RDASH 2008 Pictures

RDASH 2008 Organizers

Dr. Katie Zuckerman greeting RDASH attendee
Dr. Katie Brigham

Drs. Anna Rosenquist (left) and Alenka Zeman
(right) welcome the RDASH attendees and
explain the schedule of events

RDASH was attended by nearly 70
residents and fellows

Practice 101: Prearing to Meet the Legislators

Meeting with Donna, a staffer for Senator
Petrucelli

An Act Relative to Children’s Mental Health, S.2518

It was a Friday night, and I was partway through my shift on the inpatient pediatric unit at the MassGeneral Hospital for Children when I got the call:“We have a 15 year old female we’re admitting to you after a suicide attempt.She’s medically stable, but we can’t find a psychiatric bed for her.”Mary, as I’ll call her, had spent the past four days in the emergency room while numerous psychiatrists and case managers scrambled to get her admitted to a psychiatric facility that would be covered by her insurance.By Friday evening, the emergency room staff decided that they were unlikely to find a bed over the weekend, so Mary was admitted to the pediatric floor for monitoring and observation while the hunt for psychiatric placement continued.

When I finally met her late that Friday night, it had been more than 4 days since her suicide attempt, and she and her family looked exhausted.As I interviewed them, I learned that Mary had been feeling depressed for over a year.Her family had been aware that Mary seemed down, but did not understand the extent of her depression.She had not received any outpatient treatment because it was not covered by her insurance.It was frustrating and sad to watch the story unfold and realize that this could have been caught much earlier.It was even more frustrating to not be able to get Mary the treatment she needed in a timely fashion.

It is because of my experience with patients like Mary that I have become involved in pediatric advocacy.As a new pediatrician, much of my time is spent learning the intricacies of the body, and I am only now realizing that I must begin to understand the intricacies of politics as well.Children cannot speak for themselves and so pediatricians must speak for them.Through the MassGeneral Hospital for Children Advocacy Group, I have recently become aware of a bill currently under consideration: “An Act Relative to Children’s Mental Health, S.2518.”

This bill dates back to a 2002 class action lawsuit, Rosie D vs. Romney, which was filed on behalf of eight children with serious psychiatric problems who were unable to obtain services at home.The lawsuit claimed that the Commonwealth violated the Early Periodic Screening, Diagnosis and Treatment (EPSDT) program of the Medicaid Act which is designed to assure availability and accessibility of health care resources for low-income children.The trial began in 2005 and involved more than 30 witnesses over 6 weeks testifying about the need for home-based services and the harm that occurs when these services are not available.

In early 2006, Judge Michael Ponsor ruled in favor of the plaintiffs and went on to say that Massachusetts did not provide adequate screening, in-home behavioral and crisis services, case management and care coordination for an estimated 15,000 children with serious emotional disturbances.This landmark decision resulted in a flurry of activity to remedy the situation.After 2 years of work and numerous revisions, “An Act Relative to Children’s Mental Health” is currently under review.This bill would improve and expand mental health services for children in Massachusetts by mandating early screening for behavioral health problems, ensuring children are treated in the most appropriate setting, improving insurance coverage and broadening delivery of state services.

On April 8^th, I and other pediatricians from across Massachusetts gathered at the Statehouse to advocate for this bill and others like it.Residents and Fellows Day at the State House is organized by the residents at MassGeneral Hospital for Children and sponsored by the Massachusetts Chapter of the American Academy of Pediatrics.This event is an opportunity for new pediatricians to gather at the State House for lobbying workshops from leaders in the field, learn about pediatric-relevant bills currently undergoing review, and meet with their own legislators.

Politicians need to hear from parents and pediatricians about the importance of bill S.2518.If you’re interested in supporting this bill, please find your elected officials at http://www.wheredoivotema.com/bal/myelectioninfo.phpTo contact them, please visit http://www.mass.gov/legis/memmenu.htm.Hopefully through our joint efforts, other families will not have to experience a suicide attempt, 4 days in the emergency room and 2 days admitted to the hospital in order to get their daughter the help that she needs.

