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AMERICAN ACADEMY OF PEDIATRICS

CHAPTER ANNUAL REPORT

January 1, 2010 – December 31, 2010

10/14/10

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 ahovde@aap.org, with

copies to the respective district chairperson and vice chairperson.

Name of Person(s) Preparing Report: Gary Floyd, MD, FAAP

Chapter: Texas

District: 7

GOALS (30%)

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). See example below and describe

your goals in the shaded template that follows.)

EXAMPLE GOAL: Promote optimal immunization of children (top priority in chapter

strategic plan, adopted March 2007).

MEASURABLE OBJECTIVES:

1) Increase immunization rates of two-year olds in the state from 65% (2005 rate) to 85% by

May 2010.

2) Increase pediatric practices’ participation in the state immunization registry from 150 (number

participating in 2006) to 300 by May 2010.

3) Support 100 of the state’s pediatric practices in implementing a Quality Improvement (QI)

initiative focused on immunizations between September 2007 and May 2010.

ACTIVITIES:

1) Track statewide immunization rates of two year olds.

2) Fulfill contract with state Department of Health and Human Services to carry out an

“academic detailing” and technical assistance program for pediatric practices on immunization

best practices (including training for participation in state registry).

3) Provide workshops on immunization practice at chapter annual meetings.

4) Discuss immunizations at Open Forums and in chapter newsletters, reporting on immunization

rates and level of participation in immunization registry, as well as members’ experience in

addressing barriers and developing strategies to improve immunization practice.

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5) Collaborate with state AHEC system to disseminate and support a QI module on improving

immunization practice.

OUTCOMES/RESULTS:

1) Chapter provided: immunization workshops at annual meetings in 2007, 2008, and 2009;

Open Forum discussion of immunizations in January, 2008 and 2009; 5 newsletter articles on

immunizations, June 2007 & 2009 (2 in fiscal year 2009); 75 office technical assistance visits for

immunization assistance, July 2007-May 2009 (32 in fiscal year 2009).

2) State immunization program chart audits in March 2009 revealed that 83% of children

received the recommended immunizations by 30 months of age. Rates did not vary by race or

ethnicity.

3) The chapter gets participation data from the registry and, as of May 2009, 205 pediatric

practices reported that they are participating in the state immunization registry.

4) As of May 2009, the state AHEC program reported that 35 pediatric practices have completed

an on-line program on immunization QI. The chapter responded to technical assistance requests

from 20 of these practices.

GOAL A:

Lead advocacy and educational activities related to obesity prevention.

MEASURABLE OBJECTIVES (up to 3):

1) Engage in advocacy and educational activities related to nutrition and healthy eating

habits. (Goal #3:Public Health, Obesity Objective A1)

2) Promote the role of physical activities in obesity prevention. (Goal #3: Public Health,

Obesity Objective A2)

3) Expand value and scope of educational opportunities for members. (Goal #4

Organizational Support, Education Objective E1)

ACTIVITIES:

1) Hosted 3 trainings for health care professionals to teach them to be leaders in the

implementation of evidence-based strategies to prevent childhood obesity. The Texas

Chapter was awarded a grant from the National Initiative for Children’s Healthcare

Quality (NICHQ) Be Our Voice campaign to conduct the activity.

2) Secured additional grant dollars to serve as seed money for Be Our Voice participants

to use towards project development.

3) Led obesity prevention-focused policy development for statewide coalition, Partnership

for a Healthy Texas; Conquering Obesity.

4) The chapter submitted a resolution to the AAP for creating a Section on Obesity.

OUTCOMES/RESULTS:

1) The Texas Chapter was one of 8 sites funded to participate in the NICHQ Be Our Voice

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campaign. The project, done in collaboration with the American Academy of Pediatrics,

the California Medical Association Foundation, and the Robert Wood Johnson Center to

Prevent Childhood Obesity, is aimed at engaging and training healthcare professionals

across the nation in the fight against childhood obesity. The goal was for each site to

train 20 healthcare professionals to be leaders in the implementation of evidence-based

community strategies to prevent childhood obesity.

Unlike most other sites that chose a county or region of the state for the focus of their

initiative, TPS defined the targeted community as the entire state of Texas. Recognizing

regional needs and differences, the Texas Be Our Voice team felt it important to offer a

spectrum of community-based advocacy strategies for the trainees to tailor to their

region. TPS therefore conducted three successful, six-hour trainings in Austin,

Harlingen, and Fort Worth from March-May 2010. Through the Texas Be Our Voice

team efforts, 64 healthcare professionals from throughout the state were trained and they

created individual advocacy work plans delineating specific action steps to focus and

begin their efforts in their community. As the first grantee to conduct the training prior

to program initiation at most other sites, Texas was able to share lessons learned and

successful strategies with the other seven Be Our Voice sites.

Opportunities for sustainability of the Texas Be Our Voice training have already become

available, as residency programs both in Austin and Dallas have expressed interest in

incorporating the advocacy curriculum into their pediatric residency programs. First

year residents at Dell Children’s Medical Center in Austin have already received lectures

from the Be Our Voice advocacy training curriculum. Community programs, including

Marathon Kids, are also exploring how to incorporate the Be Our Voice advocacy

training into their initiatives. We anticipate by the completion of the project, numerous

community efforts will be underway to address childhood obesity.

