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Black Maternal Mortality

Despite recent information this week, the incidence of Black maternal mortality in the U.S. continues to be one of the most egregious modern day health inequities that requires our continued examination into its multifaceted causes, effects and repercussions.

A maternal death is defined by the World Health Organization as, “the death of a woman while pregnant or within 42 days of termination of pregnancy, irrespective of the duration and the site of the pregnancy, from any cause related to or aggravated by the pregnancy or its management, but not from accidental or incidental causes”. According to the CDC, in 2021, the maternal mortality rate for non-Hispanic Black women was 69.9 deaths per 100,000 live births, 2.6 times the rate for non-Hispanic White women (26.6). Maternal mortality rates among Black women were significantly higher in comparison to those of White and Hispanic women.


Read more . . .


Amna Khan, MD, FAAP

Equity, Diversity, and Inclusion Champion, Chapter 1 AAP

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Developing Concerns

As every pediatrician is aware, there is a HUGE problem with ADHD medication shortages. And if the ADHD medication shortage wasn’t frustrating enough, apparently certain ADHD medications have doubled or tripled in cost since the shortage began in October 2022.


According to a December 2023 report, the prices that retail community pharmacies pay for specific dosages of methylphenidate and dexmethylphenidate doubled from late 2022 to December 2023. And they were not cheap to begin with. For example, 100 tablets of 5 mg short acting Adderall costs about $1139, and 100 capsules of Vyvanse costs around $1306 without insurance. And generics are in very limited supply for those medications that have generic availability. So not only is the medication hard to get, but the pharmacies are passing on the increased costs to our patients. In addition, many of our patients are only able to get a limited quantity (for example, 10 daily tablets with my prescription for 30 tablets) at a time from the pharmacy with a monthly prescription. 


WHAT CAN WE DO ABOUT IT? 


Read more . . .


Renee Wachtel, MD, FAAP

Chair, School Health and Behavioral & Developmental Committees

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President's Column

Happy spring everyone! I hope by the time you read this, viral respiratory illness season is finally slowing, and the snot is no longer flowing. As I often say, I am continually humbled and amazed by the wonderful work all of you do to improve the lives of kids and make our communities—and our chapter—stronger. That’s why this month I want to highlight several great opportunities for anyone interested in growing their advocacy and their leadership skills. Read on below for more information on these exciting opportunities. You will also learn more about these opportunities in this April Newsletter!


They are: 

  1. Our amazing Advocacy Committee is seeking both a trainee and an attending co-chair.
  2. We are seeking applicants for our Chapter CATCH Facilitator position.
  3. Our wonderful Pediatric Insider News editorial team is looking for a new member editor.


I hope many of you will consider applying for one of these roles. They are all vital to the functioning of our chapter, and a great way to continue to grow as leaders and advocates, because all of you are the heart and soul of our amazing chapter. All of us on the board are honored to be able to serve you, and we want to continue to improve how we do that. 


Here’s to warm days and drier noses.


Nikki Webb, MD, FAAP

AAPCA1 President




Reader's tip!


 Find a podcast featuring our Climate Change and Child Health Committee Chairs, Dr. Sonja Swenson and Dr. Naomi Bardach;  along with reading and listening recommendations by Dr. Amna Khan under "Resources" in this Newsletter!

Child Death Review

The first Child Death Review Team in California was started by Dr. Michael Durfee in 1978 in Los Angeles. His impetus was discovering that a child who died from child abuse or neglect was inconsistently documented by death certificate, state homicide data or state child abuse reporting. PC11666.7 in 1989 allowed the creation of CDRTs with the sharing of confidential information between various agencies so that cases of child abuse-related fatalities would not be missed.


The good news is that relatively few children die from child maltreatment. However, many children die from preventable causes. The main goal of child fatality review is to understand why children die in a community (county) and then to take action to prevent subsequent injury or death.



Most counties in California have teams and there is a current movement to activate or reactivate teams that have either ceased or decreased their reviews. There is an online CDRT toolkit with extensive information and state of the art recommendations for how to form and run a CDRT.


Membership is multidisciplinary but at a minimum includes Coroner’s Office, District Attorney, social services, pediatrician, EMS, law enforcement, and probation. Our team in Contra Costa includes SIDs Program (Public Health), Crisis Center and the Child Abuse Prevention Council.


