Chapter:

                        Rhode Island

District:

                        District I

Name of Person Preparing Report:

Laurey Collins Burris,       Rosalind Vaz, MD

Title:

  Executive Director,              President

Phone, Fax and E-mail:

877.227.7447              401.444.3709(P)

(phone/fax)               401.444.6218 (fax)      

lburris.together.net     rvaz@lifespan.org

Chapter President:

              Rosalind Vaz, MD

Chapter Vice President:

              Richard Smith, MD

Chapter Executive Director:

             Laurey Collins Burris

Other Chapter Officers:

Keivan Ettefagh, MD (secretary/treasurer)

Scott  Berns, David Chronley, Richard Dvorin, John Farley, Laurie Grauel, Richard Greco, Ellen Gurney, William Hollinshead, Carole Jenny, Alessandra Kazura, Louise Kiessling, Elizabeth Lange, Victor Lerish, Edward McGookin, William Oh, Richard Ohnmacht, Georges Peter, Fortunato Procopio, Monica Schaberg, Peter Simon, Andrew Snyder, Thomas Tracy, Jr., Patrick Vivier

Anne McKinnon (Recording Secretary)

Annual Chapter Dues (per member)

$75.00

Annual Income:

$14,790

Annual Expenses:

$12,854

Reserves:

$12,500

Name

Chairperson/Contact Person

Membership

Laurie Grauel, M.D.

Legislative

Victor Lerish, M.D.

Adolescence

Rosalind Vaz, M.D.

Child Abuse and Neglect

Carol Jenny, M.D.

Newsletter

Monica Schaberg, M.D.

Public Relations and Communications/Media

Keivan Ettefagh, M.D.;Andrew Snyder, M.D.

Child Health Financing

David Chronley, M.D.

Children with Disabilities

Monica Schaberg, M.D.

Fetus and Newborn

William Oh, M.D.

Injury and Poison Prevention

Scott Berns, M.D.

Pediatric Emergency Medicine

Scott Berns, M.D.

School Health

Fred Procopio, M.D.

Meetings

William Oh, M.D.,

David Chronley, M.D.

CATCH

Peter Simon, M.D.

Richard Ohnmacht, M.D.

Advocacy

Rosalind Vaz, M.D

Residents

Linda Jacobs, M.D.

Web Site

Andrew Snyder, M.D.

Tobacco and Mental Health

Alessandra Kazura, M.D.

1.To promote the health, socioeconomic and psychological well being of infants, children, adolescents, young adults, and their families within the Chapter area. 2.To promote the scientific, educational, political, economic and socio-cultural aspects of Pediatric medicine. 3.To contribute to the aims and activities of the American Academy of Pediatrics at state and local levels in Rhode Island. 4.To cooperate with organizations of like purpose.

Two general goals of the Chapter are to increase legislative activity and to increase participation in Chapter committees including the Resident's Committee. These goals are related to the specific goals listed below: mental health-to assess and improve the availability of mental health services for children; tobacco-legislative advocacy (appropriate spending of tobacco settlement dollars and prohibition of smoking in child care facilities and restaurants; school health collaboration with the departments of health and education on school health issues; child  abuse- legislative advocacy for children.

Chapter officers from information brought forth by chapter members, community organizations and the Rhode Island Department of Health developed these goals.

The attainment of the goals will be measured in part by legislative participation, committee activity, development of a training program for school physicians, and advances in addressing the mental health crisis for children. 

The Chapter collaborated with the Departments of Health and Education to improve school health programs, to enhance the working relationship between schools and community health providers and to strengthen the role of the school physician. A training program was held for school physicians representing the first time school physicians have ever met or received training. It has been proposed that a school physician have a background in either family medicine or pediatrics. 

Chapter committees have taken a lead in working on several priority issues. Committees have provided testimony for the legislature when appropriate.

New members were recruited via the newsletter. The web site was used to gather input from members.

Chapter members work closely with the State Immunization Program. Through this association Rhode Island became the first state to provide prevnar according to AAP guidelines at no cost using State funds. An additional function was added to KidsNet, the State's immunization registry in place since 1997. Doctors and parents will now be automatically notified of missing immunizations and lead screens.

On behalf of the Chapter, Victor Lerish, David Chronley and Henrietta Leonard convened a meeting attended by more than 150 State leaders (including State Department Directors, mental health workers and others). Data on the availability of mental health services was presented detailing the mental health crisis for children in the State. Progress has been made on this issue, but additional work is needed. This will continue to be a priority area for next year.

