Supplement
REPORT OF COUNCIL ON SCIENTIFIC AFFAIRS
CSA Report 1-A-07
Subject: Council Activities
Presented by: Laurie Sutor, MD, Chair
Newborn Genetic Screening
During the 79th Legislative Session, HB 790, co-authored by Rep. Crownover (R-Denton), passed and mandated expansion of the state's newborn screening program. Texas moved from screening for five conditions to screening for at least 29, all of which are recommended by the American College of Medical Genetics. Implementation of the latest technology, tandem mass spectrometry, was included in the legislation and is in full operation as of late 2006.
TMA and Texas Pediatric Society (TPS) have partnered in efforts to provide input to the Health and Human Services Commission (HHSC) and the Department of State Health Service (DSHS) regarding the expansion. In 2006, the TMA/TPS newborn screening Physician Advisory Team actively participated in meetings and other communications with HHSC and DSHS regarding: the needed changes in the state's specialty referral and case management processes for newborns with positive screens; patient and physician education materials and methods, including an online CME program covering the clinical information related to the screening tests/diagnosis/ treatment; and other recommendations to streamline the program.
The TMA brief on newborn screening for the 80th Legislative Session includes medicine's 2007 agenda which is to support adequate physician reimbursement for conducting newborn screenings and to ensure fees collected from physicians and hospitals are dedicated to the Texas newborn screening program's case management, follow-up, ongoing treatment, and clinical management services and not diverted to other costs. TMA's ongoing message includes: (1) the Texas newborn screening program is not nimble. Physicians don't receive positive test results in a timely manner. Nor is there a system in place that quickly gets children with positive test results to clinicians who can confirm the diagnosis, initiate treatment, and manage the child's medical care. That problem is most acute in rural and border areas; (2) 75 percent of the DSHS laboratory building debt is paid for by newborn screening testing fees. The ratio of the state's dollars spent for newborn screening laboratory fees versus case management, follow-up services, and on-going treatment is approximately 15-to-1, compared with the national average of 3-to-1; (3) enhancing the state's newborn screening program must include advisory participation from frontline practicing clinicians such as pediatricians, primary care physicians, pediatric specialists, clinical geneticists, genetic counselors, nurses, and other major stakeholder organizations.
TMA Ernest and Sarah Butler Awards for Excellence in Science Teaching Program
Implementation of a three-year pilot TMA affiliation with the Science Teacher Association of Texas (STAT) began with STAT's 2006 Outstanding Science Teacher Awards program selection of winners. The winners were announced in November 2006 at the annual Conference for the Advancement of Science Teaching, the largest state continuing education event for science teachers in the U.S. TMA helped sponsor the awards luncheon for the winners, coordinated the awards ceremony keynote address and presentation by Susan Strate, MD, manned a booth honoring science teachers, had several drawings for a laptop computer and other teaching aids/supplies, and will honor the winners at the Opening Session of the House of Delegates at TexMed 2007.
The winners are: Outstanding High School Science Teacher - Sara Anderson, Frenship High School, Wolfforth; Outstanding Middle School Science Teacher - Nancy Owens Schunke, Dunbar Middle School, Lubbock; and Outstanding Elementary School Science Teacher - Amy Hill, Lubbock Christian School, Lubbock.
Funding for the TMA Ernest and Sarah Butler Awards for Excellence in Science Teaching is made possible through a grant from TMA Foundation, with annual core support derived from the TMAF Ernest and Sarah Butler Endowment for the Recognition of Excellence in Science Teaching. The 2006-2007 program is additionally supported by a generous gift from Blue Cross and Blue Shield of Texas and gifts from physicians and their families.
Texas Renal Coalition
In June 2006, the TMA Board of Trustees approved the council's request for the TMA affiliation with the Texas Renal Coalition (TRC) and TRC's "Decrease the Increase" initiative. This project is initially a demonstration project in Lubbock and surrounding counties.
TRC, organized in 1995, is a 501[c] [3] not-for-profit corporation with the mission: "To assist in the advancement of future health care programs for dialysis and transplant patients and those patients affected by urinary tract or kidney disease. By acting as a clearinghouse for information related to legislative issues and advances in research, the coalition will provide a forum for all interested parties involved in the treatment, research, or educational programs related to kidney disease." TRC's goal is to affect a 50 percent or greater decrease in the number of new end stage renal disease (ESRD) patients requiring dialysis or renal transplantation over the next five years.
TMA is utilizing its various publications and other means to help disseminate information to physicians in particular. TRC also will prepare television and radio public service announcements to target the general public as well as chronic renal failure patients and their families.
TRC reports the following information:
- Patients in the U.S. with ESRD will double over the next five years, from 300,000 to 600,000, with Texas patients increasing from 27,000 to 47,500. CDC reports that reasons for the increase are that chronic conditions, such as obesity and diabetes, also on the increase, can lead to ESRD, and patients are living longer because of continued progress in treating kidney diseases.
- Kidney disease is the ninth leading cause of death in the U.S.
- 1 in 9 Americans are afflicted with kidney or urinary tract disease plus an equal number are at risk.
- 4,000 Texans are currently waiting for a kidney transplant.
- The growing number of ESRD patients is outstripping treatment resources.
The major tools being promoted by TRC are: high blood pressure control (<140/85), diabetes control, early nephrology referral, ACE inhibitor therapy in chronic renal failure, and treatment of intercurrent urinary tract infections. CSA believes the "Decrease the Increase" project is a valuable scientific evidence-based effort that will help physicians, particularly primary care physicians, and patients to be more proactive regarding treating and preventing kidney disease.
National Wear Red Day Initiative
CSA partnered with the American Heart Association, Texas Chapter, to distribute red dress pins and initiative materials for all attendees at the TMA 2007 Winter Conference, Feb. 2, 2007. National Wear Red Day is a national effort of the American Heart Association to bring attention to the extent of heart disease in women and to support ongoing research and education about this issue.
Clinical Reviews
The council provided TMA's comments for several scientific reviews of materials/clinical guidelines/measures for the AMA Physician Consortium for Performance Improvement, the Texas Medical Disclosure Panel, and the Newborn Screening Program at the Texas Department of State Health Services.
TMA House of Delegates: TexMed 2007