children for legal services such as a medical-legal
The AAP policy statement Providing Care for
Immigrant, Migrant and Border Children is under
revision and will discuss barriers that immigrant
children and families face in accessing legal services. It will recommend that pediatricians increase
coordination with legal services and medical-legal
partnerships in the community.
The Academy endorsed ( http://bit.ly/2szHySm)
the Fair Day in Court for Kids Act of 2016 (S.
2540), which provides unaccompanied children
with access to counsel throughout their immigration proceedings.
2. Protect Children of Migrants
Calling the separation of migrant families arriving
at the U.S. border “fundamentally un-American and
cruel,” the Academy and 183 other organizations issued a joint letter ( http://bit.ly/2n8x7D9) in March
to Department of Homeland Security Secretary
John Kelly opposing the proposal.
The AAP Council on Community Pediatrics will
continue to educate pediatricians about the impact
of family separation on immigrant children’s health
and well-being through communications, education activities and revisions to the AAP Immigrant
Health Toolkit ( http://bit.ly/1fgRTeB).
3. Response to Executive Order Limiting
Immigration and Entry
The Academy repeatedly has spoken against several federal proposals that would harm immigrant
children and their families.
The Academy responded to President Donald
Trump’s immigrant and refugee-focused executive
orders with a press statement ( http://bit.ly/2rRmq-
Jv) that was picked up by several national news outlets. The Academy also signed a letter (http://bit.
ly/2rICzPo) to President Trump led by the Council
of Medical Specialty Societies expressing concerns
about the refugee and immigrant ban. When the
revised travel ban executive order was released
in March, the Academy again issued a statement
( http://bit.ly/2s0PP4R) denouncing the action.
In March, the Academy issued a statement (http://
bit.ly/2q TBDGF) strongly opposing a Department
of Homeland Security proposal under consideration
by Secretary John Kelly that would separate immigrant mothers from their children when they arrive
at the U.S. border. Later, the Congressional Hispanic Caucus sent a letter ( http://bit.ly/2sdc3QL)
to Secretary Kelly opposing the proposal quoting
the AAP statement.
A plenary session on Sept. 16 at the National
Conference & Exhibition will discuss the impact of
federal immigration policies on children.
4. Improving Mental Health Access for Children
The Academy championed a provision in the
21st Century Cures Act legislation signed into law
in December 2016 that creates a $9 million grant
program modeled after child psychiatry access pro-
grams in more than 30 states. The grants support
the development or improvement of statewide or
regional pediatric mental health care telehealth ac-
cess programs. The Academy also strongly supported
a provision that allows for federal reimbursement of
medical services (such as screening, diagnostic and
treatment services) for children and young adults
receiving inpatient care in Institutions for Mental
Disease beginning in 2019.
The Academy is working with other professional
societies to address children’s access to mental health
care. In December, the AAP-led Child and Adolescent Mental Health coalition sent a letter outlining
mental health priorities to President Trump’s transition team.
The Academy also supports liaisons to American
Academy of Child and Adolescent Psychiatry (
AACAP) committees. The AACAP resource A Guide to
Building Collaborative Mental Health Care Partnerships in Pediatric Primary Care ( http://bit.ly/2s0BY
eJ) provides guidance to child and adolescent psychiatrists on working with primary care clinicians.
5. Advocate for Epinephrine Supply in Schools
to Serve Entire School Population
The AAP Council on School Health
(COSH) worked with
several AAP departments to promote
federal and state advocacy efforts supporting
access to “stock” epinephrine in schools.
COSH representatives worked with the National
Association of School Nurses and National Association of State School Nurse Consultants to develop policies and protocols to help ensure the timely
treatment of anaphylaxis in schools.
The Academy supports chapter efforts to address
the rising cost of epinephrine auto-injectors. Potential state strategies include advocating for legislation
to require greater cost transparency of prescription
drug pricing and requesting a state commission or
state attorney general investigation of prescription
COSH and the Section on Allergy and Immunology developed Managing Allergy & Anaphylaxis
in the Pediatric Clinic and Beyond, a web-based
learning experience addressing the management of
allergies and anaphylaxis in the clinical, early care
and education, and school settings.
6. Not One More Child Should Die in a Dental
Chair: Remembering Caleb
The AAP clinical report Guidelines for Monitoring
and Management of Pediatric Patients Before, During,
and After Sedation for Diagnostic and Therapeutic
Procedures: Update 2016 ( http://bit.ly/2s1inev)
recommends against the single dental operator-an-
esthesia model. The second person should be an
independently qualified and licensed professional,
who possesses advanced airway skills consistent with
the AAP/American Academy of Pediatric Dentistry
(AAPD) guidelines. Some dental providers are as-
signing their dental assistant the task of monitoring
the sedated patient. However, dental assistants in
many states are not required to have a high school
diploma, even if they take a Pediatric Advanced Life
Support course. They simply do not have the train-
ing necessary to provide the appropriate standard of
care that pediatric patients require while sedated for
The AAP Division of State Government Affairs
can assist chapters with state advocacy consistent
with AAP/AAPD guidelines.
7. Endorsing Evidence-Based Firearm Policy
and Policy-Informed Research
The Academy has long-standing policy supporting
advocacy to reduce the toll of gun violence on children. The policy Firearm-Related Injuries Affecting
the Pediatric Population ( http://bit.ly/1RDYRLz)
supports funding for research related to the prevention of firearm injuries, including surveillance
through the National Violent Death Reporting
System; accurate evaluation of health care-based
screening and intervention; and local, regional and
national efforts to identify and disseminate violence
The Academy has consistently advocated for
elimination of restrictions on Centers for Disease
Control and Prevention (CDC) gun violence prevention research. In April, the Academy renewed its
endorsement of legislation to provide the CDC with
$10 million for gun violence prevention research.
The Academy has advocated for federal evidence-based policies to reduce access to firearms
for those most at risk of perpetrating gun violence,
including more effective and comprehensive background checks, banning assault weapons and large
capacity magazines, and reducing the number of
straw purchases of firearms for those who are prohibited from purchasing them. The Academy has
supported several legislative efforts to enact these
Chapters also have encouraged states to support firearms research and data collection activities
( http://bit.ly/2q TMsZh). Through the Periodic
Survey of Fellows, the Academy assesses members’
experiences with treating gun injuries, counseling
practices and views on gun injury prevention strategies and policies.
8. Calling for Statement from National Leaders
Against Hate and Discrimination
In December, the Academy wrote to first lady
Melania Trump ( http://bit.ly/2q TNqEW), offering its assistance on her cyberbullying initiative. The
Academy has requested a meeting with the first lady
to discuss her goals for children.
In February, the Academy voiced strong opposition ( http://bit.ly/2rIHTCe) to guidance issued
by the Trump administration, no longer requiring
public schools to allow transgender students to use
restrooms corresponding with their gender identity.
The Academy was an anchor organization on an
amicus brief ( http://bit.ly/2rR9fs0) in conjunction
with other leading medical organizations supporting
protections for transgender students in Gloucester
County School Board v. G.G. The Supreme Court
case would have decided whether the Obama-era
guidance was lawful and, more broadly, whether Title IX antidiscrimination provisions apply to gender
identity. In light of the Trump administration guid-