In June, We Let Our Children Play

In June, we let our children play under sunny skies,

Making sure to take advantage of any opportunities that arise,

For taking pride in who we are and staying true

We embrace our diverse voices and grow stronger, too.

It’s prime time for graduations - If your family is celebrating a commencement, I hope that there is great joy, lots of sunshine and short, inspiring speeches at the ceremony. I’m writing this column the day after attending the UCSF Medical School commencement ceremony. It was great to see the students I knew from small group sessions and rotations through my office walking onto the stage to have their hood placed by loved ones and mentors. We were there to celebrate another “doctor in the family” - congratulations, Dr. Zoe Onion! We also got to listen to a commencement address by Dr. Will Flanary, AKA Dr. Glaucomflecken. He entertained and inspired me with important advice about admitting mistakes, relying on colleagues, making time for creativity and never, ever sleeping in your contact lenses. One thing he spoke about, from both a personal and professional perspective, was recognizing the co-survivors of medical trauma. In his case, he talked about his wife’s experience with his sudden cardiac arrest, resuscitation, ICU stay and rehabilitation. As he spoke, I thought about how much this is woven into our practice as pediatricians. We all appreciate (and sometimes joke about) the fact that parents are our patients as much as the kids. It’s true, especially when kids are in crisis or seriously ill. The parents are experiencing that stress and trauma, and as pediatricians we are there to treat and support both the child and the family.

June is a month filled with celebrations of all sorts. It’s LGBTQ Pride month, and in our current political climate it’s all the more important for us to celebrate, recognize, support and uplift our LGBTQIA+ colleagues, friends, family members, acquaintances, co-workers and patients. Everyone should be supported and affirmed in expressing and living their gender and sexuality. We should all do what we can to create that environment and safe spaces for all. June is also National Great Outdoors Month - I think it’s fitting that Mental Health Awareness month (May) is followed by Great Outdoors Month, given the ample research linking time spent outdoors to improving mood and mental health. I’ll certainly be celebrating World Bicycle Day on June 3 by getting out for some miles! We will also be celebrating Juneteenth on the 19. I hope that you take some time to celebrate our newest federally recognized holiday and learn more about the history of slavery and emancipation that we commemorate on that day.

Looking back into May, I’d like to thank Yolanda Ruiz, Sana Sayyid, Drs. Mika Hiramatsu and Yasmin Carim, and the rest of the CME committee for putting on the excellent “Ask the Experts” meeting at the Partnership Health offices in Fairfield. We learned about adolescent gynecology, growth, endocrinology, irritable bowel syndrome, and integrative medicine. With lots of time for cases and questions, it was a really useful morning of learning, discussing and networking. Thank you as well to our speakers - Dr. Suruchi Bhatia, Dr. Jenifer Matthews, Dr. Rosie Monardo and Dr. Vivien Nguyen. I’m already looking forward to our next CME in December - stay tuned for details on the topics, speaker and location.

As always, I am going to end my column by encouraging you to get involved in one of our chapter committees or leadership opportunities. We have recruited a chapter EDI Champion and are looking forward to introducing them and learning more about how we can incorporate equity into all of our chapter actions and activities. We are still recruiting for a South Valley Member at Large and CATCH Grant co-facilitators. You should also have gotten an email with a link to a ballot to vote for our next Chapter Vice President. I’m so pleased that we have two excellent candidates and I encourage you to find that email, read about Drs. Patel and Kaur, and cast your vote! 

World Refugee Day: Celebrating Triumph of Human Spirit!

Bhavin Doshi, MD, MPH, FAAP

Early Career Physicians Committee & Immigrant Health Task Force Chair

CAN YOU IMAGINE LIVING IN A PLACE…?



… Which is laden with constant fear of dying? 

… Which is extremely unsafe and hostile for your family?

… Where you are not allowed the freedom to think or speak your mind?

… Where you feel insecure for your family’s basics needs like food, education and shelter?