2) Additional funding for the Be Our Voice project was received from the Texas Medical

Association Foundation, which provided seed money to the trainees for their community

advocacy efforts. Eleven grants were awarded in increments up to $500 each to the best

programs to emerge from the training process. In addition, the Texas Be Our Voice team

will accept additional national funding that has become available to develop and create a

sustainability plan for the project after this initial pilot phase is complete.

3) In early 2010, staff from the Texas Chapter was nominated as chair of the Steering

Committee for the Partnership for a Healthy Texas; Conquering Obesity. The

Partnership is comprised of over 40 local and statewide groups focused on developing and

promoting obesity prevention policy. The Partnership serves as the policy arm of obesity

prevention advocacy in Texas.

In March the Partnership membership met to identify priorities and since that time the

Texas Chapter has led the Steering Committee in discussions to further research and fine

tune the issues identified into a list of legislative priorities for 2011. Among the prep

work, the Texas Chapter has hosted 2 briefings for key legislative staff; one focused on

early childhood and another focused on food access that included the State Comptroller,

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Susan Combs, who spoke to the cost of obesity to the state. An additional briefing

targeting parents scheduled to take place in early January. The Texas Chapter is also

assisting with a statewide editorial board tour focused on raising awareness about obesity

advocacy during the next legislative session which begins in January 2011.

Of note, the Partnership, under leadership of the Texas Chapter, was awarded a

Campaign for Healthy Kids grant from Save The Children to conduct both the briefings

and editorial board tour. The dollars ($35,000) come from a collaboration between Save

the Children and the Robert Wood Johnson Foundation to leverage existing advocates

and resources to advance policies to reduce childhood obesity in 15 southern states.

4) As a result of the resolution, the AAP surveyed members to see if they would be

interested in joining a Section on Obesity. Of the 482 people who completed the survey,

453 said they would join the section if one was created. The pre-Provisional Steering

Committee has been working to complete the official application to create a Provisional

Section on Obesity, and plans to be submitting that application by December 31.

GOAL B: Expand immunization education among Texans and preserve immunization

administration as a component of pediatric practice.

MEASURABLE OBJECTIVES (up to 3):

1) Advocate with public and private payers on behalf of members. (Goal #2: Pediatric

Practice – Fair Market Value for Pediatric Services Objective A1)

2) Promote practices and resources designed to improve the current vaccine financing

paradigm and provide support to members for achieving proper payment. (Goal #3:

Public Health, Immunizations Objective C1)

3) Provide education on immunization and infectious disease related topics. (Goal #3

Public Health, Immunizations Objective C3)

ACTIVITIES:

1) Advocated directly with Blue Cross Blue Shield Texas to improve their payment policy

for the enhanced Prevnar vaccine, Prevnar 13, as well as to reconsider their policies

related to vaccine payment methodology as it relates to all vaccines.

2) Provided evidence-based education to Texas pediatricians as well as other health care

providers and community advocates on immunizations and infectious disease related

topics.

3) Expanded a cocooning initiative with the Texas Department of State Health Services,

distributing TPS developed Pertussis brochures, with an emphasis on cocooning, to local health

departments and interested community groups.

OUTCOMES/RESULTS:

1) Blue Cross Blue Shield of Texas increased their rate of payment for Prevnar 13 to

$131.00 effective July 23, 2010. In addition, BCBS TX indicated that they are examining

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the possibility of using the Centers for Disease Control’s single dose list prices as a basis

for payment to avoid this type of problem in the future.

This change in policy came out of months of direct communication with BCBS TX as well

as increasing media pressure leveraged by the Texas Chapter. Several stories about the

problem ran on air as well as in print in large Texas markets such as San Antonio and

Fort Worth. The BCBS TX decision came just hours before an article was set to run in a

statewide publication that is widely read by state legislators.

2) Collaborated with the Texas Immunization Partnership to host the 2010 Texas

Immunization Summit to promote vaccine awareness, discuss the state of immunizations

in Texas, and encourage continued efforts to raise immunization rates in the state among

children and adults. With 240 people in attendance and 21 speakers the Summit was a

great success. The Texas Chapter was integrally involved in the planning and hosting of

the summit from physician involvement to financial contributions.

3) An outbreak of Pertussis in Williamson County, just north of Austin, has resulted in

350 cases in 2010. Leaders within the Texas Chapter took the opportunity to expand

efforts to educate the community about the importance of receiving the Pertussis vaccine

as well as the concept of cocooning. Brochures developed by the Texas Chapter with

grant funding from the Texas Department of Health Services in 2009 were reprinted and

distributed to local health departments across Texas, to the Immunization Partnership

(which has a state reach but is located in Houston) as well as to other interested

community organizations.

The chapter also gave permission to the San Antonio Health Department to add their logo

to the brochure and re-print for a widespread distribution effort they are planning.

GOAL C: TPS will continue to build infrastructure and capacity in the organization to

improve children’s health and support pediatric practice in Texas.

