The NYSAFP Strives to Improve the Health of Patients, Families and Communities by Serving

“The NYSAFP strives to improve the health of patients, families and communities by serving members of the Academy through education and advocacy.” “The Mission of the American Academy of Family Physicians is to improve the health of patients, families, and communities by serving the needs of members with professionalism and creativity.” Meeting: NYSAFP Advocacy Commission

Date: August 6, 2016

Members Present: David Silverstein, Bill Klepack, Anita Ravi, Marten Peterson, Elizabeth Lynn, Martha Simmons, Philip Kaplan, Howard Lanney, Christine Doucet, Rachelle Brilliant, Padraic Bambrick, Marcy Savage on phone

Members Absent: Theresea Mastronardi, Linda Prine, Michael, Ben Shuham

Agenda Item Discussion Action (assigned to) 1 Approval of Minutes from March 2016 approved without changes. None Minutes 2 Albany Update by Update delivered on legislation that passed both houses as of PB to send Reid, McNally & end of session. Continue to work with coalition to push for legislative Savage Governor to sign step therapy bill. Dr. Klepack noted that language on CME mandates result in redundant unproductive courses and mandatory CME. NYSAFP should push for input on content. Marcy noted that discussions are beginning with partners regarding CME MS/PB to reach courses. Dr. Kaplan recommended a NYSAFP program to out to MSSNY on fulfill the CME. Marcy noted that MSSNY is in that what they are process. developing for CME.

Recommend Education look at creating a CME program that covers these requirements. (Once we have them.)

Lobby DOH to allow specialty developed CME to fulfill requirement. 3 Old Business None

“The NYSAFP strives to improve the health of patients, families and communities by serving members of the Academy through education and advocacy.” “The Mission of the American Academy of Family Physicians is to improve the health of patients, families, and communities by serving the needs of members with professionalism and creativity.” 4 New Business A8650 Paulin / S6835 Lanza – legislation for Identification NYSAFP draft and Assessment of Human Trafficking Victims letter of support for legislation This bill passed both houses and is recommended that NYSAFP support is signage and draft a letter. Ask the Board approve to the Dr. Klepack noted that on the absence of penalties in there is concept and that no compliance. Dr. Ostrander sign the letter.

CONSENT CALENDAR No discussion unless member objects to recommended position below by Chair BILLS FOR DISCUSSION

Discuss NYSAFP position to take (Support, Oppose, No Position)

BILL w/ Sponsor Same As Summary Recommended Position

S4499C Funke A1266C Lavine Relates to licensure of athletic Support but suggest trainers. Would not create a that a physician be new scope of practice. a part of the advisory committee on Athletic Trainers

A10486 None Relates to professional Monitor Rosenthal misconduct of medical professionals

A10532 Glick None Relates to access to patient or Monitor client records in the investigation and prosecution of professional licensing and misconduct proceedings

S8068A None Relates to the establishment of a No position

“The NYSAFP strives to improve the health of patients, families and communities by serving members of the Academy through education and advocacy.” “The Mission of the American Academy of Family Physicians is to improve the health of patients, families, and communities by serving the needs of members with professionalism and creativity.” DeFrancisco state insurance company Any pending advisory board, a state legislation insurance producer advisory regarding insurance board and a state insurance advisory boards adjuster advisory board should include a physician

A10495 Solages S7713 Kennedy Relates to establishing the Support and reach lactation accommodation in out to sponsors public transportation facilities offering assistance. act

A10123 Peoples- None Relates to disclosure of a list of Quiet support Stokes practitioners registered to certify patients for the use of medical marijuana

A7503 Gottfried S5481 Hannon Relates to community Table response to paramedicine services provided bill right now until by emergency medical more background is providers provided and address in the fall. Motion to oppose made by Dr. RMS and Dr. Doucet, seconded by Dr. Lynn Doucet will reach out to sponsors.

a) Resolutions Referred to Advocacy Commission from COD Resolution 2

Increase Access to Comprehensive Reproductive Health Care Services for Incarcerated Women Submitted by: Public Health Commission: Linda Prine, MD

RESOLVED, that the New York State Academy of Family Physicians (NYSAFP) advocate that the standards and recommendations created by the National Commission on Correctional Health

“The NYSAFP strives to improve the health of patients, families and communities by serving members of the Academy through education and advocacy.” “The Mission of the American Academy of Family Physicians is to improve the health of patients, families, and communities by serving the needs of members with professionalism and creativity.” Care on health care for women in jails, prisons, and juvenile detention and confinement facilities be honored in New York State and where their recommendations differ from the United States Preventive Services Task Force guidelines, we support the task force guidelines, and be it further

RESOLVED, that the NYSAFP’s delegates to the AAFP Congress of Delegates present a resolution to the AAFP to support comprehensive and appropriate health care to incarcerated women including but not limited to reproductive health.

