/Chapter Executive Board established a disaster relief fund to assist Texas physicians impacted by the devastation caused by Hurricane Ike. The AAP provided $10,000 in grant dollars which was then matched by TPS/Chapter for a total of $20,000. Other monies have been contributed by TPS/Chapter members sensitive to the needs of the Houston/Galveston corridor. Affected residents will be provided monetary assistance to cover the expenses incurred as a direct result of the hurricane. An application process was developed with the TPS/Chapter Executive Committee of the Board charged with reviewing requests.

OTHER CHAPTER ACTIVITIES

We realize that chapters often expend resources, both time and money, on initiatives that are important to the success of the chapter, but may not be specifically spelled out in the goals. The following are topic areas that have been noted in previous years’ chapter annual reports. Please indicate whether your

chapter is involved in activities focused on any of these areas, and briefly describe the activity. Please

only report on activities NOT reflected in the goals section of this report. PLEASE DO NOT EXCEED 50 WORDS PER TOPIC AREA.

Access: See Goal 3

Adolescent health___________________________________________________________

Chapter management issues_____________________________________________________

Children with special health care needs/foster care: Collaborated with HHSC in promoting information the new state foster care program implemented in April 2008. Resources were disseminated to the membership on the Health Passport and training opportunities. Provided guidance to HHSC on designing a tailored benefits program for CSHCN. The program will include enhancement to current benefits to help improve access to care, coordination of services, and transition into adult care. Also see Goal 3-A.

Community outreach: With grant funding from the AAP, TPS/Chapter administered the Healthy GrandFamilies project, an obesity intervention program targeting grandparents. Pediatricians in the Houston and Dallas areas partnered with community based organizations to provide a series of six workshops, each workshop targeting an important aspect of nutrition or exercise.

Disaster preparedness: See Goal 2-C and 2-D.

Finance: See Goal 2-B.

Health care equity: See Goal 3-C.

Health care organization collaboration: TPS/Chapter regularly collaborates with other organizations on issues related to children’s healthcare and the medical profession, including: Texas Medical Association, CHAT, Texas Health Institute, Partnership for Obesity, Hogg Foundation, Texans Care for Children, Center for Public Policy Priorities, United Way, Public Health Coalition, Parks and Wildlife Association, Texas Academy of Family Physicians

Improving communications: Added committee pages to website, streamlined process for committee reporting

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Immunizations: ID Committee holds monthly phone calls to discuss issues of importance and offering guidance to the state. Collaborated with staff for the Senate Committee on Public Health on recommendations for several bills related to immunization financing and a lifetime vaccine registry. Also, see Goal 2-B.

Increase chapter visibility/profile/expert recognition: Participation in numerous policy making statewide committees, representation on a variety of coalitions related to children’s health and well-being, sponsor of events (Immunization Summit, Legislative Briefings, etc), expert testimony during interim legislative process.

Managed care/Medicaid: Several members of the TPS/Chapter leadership actively participate in quarterly Medicaid Program Improvement Process meetings as well as Public Benefits Review and Design Committee meetings to provide expert guidance to the state on periodicity and content of well child exams, reimbursement, and to help alleviate administrative burdens in the program. Advocacy with state on payment for certain services such as after hour codes, obesity, developmental screening; also see Goal 3-C.

Medical home: Participation in Steering Committee for Medical Home Demonstration Project

Membership Issues/Member Participation: See Goal 4-A, 4-B, 4-C.

Mental health: Advocacy for reimbursement of developmental screening in Medicaid program. Participation in Mental Health Forum – a group comprised of various children’s mental health advocacy organizations that meet monthly to share information and resources and discuss legislative priorities for the 2009 Legislative Session to ensure that children are getting necessary services.