MEASURABLE OBJECTIVES (up to 3):

1) Make improvements to TPS website including updating to a more user-friendly

interface and incorporating the ability to track and analyze site metrics (Goal #4:

Organizational Support, Communications Objective A)

2) Develop new mechanisms to promote interaction between members, committees, and

staff (Goal #4: Organizational Support, Communications Objective A1)

3) Enhance communication utilizing new technologies (Goal #4: Organizational Support,

Communications Objective A2)

ACTIVITIES:

1) Development and implementation of a new website and database.

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2) In 2010, the chapter has employed 2 new mechanisms to engage members through

different media platforms, including the creation of Facebook page and development of a

chapter blog, “TPS Talk”.

3) Implementation of a new mass email solution, Vertical Response.

OUTCOMES/RESULTS:

1) In September of 2010, the chapter launched a new website which is both visually and

technologically superior to our previous site. Along with a new modern look, the site has

been re-organized to offer visitors a user-friendly experience when browsing for

information. The new dynamic website includes a scrolling picture showcase with

important messages on the homepage, a sidebar newsfeed that can be updated with the

latest information, a password protected searchable member directory, and the ability to

directly process payments for events and contributions. The new site also allows staff to

update information and maintain content in an efficient and timely manner.

We also now have the ability to track website metrics through Google analytics; such as

number of unique visitors, hits to each individual page, average time spent on each page,

and a variety of other statistics that will be helpful in evaluating the interests and needs of

our membership and the community.

Since the site launched on September 9, 2010 we’ve had 40,205 page views

from 3,918 absolute unique visitors.

Though the new internal database itself is not accessible to members, the new capabilities

which interface with the website do provide improved functionality and access to

information for members. Enhancements to the member directory (only accessible to

active chapter members) allow easier and expanded search functions. Members are also

able to register for events, pay membership fees, and make contributions to our

foundation online. We also have improved upon our online forms, which allow members

to submit a variety of information to different staff directly through the website.

2) Because members go to a variety of locations to find information, we felt it important

to take advantage of the various means of communication that may engage different

groups. The chapter is now using social media to foster interaction between members and

to disseminate information through different platforms. In addition to promoting

information and discussion in places that members frequent, we felt that utilizing social

media may particularly appeal to our younger members and engage them in chapter

activities in a more meaningful way. Our hope is to use these platforms to communicate

succinct messages, encourage discussion, and help increase chapter visibility.

The chapter Facebook page was created November 18th

, and has a total of 10 followers.

Thus far the 4 posts have produced a total of 245 impressions (# of times updates have

been seen on Facebook).

Since the blog was created on November 17, 2010, there have been 71 views.

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3) Vertical Response, the chapter’s new email system, improves communication for

newsletter and mass emails to entire membership, as well as targeted messages for specific

member groups. Through this service we are able to better quantify interest, which will

help in maximizing efficacy in messages. For example, we are able to track how many

members click a certain link within messages, allowing us to identify areas were

physicians may need more information. This function allows us to better serve the needs

of our membership by tailoring information and education to topics that are most

relevant.

OTHER CHAPTER ACTIVITIES (30%)

PLEASE DO NOT EXCEED 50 WORDS PER TOPIC AREA. 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.

Immunizations: See Goal (specify) No Activity Activity (describe)

+See Goal B.

+The Texas Chapter's Immunization and Infectious Disease Committee led efforts to provide

physician feedback to the State Department of Health Services Immunization Branch as they

applied for and were awarded a grant from the Centers for Disease Control. The grant will allow

DSHS to improve the state's current immunization registry, ImmTrac, by updating the current

infrastucture that hosts the registry as well as allows for electronic (HL7) data reporting. Two

conference calls in addition to attendance at face-to-face meetings have been held.

Mental Health: See Goal (specify) No Activity Activity (describe)

The chapter received grant funding to conduct a program utilizing an online web meeting tool to

connect primary care providers in need of consultation with a child psychiatrist. Sessions are

open to pediatricians seeking consultation as well as those looking to gain insight from case

studies. In addtion to direct case consultation with a sub-specialist, we hoped to provide all

participants with valuable information for future use and the confidence needed to assess similar

situations that may arise in their practice. Thus far we have conducted 3 successful sessions with

over 20 participants.

Oral Health: See Goal (specify) No Activity Activity (describe)

In an attempt to require private insurance companies to reimburse pediatricians to apply fluoride

varnish in the office setting (Texas already covers physician application in Medicaid) the Texas

Chapter has begun to take the initial steps, communicating with the Texas Dental Association to

see if they are willing to support us in this policy change. The issue is seen as a scope expansion

by the dentists but their legislative and executive committees are reviewing the Chapter's

request. Next steps include approaching the Texas Association of Health Plans as well as

regulatory entities.

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Children With Special Health Care

Needs/Foster Care: See Goal (specify) No Activity Activity (describe)

+Based on formal recommendations developed in a chapter sponsored forum, the Department of

State Health Services conducted a survey to assess quality of health care for children with

special health care needs. Results were compared with data from a national survey and presented

to our Children with Disabilities Committee in November for further review. Several areas of

need were identified, and this info will be used to develop initiatives and priorities for CSHCN.