Modified press release

Here’s another version of the press release, this one focuses on the school nutrition bill:

Young Pediatricians Advocate to Reduce Childhood Obesity

Boston, MA – On April 8, 2008, over sixty pediatricians in training will be gathered at the Massachusetts State House to advocate for children’s healthcare at the third annual Pediatric Residents and Fellows Day at the State House.On the top of their agenda will be a school nutrition bill (H. 4376) that the doctors hope will reduce the epidemic of childhood obesity in Massachusetts.

Dr. Emily Kung, one of the event’s organizers, says that pediatricians feel the impact of increased childhood obesity in their daily practice.In Massachusetts, 29% of children and 55% of adults are overweight or obese.She feels that the obesity problem stems from unhealthy environmental influences.“At my pediatric clinic in Chelsea, I have seen many recent immigrants from Central and Southern America become overweight or obese within a few months of arriving in this country.The abundance of cheap, often unhealthy food in this country contributes to this epidemic of obesity.”

Dr. Alenka Zeman, a pediatrician at MassGeneral Hospital for Children adds, “The school system is an important area where policy makers can hope to improve childhood nutrition.Although we can’t always control what foods children eat at home, we can control what our government serves them at school.”

The bill that the doctors are supporting (H. 4376) will mandate replacing sodas in school vending machines with healthier beverages.In addition, it will improve standards for fat and sugar in school meals, and provide more fresh fruits and vegetables in school lunches.“We feel that these changes have the potential to make a big impact on the long-term health of children,” says Dr. Zeman.The pediatricians want schools to set a healthy example for their students.

The third annual Residents Day at the State House is sponsored by the Massachusetts Chapter of the American Academy of Pediatrics.Pediatricians from all over the state will be in attendance.”Children can’t vote, so they are often overlooked in the legislative process. We as pediatricians must speak for them,” Zeman states.

Getting the press involved

Hi there.  My name’s Catherine, and I’m one of the interns who’s been involved in helping organize RDASH.  One of my tasks has been to get the word out to the press so that even more people can become informed about the bills we support and about pediatric advocacy in general.

Thankfully, I’ve had a lot of help from the public affairs office at MGH.  Thanks to them, we’ve sent a press release to the Boston Globe, Boston Herald, Boston Metro, Beacon Hill Times, and channels 4, 5, 7, Fox 25 and NECN.  Very exciting.  Here’s the press release:

Boston, MA – On April 8, 2008, over sixty pediatricians in training will be gathered at the State House to advocate for children’s healthcare. Children’s mental health, childhood obesity, and booster seat legislation will top the agenda of the 3rd annual Residents Day at the State House, sponsored by the Massachusetts Chapter of the American Academy of Pediatrics.  Residents and other pediatricians from all over the Commonwealth will hear from speakers such as Dr. Jack Shonkoff, Director of the Center on the Developing Child at Harvard University, and John McDonough, D.P.H., former State Representative and current Executive Director of Health Care For All, who will lead these young physicians in bringing their patients’ needs to the forefront of the legislative agenda.   “Children can’t vote, so they are often overlooked in the legislative process. We as pediatricians must speak for them,” asserts Massachusetts General Hospital for Children (MGHfC) resident Anna Rosenquist, who helps organize the annual event. She will be joined by residents and other physicians from Baystate Medical Center, Children’s Hospital Boston, MGHfC, Tufts-New England Medical Center, and UMass Memorial Children’s Medical Center.  The event will familiarize these child health experts with the legislative process and connect them with their legislators during afternoon meetings. The event will be held from 9am to 4pm on Tuesday, April 8th in the Great Hall at the Massachusetts State House.

School Nutrition Bill

One of the issues we are focusing on at this year’s Day at the State House is childhood obesity. Every medical student has seen the infamous slides documenting the alarming rise in adult obesity rates over the past few decades (http://www.cdc.gov/nccdphp/dnpa/obesity/trend/maps/), but it wasn’t until I became a resident and started following patients in my own pediatric clinic that I realized the extent of the effect of the environment on childhood obesity. At my clinic in Chelsea, I have seen countless recent immigrants from Central and Southern America become overweight or obese within a few months of arriving in this country. These are not children that are undernourished in when they arrive-they start out around the 50th percentile and proceed to have nearly vertical weight-for-age growth curves. The abundance of cheap, often unhealthy food in this country, while a sign of our prosperity, also contributes to this epidemic of obesity.

