April • 2020
April Among Unprecedented Times

In these unprecedented times,
We have a few comforting lines.
But also, child abuse prevention couldn't be more relevant
Along with elections, development & behavior, school and immigrant health elements.
President's Column:
"You don't decide to become a pediatrician, you just realize you are one."
Raelene Walker, MD, FAAP
I graduated from medical school in 1995, completed my pediatric residency in 1998 and so have a fair number of years of experience as a physician, and specifically as a pediatrician. In that time, for many different reasons, I have always been proud to be a pediatrician, to be part of the group of people that heal, nurture, and care for children and their families, and who do so knowledgeably and enthusiastically. Right now, with the challenges of COVID-19 and all that it is bringing to our world, our communities, and our children, I have never been prouder to be a pediatrician. I am humbled and honored to see my colleagues rise up, pitch in, work hard and further dedicate themselves to improving the health and lives of children as much as possible, with no hesitation. I am reminded of a quote that I was told by a medical school mentor, "You don't decide to become a pediatrician, you just realize you are one." At the time, I thought it was a rather simplistic statement…no one is a pediatrician until they have studied, practiced, worked to become one, but as I watch all of us care for children, especially now, I am struck by how innate it is for us as a group of professionals to use our skills, including our compassion, to take care of children, even when we are dealing with what is probably the most challenging health crisis for our world that any of us have ever experienced. Our District Chair, Dr. Yasuko Fukuda passed along another quote about being a pediatrician and I’d like to close by sharing those words, and by saying thank you, and asking each of you to care for yourselves and each other as we all continue to care for children.  

I wear my heart on my sleeve for the love of my patients
Quinn Bensi, MD | Physician | February 16, 2020
Update & Resources on Coronavirus Disease 2019 (COVID-19)
We are continuing to monitor the COVID-19 outbreak in Northern California and as a chapter are adjusting to ensure the safety of our members and community at large. We are committed to following all recommendations from the Centers for Disease Control and Prevention (CDC), the American Academy of Pediatrics (AAP), and state and local public health departments. We recognize that the landscape is changing rapidly, with new information released daily, so we encourage you to monitor the latest information and key messages on our chapter website.

Also, we've begun a weekly Solution Share Chapter Member Chat on Thursdays at 7:30-8:30 PM, inviting out panelists with knowledge of the ongoing developments and changing landscape to help address your questions. Sign up HERE to receive the Zoom login information.
Chapter Elections
We are gearing up for chapter elections in May. If you are interested in taking an active role on the AAP California Chapter 1 board, we encourage you to consider running for an open board position:
  • South Valley Member-At-Large
  • San Mateo Member-At-Large
  • Alameda Member-At-Large

Board structure, responsibilities and application information can be found in this Nominations Call Out . For specific information on the regions that the above Member-At-Large positions cover, visit About California Chapter 1.

Deadline to Apply: Friday, April 10, 2020
April is Child Abuse Prevention Month:
Pointers, Tools and Resources to Address and Mitigate the Underlying Health Inequities and Intensified Risk of Violence in Today's Pandemic Landscape
Casey L. Brown, MD, FAAP, Rachel Gilgoff, MD, FAAP & Aparna Kota, MD, FAAP
CAPET Committee Co-chairs
Greetings from your AAPCA1 Committee on Child Abuse Prevention Education and Treatment (CAPET). As the CAPET Committee prepares for Child Abuse Prevention Month, we write to you amid a stunningly different landscape – that of a world-wide pandemic, shelter-in-place orders, and “social distancing”. We recognize that increased isolation and stress exacerbate underlying health inequities and intensify risk of violence for children, intimate partners, and elders, all while supports become more difficult to access. How can we, as health care providers, support children and families in need, while taking care of ourselves and our own family members? We have identified five points to consider. 
#1 Rates of abuse and neglect may increase during this time of increased stress and economic hardship.
#2 We can prevent child maltreatment.
#3 Social support is critical in improving health outcomes. A better message is "together but separate" or "physical distancing" rather than "social distancing."
#4 Toxic stress impacts our immune system.
#5 Practical tools and strategies to increase social support, positive experiences, and manage stress are more important than ever.
Child Abuse Prevention, Education and Treatment (CAPET) Committee Relaunch
Casey L. Brown, MD, FAAP, Rachel Gilgoff, MD, FAAP & Aparna Kota, MD, FAAP
CAPET Committee Co-chairs