+Child Abuse and Neglect Committee organized a conference call to provide input to state on a

foster care re-design initiative.

Early Brain

Development: See Goal (specify) No Activity Activity (describe)

The chapter held a 4 hour pre-meeting session at our 2010 annual meeting that focused on

aspects of early childhood brain development, including early identification and referral for

suspected developmental delays, assessment and management of autism, and environmental

factors contributing to problem behaviors.

Access: See Goal (specify) No Activity Activity (describe)

+Hosted a webinar provided by Dr. Brendle Glomb, Texas Medicaid Associate Director, to

educate physicians on improved program processes and services, and enable them to utilize

improvements to provide optimal care for pediatric Medicaid patients. The purpose of the

webinar was to promote benefits of the Medicaid program to increase utilization and access to

services.

+Provided testimony on the state's legislative appropriation request, focusing comments on the

adverse impact proposed cuts to funding for key programs would have on children, access to

care, and the overall health of our state.

Quality: See Goal (specify) No Activity Activity (describe)

+Three Texas Chapter representatives serve on the Health and Human Services' Quality Based

Payments Workgroup. The Group, established through legislation in 2009, is charged to

identify, develop and test alternative reimbursement strategies for health care services and

reduce costs. To date, approved projects include reducing birth trauma by focusing on

eliminiating unnecessary elective inductions as well as focusing on asthma payment incentives.

+The Chapter has also developed draft legislation for 2011 focused on an effort to improve rates

of health care worker vaccination.

Child Care Health

and Safety: See Goal (specify) No Activity Activity (describe)

The Texas Chapter has championed early childhood focused obesity prevention measures. To

that end, the Chapter has provided feedback and supported regulatory changes (very near being

finalized) that would require early childcare institutions, licensed by the state, to follow AAP

guidelines limiting screen time. Additionally, Texas Chapter representatives have served on the

Early Childhood Health and Nutriton Council created by the 2009 Legislture. Recommendations

are being finalized but will include implementing current Dietary Guidelines for Americans in

child care setting.

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Child Health Finance: See Goal (specify) No Activity Activity (describe)

Chapter representatives met with staff from the Texas Comptroller’s office to discuss draft rules

related to the methodology and rate of sales taxes on drugs and medical equipment. We

articulated concerns on the public health impact of sales tax on items such as vaccines and the

administrative complexity associated with selectively taxing medical equipment. As a result this

input, some sections of the draft rule were eliminated and other components are undergoing

review – which may prevent price increases to these important medical products and slow the

growth of escalating healthcare costs.

Health Care Equity: See Goal (specify) No Activity Activity (describe)

Chapter members and staff participated in the Integration of Health and Behavioral Health

Workgroup, a stakeholder group established by House Bill 2196 of the 81st Texas Legislature to

recommend best practices in policy, training and service delivery to promote equity in physical

and behavioral health. The workgroup produced a report for the legislature which examines the

interconnectivity of physical and behavioral health conditions, the provision of primary care and

behavioral health services within a collaborative care context, barriers to integration and best

practice strategies.

Medical Home: See Goal (specify) No Activity Activity (describe)

+A representative of the Texas Chapter serves on the Board for the Texas Medical Home

Initiative. The project will attempt to facilitate increased clinical quality and efficiency,

improved patient and physician experience of care, and overall care coordination. The Board

decided to start on a small scale initially and as a result only include children under 18 with

severe asthma will be included along with adults.

+Several chapter members serve on the Department of State Health Services Medical Home

Workgoup which focuses on children with special health care needs and meets quarterly.

Profession of

Pediatrics: See Goal (specify) No Activity Activity (describe)

+The Texas Chapter receives state funding to operate the Primary Care Preceptorship program,

which gives medical students hands-on learning opportunities in pediatric offices. The goal of

the program is to ignite interest in the practice of pediatrics. Of those that participate, a

significant number select pediatrics as their specialty.

+The Chapter spent 2010 promoting a new loan repayment program authorized by the 2009

Legislature that repays loans for physicians serving in a Health Professional Shortage Area up to

$160,000. In 2010, pediatricians accounted for 170 of 718 funding recipients

Adolescent Health: See Goal (specify) No Activity Activity (describe)

The Texas Chapter was featured in the first annual Texas Campagin to Prevent Pregnancy

Conference in late October. The Chapter provided an overview from a physician perspective of

policies that impact teen pregnancy rates in Texas.

Breastfeeding: See Goal (specify) No Activity Activity (describe)

The Be Our Voice Obesity Prevention Advocacy trainings included breastfeeding promotion as

part of the curriculum. As a result, one of the advocacy projects proposed and ultimately funded

by the chapter was to create a "Baby Café' in Hidalgo County. The Baby Café will promote

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breastfeeding to mothers in a community setting, and will give mothers a non-clinical place to

get support for breastfeeding their babies.

