June • 2020
June Marks an Interesting Turn in Our Journey

June marks an interesting turn in our journey
Outgoing Members-At-Large and their leadership, acknowledgment worthy
A number of new events and initiatives
Including the Healthy People 2020 grant, Psychiatry Portal, and Screening Program for Genetic Diseases.
President's Column
Raelene Walker, MD, FAAP
As we enter June and the end of the academic year, what is usually a time of many celebrations is very different with virtual graduations, numerous video conferences and many unknowns. What we do know is that too many people are struggling in so many ways and too many are experiencing pain and loss. I’d like to begin by offering condolences and heartfelt support to everyone, along with gratitude for everyone helping us all navigate these challenges as well as possible.  

In further gratitude, I want to acknowledge and thank our three outgoing Members at Large whose terms are ending at the end of June:  Dr. Beth Grady from San Mateo, Dr. Jolie Limon from the South Valley, and Dr. Amanda Millstein representing Alameda County. All three have been extremely active members who have continued to work and advocate for children as members of our chapter and as wonderful pediatricians and people. As their terms come to completion, we will be announcing the results of our chapter election shortly, which will include the new Members at Large for these regions. Thank you so much!

As we all work hard to continue to take care of children and support pediatricians during this pandemic, I want to highlight two upcoming events we are holding to assist with this. We are hosting a Social Media Strategy webinar on Thursday, June 11 to help practices to reach out and connect with patients and families. We are also continuing our Solution Sharing Chapter Chats about what is next with COVID and our chapter and would like to hear from you about what topics would be most beneficial. Please complete this two question survey here to help us with that.  
We are continuing to upgrade and improve our website, www.aapca1.org . Please check out our new membership spotlight page , to highlight the great and important work of our members. And, if you know someone in our chapter who deserves to be recognized, please let us know.  
Finally, I’d like to close on some exciting news. Our chapter was awarded the AAP Healthy People 2020 Global Health grant! Congratulations to project leads Dr. Alexandria Valdrighi , Dr. Raul Gutierrez and the Immigrant Health Task Force as we advocate together for immigrant children and address the public charge rule. This is a two year grant, one of three for the entire country, and I’m so proud of the work that went into being awarded the grant and look forward to the positive results to come out of it.  Read more about the project and if interested, sign up to participate in these efforts HERE .

Wishing you good health and joy as we begin summer.
Reflections from Alameda Member-At-Large
Amanda Millstein, MD, FAAP
Nearly 4 years ago, standing in the entryway to my then-apartment and bouncing my 6 month old son on my hip, still trying to get my bearings as a new mother and a new primary care doctor in the East Bay, I hung up the phone with Mika Hiramatsu . With her urging, I resolved that I’d run for the Alameda County Member-At-Large position. 

Mika -- if you’re reading this -- thank you. I’m forever grateful for your encouragement.

The 3 years I’ve served on the AAP-CA Chapter 1 board have shown me the power and tremendous good that comes from pediatricians organizing together and using our collective voices to advocate for issues that affect the children and families we care for. I’ve seen...
Film Night: Screenagers Next Chapter
Nelson Branco, MD, FAAP & Mika Hiramatsu, MD, FAAP
CME Committee
All of us have gotten more questions from parents and guardians about screen use during the COVID shelter in place. With distance learning, Zoom meetings and classes, online socialization and fewer activities - we spend even more time on screens than we used to. Kids are no exception and parental concern about screen use seems to be rising at double the rate of hours spent on screens. “Screenagers” talks about the increasing rates of behavioral health concerns and explores the connection to screens and how the challenges of anxiety, depression, stress and trauma are affecting families. One of the filmmakers, Dr. Delaney Ruston , shares the story of her family and her 16 year old daughter's struggles with depression. This film is a must-see for pediatricians, and their website is a great place to get more information. None of the ideas presented will be new, but you will learn new ways to approach the discussion with families and be introduced to resources that you can offer the families in your practice. 

Although the chapter CME committee postponed with great disappointment our much-anticipated Adolescent Health Day meeting, scheduled for April 25, the exclusive chapter showing of “Screenagers, Next Chapter,” will still go on, thanks to the generosity of director Lisa Tabb . Dr. Ruston will host a Q & A after the film. Mark your calendars for Tuesday, June 23, from 6:30-8:30 p.m. and register.
We hope to present Adolescent Health Day in spring, 2021. Also, planning has begun for Pediatric Puzzles 2020 . Given the unlikelihood of being able to have an in-person large event, we are recruiting outstanding speakers for a virtual meeting in which we hope to include network/reunion events for our local residency program alums. Stay tuned!
California Department of Public Health Genetic Disease Screening Program: Spinal Muscular Atrophy - Expansion of the California Newborn Screening Panel  
Richard S. Olney, 1 MD, MPH, FAAP & Myles B. Abbott, 2 MD, FAAP
In July 2020, the California Newborn Screening Program of the California Department of Public Health ( CDPH ) will add spinal muscular atrophy ( SMA ) to California’s state-wide newborn screening (NBS) panel. The NBS program assays blood collected at 12-48 hours of age from nearly all infants born in the state for more than 80 serious but treatable diseases.

