June • 2022
With June We Are Indefatigable 

With June, we introduce new resources and a Job Board,
Discuss gun violence, Pride Month, our passions restored,
Thank outgoing leaders, welcome continued advocacy,
And promise to children that we stand for them indefatigably.
President's Column
Nelson Branco, MD, FAAP
As I write this, we are all grieving the loss of two teachers and nineteen fourth-grade students in Uvalde, Texas. The tragedy is compounded by the fact that when we talk about it, we must use the phrase “the most recent.” In this case, the Uvalde mass shooting followed one in Buffalo where ten Black people were killed and three injured in a supermarket. It is incomprehensible that even now, our political leaders are not advancing any common sense gun safety legislation. I know that the AAP and our pediatric colleagues are organizing, planning, and mobilizing to put pressure on Congress to act. Please share your ideas, your time, and your passion in these efforts - we can’t allow our feelings of sadness and anger to stop us from doing something to change this pattern.
The day our last Chapter newsletter was published, I mentioned that I’d be at the Spring CME event - “Itches, Wheezes, and Sneezes.” I was, indeed, in attendance along with many colleagues and friends. It was a great meeting, and I really appreciated being in person once again to learn from the experts, ask questions and discuss cases. I’d like to again thank our CME Committee as well as our chapter staff, Isra and Yolanda, for all of their hard work putting the meeting together and keeping it all running smoothly. We’re also grateful to Partnership Health Plan for allowing us to use their facilities for the conference. Rest assured that the CME Committee is still hard at work - they’re already planning the next meeting - Pediatric Puzzles. Stay tuned for details!

I’d also like to take a moment to thank several of our friends and colleagues who have worked with the chapter and are stepping back from their current positions. To start, I want to thank Dr. Janice Kim, who has been our chapter Secretary and Communications Director. I’ve worked with Janice on the CME Committee, Board, and Executive Committee since she moved to the area and became involved with our chapter. Similarly, I have had the pleasure of working on the Board and Executive Committee with Dr. Nivedita More as our chapter Treasurer. I appreciate how she jumped right in after moving here from Orange County and lent us her time and expertise. Thank you Janice and Nive, I know we will find many other ways to use your talents in the future.
There is another member of our chapter board completing their term this month. Dr. Meera Sankar will be ending her term as the Santa Clara Member At Large (MAL). I am grateful to Dr. Sankar for stepping up when the Santa Clara MAL position was vacated, and then staying on for another term. We’ve all benefited from her hard work and expertise. Thank you, Meera. We are also saying thank you to Dr. Zarah Iqbal, who is stepping down as one of our two chapter representatives to the State Government Affairs Committee. Dr. Iqbal has been a strong advocate for children and pediatricians - thank you for bringing our voice to Sacramento, Zarah. In addition, Dr. Ali Valdrighi will be stepping down as co-chair of our Immigrant Health Task Force. Thank you, Ali - we appreciate all that you do.
I’d also like to point out that all of these transitions mean that there are many opportunities to get involved with our chapter leadership. Please check your inbox for a ballot for our new board members and officers, and for another email with leadership opportunities. We would love to have more of our chapter members involved with our committees, our board, and our projects. You can find information and details on what’s happening on our website, along with the latest addition, a pediatric job board. Many thanks to Dr. Niki Saxena, Dr. Mika Hiramatsu, and our chapter Practice Support Task Force for creating this resource for us. 
Vice President's Column
Nicole Webb, MD, FAAP
Advocacy Day Update

Each year, AAP-CA sponsors an Advocacy Day for pediatric trainees and faculty in Sacramento. This year, we were able to gather together in person again after over 2 years. Over 80 people attended Advocacy Day, the majority of them were pediatric residents from programs across the state. They were joined by faculty from their programs and leaders from each of our AAP chapters in California. 

