Minutes

Dr. Andy Kairalla, President, called the meeting to order at 3:30 p.m. Attendees are listed on the attachment.

II Approval of Minutes

Dr. Kairalla presented the minutes of the previous annual business meeting of September 1, 2000 and the boards teleconference meeting of January 11, 2001. These minutes were approved as recorded.

Financial Report

Dr. Michael McMahan, Secretary-Treasurer, reported the YTD financial report of the Society. The account balance as of 1/1/01 was $17,720.43. Income since January has consisted of $1,200 from membership dues, $4,250 in corporate sponsorship by Mead Johnson and $2000 in corporate sponsorship by Ross. This has resulted in a total income to date of $25,170.43. Total expenses to date are $3,812.55 leaving a balance of $21,357.88. Projected income from membership dues is $5,150 and estimated expenses for the annual meeting are $3,777.57. Dr. Kairalla noted that the Society is accumulating a sizeable bankroll and suggested that we should begin considering how to best utilize the financial resources of the Society.

Membership Report

Dr. Mark Hudak, president-elect, reviewed the efforts of the society over the last 3 years to identify who the Neonatologists are in the State of Florida. An attempt has been made to approach each identified Neonatologist either by mail or hand delivery of a membership packet by a Mead Johnson representative. This year the Society has 105 members, 46 of whom have paid their dues. According to Dr. Duara, Past-President, there are 200 – 230 board certified or eligible Neonatologists in the State of Florida.

Legislative Report

Dr. McCarthy’s report was given by phone. Dr. McCarthy noted that given the current state of the economy and the threats to the tourist industry in our State, this will be a difficult year to find the money for any new projects.

Legislative Issues

The Florida Pediatric Society had requested that Medicaid reimbursements for pediatric physicians be increased to Medicare levels last session. Only a slight increase was obtained. Dr. Bowers added that this was still a major priority of the society, but was unsure how this would change given the recent events and there economic impact on the State of Florida.

The March of Dimes is supporting the expansion of the Birth Defects registry, changing it from passive to active surveillance. To accomplish this statewide would cost approximately 4 million dollars. The March of Dimes felt that this was probably not feasible so they are proposing an incremental expansion that would start with active surveillance in 5 of the larger counties. Around $800,000 would be required this year. A letter of support form the Society would be appreciated by the March of Dimes. Dr. Hudak and others had a number of questions regarding the data that is being collected and how good it is. The Society elected to hold off on a letter of support until more information can be obtained. Dr. McCarthy will a obtain a copy of the March of Dimes proposal and forward it to Dr. Kairalla

A more controversial issue that the March of Dimes is supporting is the expansion of newborn screening tests. Nationally, the March of Dimes is proposing an expansion to test around 28 separate diseases. Locally, the proposal is to add Biotinidase Deficiency, Maple Syrup Urine Disease and Homocystinuria to the current screening tests. Dr. Hudak asked if this was the consensus of the expert panel. He thought that that panel had suggested the addition of 7 tests including cystic fibrosis. Dr. Bowers noted that in the CMS budget they are proposing the addition of 7 new tests to the current 5. It was suggested that the Society find out what CMS is proposing and proceed carefully with recommendations. It was also noted that for approximately $25 the parents can submit a specimen to a lab and have over 30 different diseases screened.

FSN supported a coalition to protect health care access because of cuts proposed by the Governor, the cuts were defeated.

AHCA Issues

Pediatric standards are currently in the rulemaking process and should be out soon. Dr. Meadows, the Secretary of AHCA, seems to be in favor of them and plans a news conference when they are released as we will be the first state to release pediatric standards.

Neonatal standards are under development. The next meeting is scheduled for October 2.

Dr. Meadows has given permission for the development of standards for pediatric cardiology and pediatric organ transplant.

The Herpes Practice Parameter / guidelines was discussed. There was a motion to post these guidelines with references on the web-site. The motion was passed.

Education Report

In Dr. Stern’s absence, Dr. Kairalla presented the education report:

Mead Johnson is sponsoring the annual dinner lecture by Dr. Alfonso.

Neonotes are being e-mailed to all members on a monthly basis. There is a web site to discuss these notes and all were encouraged to do so. Dr. Kairalla was acknowledged and praised for his effort in putting these notes together.

Dr. Alfonso’s textbook on CD was provided to members last year, an update is coming out.

Educational links have been added to the Society’s website (fsneo.org, Username: member, Password: fsneo). Examples: Cedar Sinai web site with 400 neonatal topics, University of Alabama web-site with "canned" lectures and Natlu. The link for the Cochran Reviews will be added. Dr. Kairalla requested that if members have suggestions for additional links they e-mail him.

There was a discussion of sharing photographs, pathology and X-rays of patients on the web-site as an educational resource. There may be a legal issue with respect to consent and release forms for any photograph that has an identifiable patient.

FMA Report

Dr. Duara, Past-President FSN, presented the FMA report:

A meeting was held yesterday. Dr. Duara noted that there is a need to plan ahead for legislative sessions as the agenda has been set for 2002.

Priorities for the FMA: (1) an increase in physician Medicaid reimbursement for patients 0 – 21 years of age. (2) TORT reform is becoming a more important issue for physicians. There are many complaints about the cost of malpractice insurance. There also are many issues being raised about the NICAD. The idea of a catastrophic relief fund for all was raised rather than just protecting Obstetricians. (3) Limiting the scope of practice, for example: PRNP’s are asking to prescribe controlled substances. The FMA is opposing this. (4) Physicians feel strongly that they should have the right to choose their 1^st assistant. Some surgeons are finding the hospitals assigning non-physicians as their 1^st assistant. (5) Expert witness testimony is being looked at. The FMA is working on guidelines that may include a requirement that the Board of Medicine certify an expert. The expert would be required to be trained and certified in the discipline that they are testifying, be experienced in caring for patients with similar problems, and be actively treating patients in the same discipline within the last five years. The testimony of an expert would be subject to review that could result in revocation of their certificate.

AAP Report:

Dr. Kairalla presented the AAP report for Dr. Chandler:

New Pediatric-coding manual for 2002 is due out by the end of the year. Lots of changes. One of the major changes that will hopefully will make it is a 992XX code that will cover babies from 1500 – 255 grams. There are some new transport codes, one for supervising a transport and one for attending a transport. There is a new code for work performed by the same group at two different hospitals.

District X of the Perinatal Section is a newly formed district that includes Florida. Dr. Wally Carlo is the head of that section. The two representatives from Florida are Dr. Chandler and Dr. Duara. Bylaws have been written and should be sent to us soon. The next District X meeting should be May 16 – 19, 2002.

Discussion of Future Meetings:

It was noted that attendance at the annual meeting has been limited. This may be in part due to the inability to have a meeting that is a convenient location for the entire state. Dr. Bowers suggested that we should consider changing our meeting to co-ordinate with the Florida Pediatric Society (June 22 – 24 in Orlando) instead of the Florida Medical Association. This might make the FSN meeting more attractive to attend.

Old Business

Neonatal Outcomes Data Collection

Dr. Duara not available for discussion, but this is not likely to proceed, as the state would not back this initiative.

RSV Registry

The Bureau of Epidemiology is performing data collection. Graphs are sent out and updated weekly. Dr. Hudak briefly addressed the cost effectiveness of RSV prophylaxis.

Adjournment

The meeting was adjourned at approximately 17:00 for social hour, dinner and a presentation by Dr. Alfonso.

Respectfully submitted,