SMA is an autosomal recessive neuromuscular disorder caused by deletions of the Survival Motor Neuron 1 ( SMN1 ) gene. SMA is a leading genetic cause of death in children and occurs in approximately 1 in 10,000 infants at birth. With California’s birth rate of some half million per year, it is estimated that 50 infants will be diagnosed each year.
Announcing the UCSF Child & Adolescent Psychiatry Portal (CAPP)
Petra Steinbuchel, MD
Director of Outreach and Education for the UCSF Benioff Child & Adolescent Psychiatry Portal
There is an increasing prevalence of behavioral health problems in children, as suicide is the 2nd leading cause of death amongst 10-24 year olds (WHO 2017), and only 50% of those with clinically significant behavioral and emotional problems being detected (Weitzman, Wegner Pediatrics 2015;135(2):384-395. May 01, 2015), with often a 2-4 year, or longer, lag time between symptom onset and diagnosis. There is also a severe shortage of child psychiatrists i.e. currently 8.6 per 100,000 in the US, 13 per 100,000 children in CA, and this is not forecasted to improve (AACAP, 2020). Pediatricians often receive little training in diagnosing and treating behavioral health conditions, and many may hold the belief that mental health professionals, especially child psychiatrists, are the only providers suitable to treat children with behavioral health conditions.
Chapter Spotlight:
Stories Matter - How Narrative Medicine Is Socializing The Art Of Healing 
Alya Ahmad, MD, FAAP
Narrative Medicine: I have heard of that, but what is it? I often get asked this question. As a master’s student of Narrative Medicine, I am still trying to hone in on the best response to that question. 

For many, Narrative Medicine (NM) is not a novel concept. We have watched movies or read books of doctors helping, listening, or learning from patients as they wrestle with their illness. Many writers like William Carlos Williams , Abraham Varghese , or Rita Charon have authored stories that convey the art of healing. In Rana Awdish’s “In Shock,” a physician chronicles her own journey of becoming a patient in her last years of training. As the roles reverse, the fractured disparities of doctor-patient interactions become real. She calls upon the need for doctors to be present, “bearing witness to the patient’s pain”. Just like an artist, a clinician should train “to see the negative space on a canvas… The healing potential of medical knowledge is magical. It is also a lie. Medicine cannot heal in a vacuum, it requires connection…”
The SGA Side
Nora Pfaff, MD, FAAP and Zarah Iqbal, MD, MPH
SGA Chapter Representatives

The CA state budget is delayed due to delays in state and federal tax deadlines and massive unemployment, however by law, a budget proposal needs to be submitted by June 15th . Therefore, advocacy on behalf of issues we feel need legislative funding continues. AAP-CA has been busy working on advocating on issues of meals for children during the summer, mental health “first aid” resources, and assistance for foster families. 

Specific bills that were discussed during the May meeting included the following bills that were supported: AB 2464 (statewide telehealth support for behavioral and mental health), AB 2949 (supporting more nutritious breakfast and lunch meals at school), AB 2362 (enforcement of fines for firearms dealers who fail to obtain insurance). The committee was also in support of AB 3133 (prohibiting refugees from being denied resettlement in CA based on any criterion), AB 2112 ( supporting best practices to guide suicide prevention), and AB 3003 (requiring the DPH to develop and maintain a referral network of providers for maternal postpartum depression). 
  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 (Be on the lookout for the new AAP-CA website to roll out soon!)
  2. For latest organizational advocacy updates follow @AAPCADocs on twitter

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

A Pediatrician’s Role in Oral Health
This study by Veronica Brandley, pediatric dental resident training in San Diego, CA at the San Ysidro Health Children’s Dental Clinic at Rady Children’s Hospital, seeks to learn more about pediatrician’s training in oral health care, the dental services provided in office, and the demographics of the practices and patients. As a current pediatrician and active member of the American Academy of Pediatrics, your participation via this survey will provide valuable data. The survey has been approved by the NYU Langone IRB. The survey is anonymous and will take no more than 10 minutes to complete. To participate, click HERE .

View the Key Study Information and Informed Consent . For questions or concerns, contact Veronica Brandley, DMD at (619) 205-1950 or at veronica.brandley@nyulangone.org .

The 6-session online ECHO course will start Tuesday, June 23, 2020 and will take place on the following dates : 6/23, 6/30, 7/7, 7/14, 7/21, and 7/38. 6 CME and 6 MOC Part II credits are available at no cost .
Enrollment is on a first-come, first-serve basis and is limited to the fi r st 2 3 practices. Participants are encouraged to sign up if they can attend all six sessions and are allowed to bring up to 8 team members (including nurses, office staff, social workers, physician assistants and others). Enrollment is currently open to AAP Chapters. Please note, only 1 team lead/pediatrician (AAP Member, MD or DO, practicing in the United States) should fill out the Interest Form . If you have any questions, please email Zaneta Balaban , PATTeR Program Manager, at zbalaban@aap.org .
June 11, 2020: Social Media Marketing for Medical Practices - REGISTER
June 23, 2020: Screenagers Film Night - SAVE THE DATE!
September 12, 2020: ACT 2020 Conference - SAVE THE DATE!
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