Our team reviews all Coroner cases under 18 and meets bimonthly. Coroner cases include all homicides, suicides, “accidents”, suspected SIDS and undetermined deaths. Most natural deaths such as prematurity, congenital conditions and infections are not reviewed by our team.


Read more…


Jim Carpenter, MD, FAAP

Chair, Contra Costa County Child Health Review Team

Read More

The following are just a few of the key bills to note of interest to AAP-CA. Visit the AAP-CA website’s Advocacy page at https://aap-ca.org/advocacy/ to see the entire list of AAP-CA tracked bills that made it to the Governor’s desk where you can read the outcome of each bill and an in-depth analysis.


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. 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.

AAP-CA Bill Tracker

Committee Meetings & Chapter Leadership Positions


Mental Health Committee Meeting


Date: Wednesday, April 10

Time: 7PM via Zoom


Diane Dooley, MD, MHS, FAAP,

Mental Health Committee Chair

Register Here

Join AAP-CA3 for their Virtual Town Hall: Issues in Immigrant Health 


Pediatricians provide insights into issues they are seeing with refugee/border patients in San Diego. Register for a presentation with Q&A and free 1.5 CME credits. 


Date: Monday, April 8

Time: 6:30PM via Zoom


Speakers:

Janine Young, MD, FAAP

UC San Diego


Kristin Brownell, MD, MPH

Family Health Centers of San Diego


Register Here


Advocacy Committee Chair Positions


Are you passionate about child health, health equity, and advocacy? Are you looking for an outlet to meet others with similar interests and to expand your advocacy and leadership skills? If so, we invite you to apply to serve as a Co-Chair for the Advocacy Committee!


About the roles

  • One trainee (student, resident, or fellow) to serve a one-year term
  • One attending member to serve for at least two years


Roles begin starting late Spring/early Summer. Ideal applicants will show strong leadership and collaboration skills, a demonstrated commitment to health equity, and advocacy interest/experience.


About the committee

The AAP-CA1 Advocacy Committee brings together pediatricians and trainees from throughout Northern and Central California to build relationships, enhance advocacy skills, and effect change towards healthier, more equitable ecosystems for young people. We host advocacy committee meetings on a quarterly basis and organize advocacy-related events and collaborations, such as Chapter Chats on advocacy skills and Advocating for Children Together (ACT) conferences. Our leadership structure consists of 2-3 attending co-chairs and 1 trainee co-chair, because we value a diverse range of perspectives and experiences.


How to apply | Deadline extended to April 15, 2024

  1. Complete the application form HERE
  2. Email your CV to co-chairs Dr. Morgan Leighton (morganleighton89@gmail.com) and Dr. Stephanie Fong Gomez (fonggomezmd@gmail.com) and cc info@aapca1.org


Apply Here

CATCH Facilitator Position


The AAP Community Access to Child Health (CATCH) Program is seeking applications for the position of Chapter CATCH Facilitator (CCF). CCFs are appointed by their state Chapter to serve a renewable three-year term. CATCH’s mission is to support pediatricians to collaborate within their communities to advance the health of all children. Our vision is that every child in every community reach optimal health and well-being.


To apply send CV to Yolanda Ruiz ayolanda.ruiz@aapca1.org.

Temporary Funding Assistance for Providers


The Temporary Funding Assistance Program made available by Optum assists providers affected by disruptions in Change Healthcare's services, bridging short-term cash flow gaps. It offers free financial relief, determined by the variance in weekly claims/payment volume before and after the disruption.

Visit the Website

DMHC Wants to Hear from Physicians about Health Barriers


The Department of Managed Health Care (DMHC) is in the process of conducting behavioral health plan investigations to assess barriers and challenges physicians and other provider types experience in providing or ensuring behavioral health services for their patients. DMHC is looking to identify systemic changes that could be made to improve timely and appropriate access to behavioral health care services. For 2024, DMHC is conducting investigations of the following five health plans:


  • Chinese Community Health Plan
  • Molina Healthcare of California
  • UnitedHealthcare of California
  • San Francisco Health Authority
  • Aetna Health of California


This is an opportunity for physicians to share specific barriers both they and their patients encounter when trying to provide or secure timely and appropriate access to behavioral health services for their patients.