Under the leadership of Rosalind Vaz, the residents formed The Pediatric Resident Advocacy Network. The mission is to make children's health advocacy an integral part of training and future professional lives. The Network supports resident based advocacy efforts as well as facilitates resident participation in community advocacy projects in the areas of education, direct service, legislation and public policy.

• The Chapter and the RI Council on Child and Adolescent Psychiatry are collaborating on the production of a resource guide of child psychiatrists in southern New England.

• The Chapter and the RI Council on Child and Adolescent Psychiatry are collaborating on a workshop on psychopharmacology for children and adolescents.

• The Chapter and the RI Council on Child and Adolescent Psychiatry have collaborated on efforts to promote parity in child mental health services, and to call attention to a critical inadequacy in child mental health service resources. This collaboration has included local media appearances from Victor Lerish and Henrietta Leonard.

• David Chronley and Lyman Page continue to work to develop legislation to lower lead poisoning rates by creating safer homes.

• David Chronley, Carol Jenny and Rosalind Vaz successfully lobbied to pass child abuse legislation to protect children from having to visit a documented perpetrator parent. A high profile editorial on this topic was written by doctors Vaz, Chronley and Jenny and was featured in several papers. Rosalind Vaz testified before both the House and Senate on child abuse.  

• Alessandra Kazura represents the RIAAP on the RI Tobacco Leadership committee. This year's issues have included allocation of tobacco settlement dollars, prohibition of smoking in licensed child care facilities and restaurants.

• Chapter Residents Lisa Keswick and Marc Rosenthal testified before the House and Senate Judiciary committees on behalf of the Chapter in an effort to pass bills, which promote the safety of children. They provided testimony on the following bills: increasing background checks on gun purchases, enhancing seatbelt law enforcement, improving protection for child abuse victims and lowering the blood alcohol limit while driving.

• The Rhode Island Chapter continues to work closely with the Rhode Island Department of Health to maintain high levels of immunization.

• Victor Lerish represented the Chapter at a poison control hearing opposing the removal of the Poison Control Center from Rhode Island. He is now on the oversight committee of the Poison Control Center for Rhode Island and Massachusetts located at Children's Hospital in Boston.

• Under the leadership of Alessandra Kazura, the Chapter has taken a lead role in publicizing the crisis in accessing children's mental health services and is working toward both short and long term solutions.

• Fortunato Procopio worked with the Health Department to modify the policies regarding OTC and emergency medications. Rhode Island's school entry immunization regulations now mirror Massachusetts'.  A new school health form was also created.

• Scott Berns is the co-director of the Injury Prevention Center. The mission of the center addresses injury prevention at the grass roots level, including community outreach, research, education and advocacy. Testimony was given to the legislature on the following topics: child safety seats, seat belts and firearm safety.

• Monica Schaberg has formed a committee of community pediatricians to work on the issues facing children with special needs.

• David Chronley, Michael Msall and Monica Schaberg participated in several forums convened by the Department of Health to develop a mission statement for children with special health care needs.

• The Chapter's advocacy committee chaired by Rosalind Vaz is a joint Committee with the Department of Pediatrics at Hasbro Hospital and Brown. Dr. Vaz surveyed hospital based and community pediatricians for advocacy opportunities for residents, some of which are already being implemented.

Arlet Kurkchubasche participated in the Million-Mom March and was a keynote speaker for the rally that was held within Rhode Island.

Thomas Tracy has been to the State Capital several times throughout the year to advocate for Pediatric injury prevention.

• Louise Kiessling represents the Chapter and the pediatric community on the Rhode Island Medical Society Council, which brings together representatives from all the specialty societies in the state. The Council meetings provide a forum at which our voice can be heard, whether it is on managed care issues or speaking out on behalf of children's issues. This also allows us to tap into the Society's lobbying abilities, insuring that input is generally sought from Chapter leadership on bills that would impact on child health.

• Victor Lerish, Richard Smith, Ellen Gurney, and James Monti represent the Chapter on the Primary Care Physicians Advisory Committee for the State Health Department. The committee speaks out for the primary care needs of the under served and uninsured in the State, and has been able to act as a sentinel for the Director of the Department of Health, increasing awareness of problems with health care delivery in RI. The committee is addressing the following issues: access to pediatric sub-specialty services for Medicaid Managed Care at Rhode Island Hospital, the effect of insurer rate reduction on access, and access to mental health services for children. The Chapter gathered information on mental health access for the Director of the Department of Health.