The day began with introductions and overviews by our amazing AAP-CA State Government Affairs co-chairs, Drs. Jacques Corriveau and Sharon Pham. Our co-chairs and our wonderful staff were responsible for planning the event. We heard from inspiring and energizing speakers including Assembly Member-Elect Matt Haney, who shared thoughts from his long career in public service and his childhood growing up as the middle son of our own former CEO and Executive Director, Kris Calvin. We also heard from California Medical Association CEO Dustan Corcoran, and Crystal Strait, longtime pediatric advocate, former staff member, and co-founder of ProtectUs with State Senator Richard Pan.

After those inspiring sessions, we prepared our talking points and then headed out to meetings with legislators. Our wonderful AAP-CA Executive Director Karmi Ferguson and our lobbyist Lydia Bourne ensured that most of us had meetings with elected officials from our home districts. We had an ambitious agenda, primarily focused on supporting vaccination. We spoke about a budget task, $135 million over 3 years to support routine vaccinations, the rates of which have seen an alarming decline during the COVID-19 pandemic.
June is Pride Month

Shifting gears a bit, since you’ll be reading this in June, I also wanted to acknowledge Pride. As many of you know, Pride is an annual tradition celebrated in the month of June to honor and acknowledge the lived experience of LGBTQ+ people, including the long history of persecution they have faced individually and as a community. While the first Pride marches occurred on June 28, 1970, most credit the beginning of Pride as June 1969 with the Stonewall uprising, following a police raid at the Stonewall Inn on June 28, 1969. This was a watershed moment that galvanized and brought much greater attention to the gay rights movement in the US and to the discrimination and persecution faced by members of the LGBTQ+ community.

Flashing forward to today, this June marks 51 years of Pride. I’m sure many of you, either individually in your practices or part of larger group or organizational efforts, have acknowledgements, remembrances, or other events planned for the month. We would love to hear about them, so send those updates our way via email at info@aapca1.org! We will share them in our Membership Spotlight and on social media.

On a more serious note, as we all know, while much has changed since 1969, LGBTQ+ people, including children, still face significant discrimination and experience wide health disparities as a result of structural and systemic inequity. This is seen in education and in access to care, with recent laws in Florida, Texas, Alabama, and many other states only several among countless examples. 

We also know that LGBTQ+ youth are at much higher risk of poor mental health outcomes and suicide. Suicide is the second leading cause of death of US adolescents overall, and LGBTQ+ youth are over four times more likely to attempt suicide than their cisgender, heterosexual peers, and over half of transgender and nonbinary youth attempt suicide. These disparities are even greater for transgender and gender-diverse youth of color. 

According to the Trevor Project 2022 Survey on LGBTQ Youth Mental Health, 73% of LGBTQ youth reported experiencing symptoms of anxiety in 2022 and 58% reported symptoms of depression.
New Resources for Your Practice
Addressing Social and Mental Health and Early Childhood Wellness Resource Page
View our ASHEW Initiative webpage for  resources in the following categories:
  • Family Voice
  • Quality Improvement
  • How to Identify, Address, and Screen for ACEs
  • Culture Humility and Anti-Racism
  • Resilience
  • Building out Networks of Care
  • All Webinar Recordings
Baby Formula Resources
From the California Department of Public Health
Important information:

  • Hospitals have what they need and CDPH is working to get some supplies from hospitals to distribute through food banks
The National Maternal Mental Health Hotline is LIVE!
Call or text 1-833-9-HELP4MOMS (1-833-943-5746)
The National Maternal Mental Health Hotline is LIVE! The Hotline, funded by the U.S. Health Resources and Services Administration (HRSA) and powered by Postpartum Support International (PSI), is available 24/7, 365 days a year, in English or Spanish and other languages by request. 

At PSI we are so excited about this first-of-its-kind resource and grateful to HRSA for their leadership and support to make this a reality.  

Staffed by licensed and credentialed perinatal mental health and healthcare providers, childbirth professionals, and certified peer specialists, the Hotline provides immediate and informed access to support, understanding, brief intervention, and resources to all pregnant, postpartum, and post-loss individuals AND their partners and families.

