June 2018
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Medicaid Rate Increase
Carl Yanagida
CFO, Washington State Health Care Authority
New rates are in the works! 

The dust is settling on the 2018 legislative session, and state agencies are adopting work plans to implement new statutes and budget provisos.  Here at the Health Care Authority, one of the budget provisos we are working on is the pediatric Medicaid rate increase. The implementation for this particular proviso is a bit more complex than some others in the past. The Legislature appropriated $13.8 million for this reimbursement rate increase. 
Advocacy Update: Interim Work
Amber Ulvenes
WCAAP Legislative Liaison

Chapter continues work while legislature is adjourned

The legislature is now in interim mode. Legislators, agencies and stakeholders now are working to implement policies passed during the 2018 session.  In addition, they are doing new research in advance of the 2019 session. Your team has been busy engaging in this work on several fronts. First, we've been spending time with the Health Care Authority (HCA) to help them discern how to spend the $13.8 million appropriated for increased pediatric Medicaid rates for E&M codes and vaccines. Learn more...

Pediatric Population Health Forum

Day-long forum with a strong emphasis on pediatric life stages and social determinants of health.

Yakima, WA | Yakima Convention Center
Saturday, September 22, 2018
8:00 AM to 4:00 PM 

Learn strategies from state and national leaders and clinicians at the forefront of value-based care in pediatrics to integrate care and improve outcomes. Morning plenary speakers and afternoon breakout sessions will focus on the most effective ways to improve child health and to support the use of medical homes. Featuring Key Note Speaker: Sue Birch, Director, Washington State Health Care Authority. View the agenda here.

A Perfect Match: Kaiser Permanente Group Membership
Michelle Heng, MD, FAAP
Kaiser Permanente
A shared commitment to the health of the community

The thing that attracted me to Pediatrics in the first place was the melding of interesting medicine with child advocacy.  No other discipline seemed to have that important advocacy piece build into its DNA so completely.  However, the reality of the day-to-day care of patients can leave little time or energy for advocacy work.  I've been a member of the WCAAP for years but it wasn't until I attended my first WCAAP Advocacy Day in 2017 that I realized the power of this organization.  While I could snatch some time here or there to do advocacy work on behalf of my patients, the WCAAP had people working on it constantly.  My membership was allowing me to be part of that effort.  
Learn more...

Newborn Hearing Screening for Patients with Orofacial Clefts
Emily Gallagher, MD, MPH
Assistant Professor | Craniofacial Center
Department of Pediatrics
Seattle Children's

Timely referral and medical support is essential

Cleft lip and palate is one of the most common birth defects, occurring in about 1 in 750 births.  An intact palate is crucial for normal feeding, speech, and hearing, yet determining a child's hearing status at birth may be complicated if a cleft palate is present.  Children with cleft palate usually have Eustachian tube dysfunction and develop middle ear effusions with conductive hearing loss.  They also have a slightly increased risk of having sensorineural hearing loss. Tympanostomy tubes are usually placed with the palate repair (around a year of age), but this treatment is not effective until the palate has been closed. Children with cleft palate who do not pass the newborn hearing screen may not have a definitive hearing diagnosis until after a year of age.

Expansion of Behavioral Health Services for 
Inland Northwest Children
Keith Georgeson, MD
Chief Executive of Children's Services
Sacred Heart Children's Hospital
New inpatient and intensive outpatient care on the horizon

The Inland Northwest region has seen a dramatic increase in the number of children and adolescents with anxiety and depression disorders. Demand for child and adolescent psychiatric services is stretching resources throughout the region and in many cases, delaying appropriate care.  As an example, the emergency department at Sacred Heart Children's Hospital has often become an overnight holding area for children needing acute psychiatric care because our psychiatric ward has no available rooms.
Using the Collaborative Care Model to Integrate Behavioral Health Care in Pediatrics
Anna Ratzliff, MD, PhD
Associate Professor
Depression Therapy Research Endowed Professorship
Director, AIMS Center
Director, UW Integrated Care Training Program
New opportunity to fund CoCM delivery

The collaborative care model (CoCM) of integrated behavioral health care delivers mental health services in primary care settings.  This work is performed by a team including a primary care provider and a behavioral health provider supported by psychiatric consultant. This model has been shown to be effective for pediatric populations for treatment of ADHD and adolescent depression, although developing funding strategies to cover the cost of care delivered this way has been challenging. Fortunately, there is a new opportunity in Washington State to fund CoCM delivery for Apple Health (Medicaid) patients.