Community Outreach: See Goal (specify) No Activity Activity (describe)

+The charitable arm of our chapter, the Texas Pediatric Society Foundation, raises money that

goes to fund community initiatives that make a positive contribution to the health, safety and

welfare of children. In 2010, $29,730 in grant funding was awarded to 13 different programs

which enhance the well-being of Texas children. Programs receiving funding ranged from

physician education efforts to providing direct services for children with special needs. The 2010

Foundation Benefit raised over $40,000 to fund the next round of grant proposals currently under

review.

+See Goal B, Activity 3

Disaster Preparedness: See Goal (specify) No Activity Activity (describe)

Several representatives of the Texas Chapter met with the Litaker Group in spring of 2010 at the

request of the Department of State Health Services to provide insight for an after action report

related to the state's response to the H1N1 pandemic. Meetings took place through the state and

in various formats. The report, which is being finalized, will evaluate and examine the agency's

response. DSHS was the lead response agency to the Novel 2009 H1N1 outbreak.

Early Hearing Detection &

Intervention: See Goal (specify) No Activity Activity (describe)

+Texas Chapter physicians serving on the Medicaid Process Improvement Project workgroup

advocated for separating payment for routine hearing screening from the overall EPSDT exam

payment. The Health and Human Services Commission is currently working on policy to reflect

this recommendation.

+The Chapter has/is advocating for reforms within the Texas newborn hearing screening

program. Several legislative initiatives have been drafted for 2011 and the Texas Chapter’s Fetus

and Newborn Committee is actively reviewing and providing feedback based on legislative

requests.

Health Care Organization

Collaboration: See Goal (specify) No Activity Activity (describe)

+Chapter reviews draft medical policies for BCBSTX

+We are highly involved with healthcare collaboratives and coalitions on issues related to

children’s healthcare and the medical profession as well as on legislative issues. In addition to

working with community organizations and other professional societies, we have increased

participation with state agencies to make the pediatric viewpoint available to policy and advisory

committees, including the Health Information Exchange Committee, Medicaid Process

Improvement Workgroup, Public Health Benefits Review Committee, Taskforce on CSHCN, etc

Increase Chapter Visibility

Expert Recognition: See Goal (specify) No Activity Activity (describe)

+The Child Health Fund hosted their 2010 Annual Meeting in Austin and reached out to the

Texas Chapter to collaborate on hosting a Child Health Forum focused on the impact of health

care reform to Texas. The Texas Chapter helped host the event which included people from

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around the nation and identified speakers which included a member physician as well as

Congressman Lloyd Doggett.

+Additionally, representatives of theTexas Chapter spoke at multiple conferences as well as

Grand Round forums and distributed statewide editorials based on timely topics.

Managed Care

Medicaid: See Goal (specify) No Activity Activity (describe)

Provided input to the Texas Health and Human Services Commission on expanding Medicaid

managed care into regions of the state that currently operate under a fee-for-service model.

Though the expansion is not ideal, the chapter has worked with the state to communicate

concerns with the hope that the transition will be conducted as smoothly as possible.

Obesity: See Goal (specify) No Activity Activity (describe)

+ Please see Goal A

+The Texas Chapter provided guidance and identified speakers for a Houston Obesity Summit in

the summer of 2010 hosted by a state representative that wanted to provide obesity prevention

resources to her constituency.

+The Texas Chapter's Obesity Committee continued to field calls from members and physician

colleagues requesting access to Body Mass Index cards developed along with the Chapter's

Obesity Toolkit.

+Chapter representatives have spoken on behalf of the Partnership for a Healthy Texas to several

Austin-based Foundations interested in obesity prevention work.

Pediatric Councils: See Goal (specify) No Activity Activity (describe)

+Advocated for appropriate payment for Prevnar-13 from BCBSTX (see Goal B, Activity 1).

+Provided input on new BCBSTX initiative, Blue Solutions, which categorizes providers into 2

tiers based on a rating that is derived from a combination of evidence based measures they have

been using and cost efficacy data. Expressed concern to BCBS that of the 2 measures they have

identified, only 50% of pediatricians would have adequate data to be evaluated for the program.

+Collaborated with state medical society on problems in pediatrics to be discussed during bi-

annual meetings with payers.

Practice Management: See Goal (specify) No Activity Activity (describe)

+As part of our annual meeting, the chapter conducts a 2-day conference dedicated to practice

management topics.

+ The chapter is actively working with the state and the Regional Extension Center outreach

program in Texas to promote the adoption and meaningful use of Electronic Medical Records to

our members.

Professional

Education/CME: See Goal (specify) No Activity Activity (describe)

+ The Chapter 2010 Annual Meeting provided 26 hours of CME with 9.5 in ethics credits. The 4

day meeting included 5 sections and served over 375 registrants.

+Our 2010 Annual Leadership Planning Summit provided committee members with the

opportunity to hear presenations on hot topics and engage in discussion around important issues,

such as health reform, H1N1 and workforce issues.

+Provided advocacy presentations to residents and special interest medical students

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+Please see Goal A, Activity 1 and Goal B, Activity 2

Public Education: See Goal (specify) No Activity Activity (describe)

+ See Goals A and C

+The Texas Chapter took on the issue of child abuse in neglect in the summer of 2010 after

complaints were received about a prominent pastor delivering a pro-corporal punishment

sermon. The President-Elect of the Texas Chapter, a certified child abuse physician, wrote an

editorial outlining helpful tips for discipling children. The editorial was picked up by many

papers statewide and came at the critical time when children are home for the summer and in

closer proximity for longer periods with parents or caregivers when tensions may run high.

