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​​StateView compiles up-to-date information on state policy trends and resources for chapter advocacy efforts and focuses on important state-level child health advocacy issues, and summarizes valuable resources from the AAP and other public and private sector sources.​​​​​​​​

February 19, 2018: AAP West Virginia Chapter Holds First Advocacy Day
Last week, the AAP West Virginia Chapter visited the state capitol to promote the chapter’s 2018 Legislative Priorities to lawmakers. Included among the priorities is establishing EPSDT or the CHIP benefit package as the state’s benchmark plan for insurers, increasing the tobacco purchase age to 21, responding to the state’s opioid epidemic and protecting the state’s strong school immunizations laws. The chapter also discussed firearm injury prevention and obesity with lawmakers.

In honor of the chapter’s advocacy day coinciding with Valentine’s day, the West Virginia Senate adopted Senate Resolution 40, designating February 14, 2018 as Tiny Hearts Day. The resolution highlights the chapter’s priorities and extends the Senate’s gratitude and appreciation for all the work the chapter does on behalf of all children and families in the state.​

February 15, 2018: American Lung Association State of Tobacco Control 2018
There’s great news in tobacco control—smoking rates by both adolescents and adults have fallen to historic lows—but much more remains to be done to protect children from exposure to tobacco smoke and initiation of use.

State of Tobacco Control 2018, a report from the American Lung Association, grades state progress on several key tobacco control measures. The report highlights where states have made strides in curbing tobacco use, and where additional efforts are required. The overall key findings of the report highlight the uneven progress in policy change to reduce tobacco use, which has left vulnerable populations behind—including low income families, those living in public housing, and LGBTQ individuals.

For more from the AAP on tobacco prevention efforts, see our policy statement Public Policy to Protect Children From Tobacco, Nicotine, and Tobacco Smoke and visit the AAP Julius B. Richmond Center of Excellence. Also see our Tobacco 21 and Electronic Nicotine Delivery Systems (ENDS) State AdvocacyFOCUS resources.​​

February 13, 2018: AAP Washington Chapter Visits Olympia
This month, 85 members of the AAP Washington Chapter (WCAAP) visited the state capitol to advocate for the chapter’s 2018 legislative priorities. Chapter members met with their legislators and discussed increasing Medicaid payments, improving access to behavioral health care, raising the tobacco purchase age to 21, and preventing children’s access to firearms. A new component of the chapter’s advocacy day included inviting legislators to for lunch to lead table group discussions on child health issues. Below, Washington State Senator David Frockt (D-46) leads a discussion with members of the chapter.​

Below, WCAAP members gather on the steps of the capitol.

February 12, 2018: States Consider Banning Tackle Football for Children
As more research about the potential long-term effects of head trauma become available, states have turned their attention to reducing the number of concussions sustained by student athletes. All 50 states and the District of Columbia now have laws that require children suspected of sustaining a concussion during a game or practice to be removed from play and medically cleared prior to returning to play.

Some states are now addressing the sports where children are most likely to sustain concussions. So far this year, Illinois, Maryland, and New York have introduced bills to ban tackle football for children. The Illinois bill would ban tackle football for children younger than the age of 12 and the Maryland and New York bills would prohibit the sport for children younger than 14.

For more information from the AAP on tackle football, see our clinical report Tackling in Youth Football.

February 8, 2018: State Funding of PreK
Over the last 5 years states have increased funding for prekindergarten (PreK) programs by 47%, and 44 state-funded PreK programs now serve nearly 1.5 million children. How States Fund Pre-K: A Primer for Policymakers, a new report from the Education Commission of the States (ECS), examines how states use federal, state, and local funding to provide these programs to young children. Most federal funds come from Head Start, while state funds flow from the state general funds, block grants, or state education funding formulas.

To learn how much funding your state provided to PreK in 2016-17, see the ECS resource, State Pre-K Funding 2016-17 Fiscal Year: Trends and Opportunities.