The CAPET Committee is relaunching this month. The newly revamped committee mission is below. The committee will meet quarterly. If you are interested in joining this committee, please sign up here:
Mission: The AAPCA1 CAPET Committee aligns with the AAP Resilience Project and COCAN to improve care and outcomes of children and families through the prevention, education, and treatment of child abuse and neglect. The committee will engage our local providers, families, and communities to build partnerships with child- and family-serving organizations, educate the pediatric community, support policy and research activities, and promote a strengths-based and trauma-informed approach.
The committee will utilize a trauma-informed, strengths-based, public health approach to Prevention, Education and Treatment:
Primary Prevention: “Prevent”
  • Awareness campaigns, family-focused, family strengths, resilience, social/community connectedness/supports, parenting support (Period Purple Crying, Triple P), Home Health/NFP, corporal punishment (“Hit No More”, “No Hit Zones”), SDOH/ACEs screening
Secondary Prevention: “Protect”
  • “Pink flags”, high risk children/families, siblings/contacts with abuse and/neglect, family violence, high SDOH/ACEs
Tertiary Prevention: “Heal”
  • Identify children with suspected maltreatment, community and family linkages, prevent future maltreatment (therapy, community and family support and engagement, high-risk behaviors)
Newly Formed Immigrant Health Task Force
Alexandria Valdrighi, MD, FAAP & Raul Gutierrez, MD, FAAP
AAPCA1 has formed an Immigrant Health Task Force. If you are interested in joining, please sign up here:
Background : As physicians, we are privileged to provide care to families from diverse populations and countries of origin. Unfortunately, our country's current immigration policies have incited fear as well as established systematic efforts to remove basic healthcare and social support for immigrant children and families that is detrimental to their health. Fifty percent of California’s children have at least one immigrant parent. Many counties in our chapter have populations where one-third of the residents are immigrants. Making healthcare facilities a safe space for immigrant families as well as optimizing care is an important goal for the chapter and its members. 

Description : Our vision for the AAPCA1 Immigrant Health Task Force is a coalition of physicians from community and academic institutions working together in order to create a cohesive effort at promoting immigrant health in Northern and Central California. It would be housed within the Advocacy Committee and include members from all levels of training including residents and fellows that would meet on a monthly to bi-monthly basis in order to discuss and implement strategies that benefit and protect the health of immigrant children and their families.  

  1. Collaboration between different institutions to create and share standardized policies and protocols for creating safe and welcoming spaces for immigrant children and their families.  
  2. Promote educational opportunities on immigrant health through speakers and free webinars provided to pediatricians.  
  3. Provide support for AAP opportunities such as CATCH grants that promote immigrant health endeavors. 
  4. Establish partnerships with local organizations also focused on promoting immigrant health that align with the mission of AAP-CA.  
  5. Work to mitigate effects of harmful policies, such as public charge regulations, by mobilizing and assisting our collaborators to provide accurate information to physicians and immigrant families
  6. Operationalize and expand current National AAP resources on Immigrant Health and aligning with the AAP Council on Immigrant Child and Family Health.
  7. Focus on legislative change by advocating for policies that promote, rather than hinder, immigrant health
News from the Committees on Developmental & Behavioral Pediatrics and School Health
Renee C. Wachtel, MD, FAAP
At our February 2020 meeting, the Committees discussed some important topics that are important for all pediatricians to know about. These include ACES screening, new autism guidelines, and projects involving water availability in schools. We are also collaborating with the AAP Mental Health Committee on some of these issues. 

As many of you know, California passed Proposition 56 (versions 2016 and 2018) which allocated funds to support health related areas, including developmental screening and Adverse Childhood Experiences (ACES) screening. The CA Department of Health Care Services (DHCS) has announced the availability of funding related to ACES screening, including training of physicians in the screening measures, developing new measures and new training opportunities. Drs. Dooley and Wachtel from AAPCA1 have submitted a grant proposal to expand upon the state developed training, and to support the development of appropriate resources for referral when screening is positive. This was developed in collaboration with Alameda and Contra Costa Medical Association (ACCMA), UCLA, Valley Children’s Hospital and First 5, among others. Further information will be forthcoming. 