The Chapter has a relationship with Rhode Island Kids Count, a child advocacy organization and the Rhode Island Medical Society. Chapter fellows are called to testify on a regular basis and many committees monitor specific pieces of legislation. The Pediatric Resident Advocacy Network (see description above) also actively responds to legislation. Laureen D'Ambra, Child Advocate for the State of Rhode Island attended a Board meeting to discuss current legislation.

At the time of the writing of this report the legislative session was still in progress. The child abuse legislation passed, however the following are some of the pieces of legislation still being monitored: trigger locks and weapon purchase waiting period, tobacco settlement spending, prohibition of smoking in restaurants and child care facilities, and termination of parental rights.

• The Chapter's Pediatric Update and Annual Meeting was held jointly in October with Brown University School of Medicine - Department of Pediatrics, Rhode Island Hospital and Lifespan. Seminar topics included international adoption, seizure treatment, folate therapy, pediatric dermatology, bacterial resistance, exercise intolerance and pediatric cardiac surgery. The Chapter presented awards to Senator John Chafee and Senator Thomas Izzo for their outstanding leadership and commitment to improve the lives of children. Jackie Noyes was the Chapter's guest speaker.

• The Rhode Island Hospital Department of Pediatrics and the Chapter held a Spring meeting in April. Neal Halsey from Johns Hopkins University presented on Lyme Disease and Vaccine for Children.

• Rosalind Vaz was on the planning committee of the school physician training (see details on training above). Keivan Ettefagh and Laurey Collins Burris assisted in the planning of the conference.

• Fortunato Procopio and Laurey Collins Burris attend the Chapter Advocacy Summit in Denver.

• Alessandra Kazura , Anthony Alario and Julie Boergers (child psychologist) gave a pediatric Grand Rounds in February on smoking cessation strategies for adolescents and parents.

• Andrew Snyder created and regularly updates the Rhode Island Chapter Web site.

• The chapter is supporting the Third Annual Northeast Child Maltreatment conference. Carol Jenny was the Chapter representative on the planning committee.

• CATCH co-chairs, Peter Simon and Richard Ohnmacht held a technical assistance meeting for those interested in applying for a CATCH grant.

• Once each month, Richard Smith is a guest speaker on "Landmark News", a weekly radio program. Recent topics have included asthma, obesity, violence, immunizations and the recognition and management of childhood illnesses.

•  Several pediatric residents presented public education talks on bike safety and helmet use.

• Keivan Ettefagh presented a Media Literacy Slide show to the PTO and a parent's group.

• Keivan Ettefagh did the TAR WARS program at the Portsmouth Middle School. Dr. Ettefagh also developed a Power Point Slide Show for anyone to use in TAR WARS presentations.  It is available for downloading from the Chapter web site.

• David Bourassa serves on Connecting For Children, a community task group that addresses safety issues including supplying and educating on correct use of car seats.

• Jeanne Ziter presented parent education seminars on a variety of pediatric issues.

• Rosalind Vaz was on the planning committee for the conference, "Adolescent Mental health and School success", a conference for teachers and school personnel.

• Scott Berns is working on a project that looks at team performance in an effort to prevent medical errors. He is doing a retrospective chart review looking for error chains. This work has been published in the Annals of Emergency Medicine.

• Shelly Miyamoto, a second year pediatric resident from Brown University and Rosalind Vaz presented, "Pediatric Resident Advocacy Network" at the APA/SPR/AAP meetings in Boston in May 2000.

• Katie Walsh, a second year pediatric resident at Brown University and Judy Owens presented the results of a resident advocacy needs assessment survey at the APA regional meeting in Vermont during the Spring of 2000.

• Alessandra Kazura received a K award from AACAP/NIDA to support clinical research and career development in the area of family influences on child and adolescent tobacco use.

• Alessandra Kazura, Anthony Alario, Suzanne Riggs and Patrick Vivier, are co-Investigators on a NIDA funded grant, which is testing smoking prevention counseling strategies in a pediatric clinic (Raymond Niaura, Ph.D., Principal Investigator).

• Patrick Vivier is researching immunization rates for Medicaid.

• Rosalind Vaz serves on the School Based Health Center Director's (Department of Health) Advisory Group. This provides guidance to schools and committees on the design and management of school-based health centers.

• Chapter Residents participated in Tar Wars, an anti-smoking curriculum co-sponsored by the Chapter, the RI Medical Society and the RIAAFP. This involves two teaching sessions to fifth graders, educating them about the dangers of tobacco use and the media's role in promoting its use.

• Richard Smith serves as a medical consultant to the Woonsocket Head Start.

