Beth Ebel, MD, MSc, MPH, FAAP
Co-Chair, WCAAP Legislative Committee
Think back to the darkest moments last year. As the legislative session ended in Spring 2020, pediatric providers moved into crisis mode as the enormity of the COVID-19 pandemic rolled over all of us. WCAAP legislative accomplishments passed by the Washington State House and Senate were vetoed by Governor Inslee, including the hard-fought rate increases to improve access to care for kids. Practices struggled to keep the doors open, look out for vulnerable kids and families, keep clinic staff safe, and continue essential health care work while schools, transportation, and workplaces were shuttered. Did you try to make hand gel? Finally learn to thread a bobbin only to make a mask inside out? Search for toilet paper? Kill your sourdough starter? Secretly cherish the time spent with grumpy dislocated older children who moved back into their rooms? Did you have patients whose parent or grandparent died? Lose a member of your own family? Yearn to see your parents? Volunteer to help folks who couldn’t get a vaccine appointment? Did you worry for kids who didn’t get back to school? Meet their pets and smaller siblings on telehealth? Zoom from your car? Learn to smile with your eyes?
Pediatricians and pediatric providers responded with urgency, generosity, and the conviction that we could help families and each other. Nearly one out of ten WCAAP members joined weekly COVID response webinars at 7am at the height of the pandemic. We shared expertise, learned from each other, and hammered out new guidelines to safely provide care and welcome families back. We helped draft critical guidelines for getting kids back to school, reminded families about the safety of seeing their child’s doctor, and morphed into experts at telehealth. Over last summer and fall as other businesses stayed closed, over 100 pediatric providers across the state met with their legislators via zoom and advocated for access to care and Medicaid parity, behavioral health, insurance for new moms, and steps to reduce youth nicotine exposure. We gathered teams to look at the inequity of Washington State revenue sources, ensure telephone and telehealth parity, and sought ways for kids to safely get back to school and back to their medical home. The glimmer of several highly effective vaccines raised hope.
Despite the waves of illness and struggle, we started 2021 with a fantastic (zoom) turnout for WCAAP Advocacy Day, complete with breakout rooms, managed scrambles, huge resident and early career participation, and a wonderful and energizing day. WCAAP staff were (of course) amazing. The foundation for legislative heavy lifting was built: personal relationships with lawmakers, focusing on goals, massive participation on VoterVoice Action Alerts across the entire state, testimony by so many pediatricians at all stages of their careers! And a shared realization that significant measures were needed, now, for struggling families. This hard work, built on years of advocacy, led to largely bipartisan support for transformational laws for kids and families.
Which brings us to spring 2021. The last cherry blossoms drift into pink shadows, the days grow longer and lighter, and immunizations nose ahead of COVID variants in the US amid waves of bottomless global suffering. In this difficult year, let’s take a moment to celebrate the legislative accomplishments which have been years in the making.
- Reimbursement for kids with Medicaid is now on par with Medicare for many of the most common primary care codes. A result of the collective work of the medical societies, with leadership from WCAAP, the increase will take effect in October and will solidify Washington’s commitment to ensuring access to pediatric care across the state.
- Support for the Washington Mental Health Referral Service for Children and Teens was continued and even increased to help meet rapidly growing needs.
- Intensive inpatient / partial hospitalization pilots received continuation funding and increased capacity, and, on the upstream end of the spectrum, our state passed legislation to better meet the behavioral health needs of 0-5 year-olds covered by Medicaid. While more support is needed to make meaningful impacts in kids’ access to behavioral health care, there are new efforts to strengthen behavioral health services within the pediatric medical home.
- New moms on Apple Health will be able to keep their health insurance for the first year following the birth of their child, instead of losing it at 60 days postpartum.
- Telephone and telehealth visits, which have expanded access for so many, will continue to be reimbursed as a full visit.
- Options for childcare and developmental screening are expanding.
- Washington State, with one of the most notoriously regressive revenue models in the US, is taking steps which to shift some revenue burden from poor families. The Working Families Tax Credit passed with strong support, to address poverty for one in every two children and a bill to improve TANF passed.
- The vape tax and measures to prohibit flavored nicotine products did not pass this year, but the coalition is strong and our voices are growing. We’ll get it next year.
Congratulations to all of us, and thanks. We did it together. Each of you. During a time of existential dread and fear and illness. Every pediatrician, pediatric provider and WCAAP staff member and volunteer. Legislators all across Washington State. Just in case your family or partner forgets to mention it to you…YOU ARE AMAZING! YOU HELPED THOUSANDS AND THOUSANDS OF CHILDREN, ESPECIALLY THOSE WHO MOST NEED IT, ACROSS THE WHOLE STATE. YOU DID THIS AMAZING WORK THROUGH THE DARKNESS OF THE COVID PANDEMIC.
On behalf of the legislative committee and staff, thank you for your incredible work and care.