Action: Dr. Prine will work to create a letter for DOCCs and others subject to approval by the Board.

Resolution 4

SUBJECT: Oppose Discrimination Against Transgender People PRESENTED BY: Public Health Commission AUTHOR: Linda Prine

RESOLVED, that New York State Academy of Family Physicians (NYSAFP) endorse existing anti- discrimination laws protecting people from discrimination based on gender expression and identity

RESOLVED, that the NYSAFP oppose restroom restrictive laws that compromise the safety and health of transgender people, and be it

RESOLVED, that the NYSAFP supports adding gender expression and gender identity to the protected categories within New York State’s anti-discrimination laws and be it further,

RESOLVED, that the NYSAFP delegates take a resolution to the AAFP Congress of Delegates (COD) asking the AAFP to oppose laws that compromise the safety and health of transgender people.

Action: RMS to look at Governor’s executive order on GENDA and determine if state legislation is needed.

Resolution 9

SUBJECT: Physician Protection Under Single Payer SUBMITTED BY: Andrew Merritt, MD

RESOLVED, that NYSAFP only support single payer models in this state that include protections for practicing physicians from unilateral decisions by the payer, and be it further

“The NYSAFP strives to improve the health of patients, families and communities by serving members of the Academy through education and advocacy.” “The Mission of the American Academy of Family Physicians is to improve the health of patients, families, and communities by serving the needs of members with professionalism and creativity.” RESOLVED, that NYSAFP delegates to AAFP COD seek to incorporate protections for practicing physicians from unilateral decisions by the payer in resolutions regarding single payer brought to AAFP COD.

Discussion: Dr. Klepack notes that Gottfried legislation affords an avenue for physicians to negotiate along with other interested groups but without a single voice a bargaining position may be weakened

Action: We recommend that this resolution go forward as a stand along resolution to AAFP COD.

Resolution 11

The Role of Medically Supervised Safer Injection Facilities as a Harm Reduction Strategy in New York State SUBMITTED BY: Public Health Commission: Ray Harvey, MD & Scott Hartman, MD

RESOLVED, that the New York State Academy of Family Physicians (NYSAFP) will send a letter to the Department of Health supporting a pilot of safe injection facilities in New York State.

Discussion: Ithaca has a program in place. Dr. Doucet suggests maybe there were exchange programs similar during HIV crisis that can be worked off of. NYC is possibly looking at safe injection facilities. Dr. Silverstein suggests that there will be opposition in communities. Dr. Klepack notes that it is still worthy of pushing

Action:. Reach out to allies who have already started these programs. Ask Dr. Harvey and Dr. Hartman to draft a letter to DOH and Heath chairs for board approval supporting these pilot programs.

Resolution 16

SUBJECT: Mandated NYSIIS Reporting for Adult Vaccine Doses PRESENTED BY: Ad Hoc Committee on Vaccine Policy AUTHOR: Phil Kaplan, MD RESOLVED, New York State Academy of Family Physicians (NYSAFP) shall advocate for mandated reporting of adult vaccine doses by all vaccinators in NYS to the NYSIIS or the NYC CIR, which are administered after the effective date of such amendment to law or regulation.

Action: RMS determine if MSSNY opposes. Dr. Duecet to use Suffolk County channels to find out MSSNY position as well any others with MSSNY channels. Adult permission removal prioritized for September 7th MSSNY Legislative Committee

“The NYSAFP strives to improve the health of patients, families and communities by serving members of the Academy through education and advocacy.” “The Mission of the American Academy of Family Physicians is to improve the health of patients, families, and communities by serving the needs of members with professionalism and creativity.”

Resolution on inborn errors of metabolism SUBMITTED BY: Robert J. Ostrander, MD

RESOLVED, that the New York State Academy of Family Physicians (NYSAFP) shall work with legislators to draft and pass legislation mandating insurance coverage not subject to cost sharing for specialized nutritional products used to treat inborn errors of metabolism, and be it further

RESOLVED, that the NYSAFP shall present a resolution to the American Academy of Family Physicians (AAFP) COD that directs the AAFP to advocate with the Department of HHS and members of Congress for the classification of specialized nutritional products for the treatment of inborn errors of metabolism as an essential health benefit under the ACA for individuals of all ages diagnosed with these conditions, and that they be categorized as preventive measures not subject to cost sharing ACTION: Determine other groups working on this issue. Determine if necessary to draft legislation Prioritize for MSSNY House of Delegates.

ACTION: Board Approval of Short List of Priorities for MSSNY (in no order) 1. Insurance coverage for nutritional products for inborn errors of metabolism 2. Support of Paulin/Lanza human trafficking legislation A8650/S6835 (letter to Governor) 3. Remove adult permission requirement to vaccine reporting 4. MSSNY support for specialties to develop CME courses of opioids applicable to their own physicians 5. Promote pilot programs for supervised injection facilities