• The residents are a driving force behind the Chapter's community outreach and advocacy projects. They created the Sail Away program. Several times throughout the summer, children with chronic illnesses and their siblings go sailing for a day with residents.

• Keivan Ettefagh participated in the local Shriner's Children's Orthopedic Screening clinic in Newport held in May at the Newport Hospital.

• Keivan Ettefagh is a member of the Project Head Start Health and Nutrition Advisory Committee.

• Anne Mc Kinnon received the Star Award in recognition of her seven years in the RI Safekids coalition (four on the executive board).

• Richard Smith is a Medical consultant to the Woonsocket Head Start program. He is also on the board of directors of the Woonsocket YMCA.

• Lynn Smith participated in childbirth education classes at Landmark Medical Center.

• Sixty Brown Medical School graduates attended a reception organized by Victor Lerish at the Washington AAP meeting.

• Georges Peter invited Dr. Joel Alpert and Tim Mooney from Senator Chafee's office to the June 2000 Board meeting to discuss Universal Health Insurance.

• Richard Smith participated in efforts to provide pediatric subspecialty services in his local community.

• Rosalind Vaz is on the Advisory Board to Covering Kids, a Robert Wood Johnson grant to find children who are eligible for health care coverage.

• Monica Schaberg serves as a member of the United Health Care of New England's Patient safety Initiative Steering Committee. The committee will focus finding ways to reduce errors and improve patient safety.

• Chapter Fellows serve on Blue Cross, United Health Plan, and Neighborhood Health Plan Advisory Committees. Meetings are held quarterly. Fellows have played a key role advising the plans of new AAP policies, guidelines, and immunization updates.

• Chapter pediatric residents and faculty developed a successful CATCH proposal to collaborate with community based pediatricians and other community mentors on projects to advocate for children.

• Stanley Block received a Healthy Tomorrows Partnership for Children grant called "Environmental Health Action Project" to address the issues of severe asthmatics.

• Keivan Ettefagh received a CATCH grant from the AAP to assess the Medical Home in Newport County, with the goal of identifying and eliminating the barriers that prevent every child from having a medical home. The team is broad based with representation from many groups, individuals and agencies, both civilian and Navy!

• Keivan Ettefagh is the Chair of the Newport Hospital Department of Pediatrics.

• Andrew Snyder is the medical director for Ocean State Kids Coalition. The RIAAP is a major partner of the coalition.  OSKids is helping bridge the digital divide for low-income, high-risk, and/or children with special needs and disabilities and their families.  OSKids is in the development stage for a statewide system of computer acquisition, refurbishment, and distribution to these families. OSKids will provide teaching, including one-on-one instruction of how to access the internet. OSKids will also provide an internet home (www.oskids.org) which will serve as a pediatric hub of information and access to pediatric state and community agencies.  Parents and providers will be able to obtain current and accurate parenting and health information, engage in discussions groups on special needs and issues.

• Georges Peter co-chairs and Richard Smith is the RIAAP representative to a new advisory group formed by the health department to evaluate any potential partnership, consider scientific validity, community safety, and family and professional acceptability regarding a meningococcal meningitis vaccine.

• Rosalind Vaz serves on a committee for the Adolescent and Young Adult Unit in the Division of Family Health to focus on medical issues as they relate to adolescents and young adults.

•The Division of Pediatric Surgery has collaborated regionally with other Pediatric components of the Lifespan Health System and the Women & Infant’s Network to bring about a complete health system for antenatal evaluation for fetal abnormalities and management of therapeutic systems.

The Executive Committee meets every other month.

Fall Meeting

October 22, 2000

CME, Annual Meeting

Providence

130

Spring Meeting

April 26, 2000

CME

Providence

85

There is no formal orientation although we attempt to involve new officers

and executive board members early on in National AAP sponsored activities

such as the Legislative Conference and Media Matters.

The Board encourages fellows to attend national AAP meetings, committee meetings and to apply for national committee membership. Financial support is provided to the extent that Chapter funds allow. Residents are not charged to attend the Fall and Spring Chapter meetings. The Chapter pays for a resident to attend the legislative conference.

The treasurer oversees the financial management of the Chapter. The treasurer submits financial reports to the Board. The Board makes financial decisions.

Our varied CME meetings bring together pediatricians together from across the state.

We are cross-referencing the AAP membership and the Pediatric Staff directory at Hasbro Children's Hospital (the most extensive listing of pediatricians in the state) to identify potential new members. The CME meetings and the Chapter's legislative activities have encouraged

pediatricians to join the Chapter.