A refugee is a person who has been forced to flee their home country to escape conflict, violence or persecution. The number of forcibly displaced people around the world is currently standing at a staggering number of more than 100 million out of which more than 40% are children. Fear, uncertainty and helplessness are some common emotions that grip their lives. It is extremely difficult to survive these conditions, let alone be thriving in life. 

June 20th is celebrated as the World Refugee Day, an international day designated by United Nations to honor refugees around the world. Its purpose is to celebrate the courage and resilience of the people who have been forced to flee.

It is an opportunity for the world to recognize their hardships, develop empathy & compassion towards a fellow human being, commend their resilience, understand their rights and motivate / inform a political will to integrate these people into society for a better future for them as well as the world. 

By celebrating this day, we give them hope. It can reassure them that everything is not doom and gloom; that there is still light at the end of the tunnel; that their children can still have a bright future. Life can be incredibly hard as it is, but for refugees it is much worse than what many of us may call “the worst days of our lives."

“We should champion their right to seek safety, build support for their social and economic inclusion, and advocate for solutions to their plight.”



Countries must end the conflict, persecution and human rights abuses that give people no choice but to run. By keeping our doors and hearts open to refugees, we can offer them and their children a chance to use their energy and talents in meaningful ways that ultimately benefit us all.

References:

1. Live Blog 2022: World Refugee Day events held as displacement tops 100 million. UNHCR. 20 June 2022. https://www.unhcr.org/news/stories/live-blog-2022-world-refugee-day-events-held-displacement-tops-100-million

2. Refugee Data Finder. UNHCR. https://www.unhcr.org/refugee-statistics/

3. Immigrant, Refugee and Migrant Health. CDC. June 2022.

https://www.cdc.gov/immigrantrefugeehealth/refugee-health.html

4. World Refugee Day. UNHCR. https://www.unhcr.org/world-refugee-day

Pediatric Academic Societies (PAS) Conference Recap

Maya Raman, MD, FAAP

San Francisco Member-At-Large

This past month I was excited to attend the Pediatric Academic Societies (PAS) conference in Washington DC. It was my first in-person conference since the start of the COVID-19 pandemic, and it was incredible to see thousands of pediatricians come together to advance our field.   

The conference kicked off with an opening session, which included an inspiring conversation with Dr. Wanda Barfield from the CDC, interviewed by her prior classmate Dr. Lynne P. Yao. They discussed a call to “broaden your bench” and improve the quality of pediatric research by including diverse populations in research studies and on research teams by including community leaders, not just clinicians.  

The four-day conference had a variety of poster sessions, educational lectures, and workshops. My favorites included a session on the importance of addressing social determinants of health in inpatient medicine, another focused on balanced IVFs, and a workshop focused on child-centered communication rather than our usual family centered rounds.  

A bright spot for AAP CA Chapter 1 was a workshop led by our very own Dr. Lena van der List, Sacramento Valley Member-at-Large, entitled “Write to Change the World. Demystifying the OpEd.” She is just one of many Chapter 1 pediatricians who presented their important work.

Perhaps my favorite part of this conference was the opportunity to see friends, colleagues, and mentors from around the country. I’m so glad that we’re able to share our work and learn from one another in these important ways.  I hope to see more AAPCA1 representation at the conference in the future!

Data Exchange Framework Initiative Updates

Resham Kaur, MD, FAAP

Secretary & Communications Director, AAPCA1

Project Co-Lead, Data Exchange Framework Education Grant

The Center for Data Insights and Innovation (CDII) has allocated up to $47 million for Data Sharing Agreement (DSA) Signatory Grants that provide support to DSA Signatories to subsidize their efforts to implement the DxF. The program includes two grant options for Signatories: Qualified Health Information Organization (QHIO) Onboarding Grants and Technical Assistance (TA) Grants.

Overview:

The DSA Signatory Grant Program is designed to subsidize DSA Signatories investments to achieve the DSA requirements. CDII has created two types of DSA grants. These are Technical Assistance (TA) Grant and Qualified Health Information Organization (QHIO) Onboarding Grant. 