Public Health: See Goal (specify) No Activity Activity (describe)

+Please see Goal A and B

+ The Texas Chapter participated in the Public Health Coalition, a collection of organizations

that share an interest in advancing core public health principles at the state and local level. The

Coalition's work focuses on cancer, immunizations, tobacco usage, stroke and obesity. In 2010

the Texas Chapter led the Immunization Workgoup in identifying and prioritizing issues for the

2011 Legislature. The Coalition's immunization priorities include issues from data sharing to

registry improvements.

Reach Out and Read

Literacy: See Goal (specify) No Activity Activity (describe)

The chapter Committee on Parenting has developed a short survey to assess the level of

participation in Reach Out and Read, and what resources may be necessary to further encourage

use of the program. The survey has been approved by the board for distribution to our

membership.

Smoking Cessation: See Goal (specify) No Activity Activity (describe)

+The Texas Chapter belongs to Smoke Free Texas, a coalition that supports a smoke-free indoor

workplace law. The Coalition has developed priorities and will again support a Smoke Free

Texas during the 2011 Legislature.

+The Chapter is championing legislative efforts that would increase the age required to purchase

tobacco to 19. We also promote smoking cessation policy through the Texas Public Health

Coalition, which will be focused on these and other interventions.

+ As part of a campaign to promote smoking cessation, the chapter included a large poster

display at our 2010 annual meeting.

Other(s). Advocacy

Please specify.

+The Texas Chapter collaborated with Dell Children's Medical Center in 2010 to participate in

the residents' Community Medicine Rotation. The Chapter provided multiple sessions on the

pediatrician's role as an advocate.

+The Chapter also collaborated with its partners in the Primary Care Coalition (Texas Chapter,

Texas Academy of Family Physicians and Texas Chapter of the ACP) to develop several one-

pagers in an attempt to educate lawmakers on issues from scope of practice to graduate medical

education prior the start of the 82nd Legislature.

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+Additionally, the chapter coordinated and presented testimony on many occasions in 2010

related to issues being discussed by legislators in the interim period as well as in support and

opposition to funding proposals being discussed in anticipation of 2011. This testimony

included comments on newborn screening; cuts to key safety net programs related to mental

health, children with special health care needs and immunizations; obesity prevention; school

health programs; H1N1 pandemic response; the state immunization registry; family planning and

women's health programs; and limiting consumption of trans fatty acids.

+Finally, the Texas Chapter collaborated with the Children's Hospital Association of Texas

(CHAT) to host two legislative briefings for key policy staff on childhood cancer and child

abuse and neglect. Texas Chapter physicians spoke as issue area experts during this forum. The

Texas Chapter and CHAT also collaborated to host legislative visits to Medical Child Abuse

Resources and Education System (MEDCARES) sites to promote the great work being done

based in part by state funding appropriated in 2009.

CHAPTER FINANCES (10%)

Please describe your budget process and how it relates to your defined goals (eg. allocation of

your resources based on identified priorities).

The chapter is constantly seeking ways to allocate resources in areas that support our strategic

plan and offer the largest benefit to our membership. The Executive Board reviews and approves

the budget in January and continues to monitor and adjust throughout the year as necessary.

Each year we review the income/expenses from the previous year, evaluate the success of

meeting goals set forth in our strategic plan, and budget based on needs and expectations for the

coming year.

This year, we invested in programs promoting obesity prevention and mental health education –

the two most significant areas of need as identified by our membership on a yearly needs

assessment survey as well as priority areas outlined in our strategic plan. In addition, we have

invested in IT infrastructure that will not only provide our members with value added

information exchange services, but will update antiquated technology and generate a financial

savings to the chapter in the future.

Operating Budget: $650,000 Reserves: $800,000

Total Full Time Staff: 5 Part Time Staff: 0

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

all that apply.

Grants

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

Chapter Continuing Medical Education opportunities

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

Exhibit fees at chapter meetings

Pharmaceutical/corporate contributions

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Personal/individual donations

Private foundation donations

Other(s):

Please specify:

MEMBERSHIP DEVELOPMENT (20%)

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

apply.

Mailings/letters to members and non-members

CME opportunities

General communications (eg, E-mails, Web site, general correspondence)

Personal contact by chapter officers and/or staff

Chapter newsletter

New member information packets

Resident outreach

Membership recruitment campaigns

Participation in advocacy efforts

Chapter membership committee

Recruitment of affiliate members

Member surveys

Other(s):

Please specify:

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, practice owner or employee, or research interests, etc.)

The chapter demonstrates value to our members in a variety of ways. We have 14 active

committees and 2 subcommittees that represent a wide array of topic areas and engage

members in activities specific to their particular interests. We craft educational

opportunities on feedback gathered in a yearly needs assessment to ensure we are

providing information that is relevant to our members.