Non-dues revenue generation: Annual Meeting, Grants

Obesity: The TPS/Chapter obesity toolkit, created in 2005 and disseminated to over 15,000 providers, was updated and made into an online resource that can be found on the TPS/Chapter website. In order to ensure that providers have easy access to the most up to date information, the online version contains useful tools as well as links to important info. Several TPS/Chapter members and staff have also served on a committee that reviewed obesity policies in the Medicaid program and made recommendations for improving current practices.

Oral health: Amended Bylaws to allow dentists to become TPS/Chapter members. Also, see Goal 3-B.

Pediatric councils: Participated in meetings with Texas Association of Health Plans that resulted in development of 3 working groups to address private payer practices related to immunizations, obesity, and mental health. TPS/Chapter also communicated with United Health Care on problems related to approval process and payment for Synagis resulting in information to streamline the approval process and the facilitation of direct communication with clinics experiencing problems.

Practice management: The committee on Administration and Practice Management has developed a series of seminars that will be conducted around the state in 2009.

Professional education/CME: ALPS, Annual Meeting, See Goal 1-B, 2-B, 2-B, 3-B

Profession of pediatrics: See Goal 1-D.

Public education: Promotion vaccine safety information and materials

Public health: Collaborated with TMA to promote Hard Hats for Little Heads program, a local community effort to distribute helmets to children. Also, see Goal 2.

Quality: See Goal 3-A.

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Reach Out and Read/literacy____________________________________________________

Smoking cessation: TPS/Chapter submitted an op-ed piece to every major newspaper in Texas, which applauded the decision of the Wegman’s Supermarket chain to stop carrying tobacco products in their store. Noting the dangers of smoking and exposure to second hand smoke, TPS/Chapter encouraged other businesses to follow the Wegman’s example.

Other(s) Please specify: Submitted formal letter of request to legislative and academic leaders regarding the importance of preserving an institution of medical education in the state, whose fate is undetermined after the devastation and damage caused by Hurricane Ike.

Typically, chapters’ goals and activities are reflective of the Academy’s Agenda for Children

and focus on the same priority areas. Please indicate below which AAP priority areas, if any, are

included in your goals and/or activities.

GOALS

1 2 3 4 Activities

Immunizations X A, B

Mental health X C

Oral health X B

Children with special health care

needs/foster care

X A

Access X A, B, C

Quality X A

Finance X B

Health care equity X C

Medical home X A

Profession of pediatrics X C, D

CHAPTER FINANCES

Please describe how you relate the budget to your defined goals (eg. allocation of your resources

based on identified priorities).

The TPS/Chapter budget is drafted by the Executive Director in the fall of each year and

reviewed by the Executive Committee of the Board. The budget shifts slightly from year to

year to account for new growth as well as activities that have been completed. Our budget

is easily matched to the priorities outlined in our strategic plan, a clear example of how our

finances are directly related to the activities of the TPS/Chapter. Once the Executive

Committee has formalized a draft, the budget is then presented to the full Executive Board

either in a face-to-face meeting or via teleconference. The TPS/Chapter Treasurer is

charged with presenting the budget which then must be approved by a vote of the

Executive Board. An independent audit is performed once a year. In 2008, TPS supported

5 full time staff including an executive director, director of advocacy and health policy and

physician education management specialist while seeing growth both in our membership

and budget. Approximately 37% of the 2008 budget was directed toward professional

education, with 17% focused on advocacy.

In addition to the projects funded solely by TPS/Chapter grant funding was received from

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the AAP allowing the TPS/Chapter reach out to young physicians/residents by creating a

special section, provide education to members and the community about vaccine financing

and provide grant dollars for physicians and medical students who suffered a financial loss

as a result of Hurricane Ike.

Our Foundation maintains a separate budget as an independent charitable entity, raising

funds through an annual benefit dinner and auction as well as through private donations.

Funds raised by the foundation are distributes as small grants for projects benefiting

children’s health.

Which of the following tactics does your chapter employ to generate non-dues revenue? Check

all that apply.

