May • 2023
In May, We Discuss

In May, we discuss policy, prevention and intervention,
And advocate for children's rights with conviction,
May our community stand tall, resolute and steadfast,
Protecting our children's health, now and in the future, and everlast.

President's Column
Nelson Branco, MD, FAAP
Happy pollen season! I know that the end of winter usually brings a sigh of relief as the viruses abate. This year it seems that the sigh has an end-expiratory wheeze, with pollen coating everything in sight. As I write this, I’m looking forward to “Climate Change, Child Health and the Role of the Pediatrician,” an AAP-CA webinar planned by our chapter Climate Change and Child Health Committee in collaboration with colleagues from other California chapters. I know that changes in precipitation, temperatures and weather extremes play a role in what we see in our offices every day and I’m looking forward to learning more about what I can do. If you missed the session, check our chapter website for the recording.

The AAP Advocacy Conference was held in person in Washington, DC in March. Our chapter was well represented and I’d encourage you to read about the conference in our Executive Director, Yolanda Ruiz’s article in this newsletter. I missed the Advocacy Conference this year because I was in Tulsa, Oklahoma attending the International Meeting on Indigenous Child Health, a meeting that is held every other year and co-sponsored by the AAP and the Canadian Paediatric Society. The meeting includes participants from the USA, Canada, Central and South America, Greenland, Australia, New Zealand and many other parts of the world. Despite the fact that I no longer work primarily with Native American kids and families, I really enjoy connecting with friends and colleagues at this meeting and hearing about the amazing work being done by and in Indigenous communities. There were great talks and sessions on topics like mental health, mentorship, infectious diseases, gender-affirming care and Indigenous environmental justice and child health. It’s inspiring and motivating, and I’m grateful to be able to learn and participate.

Speaking of participation, there are still opportunities to participate in our chapter leadership and activities. We are recruiting for a South Valley Member-at-Large, Chapter EDI Champion and CATCH Grant Co-facilitator. Please contact Yolanda or me if you are interested in learning more about any of these positions. We will also be holding elections for our Chapter Vice-President this month - if you’re interested in running, please contact us ASAP. I also encourage you to take a look at our AAP CA1 Committees page on our website and see if any of our chapter committees are working on an issue that you would like to work on or learn more about. Being involved in the AAP and in particular our chapter has been an important part of my career, and I’d recommend it for anyone who wants to advocate for kids and those who care for them.

Developing Concerns: IEPs Versus 504 Plans in Schools
Renee Wachtel, MD, FAAP
Committee on Developmental and Behavioral Pediatrics Chair
What is the difference between Individual Education Plans (IEPs) and 504 Plans?

An IEP is developed for a child who has a disability which impacts their learning in school. It is how a child receives special instruction and related services such as speech therapy under the federal “Individuals with Disabilities Act” or IDEA. The most common reason that a child gets an IEP is for a Specific Learning Disability, but it can also be for 9 other disabilities such as Autism, Speech Language Impairments, or “Other Health Impairments”. The school must complete a comprehensive assessment of the child to see if one of these disabilities exist and then develop an IEP. The IEP specifies accommodations in school, services the child is to receive, and goals for these services. 

A 504 Plan is developed for a child who has a mental or physical disability who needs accommodations in school to be able to fully participate with the child’s non-disabled peers. These accommodations can be physical, such as preferential seating in the classroom, or non-physical, such as extra time on tests. There is no specific list of eligible disabilities or possible accommodations. Instead it must be appropriate for the child to enable them to participate fully in school. Importantly, with a 504 Plan the child does not receive any therapy or special instruction, and does not receive a comprehensive evaluation as part of the process. 

How do I refer my patient for an IEP or 504 Plan?

The most important thing to know is that the PARENT must submit a WRITTEN request to the school principal (or designee) which requests either an IEP or a 504 Plan. You can write it and sign it, but the parent must also sign it and deliver it to the school. The written request can be simple, stating that the child has your diagnoses and is struggling in school and needs either an IEP or 504 Plan. You do not need a 504 Plan if the child has an IEP since any accommodations should be in the IEP. 

Templates for these letters can be found at the following websites:

AAP Advocacy Conference
Yolanda Ruiz, BSPH
Executive Director
At the end of March, I joined over 300 pediatricians and leaders at AAP's Advocacy Conference in Washington, DC, marking the first in-person conference since the start of the COVID-19 pandemic. Attendees from all levels of advocacy experience came together to collaborate, learn from each other, and energize their efforts to be a bigger voice for kids.

Despite being one of the farthest states from Washington, California was well-represented with 15 attendees eager to gain valuable insights into pediatric advocacy. One of the conference's highlights was hearing from the first two pediatricians in Congress, Reps. Kim Schrier, MD (D-Wash.) and Yadira Caraveo, MD (D-Colo.), who shared their experiences as elected officials and emphasized the importance of pediatric voices in Congress. 

Our California group leaders, Eric Ball, MD, FAAP, Grant Christman, MD, FAAP, Yasuko Fukuda, MD, MPH, FAAP, Richard Pan, MD, MPH, FAAP, and Sharon Pham, MD, FAAP, deserve special recognition for their guidance as our group took to Capitol Hill to urge Senators and Representatives to pass policies to protect young people online. 