The AAP has published new Autism Spectrum Disorder (ASD) guidelines (Pediatrics February 2020), which update the recommendations for the clinical practice of screening, diagnosis and treatment of children with ASD. One important update is that families should be offered genetic testing for their child with ASD, to determine the possible etiology. In California, the DHCS has so far refused to issue guidance to MediCal Managed Care Plans that they should approve this genetic testing. The Committee has decided to try again to raise this issue with DHCS and the national AAP to make this available to families with MediCal and to reduce this medical access inequity.

Lastly, the issue of access to clean drinking water in local schools was discussed. This is especially important since we are trying to avoid children drinking “sodas or drinks with added sugar”. Kaiser Permanente has supported a pilot program in one Contra Costa school, where they distributed reusable water bottles and established a water station for free clean drinking water. This is a model that should be expanded. 

Our next committee meeting will be in the fall, and any AAP pediatricians are welcome to join us. Send an email to info@aapca1.org to join. 
Annual Spring CME Conference
A reminder that our Spring CME Conference originally scheduled for April 25, 2020 has been cancelled.
The SGA Side
Your Key to State Government Affairs
Nora Pfaff, MD, FAAP and Zarah Iqbal, MD, MPH
SGA Chapter Representatives

Due to COVID-19, the California Legislature is shut down until at least April 13. Your SGA committee and AAPCA staff continue to meet virtually, take positions on bills, and provide letters of comments and virtual testimony on bills. Important policy areas our testimony has addressed this past month includes food insecurity (SB 822, AB 1995); improved support for the needs of foster children (SB 958, AB 2051 ); climate change education for CA students (AB 1922); college affordability to break the cycle of poverty (AB 1970); increased youth voter engagement through nonpartisan education & registration (AB 1913); and reduced child & family homelessness (AB 1937). Additional areas of interest include magnets marketed as toys (SB 1256) and physician loan repayment (AB 2239). We also are opposing efforts to weaken our hard fought progress on issues like gun safety (AB 2206), comprehensive sexual education (SB 1394), and vaccines (SB 1407). 

  1. For the most up to date information on AAP California bill positions, letters & outcomes from the 2019 CA Legislative year, go to aap-ca.org/bill 
  2. For latest organizational advocacy updates follow @AAPCADocs on twitter
  3. If you have questions and/or are interested in knowing more about a certain legislation, reach out to our State Government Affairs Chapter Representatives Nora Pfaff, MD, FAAP and Zarah Iqbal, MD, MPH at info@aapca1.org
Opportunities for Your Benefit
NEA-PeDRA Childhood Eczema Challenge Grant Accepting Applications
Deadline : Friday, May 1, 2020 at 5 p.m. PDT
The National Eczema Association (NEA) and the Pediatric Dermatology Research Alliance (PeDRA) are collaborating to support targeted clinical research investigations focused on pediatric eczema with the Childhood Eczema Challenge Grant. This inaugural $50,000 award is intended to stimulate early and mid-career scientists seeking to build and sustain careers as research investigators and future thought leaders within this critical field of study. Research proposals should address at least one of the following priorities related to pediatric eczema: Eczema Heterogeneity: Novel Insights, Innovations in Clinical Practice & Care, Understanding & Alleviating Disease Burden, Eczema Prevention. Read the full program description and apply here . For additional information, email grants@nationaleczema.org .

Sand Hill Foundation Invites Proposal for Improving Systems for Youth Mental Health
Deadline : May 13, 2020 at 5 p.m. PDT
Grants ranging from $50,000 to $200,000 a year for up to two years will be awarded to organizations working to address the mental health needs and promote timely access to prevention and early-intervention programs for young people (ages 11 to 24) in San Mateo and northern Santa Clara counties. Read more about the grant here . Complete RFP can be found here .
December 5, 2020: 5th Annual Pediatric Puzzles - SAVE THE DATE!

Our mission is to promote the optimal health and development of children and
adolescents of Northern California in partnership with their families and communities, and to support the pediatricians who care for them.

President: Raelene Walker • Vice President: Nelson Branco
Secretary: Janice Kim • Treasurer : Nivedita More • Past President: John Takayama
Executive Director: Isra Uz-Zaman