Click here to see CMA’s article.

CMA's Article 

ACES Champions Health Gathering


This presentation will provide information to help professionals distinguish normative from problematic sexual behaviors in children and teens, identify potential contributing factors to the behavior, and learn about common misconceptions.


Date: Friday, April 19

Time: 12PM via Zoom

Register Here

The California 2024 Summit Immunization Coalition


The California Immunization Coalition Summit is the premier event for practitioners and public health advocates to learn about the latest information about vaccine preventable diseases and communication strategies for maintaining and improving vaccination rates in California and beyond.


Date: Wednesday, June 5-6

Time: 9AM at the Safe Credit Union Convention Center located in downtown Sacramento

Register Here

Visit our Pediatric Job Posting Board!


View new available jobs or post one of your own. Visit our site to view member discounts

https://aapca1.org/jobs/

Resources

Kids Considered™ - Climate Change and Pediatric Health


Catch two of our Climate Change and Child Health Committee Chairs, Dr. Sonja Swenson and Dr. Naomi Bardach, in the Kids Considered™ Podcast, a UC Davis Children’s Hospital pediatrician-led podcast focused on child health and parenting.

Climate Change and Pediatric Health - Part 1


Climate Change and Pediatric Health - Part 2


Recommended by our Climate Change and Child Health Committee



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Reading Recs


Books:

Weathering: The Extraordinary Stress of Ordinary Life in an Unjust Society”, by Arline T. Geronimus  


“Under the Skin: The Hidden Toll of Racism on American Lives and on the Health of our Nation”, by Linda Villarosa 



Article:

"Black Mothers Keep Dying"



Recommended by Dr. Amna Khan, EDI Champion



Media Recs


Podcasts:

American Dissected, The Black Maternal Health Caucus with Rep. Lauren Underwood 


KQED Forum, How California’s Black Doulas are Fighting the Maternal Mortality Crisis 


Movie Trailer:

Black Motherhood through the Lens”


Documentary created by medical student at Brown University and filmmaker, Adeiyewunmi (Ade) Osinubi spotlighting black maternal health inequities. 



Recommended by Dr. Amna Khan, EDI Champion

Movie Trailer


Black Motherhood through the Lens”


Documentary created by medical student at Brown University and filmmaker, Adeiyewunmi (Ade) Osinubi spotlighting black maternal health inequities. 


Recommended by Dr. Amna Khan, EDI Champion

View Here

Trauma-Informed Care (TIC)


Trauma-informed care (TIC) is defined by the National Child Traumatic Stress Network  as medical care in which all parties involved assess, recognize and respond to the effects of traumatic stress on children, caregivers and healthcare providers.


The resources below, including resources from the AAP Pediatric Approach to Trauma, Treatment, and Resilience (PATTeR) project, provide information and guidance on implementing TIC in pediatric settings.

Learn More

Parenting After Trauma


All children need homes that are safe and full of love. This is especially true for children who have experienced severe trauma. Early, hurtful experiences can cause children to see the world differently and react in different ways. Some children who have been adopted or placed into foster care need help to cope with what happened to them in the past. Knowing what experts say about early trauma can help you work with your child

Learn More

Cure Violence Global


This program brings behavioral health consultation, training, and support to pediatric primary care and other providers so that children’s mental health needs are met.









Learn More
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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: Nicole Webb • Vice President: Neel Patel

Secretary: Resham Kaur • Treasurer: Amita Saxena • Past President: Nelson Branco

Executive Director: Yolanda Ruiz


Area Directors:

North Valley : Thiyagu Ganesan • Sacramento Valley: Lena van der List • Central Valley : Deborah Shassetz • South Valley: Sireesha Palkamsetti • San Francisco: Maya Raman • Santa Clara: Bindya Singh • San Mateo: Jackie Czaja • North Coastal: Jeffrey Ribordy • Monterey Bay: Graciela Wilcox • Alameda County: Renee Wachtel • Contra Costa/Solano : Omoniyi Omotoso


Pediatric Insider News Editors:

• Mika Hiramatsu • Deborah Shassetz • Alyssa Velasco


Staff:

Executive Director: Yolanda Ruiz Project Coordinator: Sana Sayyid •

Marketing Assistant: Arathzy Portillo