The winds of change blow TAFP toward prosperous shores in a year to remember. Take a look back at 2007.
By Kate McCann
When TAFP embarked on a new year in January 2007, staff didn’t expect to deviate much from its normal, steady course. But with a stranger-than-usual legislative session and the coming retirement of the Academy’s longtime Executive Director, Jim White, it soon became clear that 2007 would be anything but normal—the year would be about charting change. The Academy rose to the challenge and carried out the normal duties and more, embracing new developments that made 2007 a year of substantial progress.
The 80th Legislative Session kept TAFP’s advocacy staff on their toes, tracking more than 1,000 bills on a variety of issues. With the top priority of ensuring that legislators heard and understood the concerns of family physicians and their patients, TAFP coordinated grassroots activities and collected testimony from family physicians. The major issues in this session included Medicaid and CHIP reform, GME financing, fair contracting with managed care companies, protecting medical liability reforms passed in 2003, and public health initiatives.
From the start, this session differed from any other in Texas history and continued to surprise spectators throughout. It began with a hotly contested Speaker’s race that threw everything into confusion. Shortly after, an executive order from Gov. Rick Perry mandating that all sixth-grade girls receive the human papillomavirus vaccine, a scandal at the Texas Youth Commission and a Health and Human Services announcement that the commission would end its contract with Accenture gave the session all the drama of a daytime television show.
Even though another challenge to Rep. Craddick’s leadership in the final days of the session threatened to un-do much of the Academy’s work, the uproar subsided and many bills of interest to family medicine were on their way to the governor’s desk come sine die.
House Bill 109 by Speaker Pro Tem Sylvester Turner, D-Houston, pulled down many of the enrollment barriers in the Children’s Health Insurance Program erected in 2003 that caused approximately 200,000 children to be dropped from the roles. The new provisions changed the enrollment period from six months back to 12 months for families earning up to 185 percent of the federal poverty level, instituted an electronic income verification mechanism every six months for families above 185 percent of the federal poverty level, eliminated the 90-day waiting period to receive care and instituted a more-reasonable asset test.
The settlement of the class-action lawsuit, Frew v. Hawkins, led to an average 25-percent increase in Medicaid physician payments for pediatric services and an average 10-percent increase for adult services. Senate Bill 10, an omnibus Medicaid reform package by Sen. Jane Nelson, R-Flower Mound, called for a package of changes that will be explored in coming months. Some of those will provide incentives for beneficiaries to adopt preventive health measures, create tailored benefit packages, establish a “multi-share” program to pool state Medicaid dollars with employer and beneficiary contributions, and initiate studies on health savings accounts and the effectiveness of financial incentives.
In the managed care arena, H.B. 522 by Rep. Beverly Woolley, R-Houston, provided a first step toward real-time verification of eligibility and benefits. The bill established a technical advisory committee to determine what information health plans will be required to provide physicians and what kind of technology would best host patients’ information. The bill also established a pilot program to test the technology, beginning as early as May 2008.
Throughout the session, TAFP members played an important part in the advocacy effort by testifying before House and Senate committees, serving as Physicians of the Day in the Capitol Health Clinic, speaking to their legislators through the Key Contacts program, and donating to the TAFP Political Action Committee. TAFPPAC grew to 59 monthly donors in 2007, gathering important funds to prepare for the battles-to-come in the 2008 primary and general elections, and the 81st Legislative Session in 2009.
TAFP Communications spent the 80th Legislative Session in committee hearings and legislators’ offices tracking bills important to family physicians, talking to key lawmakers, and digesting bills’ projected effects, all to provide members informed analyses of legislative action. Accepting the charge as Texas’ only family medicine-centered news source, TAFP ramped up its efforts to bring news straight from the Capitol to members. The communications team began crafting a comprehensive legislative news package, anchored by Capitol Update electronic newsletter and Capitol Report video news Webcast.
Capitol Update and Capitol Report were created to keep TAFP members, lawmakers and their staffs, Capitol and health care reporters, and other health care organizations up-to-date on policy and advocacy issues as they relate to family medicine. Capitol Report also boosted the public image of the Academy and the specialty by putting lawmakers and family physicians in front of the camera to discuss family medicine’s concerns and to pave the way for reform.
TAFP published a series of issue briefs on pressing topics like graduate medical education, CHIP and Medicaid reimbursement, and fair contracting with managed care companies. These built on the 2006 advocacy document “Fractured: The State of Health Care in Texas,” which served as the foundation of TAFP’s legislative platform.
In recognition of the communications effort during the 80th Legislative Session, AAFP awarded Director of Communications Jonathan Nelson and Associate Editor Kate McCann the Leadership in State Government Advocacy award. They accepted the award at AAFP’s State Legislative Conference in Memphis, Tenn.