For more from the AAP on PreK and other early childhood education initiatives, visit the AAP Council on Early Childhood site.​

​​February 6, 2018: Medicaid Managed Care and Social Determinants of Health
State Medicaid programs have several options to modify payment and delivery systems in ways that can impact social health factors to meet the nonclinical needs of Medicaid enrollees. But is this possible now that the clear majority of Medicaid enrollees receive care through managed care organizations (MCOs)? Enabling Sustainable Investment in Social Interventions: A Review of Medicaid Managed Care Rate-Setting Tools, a new publication from the Commonwealth Fund, provides insight into mechanisms available to state Medicaid managed care programs to finance and sustain services addressing social determinants of health. This resource can be helpful to your chapter if your state is examining options to engage or expand Medicaid managed care in social determinants of health efforts.

To learn more about state efforts to address social determinants of health and other system transformation activities, please see the AAP System Transformation page.​

February 5, 2018: Medicaid and CHIP Critical Among Children Ages 3 and Younger
Health Insurance Coverage Among Children Ages 3 and Younger and Their Parents in 2016, a new brief from the Urban Institute, examines 2016 American Community Survey (ACS) data on coverage rates among children age 3 and younger and their parents. Findings show 48.5% of young children were insured by CHIP and Medicaid, while just 3.3% of children aged 3 or younger remained uninsured. The parents of these children were also more likely to be covered by Medicaid than parents of older children.

Coverage rates varied across states, with relation to adoption of Medicaid expansion. Approximately 8.7% of parents of children younger than 3 in expansion states were uninsured, while 18% of parents in nonexpansion states did not have coverage.

For help with your chapter’s Medicaid and CHIP advocacy efforts, contact us at

​February 1, 2018: Banning “Conversion Therapy” for LGBTQ Youth
​​Over 20,000 LGBTQ youth could be subjected to potentially harmful counselling by a licensed health care professional, with another 57,000 at risk of receiving similar treatment from clergy or other spiritual advisors. That is the conclusion of a new report from the Williams Institute on Sexual Orientation and Gender Identity Law and Public Policy at the UCLA Law School. The report cites the recent statewide trend in bans on so-called “conversion therapy”, sometimes referred to by its proponents as “reparative therapy”, which is intended to elicit changes in sexual orientation or gender identity of children and adolescents. AAP policy states that these therapies are not effective, may be harmful to LGBTQ individuals by increasing internalized stigma, distress, and depression, and therefore are never indicated.

Nine (9) states (California, Connecticut, Illinois, Nevada, New Jersey, New Mexico, Oregon, Rhode Island, and Vermont) and the District of Columbia have now banned these practices from being used with children, as have 32 municipalities around the country. AAP chapters have been on the forefront of this issue at the state level, and related legislation introduced in Congress in 2015 was endorsed by the AAP.

For more from the AAP on this issue, see our policy statement Office-Based Care for Lesbian, Gay, Bisexual, Transgender, and Questioning Youth. ​

January 30, 2018: Florida Chapter Joins Children’s Week
The AAP Florida Chapter recently came together with advocates from across the state as part of Children’s Week, to advocate for the health and well-being of Florida’s children. To prepare for meeting with lawmakers, residents took part in a Webinar led by the chapter’s lobbyist and learned more about the chapter’s advocacy priorities, which include immunizations, perinatal mental health, and curbing texting while driving. The following day, residents and chapter leaders attended house and senate committee meetings and met with their representatives and senators to promote the chapter’s advocacy agenda.

Here, chapter leaders, residents, and members of iCAN Florida’s Kids Team gather with Senator Aaron Bean after touring the senate chamber.

January 29, 2018: AAP Kentucky Chapter Advocates for Children
AAP Kentucky Chapter recently joined hundreds of advocates at the state capitol as part of the Kentucky Youth Advocates (KYA) annual Children’s Advocacy Day at the Capitol. The chapter is a partner in the development of the Blueprint for Kentucky’s Children, which prioritizes policies to improve the health and well-being of children.

Chapter leaders met with state lawmakers to promote increasing the state’s tobacco tax, making schools smoke-free, requiring bike helmets for children younger than 12 years of age, and safe disposal of opioids. As the day gets underway, AAP Kentucky Chapter officers (left to right) Past President Kim Boland, MD, FAAP; President Pat Purcell, MD, FAAP; Secretary/Treasurer Jaime Pittenger, MD, FAAP; and Vice President/President Elect Scottie Day, MD, FAAP gather in the capitol.