WCAAP Training Providers on Adolescent & Maternal Depression Screening
Michelle Izumizaki, MPH
Program Coordinator, WCAAP
CME scheduled throughout the state

WCAAP has been holding free 90-minute trainings throughout the state to support pediatric health care providers to provide Adolescent and Maternal Depression Screenings in their practices. We have trained 83 pediatric health care providers to date in standard of care for adolescent and maternal depression screening as well as where to turn for help.
Learn more...

Resolution Writing: From Idea to Execution
Wei-Jen Hsieh
Trustee & Early Career Physician Representative, WCAAP

Channeling frustration into action to shape AAP policies

This fall at the annual National Conference & Exhibition I was excited to have the opportunity to help elect one of my mentors, Dr. Kyle Yasuda, for president of the Academy. However, to my dismay, when I logged into the AAP portal, I was unable to cast a ballot. Having recently completed residency and awaiting my boards exam the following month, I was considered a "candidate" member of the Academy and despite paying Academy dues, I was not eligible to vote in national or district elections.

Congratulations New Fellows! 
Sonal Avasare, MD, FAAP 
Ryan Kearney, MD, FAAP
Elliott Weiss, MD, FAAP

Spokane's Inlander published a terrific profile of pediatrician Deborah Harper, MD, FAAP, who recently retired from practice but remains active in the community, including mentoring new pediatric health care providers. Congratulations on your retirement and thank you for your years of service to the Inland Northwest Dr. Harper! 
The American Academy of Pediatrics 2018 National Conference and Exhibition (NCE) is 
 is taking place on November 2-6, 2018, in Orlando, FL. Registration is now open. Register by September 21, 2018, to receive the lowest rates. Keep an eye out for our WCAAP guide to NCE, highlighting interesting topics and Washington State speakers. We will send it out in the fall! 

Mark your calendars for the 2019 AAP Legislative Conference: April 7-9, 2019 in Washington, DC. Each year, this important conference brings together pediatricians from across the country who share a passion for child health advocacy. Participants attend skills-building workshops, hear from guest speakers, learn about policy priorities impacting children and pediatricians and go to Capitol Hill to urge Congress to support strong child health policies. You can read about one WCAAP member's experience at the 2018 Legislative Conference in the May issue of Developments. If you are interested in attending the conference, and would like to be notified once registration opens, please email LegislativeConference@aap.org.

Depression screening webinar: AAP recommends routine (annual) depression screening for adolescents due to depression being a common and treatable problem, which often goes unrecognized and untreated.  To encourage more screening, Washington's Medicaid health plans now reimburse for adolescent depression screens with CPT code 96127.  If you are considering incorporating depression screenings into your practice, we have a new webinar training available, thanks to generous support from Amerigroup: Register Online.

Coming Up: WCAAP Committee Meetings
Join us! Committees are a great way to meet other members and get involved with Chapter work! Watch this space for upcoming meeting dates and times for Chapter committees and interest groups. Most committees meet by phone for one hour. 

Health Care Transformation Committee 
June 19 - 8:00-9:00am
Meets by telephone
Contact Mike Dudas or Francie Chalmers to learn more.

Legislative Affairs Committee
Meets weekly by phone during the legislative session & special session 
Meets monthly by phone during the interim
*In-person meeting June 8, 9:30-12:00 at SeaTac
*Next phone meeting July 17, 7:00-8:00am
Contact Lelach Rave or Beth Ebel to learn more. 

Early Learning Committee 
June 6 -7:00-8:00am
Meets periodically by telephone
Contact Diane Liebe to learn more. 

Sustainability & Engagement Committee 
June 26 - 12:00-1:00pm
Meets monthly by telephone
Contact Kim Hauff to learn more. 
Vaccine Committee
Meets 2x/year
Contact John Dunn to learn more. 

News & Events
What's Happening? 
We bring education and networking events to providers all over Washington. Find all of our latest upcoming events plus offerings from our partners around the state on our website's Events page! 
Thank you to our sponsors: 
WA Chapter AAP | WA Chapter of the AAP | jdonahue@wcaap.org

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