TAFP presented its four annual symposia around the state in 2007, reaching nearly 900 family physicians and other health professionals. These included TAFP’s 2007 Doctors in Motion in Breckenridge, Colo., the C. Frank Webber Lectureship and Interim Session in Austin, TAFP’s 58th Annual Session and Scientific Assembly in Corpus Christi and the TAFP Primary Care Summit in Houston. Symposia attendees had the opportunity to garner more than 80 CME credits at these conferences, including nearly 20 Evidence-based CME credits. The Education Department coordinated diverse CME programs at the symposia, exploring topics in addiction therapy, thyroid disorders, the HPV vaccine and asthma. Overall, attendees ranked the education at symposia at an average of 4.5 on a 5-point scale. In addition, TAFP offered its first Self-Assessment Module Group Study Workshop to aid ABFM diplomates in achieving certification and re-certification requirements. TAFP’s PrimeCME delivered 81 educational events to more than 1,100 attendees around the state.
TAFP’s newest venture came with the acquisition of the National Procedures Institute. This joint investment by AAFP, TAFP and the Society of Teachers of Family Medicine will provide members valuable practice enhancement techniques while also providing the Academy non-dues revenue. For the past 18 years, NPI has helped more than 45,000 primary care physicians provide quality, cost-effective patient care while broadening the range of services they offer and enhancing their practice revenue. NPI offers more than 100 CME medical seminars annually in cities across the country, covering a full range of office, hospital and emergency room procedures. View the 2008 event schedule and register for upcoming CME conferences on the NPI Web site, www.npinstitute.com.
Leaders and Members
TAFP’s new officers were inducted at this year’s Annual Session. The inductees included: Linda Siy, M.D., president; Robert Youens, M.D., president-elect; Melissa Gerdes, M.D., vice president; Kaparaboyna Ashok Kumar, M.D., treasurer; and I.L. Balkcom, IV, M.D., parliamentarian.
The Academy recognized some of its revered members during the 58th Annual Session. John Richmond, M.D., of Dallas, received the Family Physician of the Year Award; Mathis Blackstock, M.D., of Austin, was recognized as the 2006 Physician Emeritus; Janet Realini, M.D., M.P.H., of San Antonio, won the TAFP Public Health Award; and Mark Chassay, M.D., was awarded the TAFPPAC Award.
Texas was well represented at AAFP’s 2007 conferences. During AAFP’s Annual Leadership Forum in Kansas City, Mo., AAFP awarded Executive Director Jim White the Award of Merit and Executive Service Award, and at AAFP’s 2007 Scientific Assembly in Chicago, Leah Raye Mabry, M.D., of San Antonio was re-elected to the position of vice speaker of the AAFP Congress of Delegates and announced her candidacy for speaker. The speaker election will be held during the 2008 AAFP Scientific Assembly in San Diego, Calif.
As of December 2007, membership in TAFP had increased to 5,001 total members. TAFP attained 100 percent resident enrollment for the 2006-2007 school year and only lacks 13 residents statewide for 100 percent enrollment in 2007. We are confident that the remaining residents will submit applications by March for another year of full participation. Student membership has risen to more than 600 students. At TAFP’s 17th Annual Student and Resident Conference in March, TAFP leaders spoke about the feasibility of starting and maintaining a family medicine practice. The conference included the third TAFP Residency and Procedures Fair with residency programs demonstrating various procedures to students such as joint injections, skin lesion removal, colposcopies, perineal repairs and others.
The generosity of members to the TAFP Foundation has greatly benefited the Foundation’s work. It currently has 58 monthly donors whose contributions go toward research, scholarships and travel funding for medical students and residents. The Foundation added a new donor level this year, the Pioneer level, to recognize the contributions of Leah Raye Mabry, M.D. This year the Foundation awarded more than $20,000 in scholarships and began collecting for the newest TAFP scholarship, the Jim and Karen White Leadership Scholarship.
With the support of a 2006 grant from the Physicians’ Foundation for Health Systems Excellence, the TAFP Foundation is helping 25 small group and solo family physicians implement health information technology into their practices. The goal of the project, “Improving Diabetes Care Through Implementation of HIT in Solo and Small Family Physician Practices,” is to provide small and solo practice family physicians with an online diabetes registry to monitor their diabetic patients and help those patients control their diabetes. TAFP staff visit each practice to train practice staff, set up the registry in their offices and provide continuing support to ensure their success. Michael Parchman, M.D., of San Antonio is serving as principal investigator on the project. The TAFP Foundation will collect data on how the use of this tool impacts the practices and their patients and gather the practices for a discussion of the project’s progress at TAFP’s Interim Session in March 2008.
Back at the Office
The most noticeable change around TAFP headquarters occurred as the occupant of the corner office—Executive Director Jim White—packed up 25 years of memories, and the new executive—Chief Executive Officer and Executive Vice President Tom Banning—moved in. TAFP also welcomed new staff members Juleah Williams, membership coordinator, and Anna Jenkins, director of education, to the team. The transition to new Academy leadership, expansion of the staff, and ideas assembled during the September Strategic Planning meeting all mark a new direction for the organization. The resulting plan developed by the group of TAFP members and staff is detailed in the Strategic Planning re-cap in this issue of TFP.