​January 25, 2018: Roadmap of State Highway Safety Laws
2018 Roadmap of State Highway Safety Laws, a report from Advocates for Highway and Auto Safety, examines laws that dramatically improve highway and auto safety, including child passenger safety, distracted driving, teen driving, impaired driving, and occupant protection. Progress toward achieving these policy goals in each state is also evaluated.

Child passenger safety advocates celebrated multiple victories in 2017. Five states (Connecticut, New York, Oregon, Rhode Island, and South Dakota) enacted rear-facing until age 2 laws; 3 states (Alabama, Iowa, and Texas) upgraded their distracted driving or teen driving laws from secondary to primary enforcement; and North Dakota raised the booster seat requirements to age 8.  

For more from the AAP on these issues, see our State AdvocacyFOCUS resources on Child Passenger Safety, Distracted Driving, and Teen Driving.​

January 23, 2018: AAP 2017 State Advocacy Report
As you prepare for the 2018 state legislative sessions, take time to celebrate the successes you achieved last year by reviewing the AAP 2017 State Advocacy Report, which details 23 significant child health and pediatric practice state policies. Thanks to the dedicated advocacy work of AAP chapters and members, significant achievements have been made across the country to shape the health policy landscape in every state. Your efforts in 2018 to preserve and build on these gains are vital to children’s health and well-being. The State AdvocacyFOCUS resources included in the report are updated regularly and available at Use them to raise awareness about key child health issues with your members, policymakers, and other stakeholders.

We’re here to help you with your state advocacy work! Please contact the AAP State Advocacy team at​

January 22, 2018: Pediatrics Supplement on Tobacco and Secondhand Smoke
Tobacco and Secondhand Smoke, a supplement to the January 2018 edition of Pediatrics explores the role of research and advocacy in protecting children from tobacco and secondhand smoke. Highlighted issues include the impact of smokefree car legislation, the relationship between tobacco control laws and pediatric asthma, and the changes in adult attitudes towards tobacco control laws designed to protect children.  

Although states continue to strengthen laws regulating electronic nicotine device systems (ENDS) and raising the minimum purchase age of tobacco products and ENDS to 21, they still underfund tobacco prevention programs. Last month, the Campaign for Tobacco-Free Kids released its report Broken Promises to Our Children: A State-By-State Look at the 1998 Master Settlement 19 Years Later examining this ongoing policy concern.

For more from the AAP, see our State AdvocacyFOCUS resources Raising the Tobacco and ENDS Purchase Age to 21 and Electronic Nicotine Device Systems ENDS, and our Advocating for Tobacco 21 in Your State Advocacy Infographic.

January 18, 2018: State Use of Accountable Care to Promote Population Health
As the laboratories of health reform, states are continuing their efforts to address factors affecting health that extend beyond clinical care.
State Approaches to Addressing Population Health Through Accountable Health Models, a new brief from the National Academy for State Health Policy (NASHP), examines how 10 states are using accountable care entities to integrate health-related social needs into their health care delivery systems. The resource looks at accountable care alignment with Medicaid, use of value-based payment, multisector measurement, and numerous other features of these transformational efforts. This information can be helpful to other states looking to build on emerging efforts.

For more from the AAP, visit the AAP System Transformation and Practice Transformation pages.​​

January 16, 2018: Almost Half of States Could Exhaust CHIP Funding by March
estimates from the Georgetown Center for Children and Families (CCF) show that 11 states are expected to run out of federal CHIP funds during the month of February, and by March, as many as 24 states could be in shortfall positions. The   continuing resolution (CR) approved by Congress in December 2017 extends $2.85 billion in federal CHIP funding, but also changes how redistributed CHIP funds are awarded. Because of the change, it’s not clear how much of—or even if—redistributed funds will be available to states to continue their programs when they exhaust existing funds.

