ARTHRITIS AMBASSADOR PROGRAM

AMBASSADOR BRIEFING 

JUNE 5, 20133PM EASTERN

 

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I. Welcome & Update on April AssignmentLaurie Markle, Grassroots Advocacy Manager

II. Ambassador SpotlightKaren Anderson, California Arthritis Ambassador

III. Issue Expert Training: Pediatric Subspecialty Loan RepaymentJames Baumberger, MPP, American Academy of Pediatrics

IV. June Ambassador Assignment: Ask your Rep. to cosponsor HR 1827Laurie Markle, Grassroots Advocacy Manager

V. Launch of Ambassador Reporting CenterLaurie Markle, Grassroots Advocacy Manager

VI. July Ambassador Call NotificationLaurie Markle, Grassroots Advocacy Manager

AGENDA

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WELCOME AND UPDATE

LAURIE MARKLEManager, Grassroots AdvocacyPublic Health Policy & Advocacy

Arthritis Foundation

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MAY 9TH BRIEFING: ATTENDANCE

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AMBASSADOR SPOTLIGHT

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Karen AndersonGoleta, CA

Arthritis AmbassadorNational Public Policy Committee Member

ISSUE EXPERT TRAINING

JAMES BAUMBERGER, MPPAmerican Academy of Pediatrics

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Pediatric Subspecialty Loan Repayment Program

Ensuring Access to Pediatric Subspecialists

Arthritis Foundation Ambassador Briefing

James D. Baumberger, MPPSenior Policy Associate

Department of Federal AffairsAmerican Academy of Pediatrics

June 5, 2013

• Shortages in many pediatric subspecialties impact access to medical care for children with serious medical conditions

• Pediatric rheumatology is emblematic of this problem

• Financial incentives drive pediatric providers to primary care

Pediatric Subspecialty Shortagesand Access

Wait TimesSpecialty % of

hospitals over 2-week

benchmark

Wait times

(business days)

Wait times

(weeks)

Endocrinology 68% 51.4 10.3

Neurology 61% 47.6 9.5

Gastroenterology

59% 26.5 5.3

Nephrology 52% 33.6 6.7

Developmental Pediatrics

50% 65.7 13.1

Pulmonology 50% 40.7 8.1

Rheumatology 36% 31.9 6.4

Orthopedics 34% 38.2 7.6

Dermatology 32% 66.0 13.2

Urology 30% 35.2 7.0

Reproduced from NACHRI, Pediatric Subspecialty Shortages Affect Access to Care

Difficulty Referring% of Primary Care Pediatricians Reporting

Too Few Subspecialists to Meet the Needs of Patients

Medical Specialty Total (n = 590) Non-rural (n = 514)

Rural (n = 76)

Child/adolescent psychiatry

95.8 95.1 100.0

Developmental peds 86.6 85.9 92.0

Pediatric dermatology 81.6 80.5 89.3

Pediatric rheumatology

68.2 67.3 74.0

Pediatric neurology 66.7 66.1 70.7

Adolescent health 64.2 64.2 64.9

Pediatric endocrinology 58.8 57.2 69.3

Pediatric gastroenterology

54.5 53.8 59.2

Pediatric emergency med 49.2 46.4 68.4

Pediatric nephrology 48.1 46.2 61.3

Pediatric genetics 45.1 45.1 44.7

Pediatric pulmonology 41.7 40.2 52.0

Reproduced from Pletcher et al. Primary care pediatricians' satisfaction with subspecialty care, perceived supply, and barriers to care. The Journal of Pediatrics. 2010;156:1011-1015.

Mean Distance to Care Pediatric Subspecialty:

• Adolescent medicine• Critical care medicine• Developmental pediatrics• Neonatal medicine• Neurodevelopment• Pediatric cardiology• Pediatric endocrinology• Pediatric rheumatology• Pediatric sports medicine• Pediatric nephrology• Pediatric gastroenterology

Distance to Care (miles):

• 42• 26• 44• 15• 73• 22• 26• 60• 78• 36• 32

Myer ML. Are We There Yet? Distance to care and relative supply among pediatric medical subspecialties. Pediatrics. 2006;118:2313-2321.