__X__ Grants

__X__ National and/or state agency contracts to carry out projects and initiatives

__X__ Chapter Continuing Medical Education opportunities

____ Advertising space sold in the chapter newsletter and/or on chapter Web site

__X___ Exhibit fees at chapter meetings

__X__ Pharmaceutical/corporate contributions

__X__ Personal/individual donations

__X__ Private foundation donations

__X__ Other(s) (please specify)__Interest on investments__________

MEMBERSHIP DEVELOPMENT

Please indicate what recruitment and retention strategies your chapter employs. (Check all that

apply.)

X Mailings/letters to members and non-members

X CME opportunities

X General communications (e.g. e-mails, Web site, general correspondence)

X Personal contact by chapter officers and/or staff

X Chapter newsletter

X New member information packets

X Resident outreach

X Membership recruitment campaigns

X Participation in advocacy efforts

__ Chapter membership committee

X Recruitment of affiliate members

X Member surveys

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X Other(s) (Please specify)___Changed Bylaws to include pediatric dentists_

If you have a successful recruitment or retention strategy that you would like to share, please

briefly describe it below. Specify how your chapter demonstrates value to your members. Please

be sure to indicate, if at all, how that strategy addresses diversity. Diversity may reflect values,

beliefs, attitudes, principles and other attributes that define our culture. These may be personal

attributes (e.g. gender, race, ethnicity, language spoken, age, sexual orientation, religion, family

composition, etc.) or professional (e.g. type of community, site of practice, types of practice,

administrative or research interests, etc.)

Please indicate whether you currently have specific activities that engage the following member

types. (Check all that apply.)

X Medical students

X Residents

X Young physicians

Medical subspecialists

Surgical specialists

Academicians

Seniors

Underrepresented and minority physicians

______ Other(s)

For those types that you checked above, please then briefly describe your chapter’s activities in

the space provided below. PLEASE DO NOT EXCEED 50 WORDS PER CATEGORY.

Medical students

The TPS/Chapter has a grant to support the Preceptorship Program, a 4-week hands on clinical

learning experience in the practice setting. The program continues to grow and in this 14th

year

90 students were matched to pediatric preceptorships – an increase of 14% over last year. 37% of

students who previously participated in the preceptorship program and graduated in 2008 entered

a pediatric residency program.

Residents

Each year the Chapter holds a Pediatric/Fellow Electronic Poster Contest, which yielded 42

entries in 2008 – a significant increase compared with the 25 entries in the previous year. The

Executive Board has a permanent voting position for a pediatric resident, and there is a separate

section at the Annual Meeting for resident members.

This year to encourage resident membership and participation, TPS/Chapter held 3 resident

dinners in different locations around the state.

Young Physicians

In 2008, TPS/Chapter started a young physicians section for members under 40 or who have

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been practicing for less than 5 years. In light of the newly formed section, the Chapter used an

AAP grant to help sponsor 3 dinners to encourage young physician participation in the Chapter

and help develop section priorities. There is also a position on the board for young physician

representation.

Medical subspecialists

Surgical specialists

Academicians

Seniors

Underrepresented and Minority Physicians

Other

CHAPTER ADMINISTRATION/STRUCTURE/GOVERNANCE

Please indicate what activities your chapter engages in to support the continued growth and

development of its leadership and staff. (Check all that apply.)

Implementation of Pediatric Alliance Leadership principles

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X Mentor program

X Succession plan

X Professional educational seminars/teleconferences

X Sponsor attendance at AAP national leadership conferences

X Support membership in professional organizations

Other(s) (specify) __________________________________________

For those types that you checked above, please then briefly describe your chapter’s activities in

the space provided below. PLEASE DO NOT EXCEED 50 WORDS PER ACTIVITY .

Implementation of Pediatric Alliance Leadership principles

Mentor program

Each committee has an appointed co-chair to foster leadership opportunities for younger

physicians. Voting members of the Board include a resident member and young physician

member. Young physicians are given the opportunity to learn and grow through the

Annual Leadership Planning Summit held each spring.