Congressional inaction has created a dire situation for children, families, and state governments. The AAP continues to call on Congress to take immediate action to extend federal CHIP funding for 5 years. Thank you to all AAP members for your ongoing advocacy to make sure Congress extends CHIP funding—please keep using the CHIP Advocacy Toolkit​ to support your ongoing efforts.​

​January 15, 2018: State Children’s Cabinets | Partners in Advocacy
A new survey from the Forum for Youth Investment (FYI), 2017 State Policy Survey: Child and Youth Coordinating Bodies in the US, examines the structure of state children’s cabinets, state children’s commissions, state early learning advisory councils, and other state youth coordinating bodies; trends in their use of evidence and promotion of equity; and their challenges and accomplishments. These entities are excellent partners for your chapter’s 2018 advocacy work.

To learn how more about how your chapter can and collaborate with existing groups, or for tips on how to launch or reenergize them in you state, please contact the AAP State Advocacy Team at ​

January 11, 2018: Medicaid Expansion States See Fewer Hospital Closures
Hospitals in states that have expanded Medicaid under the Affordable Care Act (ACA) were approximately 6 times less likely to close than those in nonexpansion states, according Understanding The Relationship Between Medicaid Expansions and Hospital Closures, a Health Affairs research article. Hospitals in states that expanded Medicaid also saw more patients that were covered by insurance and provided less free care than they had in the past.

The Rural Health Research Program has identified 83 rural hospital closures since 2010, most of which occurred in nonexpansion states. Rural hospitals, often vulnerable to closure, improved financial performance more than their suburban and urban counterparts. The study also showed that financial improvements for hospitals were greatest in counties that had the highest number of uninsured residents prior to the expansion.

For more on Medicaid expansion from the AAP, please see our State AdvocacyFOCUS resource and State Advocacy Infographics

January 9, 2018: Connect with the AAP State Advocacy Team
2018 is off and running and with the multitude of issues facing state policymakers this year, the AAP State Advocacy Team is ready to support your chapter efforts through consultation, technical assistance, resources, strategy development, and learning and engagement opportunities. In addition, a quick connection to all our resources can be found at

To ensure two-way communication about important state advocacy work, please consider adding us, by using, to your chapter’s state advocacy communications. This can include your advocacy updates, calls to action, meeting information, messages to your chapter legislative or government affairs committees, and anything else related to your chapter’s advocacy efforts. We look forward to an exciting and productive year. Thanks for all you do!​

​​January 8, 2018: Medicaid Payment Increase Improved Pediatrician Participation

A new study demonstrates that pediatricians responded to the Affordable Care Act (ACA) 2013-2014 Medicaid payment increase for primary care services by increasing their participation in the Medicaid program.

Increased Medicaid Payment and Participation by Office-based Primary Care Pediatricians, published in the January 2018 issue of Pediatrics, compared survey data collected during 2011-12 and 2015-16 by the American Academy of Pediatrics (AAP) from state-stratified random samples of over 10,000 pediatrician members. Researchers found that Medicaid participation increased nationally after the increase in Medicaid payment by most indicators. Physicians accepting at least some new patients insured by Medicaid increased 3 percentage points to 77.4%; those accepting all new patients insured by Medicaid increased 5.9 percentage points to 43.3%; those accepting patients at least as often as new privately-insured patients increased 5.7 percentage points to 55.6%. This new research reiterates the important link between appropriate Medicaid payment levels and access to care.

Working on Medicaid payment advocacy in your state? Contact AAP State Advocacy at for assistance.​

January 4, 2018: Prescription Drug Monitoring Program (PDMP) Improvements
To address an increase in opioid overdose deaths, states are
working to improve their Prescription Drug Monitoring Programs (PDMPs). Currently 25 states require physicians to check a PDMP before prescribing opioids, while 14 states and the District of Columbia have PDMPs, but do not require physicians to use them. The National Alliance for Model State Drug Laws provides more information about PMDP requirements by state

Sharon Levy, MD, FAAP, immediate past chair of the AAP Committee on Substance Use and Prevention (COSUP) recently gave the TEDx Beacon Hill Talk: Opioid Addiction is Treatable. Why Aren’t We Doing It? Dr Levy also represents the Academy on the American Medical Association (AMA) Opioid Task Force.