The TA Grant is a flexible, “build-your-own-solution" pathway where Signatories identify a range of technical and operational activities and manage the entire process of applying for and managing funds directly.

The QHIO Grant is a pre-set, “assisted” pathway in which Signatories receive support to identify a technology solution that could fulfill their DSA requirements (i.e., a QHIO) and support securing and managing funding for that solution.

Applicants must select whether to apply for a TA Grant or a QHIO Grant. While the two grants offer the same level of funding, each grant opportunity offers different levels of flexibility and support. Applicants should consider the infrastructure necessary for their organization to reach DSA compliance, as well as their current capacity for applying for grants and managing funds. 

Download the DSA Signatory Grants Application Guidance Document to learn more.

The DxF Grant Portal External Link is now accepting Round 1 applications for the DSA Signatory Grant.

Stay tuned for more info coming in the following months.

How Do I Get a Free and Quick Evaluation for Developmental Delay in a Young Child?

Renee Wachtel, MD, FAAP

Committee on Developmental and Behavioral Pediatrics Chair

Most pediatricians know that the Regional Centers in California provide Early Intervention Services for children under three years old, but do not know that the Regional Centers are LEGALLY REQUIRED to provide a FREE evaluation of any child referred for possible developmental delay within 45 CALENDAR DAYS from when they receive the referral. This referral can be from the pediatrician, or the parent can self-refer, either by email or generally leaving a voice message on the Regional Center’s early intervention intake line. The Regional Center in your area will then contact the family, conduct a phone interview, and then schedule an evaluation in all 5 developmental areas, either by Zoom or in person. The Regional Center is required to provide interpretation services if the family is not English speaking. 

In California, a child is eligible to receive Early Intervention Services if they meet one of the following three criteria:

1. A 25% delay in any one of the 5 developmental areas (cognitive, motor, communication, social-emotional or adaptive/daily living)
2. A diagnosed condition with a high probability of delay, such as Down Syndrome
3. Two or more high risk conditions, such as prematurity and intraventricular hemorrhage

If the child is found eligible for Early Intervention Services, the Regional Center case manager will meet with the family to develop an Individual Family Service Plan, or IFSP. The IFSP is like an IEP for school age children, but focuses upon the services and goals  that the family wants for their child. The family is given a copy of the developmental evaluations and IFSP, which they can then share with the pediatrician.

ICYMI: 2023 Annual Spring CME Conference - Ask the Experts!

Mika Hiramatsu, MD, FAAP

CME Committee Chair

How to manage troublesome side effects of oral contraceptives? What if a child is not reaching predicted mid-parental height? Which ways can integrative medicine assist in managing chronic bellyaches? These and many more questions were answered in AAPCA1’s highly interactive and energetic Spring Meeting in Fairfield May 6. Ob-Gyn Dr. Rosie Monardo, endocrinologist Dr. Suruchi Bhatia, and GI/Integrative Medicine team Drs. Vivien Nguyen and Jenifer Matthews engaged our conference attendees with clear, focused lectures followed by small group sessions, where each attendee was able to have their individual questions answered. The variety of interesting queries was impressive, and folks also got to share their local experiences. Attendees I spoke with were enthusiastic: “This was great!” “I’m so glad I joined” and “When is your next conference?” were among the comments I received.

Planning for our annual in-person Pediatric Puzzles has begun — scheduled for Saturday, Dec. 2. Are you feeling “Zoomed-out” like many of your colleagues? As previously, we plan to include lots of audience interaction and Q & A with more emphasis and time for questions and discussion. Last year’s Puzzles group commented that the shorter day was appreciated. We are also considering other venues for interest and variety. If you have thoughts about our CME programs or wish to join the committee, please contact me: mika5h@pm.me

ICYMI: ACEs Health Champions Gathering - June 2 (RECORDING AVAILABLE)

From Mandatory Reporting to Mandatory Supporting: “Are we throwing the baby out with the bath water?” Presented by: Steve Baron, M.A., LMFT (IA) Sup. Ct., Ret. Director Family Court Services, Santa Clara County SCC Child Abuse Prevention Council SCC Child and Domestic Violence Death Review Teams.