Call or text the Hotline anytime to connect. You do not need a diagnosis to reach out for help – we are here for you.

National Maternal Mental Health Hotline: 1-833-943-5746
Call or text 1-833-9-HELP4MOMS (1-833-943-5746)
A Resource for Children of Incarcerated Parents
Michelle M. Pepitone, M.D.
Do you have a pediatric patient with an incarcerated parent? Consider a referral to projectavary.org

Parental incarceration is identified as an ACE or Adverse Childhood Event. Many children of incarcerated parents (CIP) experience shame, stigma, and social isolation, often leading to higher rates of anxiety, depression, and PTSD. 

Project Avary is a national nonprofit organization serving CIP through social-emotional support systems, community building, and leadership programs. I am a founding board member of Project Avary and have worked as a camp doctor for Project Avary's nature retreats for over two decades. I have personally witnessed the power of this community. The programs serve children ages 8-18 years at no cost to the youth or to their families. Program information, flyers, and enrollment information are outlined in this REFERRAL TOOLKIT

Continue reading to find tools for physicians...
The SGA Side
Your Key to State Government Affairs
Nora Pfaff, MD, FAAP and Zarah Iqbal, MD, MPH, FAAP
SGA Chapter Representatives
On May 10, the State Government Affairs Committee came together in person at the state capitol, along with other AAP leaders and members from all 4 chapters in California, including pediatric residents from across the state, to participate in the annual AAP-CA Advocacy Day. It was so wonderful to finally be able to gather in person and meet so many of our colleagues that we have only known via Zoom. 

The event was held in downtown Sacramento and consisted of several inspiring speakers, including Assembly Member-Elect Matt Haney (SF, District 17), Dustin Corcoran (CEO of the CMA), Senator Josh Newman (Orange County, District 29), and Crystal Strait (Co-Founder of Protect Us with Sen. Richard Pan).

We then had a total of around 30 different legislative appointments in the afternoon with various Assembly Members, Senators, and/or their staffers to advocate on behalf of children in California. Our five priorities were: AB 1797 on improving CA's immunization registry, SB 866 arguing for minors 12 years of age or older to be able to consent for vaccines, SB 855 on collecting childhood drowning data in the state to inform future legislation, AB 35 on modernizing MICRA (Medical Injury Compensation Reform Act of 1975) to better protect the rights of patients and stabilize healthcare costs, and finally we asked for budget allocation for improved vaccine (particularly COVID vaccine) access for children including providing access to transportation to and from appointments.

The day was a huge success and we received lots of positive feedback from residents and AAP members regarding the reception of our advocacy during the various legislative appointments. Something we hear over and over from legislative offices is that they want to hear from pediatricians MORE! We hope that the event was a catalyst for continued ongoing advocacy on behalf of children across our state.

For the most up-to-date information on AAP California bill positions, letters & outcomes from the current CA Legislative year, go to https://ctweb.capitoltrack.com. For the latest organizational advocacy updates follow @AAPCADocs on Twitter. If you have questions and/or are interested in knowing more about certain legislation, reach out to our State Government Affairs Chapter Representative Nora Pfaff, MD, FAAP at info@aapca1.org. 
Thank you, Dr. Iqbal and Welcome, Dr. Kaplan!