For more from the AAP, see our clinical reports Neonatal Drug Withdrawal and Medication-Assisted Treatment of Adolescents with Opioid Use Disorders

December 5, 2017: Coming Soon: 2018 State Legislative Sessions
With all but 4 states (Montana, Nevada, North Dakota, and Texas) set to convene regular legislative sessions shortly after the start of the new year,
State Net Capitol Journal takes a look at the road ahead and examines some of the priority issues that are likely to rise to the forefront at the state level next year. Leading the list are health care concerns, opioids, marijuana legalization and state preemption of local laws—all issues of concern for AAP chapters.

As we head into the end of 2017, StateView will be taking a short break. The AAP state advocacy team is here to provide you with one-on-one consultation, technical assistance, and strategy guidance as you prepare for 2018—contact us at

We wish you a happy holiday season and a new year filled with peace and happiness, and thank you for all you do to advocate for children in your states. We’ll see you in 2018!

December 4, 2017: Maine’s Vote to Expand Medicaid Revives Debate in Other States
Last month, voters in Maine overwhelmingly voted to expand their Medicaid program. Almost 60% of voters approved a ballot measure that will allow more low-income adults to become eligible for Medicaid under the Affordable Care Act (ACA). While Governor LePage has said he would only implement the measure under specific circumstances, the win has reenergized advocates hoping to do the same in their states.

A 2012 Supreme Court ruling made Medicaid expansion an option for states, and 32 states and the District of Columbia have now chosen to expand their programs. Advocates in states that have not yet expanded coverage such as Idaho, Nebraska, and Utah continue to push for expansion, and are working to put their own ballot initiatives to voters. In Virginia, the election of Governor-Elect Ralph Northam, MD and the flipping of more than a dozen seats in the state’s House of Delegates improve the chances of Medicaid expansion there as well.

For more from the AAP, please see our Expanding Medicaid Matters infographics.

November 30, 2017: Ending the Opioid Epidemic: A Practical Guide for State Policymakers
A guide from the National Center on Addiction and Substance Abuse outlines strategies that state policymakers can enact to prevent opioid misuse and reduce the number of deaths and injuries caused by opioids every year. The guide supports a public health approach to address the opioid epidemic and invest in the implementation of evidence-based substance misuse prevention and treatment initiatives.

Included within the strategies are expanding access to public and private insurance coverage for treatment programs, improving access to medication-assisted treatment programs, and improving prescription drug monitoring programs (PDMPs).

For more from the AAP, see our clinical reports Neonatal Drug Withdrawal and Medication-Assisted of Adolescents with Opioid Use Disorders. The AAP is also a member of the AMA Opioid Task Force.​

November 28, 2017: States Make CHIP Contingency Plans
Nearly 2 months have passed since the federal funding deadline to extend the Children’s Health Insurance Program (CHIP), with October projections indicating that as many as 11 states could run out of CHIP funds by the end of 2017. As states await Congressional action, some are beginning to take steps to address the program’s funding uncertainty. Most recently, West Virginia announced it would be shutting down its CHIP program on February 28, and Colorado and Virginia are beginning to inform families that their programs will end. Oregon, meanwhile, announced it would spend $35 million of state funds to keep the program operational, and Minnesota has tapped its own funds to keep its program running after exhausting leftover funds.

To advocate for an immediate extension of CHIP funding, the AAP is joining other child health advocacy organizations for a CHIP Day of Action Thursday, November 30, 2017. AAP chapters and members are encouraged to participate using the newly updated CHIP Advocacy Toolkit, which contains the latest state of play, talking points, social media messages, graphics, and other helpful resources to help you advocate. ​

November 27, 2017: Vigils Commemorate Sandy Hook Anniversary
As the 5th anniversary of the Newtown, Connecticut elementary school shooting approaches, Moms Demand Action will host over 200 vigils in 40 states from December 2 until December 17, 2017. To find a vigil in your state, consult this list or check the Nationwide Vigils and Events to #EndGunViolence Facebook page.

​​​As you prepare for your 2018 state legislative sessions, our State AdvocacyFOCUS resources on Assault Weapon Bans, Safe Storage of Firearms, and Universal Background Checks for Gun Purchases are available to support your advocacy efforts.

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E-mail your comments and suggestions to the AAP State Advocacy team. Please contact us at 630/626-6240 if you require additional assistance or information.​​​