by Alyson Sulaski Wyckoff • Associate Editor
Sandra G. Hassink, M.D.,
M.S., FAAP, was at home when
the call came in from AAP President Thomas McInerny, M.D.,
FAAP, that she was just elected
the next AAP president-elect. To
ensure she wasn’t dreaming, Dr.
Hassink asked Dr. McInerny to
repeat the news. Then she asked
him to email it to her.
Dr. Hassink, of Wilmington, Del., ran against
Thomas W. Tryon, M.D., M.B.A., FAAP, of Kansas
City, Mo. She follows James M. Perrin, M.D., FAAP,
of Boston, who assumed the office of AAP president
When Dr. Hassink becomes president on Jan. 1,
2015, she plans to take the AAP Agenda for Children
and “make it a national priority.” The agenda consists
of tackling poverty and child health, epigenetics,
early brain and child development, and children
It’s a tall order, but Dr. Hassink is undaunted.
“This is about raising the flag that what we do today
impacts children for the rest of their lives,” she said.
“We don’t have a minute to waste to start helping
children be healthier.”
A former chair of AAP District III and past pres-
ident of the Delaware Chapter, Dr. Hassink has held
leadership roles in the Academy for more than two
decades. She is an expert on childhood obesity and
on the staff at Nemours/Alfred I. duPont Hospital
Voting was held from Oct. 25 through Nov. 25,
allowing the candidates to make presentations during
the AAP National Conference & Exhibition in late
October in Orlando, Fla. Listen to Dr. Hassink’s
speech at http://bit.ly/1hP6z2X.
Voters also approved two membership-related
amendments to the AAP bylaws. The category of
resident member now will include international pediatric residents and surgical residents, and senior members will include Emeritus Fellows and Retired
Physicians often unaware
that Medicaid patients qualify
for home care services
by Douglas McNeal, M.D., FAAP, and
Jerie Beth Karkos, M.D., FAAP
Home-based services provided by a private duty nurse
or a personal care aide for children covered by Medicaid often are underutilized because physicians aren’t
aware that these services are mandated under the
Early and Periodic Screening, Diagnosis and Treatment (EPSDT) program.
Many private insurance policies do not cover private duty nursing and those that do usually have a
lifetime limit. Personal care aides usually are not covered by private insurance. However, both of these
services are mandated under the EPSDT program
for those 0-21 years of age based on a child’s medical
needs and the family’s ability to care for the child. In
addition, federal courts have upheld EPSDT mandates for these services.
One major reason for the dearth or significant
delay in prescribing these much-needed services for
families is that clinicians have poor awareness and
understanding of the program, including the differences in service eligibility for those covered by the
Medicaid EPSDT program and Medicaid programs
that serve adults.
Under federal law, EPSDT programs are required
to provide all medically necessary services to “correct
or ameliorate physical and mental illnesses and conditions” discovered in Medicaid-eligible children by
routine screening regardless of whether such services
are covered under the state Medicaid plan for adults
ages 21 and over ( 42 U.S.C. § 1396d(r)( 5)).
Because Medicaid is a federal program administered
by states, uniform access to EPSDT mandated home-based services has been blocked by state-specific interpretation of medical necessity. While states must
report their performance in meeting EPSDT mandates yearly to the Centers for Medicare & Medicaid
Services (CMS), there is no specific tracking of home-care service provision. Therefore, a key way to ensure
states fulfill their obligations to children under
EPSDT are due process rights and protections,
including the right to a state hearing before an impartial decision-maker.
Focus On Subspecialties
Raw milk risks examined
A new AAP policy statement reviews the
health hazards of consuming unpasteurized
animal milk and milk products. Children, in
particular, are more prone to illness from contaminated raw milk products. Page 17
See Election, page 19
See Home care, page 4
Volume 35 • Number 1 • January 2014
In this issue
Members approve 2 bylaw changes
Dr. Hassink elected 2015 AAP president
How are respiratory viruses transmitted?
by H. Cody Meissner, M.D., FAAP
Three major routes for transmission of respiratory viruses are recognized.
This understanding forms the basis for infection control recommendations.
Match the route of transmission in column 1 with the characteristics
of that route in column 2.
Routes of transmission Characteristics
1. Small particle aerosol a. close contact required
2. Large particle droplet b. direct contact with
aerosol infectious secretions secretions
3. Self-inoculation with c. capable of distant
contaminated secretions spread
See Answers and more, page 4