Succession plan

There are term limits to committee chairmanship and Board positions, allowing the

succession of younger members into leadership roles. As committee chairs complete their

terms, the younger co-chairs are able to assume the responsibility as chair and a new co-

chair is appointed.

Professional education seminars/teleconferences

Annual meeting of typically 200 attendees, Annual Leadership Planning Summit, webinars,

committee conference calls, advocacy presentations

Sponsor attendance at AAP national leadership conferences

TPS supports the President of the TPS to attend the ALF along with the Chapter Chair

and Alternate Chapter Chair. TPS/Chapter sponsors two members to attend the both the

AAP Annual Legislative Conference and the AAP Advocacy Conference.

Support membership in professional organizations

TPS/Chapter supports Executive Director and 2 staff members in the Texas Society of

Association Executives.

Other(s)

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SUMMARY

Please succinctly summarize (250 words or less) your chapter’s key initiatives – what the chapter

is all about.

The mission of the TPS/Chapter is to focus its talent and resources to ensure that the

children in Texas are safe and healthy, that its members are well informed and supported,

and that the practice of pediatrics in Texas is both fulfilling and economically viable. The

leadership and staff of the TPS/Chapter are actively involved both at the community and

state levels in assuring that our members are seen as the physician experts on all issues

related to children.

In the hectic lives of today’s pediatricians, we know that providing invaluable membership

services is the only way of encouraging continued participation. From child safety to

public health measures, we have structured our priorities around the emerging issues of

today and strive to shape our Chapter in a way that allows quick response to new needs as

they present themselves.

Like the old Whitney Houston song said, “I believe the children are our future, teach them

well and let them lead the way,” our membership continues to prioritize prevention as one

of the best tools to ensuring children grow into healthy and productive adults. Providing a

venue, therefore, that gives physicians the tools to make a difference beyond the walls of

their practice is, along with prevention, behind every TPS/Chapter activity.

SPECIAL ACHIEVEMENT AWARDS

After reviewing all the reports, the District Vice Chairpersons (DVC) Committee identifies

individual member achievements, as well as successful chapter projects, that they believe are

innovative and worthy of consideration for a Special Achievement Award. Special Achievement

Awards recognize outstanding AAP work of individuals or chapter achievements.

To assist the DVCs in their efforts, please briefly highlight chapter and individual projects

below that you consider to be bright and innovative. Please indicate whether these are

chapter projects, or projects spearheaded by an individual member. If it is a member project,

please identify the member so that he or she can be considered for a Special Achievement

Award.

Chapter Projects:

On behalf of the TPS/Chapter Committee on Children with Disabilities, Richard Adams

and Robert Warren led a year-long effort to identify core quality measures of care for

Children with Special Health Care Needs. This effort culminated in a day long discussion

among stakeholders, including state policy leaders, of appropriate measurement tools for

implementation in all state programs.

Don Murphy, who received the TPS/Chapter Executive Board Award for his efforts in

RSV and influenza surveillance, led a statewide effort on behalf of the TPS Committee on

Infectious Diseases and Immunizations to collect data on RSV and influenza prevalence.

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His data was used by the state Medicaid program to determine the beginning and

endpoints for the RSV season in Texas and was subsequently used by United Healthcare to

change policy determining the start date of their coverage for Synagis.

Individual Projects:

Jane Rider serves as the chair of the Frew Technical Advisory Committee, a group of

physicians and stakeholders invited to guide HHSC in developing proposals to dedicate

strategic funding from a class action lawsuit focused on improving access to care for

Medicaid beneficiaries under 21. The state appropriated 150 million dollars for the

development of innovative ways of improving Medicaid services. Agency representatives

and plaintiffs’ attorneys sit around the same table to discuss proposals, and Dr. Rider has

done an excellent job facilitating a productive discussion and lending her pediatric

expertise.