1980s The 1980s: AAP built new headquarters, helped ensure future vaccine supply by Alyson Sulaski Wyckoff, Associate Editor Copyright © 2020 American Academy of Pediatrics Editor’s note: This is the seventh of a series of articles on the AAP’s 90th anniversary published by AAP News, (July, 2020). In the 1980s, the Academy built a new headquarters, continued progress on childhood injury prevention, addressed vaccine issues, took on pediatric AIDS, introduced Neonatal Resuscita- tion Program (NRP) training and launched AAP News. Access to health care for all children became an advocacy priority. Membership climbed from 21,575 in 1980 to 37,307 in 1989. Federal, state advocacy Soon after President Ronald Reagan was in office, the Omnibus Reconciliation Act (OBRA) of 1981 was passed with major cuts to domestic discretionary programs. The General Accounting Office estimated OBRA decreased the national monthly case- load of those receiving Aid to Families with Dependent Chil- dren (AFDC) by 442,000. As a result, children lost Medicaid coverage that had been provided automatically when their families received AFDC. These changes drew attention to the large numbers of uninsured children as well as notable disparities across states in Medicaid eligibility, benefits and ease of enrollment for eligible children. Across the decade, AAP leaders, through the Washington office and chapters, worked to address enroll- ment barriers and reimbursement levels for pediatric care. They took a renewed interest in promoting and financing preventive care for all children, releasing policies on principles of health insurance for children and a minimum benefits package for Medicaid. The first AAP Legislative Conference was held in 1988, bringing members to the nation’s capital to hear prominent speakers, sharpen advocacy skills and meet their congressional representatives. Saving vaccines In the aftermath of a sensationalized TV report in 1982, “DPT: Vaccine Roulette,” rising concern about adequacy of the future vaccine supply prompted the AAP to press for what became the National Childhood Vaccine Injury Act of 1986. Lawsuits threatened to cause the system to collapse. The legislation pro- vided for a no-fault alternative to the traditional tort system, with compensation to individuals found to be injured by certain vaccines. The Vaccine Injury Compensation Program began in 1988. James E. Strain, M.D., FAAP, had just started as AAP exe- cutive director when AAP President Martin H. Smith, M.D., FAAP, was at work on the vaccine program, recalled Dr. Strain in his oral history (http://bit.ly/37eph03). Dr. Strain, who died earlier this year, was AAP president in 1982-’83. Addressing pediatric AIDS In the early 1980s, a new life-threatening epidemic, acquired immunodeficiency syndrome (AIDS), emerged among infants and children. The Academy took a leading role beginning with a task force on pediatric AIDS in 1987. A year later, the AAP came out with policy statements on perinatal HIV infection and guidelines for infection control of HIV in hospitals, medical offices, schools and other settings. The task force became the Committee on Pediatric AIDS. Mexico border health AAP concern about migrant children prompted a 1983 conference. Children living in the states bordering Mexico had increased health issues, and mothers’ prenatal care was lacking. To help families frequently moving for agricultural work, the Academy published a migrant health directory to refer them to physicians and clinics in the next community the families would visit. uni24F0
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