Members are provided with a variety of ways to be involved in chapter activities. Members with a particular interest area are personally recruited to participated on committees (this was also done through our newsletter again this year with success) and/or work on time limited projects or one time requests (calling a legislator).          

The web site has provided a way to communicate with members and solicit input on a regular basis as well as provide time sensitive information to the membership for action.

There are two active medical sub specialists on the Board in psychiatry and surgery. Alessandra Kazura serves as a liaison from the American Academy of Child and Adolescent Psychiatry to the AAP Committee on Bioethics. She also serves on the AACAP Task Force on Ethical Issues in Child Mental Health Research.

The Board informed Chapter members of the opportunity to serve on AAP committees and then supported the following applications: Francois Luks for the Committee on the Fetus and Newborn, Pamela High for the Committee on Early Childhood Adoption and Dependent Care and Carol Jenny for the Committee on Child Abuse and Neglect.

The Board encourages subspecialty members to present information and issues at Board meetings.

The executive board was constituted to bring together pediatricians from varied practice settings (HMO, urban health center, suburban practice, and hospital practice) as well as academic pediatricians, health department pediatricians and senior members.

Both pediatricians new to practice and emeritus fellows are members of the Board and serve as a link to similar members.

Residents are active members of the Chapter. Residents at Hasbro Children's Hospital are automatically members of the Chapter. A resident is a member of the Executive Board. Residents are encouraged to attend national AAP meetings.

Alessandra Kazura for her work on tobacco and mental health issues; Fortunato Procopio for his work on school health; Andrew Snyder for the design and maintenance of the Chapter web site and his work to help bridge the digital divide; Shelly Miyamoto for her part in organizing The Pediatric Resident Advocacy Network, and as vice-president of the RIAAP resident section; Keivan Ettefagh for his commitment to public education with the development of the Tar Wars power point presentation and his many Media Maters presentations.

Governor Lincoln Almond signed a proclamation declaring October Child Health Month in Rhode Island. Richard Smith talked about inhalant use on his radio show.

Chapter Excellence Award

Scott Berns was appointed by the White house to serve in the 2000-2001 class of White House Fellows.

Jackie Noyes presented Christy Ferguson(from the Rhode Island Department of Human Services) with an award from the Academy for advocacy for children. Francois Luks was awarded the outstanding “Teacher of the Year” by the Department of Surgery for his academic teaching efforts in Pediatric Surgery. Francois Luks and Thomas Tracy were selected to participate in a National Institute of Health sponsored conference on the fetus to take place in Belgium in September. They will present individual areas of expertise in congenital diaphragmatic hernia and fetal intervention. Conrad Wesselhoeft was awarded a Brown University Teaching Recognition Award for 30 years of teaching excellence.

Distinguished Service Award to Past Co-Presidents: David Chronley and Victor Lerish. Chapter recognition awards: Andrew Snyder for his work on the Chapter website, Lyman Page for his work on lead poisoning, Fred Procopio for his work on school health. Awards were also presented to Senator John Chafee, and State Senator Thomas Izzo for their work on children's issues.

Our success as a chapter is due in large part to the smallness of our state, which facilitates communications between pediatricians. There is a strong allegiance to our one academic medical center and a longstanding history of effective networking between the Chapter and RI Dept. of Health, RI Dept. of Children Youth and Families, Dept. of Human Services, RI Medical Society, other child advocacy groups. Chapter successes include successful lobbying for child abuse legislation, a graduated licensing bill and a school breakfast program, completion of a chapter web site, a highly informative newsletter, resident and fellow involvement in advocacy activities, and continued outstanding and well attended CME meetings among other accomplishments.

Under the leadership of Rosalind Vaz, M.D., the residents formed The Pediatric Resident Advocacy Network. The mission is to make children's health advocacy an integral part of training and future professional lives. The Network supports resident based advocacy efforts as well as facilitates resident participation in community advocacy projects in the areas of education, direct service, legislation and public policy.

E-mail address for the Network: pediadvocacy@lifespan .org

Contact: Rosalind Vaz, M.D.

              401.444.3709(Phone)

              401.444.6218 (fax)      

              rvaz@lifespan.org

Keivan Ettefagh developed a Power Point Slide Show for anyone to use in TAR WARS presentations.  It is available for downloading from the Chapter web site, www.riaap.com.

Contact: Keivan Ettefagh

401.847.2290 Ext.237 (phone)

401.849.86 (Fax)

ettefaghke@prodigy.net