One important venue where we can intervene in this epidemic is the school system. We need to educate children about nutrition and set a good example by offering them healthy food choices while they are in school. The Massachusetts state legislature is now considering a school nutrition bill, H.4376. This bill will ensure that food choices in school cafeterias and vending machines are consistent with current, evidence based guidelines for nutrition.

I am excited to have the opportunity to speak to legislators about this bill, because I believe it will have a lasting, positive impact on the children in my clinic, and across the state!

-Emily Kung, MD

Mental Health Bill

I’m one of the pediatric residents at Mass General working on the mental health bill currently winding its way through the MA legislature. This bill aims to really highlight and hopefully help fix a key problem in our society – the mental health of our young.

Recently it seems that our pediatric medical wards have been filled with young children and teenagers awaiting placement in a mental health facility. It fills hospital beds needed by other patients and more importantly delays their own treatment since all we essentially do is babysit them after they’ve been medically cleared.

This bill will hopefully streamline services, increase insurance coverage, and really make someone accountable for making mental health services available for our young. I’m very excited that we’re supporting it and hope that it will pass this year. What do you guys think?

Thanks! Robin

RSVP for RDASH2008!

Hi, my name is Miranda Ip, and I’m a PGY1 at MassGeneral Hospital for Children.  I’ve been keeping tally on the number of folks who have RSVP’d for our April 8th event at the State House, and the count today is 73, which is fantastic!

While the deadline to RSVP was last week, if you’re just finding out from your residency program/scheduling-powers-that-be that you might have some free time, please let us know so that we can make room for you at our event!

Pediatric Residents Day at the State House

Here at the MassGeneral Hospital for Children, we are all getting excited about the upcoming event “Residents’ Day at the State House”.  It is amazing that this event is already in it’s third year!  The planning for the first event in 2006 seems so fresh in our minds, and yet it also feels as if it has always been an MGHfC flagship event, as it so epitomizes the ethos of our department.

In 2005 and 2006 an energetic and motivated group of pediatric residents got together in their “spare” time (when not working every fourth night overnight and 12 hour days in between) and designed this advocacy event from the ground up.  A few of us on the faculty lent support, but there was never a  moment when this wasn’t 100% a resident initiated and driven event.  That fact is what makes this such a very special project.

Three years in, we again anticipate a landmark event.  Pediatric residents and fellows from all 5 of the Massachusetts pediatric residency programs (MGH, Tufts, UMass, Baystate and Boston Combined) will congregate at the State House on April 8th.  They will spend the morning with amazing lifelong child advocates who will inspire while giving them practical skills for lobbying on behalf of children.  After a networking lunch (both breakfast and lunch are free for all participants thanks to the fundraising by the residents and the generosity of some of the participating residency programs and matching funds from the Mass Chapter of the AAP), all of the participants will head off to pre-scheduled meetings with their state representatives.  The residents will lobby on issues such as the booster seat law–Massachusetts woefully lags most of the nation by not having a law on the books enforcing the AAP and National Highway and Transportation Safety Administration’s recommendation for booster seats for children who are too big for toddler carseats (typically children who weigh more than 40 lbs but are shorter than the 4 ft 9 in height needed to adequately utilize the shoulder safety belt).  The effect of 20 mins of a physician’s time in the office of a legislator describing the children he or she has seen in the PICU after unrestrained MVAs has the chance to really make a difference in passing critical legislation such as this.

Every day I am proud to be a part of the MGHfC community and I relish my role within the pediatric residency.  It is this event, however, which makes me most proud of the residents we train.  Watching these young pediatricians turn months of planning and organizing into a phenomenal program of advocacy education overwhelms me with pride.  We are training an amazing group of dedicated, energetic pediatricians who not only will take excellent care of the children in their offices and hospitals, but will take the extra steps necessary to advocate for children’s health and well being on all levels.   I’m thankful to have the opportunity to work with them.

Shannon Scott-Vernaglia, MD

Associate Residency Director