Overall, the AAP's Advocacy Conference left me feeling energized and equipped with valuable insights and tools to continue our advocacy efforts in California. If you are interested in beginning your advocacy journey, I encourage you to look into our Advocacy Committee where you will find pediatricians eager to help you every step of the way!
The SGA Side
Your Key to State Government Affairs
Nora Pfaff, MD, FAAP and Anna Kaplan, MD, FAAP
SGA Chapter Representatives
California Chapter 1, American Academy of Pediatrics Signs On to Three Support Letters: 

AAPCA1 signed on to a support letter requesting more funding for the Pediatric Mental Health Care Access Program in the FY 2024 from the Subcommittee on Labor, Health and Human Services, Education & Related Agencies. As mentioned in the letter, which you can read here: FY24 HRSA PMHCA Funding Letter Final.pdf

“We urge you to include $13 million for the program in the FY24 LHHS appropriations bill to allow HRSA to maintain all existing grantees and allow programs to expand the services they offer to additional settings, including schools and emergency departments as specified in the Bipartisan Safer Communities Act ̧ which reauthorized the program for five years. These are critically important sites for enhancing the availability of pediatric mental health team consultations because they are sites where children are often in need of care.”

In addition, AAPCA1 signed on to a letter requesting funding to conduct public health research on gun violence prevention from the Committee on Appropriations for both the U.S. Senate and the House of Representatives. As stated in the letter:

“As you consider appropriations for Fiscal Year (FY) 2024, the undersigned 408 national, state, and local medical, public health, and research organizations write to ask you to provide $35 million for the U.S. Centers for Disease Control and Prevention (CDC), $25 million for the National Institutes of Health (NIH), and $1 million for the National Institute of Justice (NIJ) to conduct public health research into firearm morbidity and mortality prevention. We also encourage Congress to explore opportunities for building out and further supporting this research at all other appropriate agencies, to ensure that federally funded research can explore the full scope of this public health issue.”

Finally, AAPCA1 signed on to a letter requesting an increase in funding for state grants and Community-Based Child Abuse Prevention (CBCAP) grants through the Child Abuse Prevention and Treatment Act. They are asking the Committee on Appropriations for both the U.S. Senate and the House of Representatives. The letter mentions:

“As you begin work on the FY 2024 Labor, Health and Human Services, and Education (Labor-HHS-Education) Appropriations bill, we write to urge you to include an increase in funding for Title I (state grants) and Title II (Community-Based Child Abuse Prevention (CBCAP), to $270 million for each of these titles. CAPTA is foundational to our country’s ability to prevent and respond to child abuse and neglect, yet it represents a small fraction of federal spending on child welfare services or prevention. It can therefore generate a major impact with relatively modest investments. Title I and Title II support the full continuum of services to infants, children and families – from prevention approaches that keep child abuse and neglect from occurring to interventions for children who are maltreated.”

For the most up-to-date information on AAP California bill positions, letters, and outcomes from the current California Legislative year, go to 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
See All Available Pediatric Jobs on our Job Board!
Opportunities for Your Benefit
Keep Your Child Safe from Cannabis Edibles
As you know, there has been a significant increase in accidental consumption of cannabis edibles by children. A recent study in the journal Pediatrics, January 3, 2023, found that in 2017, there were just over 200 reported cases of accidental consumption of cannabis edibles by children under six. In 2021, the number shot up to 3,054 – an increase of 1,375%! In total, there were 7,043 exposures to edible marijuana reported to poison control from 2017 to 2021 in children under six. The vast majority of the kids found the drug in their own home. While most children suffered mild impacts, 22.7% of exposed children needed hospitalization, and 8% of them – 573 children over the five years of the study – needed critical care. Reference (Pediatric Edible Cannabis Exposures and Acute Toxicity: 2017–2021. Pediatrics (2023) 151 (2): e2022057761).

AAP-OC Chapter in collaboration with the Pasadena Public Health Department have created this informational flyer titled, "Keep Your Child Safe from Cannabis Edibles" to promote awareness about the risks of edible cannabis especially as it becomes more easily accessible and as the rate of consumption increases among children.
May 25 - Data Exchange Framework Chat - SAVE THE DATE!
December 2 - 8th Annual Pediatric Puzzles CME Conference - SAVE THE DATE!
December 8-10 - 2023 Las Vegas Seminars - REGISTER HERE!

Other Events for Your Interest:
May 18-19 - Inflammatory Brain Disorders Conference 2023 - REGISTER HERE!
July 30 - 40th Annual Conference on Pediatric Infectious Diseases - REGISTER HERE!
Add our social media accounts to get the latest chapter updates!

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: Resham Kaur • Treasurer: Amita Saxena • Past President: Raelene Walker
Executive Director: Yolanda Ruiz

Board Members:
North Valley MAL: Thiyagu Ganesan • Sacramento Valley MAL: Lena van der List • Central Valley MAL: Deborah Shassetz • South Valley MAL: Vacant • San Francisco MAL: Maya Raman • Santa Clara MAL: Vacant • 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 Coordinator: Sana Sayyid