We publicize education, information, chapter activities and advocacy efforts in our

monthly electronic newsletter, on our website, and through our Facebook page and chapter

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blog.

We employ a variety of methods for recruiting and retaining members including:

+Distribution of membership benefits brochure

+Engaging with medical students and resident programs

+Maintaining our own membership database, where we are able to track lapsed

memberships and document retention efforts.

+Personal outreach from board members to herald the value of membership

+Offering a discounted rate to our annual meeting – which is significantly less than the

non-member fee. This encourages physicians attending the annual meeting to become an

active or associate member because yearly chapter dues plus the discounted meeting rate

equal less than paying the non-member meeting registration rate.

This year we participated with the AAP in a recruitment campaign to all lapsed Fellows &

Specialty Fellows in Texas. Through this effort we offered discounted membership to those

willing to join the chapter to encourage participation.

We strive to provide our members with all the resources and information they need to be

successful, and make our staff and leadership readily available to respond to the questions,

issues, and needs of our membership.

PLEASE DO NOT EXCEED 50 WORDS PER CATEGORY. Please briefly describe your

chapter’s recruitment activities, if any, related to the following member types in the space

provided below.

Medical students +To encourage participation in the chapter, we reduced membership dues for medical students from

$25 to $15 this year. Through an AAP funded grant, we were also able to waive registration fees to our

annual meeting for students. As a result of the free registration and special program designed for

students, we had our largest attendance ever - with 35 participants.

+Students involved in our preceptor program, a 4-week hands on learning experience in a pediatric

practice, have their chapter dues paid for as part of the program. The program saw a 21% increase this

year, with 115 participants.

Residents

+The chapter was successful in advocating that the 2nd

largest residency program in the state

reimburse residents for their TPS membership dues.

+We created a new quiz competition for residency programs as part of our annual meeting,

which will further engage resident members in chapter activities.

+The chapter has a resident member of our board and due to the great interest in this position,

this year the chapter created a an Executive Resident Planning Committee comprised of 5

residents as well as the resident board representative.

Young Physicians

+To ensure needs of this group are being represented, this year the chapter added a voting young

physician position to our executive board.

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+The chapter also hosted a reception and business meeting for Young Physicians at our annual

meeting this year, and conducted a CME session specifically designed for this group: The Best

You Can Be: Quality Improvement in Primary Care.

Medical subspecialists

+The chapter engages subspecialists by recruiting them as speakers for our annual conference.

Many of the educational sessions we provide at our conference have a subspecialty focus, and

provide a good opportunity for subspecialists to interact with members in primary care and share

their expertise.

+We also encourage subspecialsts to participate in our committees as subject experts, and have

created several committees which appeal to subspecialists of different kinds, including; Mental

Health, Child Abuse, Emergency Medicine, Hospital Care and Infectious Diseases and

Immunizations.

Surgical specialists

See "Medical subspecialists"

Academicians

Academicians make up a large segment of our membership, and are encouraged to offer their

expertise on both committees and as part of our executive board, as well as through state and

local advisory committees. We strive to ensure there is an adequate balance on our board of

physicians in academics and those in practice.

Seniors

The chapter does specific outreach to physicians who have 20 years of chapter membership and

are nearing their 70th

birthday to let them know that they will be eligible to achieve Life or

Emertis status. Membership in the chapter is free for both life and emeritus physicians.

Underrepresented and Minority Physicians

Other

The Texas chapter also has an "Office Managers Section", which is a value added service we

provide for our physician members. Office staff of any physician member are able to become

members of the chapter free of charge, which entitles them to the same benefits of all our active

members. Because of the education and information we provide on practice management issues,

as well as the discounted meeting fees for members, some physicians will become members so

office managers are able to take advantage of membership priveleges.

CHAPTER ADMINISTRATION/STRUCTURE/GOVERNANCE (10%)

Do you have a strategic plan? Yes No

If yes, when was it last reviewed? July 2009

Do you use the balanced scorecard? Yes No

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Date your bylaws were last reviewed: November 2010

PLEASE DO NOT EXCEED 50 WORDS PER ACTIVITY. Of the following choices, please

describe what activities, if any, your chapter engages in to support the continued growth and

development of its leadership and staff.

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Implementation of Pediatric Leadership Alliance principles

Mentor program

+The chapter administers a preceptorship program, which gives medical students interested in

pediatrics the opportunity to participate in a 4-week hands on learning experience in a pediatric

clinical setting. The goal of the program is to promote interest in the profession of pediatrics

through this practical mentoring.

+Each of our committees has an appointed co-chair to foster leadership opportunities for

younger physicians.

Succession plan

Our chapter has a unique structure, which fosters leadership opportunities and advancement at a

variety of levels. Because of the size of our chapter and the great amount of work being done in

our state, we have both AAP chapter representatives as well as state leadership positions – which

allows us to focus efforts at both the state and national level while cultivating strong leaders. We

have an internal President, President-Elect and Immediate Past President which change yearly.

Our AAP Vice-Chair and Chairperson representatives rotate every 3 years, which allows for an

individual to move through the full cycle of internal leadership positions before moving on to

become an AAP representative. We feel this helps to distribute workload and facilitate a great

learning process for our leadership.

