Lily J. Lou, MD, FAAP 

Dear All, 

I am primarily writing to you today about advocacy — the importance of using our expertise and trusted voices to improve healthcare for newborns and their families by speaking up about the laws and policies that govern their care. Although most all of us have demanding full-time jobs, I believe it is also our obligation, part of our professionalism, to go one step further and use our hard-earned knowledge and insight to advocate on behalf of our patients and families and for our profession. While we can tremendously impact the well-being of one baby at a time through our clinical care in the NICU, we can influence health legislation in ways that improve the plight of many babies at once, helping our lawmakers understand sound health policy. The SONPM includes advocacy as one of its strategic domains and prioritizes an approach that streamlines such activity by providing tools, training, and resources to make it easy for neonatologists to take on this role. 

Here are links (same session, on different platforms) to a hot-off-the-press podcast that features James Baumberger (AAP Sr. Director of Federal Government Affairs) and Pat Johnson (Dir of Federal Government Affairs), along with SONPM members John Zupancic, Shetal Shah, Ashley Lucke and myself—talking about what neonatologists should pay attention to as we prepare for a new administration and a new Congress this month. 

• https://soundcloud.com/totrep/cross-section-jan-2021 
• https://podcasts.apple.com/us/podcast/cross-section-aap-neonatal-perinatal/id1299474910#episodeGuid=tag%3Asoundcloud%2C2010%3Atracks%2F958399306

Like any skill, legislative advocacy can feel foreign and awkward at first. With practice and with time to understand the process, identify the holders of influence, learn about resources, and develop trusted relationships, it becomes comfortable and increasingly effective. Not taking advantage of our immense credibility as pediatricians would be a huge missed opportunity. Our legislators are trying to understand competing interests that range from farm subsidies to trade agreements to energy to highway maintenance. They work hard to prioritize their attention and US dollars by listening to their constituents; if we are not there talking about what our patients need, they are listening to someone else talk about other interests vying for the same finite funds. 

The AAP has enormous resources to help us deliver effective messages to our representatives, backed up by data, and coordinated for maximal effect. The main Advocacy website https://services.aap.org/en/advocacy/ has links to a myriad of useful tools, including an updated 2020 Blueprint for Children (a comprehensive legislative agenda, regardless of who is in office) and Transition Plan for the incoming Biden-Harris administration. There are COVID-19 advocacy resources and information to help with taking a stand on health care access for children, vaccines, tobacco & vaping, and other topical issues. The Advocacy Action Center highlights high priority issues in play and facilitates communicating with your specific Members of Congress with a single click. AAP members can sign up for a mailing list that provides action alerts and regular child health advocacy updates. AAP sponsors Days of Action, focusing calls and letters on top issues for children on specific days to concentrate the attention of Members of Congress. A Subspecialty Day of Action was held in October of 2019. Two AAP member Committees—on Federal Government Affairs (COFGA) and State Government Affairs (COSGA) guide the work and provide opportunities to serve the Academy on a national level. The inspiring annual Legislative Conference has been re-named the Advocacy conference. 

So how is this relevant to neonatologists? Can’t other pediatricians do this? 

First, there are issues more important to our patients and to us than to non-neonatologists. Some examples include the Newborn Screening Saves Lives Act, coverage for genomic testing, Medicaid and CHIP (often the payment source for 75% of NICU patients) and state coverage for donor milk for premies. Other pediatric issues also impact us in the NICU: the Subspecialty Loan Repayment program, treatment for substance use during pregnancy & support for families at risk for foster care, COVID relief for Medicare but not Medicaid, extending maternal Medicaid coverage up to 12 months after delivery, the VACCINES Act, paid parental leave, funding for the NIH and the CDC that supports our research and care activities. Second, many pediatricians are active advocates, but no-one carries the weight of a doctor who cares for newborns when talking about newborns and their care firsthand. 

The SONPM has just formalized its Advocacy Committee charter and determined the composition of its leadership council. There is an opportunity for one more neonatologist to join the group as an at-large member—please contact me if you would like more information. You will also find this posted on the AAP Volunteer Network list as a national opportunity. Shetal Shah, the committee co-chair, has taken the 150 recommendations in the Transition Plan and pulled out the neonatology-specific issues. Look for this list on the Advocacy web page. 

The AAP Federal Government Affairs office has developed neonatology specific materials to support our advocacy work. This committee is working on a priority list and plan for Section advocacy. We are developing a listserv for members interested in receiving legislative alerts relevant to neonatology. A toolkit for state coverage of donor milk coverage is available (thanks again, Shetal). The section remains committed to supporting the development of advocacy skills for neonatologists. Again, we plan to provide scholarships to the Advocacy Conference—which will take place virtually (including virtual meetings with members of congress) on April 11-13th, 2021. We hope to host additional advocacy workshops at our national meetings. We offer these tools to make it more effortless for our members to efficiently and effectively engage in meaningful advocacy. We are the best citizens if we use our gifts for maximum benefit; our unique knowledge and perspectives should be voiced in the service of our patients and our communities. We can and will make a difference. 

One of the most powerful things you can do in advocacy is to share a story. In closing, I’ll share this video (5:51 long) from The Food Bank of Alaska that beautifully makes the case that we should support their cause. We still do, so I’d say it works. 

• https://www.youtube.com/watch?v=S8nARtygkys

Take care and stay well, 

Lily