Although this event has passed, you can find the recording & slides here: https://www.avahealth.org/what-we-do/aces-health-champions-network/aces-health-champions-gatherings.html

California Chapter 1, American Academy of Pediatrics Signs On to Two Support Letters: 

AAPCA1 signed on to a support letter urging Congress to repeal the “5-year bar” which imposes new restrictions on immigrant access to benefits. As mentioned in the letter:

“Congress must eliminate eligibility restrictions and barriers to safety net access based on immigration status. As an important first step, we call on Congress to repeal the so-called “5-year bar” by quickly enacting the Lifting Immigrant Families Through Benefits Access Restoration (LIFT the BAR) Act and reject any efforts to impose new restrictions on immigrant access to benefits.”

Additionally, AAPCA1 has signed on to a support letter urging the U.S. Department of Transportation (U.S. DOT) to take immediate action to prevent deaths and serious, lifelong injuries resulting from children who may have entered independently or been left unattended in motor vehicles. As the letter states:

"Since 1990, more than 1,050 children have died in hot car incidents, including 7 already this year according to data collected by Kids and Car Safety. This month, the Federal Communications Commission adopted new rules for the 60 GHz spectrum band that will facilitate the use of short-range radar systems which can help to prevent the deaths or injuries of children who have unknowingly been left in or entered vehicles. It is now time for the U.S. DOT to act. Without a requirement for an effective detection and alert system in new vehicles, children will continue to die or be injured."

For the most up-to-date information on AAP California bill positions, letters, and outcomes from the current California Legislative year, go to www.aap-ca.org/bill. 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 and Anna Kaplan MD, FAAP at info@aapca1.org. 

California Newborn Screening Program

The California Newborn Screening (NBS) Program screens all babies for 80 different disorders. State law requires that all California babies have newborn screening soon after birth. The NBS Program’s goal is to identify babies with these disorders early, so that treatment can be started immediately. Parents can get their baby’s blood spots destroyed after the screening. To stay abreast of the NBS Program updates, sign up for the e-newsletter (https://tinyurl.com/GDSPOnline) or visit the NBS Program website (https://www.cdph.ca.gov/NBS).

Brief Survey Regarding Practice to Prevent Child Sexual Abuse - Western Michigan University

If you are a mental health provider who provides direct patient care to children, please consider completing our brief survey about provider practices regarding child sexual abuse prevention.

This survey is being distributed as part of a research project through Western Michigan University. It aims to investigate the current knowledge and practices of pediatricians and mental health providers regarding child sexual abuse prevention. Please consider completing if you are a mental health provider (at the M.A. level or above)/pediatrician who currently provides direct patient care to a patient population that includes children under the age of 18. 

This survey will take approximately 10-15 minutes. All participants have the choice to be entered into a drawing for a $50 Amazon gift card by entering their email at the end of the survey. This survey is anonymous, and your email address will not be linked to your responses. Your participation will help to advance knowledge in the field of child sexual abuse prevention.

If you would like to participate in this research study, please:

Click here to take the survey, or copy and paste the following link into your browser:

https://wmich.co1.qualtrics.com/jfe/form/SV_0kqZXpN2VUeT3jo.

Please contact Cassandra Dukes at Cassandra.dukes@wmich.edu or Amy Damashek at amy.damashek@wmich.edu with any questions you may have.

July 30 - 40th Annual Conference on Pediatric Infectious Diseases - REGISTER HERE!

December 2 - 8th Annual Pediatric Puzzles CME Conference - SAVE THE DATE!

December 8-10 - 2023 Las Vegas Seminars - REGISTER HERE!