AAP-CA1 is grateful for Dr. Zarah Iqbal's years of advocacy work as our State Government Affairs Chapter Representative. As we say goodbye, we also want to welcome Dr. Anna Kaplan to her new role as our State Government Affairs Chapter Representative! 
 Reminder to Complete the Becoming ACEs Aware in California Training
Anda K. Kuo, MD, Chapter Member
Since the ACEs Aware initiative started in December 2019, more than 22,300 health care providers have conducted more than 781,400 screenings for Adverse Childhood Experiences (ACEs) in CA. We'd love for you to join the movement to become ACEs Aware. 
Complete the online Becoming ACEs Aware in California training – it is free and takes about two hours to complete. You do not have to do the training all in one sitting. 
If you are an eligible Medi-Cal provider, your clinic will receive a $29 reimbursement for each ACE screening of an eligible Medi-Cal beneficiary that you conduct. To receive the Medi-Cal payment, you must complete the training and then complete the self-attestation on the California Medi-Cal website
Also, by completing the training, you are eligible to receive free education credits, including Continuing Medical Education (CME) and Maintenance of Certification (MOC).
Take the training at training.acesaware.org.
Opportunities for Your Benefit
ACEs Health Champions Gatherings - Part 2
Thursday, June 23, 12PM - 1PM PT via Zoom
HOT TOPIC: Parental ACEs and PCEs in Pediatric Primary Care
Presenter: RI Gillespie MD, MHPE, FAAP

Integrating Adverse Childhood Experiences Screening into Clinical Practice
In recent years, states have been working to help providers and communities address adverse childhood experiences (ACEs) — traumatic events such as abuse, violence, and neglect that occur before age 18. California is among this group of innovators, with the Department of Health Care Services’ Office of the Surgeon General launching ACEs Aware, a statewide initiative that assists providers participating in the state’s Medi-Cal (Medicaid) program through training, clinical protocols, and payment for ACEs screenings. 
A new Center for Health Care Strategies (CHCS) report, Integrating Adverse Childhood Experiences Screening into Clinical Practice: Insights from California Providers, shares perspectives from Medi-Cal providers on how to effectively integrate ACE screening into clinical practice for children and adults in a trauma-informed manner. While insights were gleaned from California-based providers, they can help inform health care organizations and providers working across the country to adopt ACE screening.

Invitation to Join the Bay Area Wellness Collaborative
San Francisco Marin Medical Society (SFMMS) is collaborating with each of the Bay Area Medical Societies to deliver a rigorous and comprehensive program - The Bay Area Physician Wellness Collaborative - to address the conditions of practice that affect physician health and wellness.

The Bay Area Physician Wellness Collaborative is led by Dr. Paul DeChant, a nationally recognized physician wellness expert with a background in practice redesign and organizational change. The program includes quarterly convenings that will focus on tangible strategies for improving the practice environment. Participants will gain access to well-known experts in the field and curated information and implementation tools that they can bring back to their organizations. Participants will also become part of an online community to share information and experiences. 

The first convening takes place June 7 at 6PM. 

View this flyer for more information. To apply to participate in the Collaborative, click HERE
June 15 at 7PM - Gun Violence and Kids: What Every Pediatrician Needs to Know - REGISTER HERE

June 22 at 4PM - Enhancing Adolescent Health & Immunization Services AAP Webinar 3 - REGISTER HERE

Postponed to July - HP 2020 Medical-Legal Partnerships - More details to come!
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Twitter: @AAPCA1
Instagram: @AAPCA1
Your membership makes a difference for children in California, thank you!

The AAPCA1's ability to advocate on behalf of children is only as strong as the support we receive from our members. Encourage your colleagues to join today by visiting the AAPCA1 website.

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.

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

Board Members:
North Valley MAL: Thiyagu Ganesan • Sacramento Valley MAL: Lena van der List • Central Valley MAL: Deborah Shassetz • South Valley MAL: Tashya Jayasuriya Whitehead • San Francisco MAL: Maya Raman • Santa Clara MAL: Meera Sankar • San Mateo MAL: Neel Patel • North Coastal MAL: Jeffrey Ribordy • Monterey Bay MAL: Graciela Wilcox • Alameda MAL: Renee Wachtel • Contra Costa/Solano MAL: Omoniyi Omotoso

Pediatric Insider News Editors:
• Mika Hiramatsu • Deborah Shassetz • Alyssa Velasco

Project Assistant: Yolanda Ruiz