Professional education seminars/teleconferences

+NICHQ Obesity Prevention Advocacy Trainings (see Goal A)

+ The Chapter 2010 Annual Meeting provided 26 hours of CME with 9.5 in ethics credits.

+Each spring we have an Annual Leadership Planning Summit, which offers sessions on hot

topics to our committee members. This year we focused on healthcare reform and scope of

practice issues.

+Co-sponsored The 2010 Immunization Summit and organized a panel for the Child Health

Fund policy forum

+Hosted a webinar on Medicaid program initiatives

+Sponsored 3 sessions that offered mental health consultation and education for primary care

providers

Sponsor attendance at AAP national leadership conferences

This year we provided full funding to send:

3 members + 1 staff person to the AAP Advocacy Summit

1 member + 1 staff person to the AAP ALF

2 members + 2 staff persons to the District Meeting

Support membership in professional organizations

+Recommend candidates for membership of state medical association committees and councils

+Delegate and alternate representatives to the Texas Medical Association House of Delegates on

our board

+Support chapter members in pursuit of appointment to AAP committees and councils

Other(s)

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SUMMARY

In 250 words or less, please summarize why your chapter should be chosen as an outstanding

chapter (include specifics, such as accomplishments and challenges that you faced).

The mission of the Texas Chapter of the AAP (also called the Texas Pediatric Society or TPS) 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

fulfilling and economically viable. Our annual report highlights the efforts of our five dedicated

staff members and our over 3,000 members to further our strategic plan goals which are to

enhance children’s access to healthcare, enhance the pediatric practice environment, further

public health initiatives, and improve our organizational support.

Our report details some of our Chapter’s successes and some of our ongoing efforts and

challenges. Hopefully, it also provides evidence of our concerted efforts through our fourteen

committees to not only collaborate with multiple state agencies and coalitions, but also to

become the sought after expert source for any and all types of issues that impact children’s

healthcare and the practice of pediatrics in our state. Through our enhanced communication

capabilities, information can be available with a key-stroke to assist a private practitioner with a

clinical issue or an academician with an esoteric research interest, and provide both physicians

with information on available best practices. With the right information and readily available

collaboration with colleagues, our Chapter enhances our abilities to achieve our goal of ensuring

that all Texas children attain their full potential for physical, emotional, and social health and

well-being.

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.

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Chapter Projects:

NICHQ Team

In 2010 the Texas Chapter was awarded an obesity prevention education/advocacy grant from

NICHQ (National Initiative for Children’s Healthcare Quality). The grant was spearheaded by a

team of five energetic and collaborative physicians; LeAnn Kridelbaugh, Kimberly Avila

Edwards, Stephen Pont, who are all pediatricians, as well as John Nava, a family physician,

and Jane Grey, a child psychiatrist. Working on this project for an average of 5-hours per week

throughout the year, the members have done an excellent job organizing the 3 training sessions

held in Texas in 2010 as well as tending to the necessary program follow-up. In addition to

staying on top of routine conference calls and reports required by NICHQ, this team has gone

above and beyond by securing an additional grant from the Texas Medical Association

Foundation to fund several of the stellar projects emerging from the training sessions. The

program has interested so many across the state and country that the team spends many hours

educating others about their activities.

Dr. Carl Tapia

Dr. Tapia, himself a young physician (by Texas Chapter definition, physicians under 40 years-

of-age), has spearheaded the Texas Chapter’s effort to build a thriving young physician section.

In collaboration with the Texas Chapter’s Membership Manager, Dr. Tapia has hosted and

facilitated conference calls for young physicians on timely topics as well as led a dedicated

young physician section during the TPS Annual Meeting. His ability to engage his colleagues

has directly contributed to the tremendous growth of the chapter’s young physician section.

Dr. Jason Terk, Dr. Skip Brown, Dr. Jerald Zarin

Drs. Terk, Brown and Zarin were all key communicators in the Chapters efforts to advocate for

fair payment from BCBSTX for pediatric immunizations. Because of their understanding of the

various aspects of vaccine financing, they were well equipped to respond to pediatrician

concerns and advocate on behalf of all chapter members to achieve adequate payment for a new

vaccine product. Their efforts served to promote fair market payment for crucial pediatric

services, benefiting all physicians administering this vaccine as well as the children receiving it.

Individual Projects:

Dr. Susan Penfield

Dr. Penfield retires at the end of the year after a dedicated career in public health at the Texas

Department of State Health Services. As the manager of the Infectious Disease Control Unit, Dr.

Penfield, a member of the Texas Chapter has served for many years as a liaison between the

Department and the Texas Chapter’s Infectious Disease and Immunization Committee. An

invaluable resource, Dr. Penfield has tended to the many issues raised by the Committee over

time including vaccine shortages and payment. She also helped organize and host H1N1-

focused webinars during the peak of the 2009 outbreak. Lastly, she has been instrumental in

overseeing the charting of RSV surveillance in the state, aiding the Committee in providing

evidence-based feedback to the state’s Medicaid program regarding the start and end of the RSV

season in Texas.