Percentage of children who must travel > 80 miles to care

Subspecialty:

• Adolescent medicine• Critical care medicine• Developmental pediatrics• Neonatal medicine• Neurodevelopment• Pediatric cardiology• Pediatric heme/onc• Pediatric endocrinology• Pediatric rheumatology• Pediatric sports medicine• Pediatric gastroenterology• Pediatric nephrology

Percentage of U.S. Children: • 19• 7• 20• 4• 26• 7• 8• 11• 24• 30• 12• 16

Myer ML. Are We There Yet? Distance to care and relative supply among pediatric medical subspecialties. Pediatrics. 2006;118:2313-2321. 12

Pediatric Subspecialty Pediatric Subspecialty Loan Repayment ProgramLoan Repayment Program

• Loan repayment of up to $35,000/year for up to 3 years

• For pediatric subspecialists and child mental health providers who agree to practice in underserved areas

• Eligible providers:– (1) those in or entering fellowship training; or– (2) those who completed training after 2010.

• Other details to be determined by Health Resources and Services Administration (HRSA)

Funding Levels

Reauthorization Bill

Authorization Levels

Obstacles• Difficult budget environment• Difficult to reauthorize a program that has yet to be

funded• Original authorization in the Affordable Care Act

Opportunities• Data-driven program based on a real need for sick

children• Not a partisan issue

Advocacy

• Need to raise profile of bill by gaining co-sponsors

• Republican co-sponsors especially important• Reauthorization helps appropriations• Appropriations helps reauthorization

Messages

• Too few subspecialists for children in need of specialty care, particularly in underserved areas

• Access impacted by wait times, distance traveled, etc.

• Student debt deters providers from subspecialty training

• “Straight” reauthorization: no policy changes or authorizing level increases

James D. Baumberger, MPPjbaumberger@aap.org

202.347.8600

JUNE AMBASSADOR ASSIGNMENTAsk your Representative to Cosponsor HR 1827

CALL•Hi XXXX, this is [first name, last name]. I’m calling today about the pediatric subspecialty loan repayment program at HRSA (pronounced “her-sa”)•There are over 300,000 children in America living with Juvenile Arthritis and less than 250 board-certified, practicing pediatric rheumatologists to care for them.•This means delayed diagnoses, increased disability, and greater healthcare costs.•While I am hopeful that the program will be funded in FY 2014, I’m cautiously optimistic and would like to see Rep. XXXX cosponsor HR 1827 to reauthorize the program should it go unfunded.•Thank you for your consideration. I look forward to hearing the Representative’s decision. •I can be reached via email at XXX@XXX.com or via phone at (XXX) XXX-XXXX

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TWO STEPS TO REQUESTING YOUR REP’S SUPPORT:1.Call

2.Email

JUNE AMBASSADOR ASSIGNMENT

TWO STEPS TO REQUESTING YOUR REP’S SUPPORT:1.Call

2.Email

EMAILHi XXXX,I hope you’re well! I’m writing today to follow up on a voicemail I left regarding the reauthorization of the Pediatric Subspecialty Loan Repayment Program.

There are over 300,000 children in America living with Juvenile Arthritis and less than 250 board-certified, practicing pediatric rheumatologists to care for them. This means delayed diagnoses, increased disability, and greater healthcare costs.

I would like to see Rep. XXXX cosponsor HR 1827 to reauthorize the program should it go unfunded in FY 2014.Thank you for your consideration. I look forward to hearing the Representative’s decision.

NameAddressEmailPhone

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Ask your Representative to Cosponsor HR 1827

AMBASSADOR REPORTING CENTERCenter Launch

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www.arthritis.org/report

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Your emailLast name

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Your comments here.

Select: Closed

Select: Current date

**SAVE & CLOSE**

AMBASSADOR REPORTING CENTERCenter Launch

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www.arthritis.org/report

ARTHRITIS AMBASSADOR AWARDS

You’ve out-performed our wildest expectations!

2013 PLATINUM AMBASSADOR STATUS: 100% assignment compliance and reporting October 2012-October 2013. Travel awards may change.

Ambassador awards will change in 2014.

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JULY AMBASSADOR CALL

JULY 10TH @ 3PM EasternPreparing for August Recess: Visiting with your Representative in your

Congressional District during the month of August

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AMBASSADOR BRIEFINGRECAP / ACTION PLAN

NOW: Call your HLA using draft language available at www.arthritis.org/ambassador_assignment.

IN TWO DAYS: If you haven’t heard back, email your HLA with a follow-up.

REPORT: Visit www.arthritis.org/report and enter your email and last name. Submit a report for your activity. Instructions available at www.arthritis.org/ambassador_assignment

SAVE THE DATE: July 10th at 3PM Eastern. We’re prepping for district visits August recess!

IF YOU’RE NEW: Join us at 4PM for the New Ambassador Orientation!

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