AUGUST • 2019
Among August

The August line-up of A's:
Awards for amazing individuals
ALF for interested resolution writers
Access in Mental Health and
Activism in climate change.

President's Column
Raelene Walker, MD, FAAP

The national headquarters of the American Academy of Pediatrics is in Itasca, Illinois, in a beautiful, big, well-designed building that was completed in 2017. As the home of the AAP, it truly belongs to its members, all of us. If any of you are near there, you should visit and be inspired by the quotes on the walls, the poster displays of current high priorities, the art work, and the amazing people inside who are working hard on behalf of children.   

Many of our chapter leaders including Nivedita More, MD, FAAP , Treasurer,   Janice Kim, MD, MPH, FAAP , Secretary & Communications Director and CATCH Grant District Representative, Jacques Corriveau, MD, FAAP , District IX State Government Affairs Committee Co-chair, Yasuko Fukuda, MD, FAAP , District Chair, and I just returned from Itasca for our annual district meeting, a 4 day meeting held jointly with another district each summer. This year, our district met jointly with District II from New York state. We are the only two districts comprised completely of chapters from a single state and therefore have many similarities. We greatly benefitted from the opportunity to learn from each other, network, and strategize together about further ways to promote child health and well-being and to support pediatricians. We also had the opportunity to make new friendships and to reconnect with old friends, which will help us all sustain our energies as we continue to do important but often challenging work.  

A highlight of this year’s district meeting was the recognition of the good work and successes of several individuals in our chapter and an award for our entire chapter: 

Special Achievement Award from District IX (AAPCA): California Chapter 1, for their efforts to improve access to mental health, their work on disaster preparedness, especially after their devastating wildfires, and their work on developmental and behavioral screenings.
J. Raul Gutierrez, MD, FAAP , for advocacy on behalf of immigrant children and communities, for leadership in creating a conference on immigrant health and forming collaborative relationships with community partners to protect our children and families and to empower all of us to become more engaged advocates. 

Diane Dooley, MD, FAAP , for charismatic leadership for the Mental Health Access Ad Hoc Committee in addressing the current barriers that pediatricians face when referring children and youth for behavioral and mental health services. 

Rhea Boyd, MD, MPH, FAAP , for passion and persistence in advocating for equity and inclusion both within the chapter as well as nationally; and for leadership and insight in developing and facilitating practical workshops and discussions to address diversity and inclusion in organizations. 

Isra Uz-Zaman, MS in recognition of her excellent work as Executive Director of AAP California Chapter 1.

Congratulations and thank you to these amazing people, and to our chapter as a whole. 
Top Left: District IX (AAPCA) Leadership
Top Right: California Chapter 1 Leaders. Left to Right: Isra Uz-Zaman (Executive Director), Janice Kim (Secretary & Communications Director), Nivedita More (Treasurer), Raelene Walker (President)
Bottom: District IX (AAPCA) and District II (New York) Leadership
"Whereas, ... Resolved" - Time to Start Writing Your ALF Resolutions!
John I. Takayama, MD, MPH, FAAP
Immediate Past President

Advocacy can come in many forms, with legislative advocacy the most visible. At the Academy (AAP), one annual effort to “change the system” is the Annual Leadership Forum (ALF) where leaders of chapters, committees, sections and councils gather to discuss merits and vote to determine the “top 10 resolutions.” As one who has written a couple, here are three key ingredients to a successful resolution.

Pick an issue that you are passionate about! My first resolution (Fall 2016) was about home health care because I provide primary care to children who are technology dependent. I have heard so much from families about how difficult it is to find a “reliable” home care nurse; some have been waiting for years and others have had to contend with episodic care, with nurses calling in sick or having to transition from one nurse to the next with gaps in between.

Write a resolution after doing your homework. Sometimes passion gets in the way of due diligence. It’s always humbling to do a PubMed search or a search of past ALF resolutions to find out that something you were concerned about has already been addressed. Homework can also reveal key information that you can include in your resolution. In my example, I found out about a national shortage of home care nurses and experts’ concerns that reduced quantity/quality of home care nursing may result in more frequent ED visits and hospitalizations.

Assemble a team that can guide you to improve your resolution. This means that you need to become connected. As a pediatrician who provides primary care for children with medical complexity, I have been a member of the APA (Academic Pediatric Association) Complex Care SIG (Special Interest Group). Through a query to their list-serve, I was introduced initially to the AAP Council on Children with Disabilities and eventually to the AAP Section on Home Care. I was invited to articulate my concerns at their executive committee meeting at the NCE (National Conference and Exhibitions); and was also able to obtain corroborating information, discuss potential solutions and craft a feasible resolution. At the actual ALF in 2017, several supporters spoke up on behalf of the resolution.

It’s summer and time for rest and rejuvenation; it’s also an excellent time to start work on your ALF resolution. For orientation and tips on assembling a team, please contact our chapter ; for hands-on help, attend our “ Advocating for Children Together ” conference. For detailed steps on writing a resolution and searching the database of past ALF resolutions, go to the ALF webpage and/or the Guidelines for Submitting Resolutions .
Mental Health Access Committee: Pediatric Mental Health Day Conference - Come to Madera on November 9!
Diane Dooley, MD, MS, FAAP

The Mental Health Access Committee is excited to announce that we will be holding a second California Chapter 1 Pediatric Mental Health Day CME conference in Madera on Saturday, November 9 . Our first conference on this topic, sponsored jointly by the CME committee and the MH Access Committee and held in May, had record attendance of pediatricians and other care providers anxious to develop their skills in addressing mental health issues in their practice. The attendees gave us outstanding reviews for both the speakers and the format of the first conference.
Valley Children’s Hospital in Madera is generously sponsoring this conference in partnership with AAP California Chapter 1, which will allow us to reduce the price of the conference and bring in another group of outstanding speakers. Save the date and consider a November trip down to visit scenic San Joaquin Valley farms and wineries, just 2.5 hours driving time from Oakland and 60 miles from Yosemite. Sign-up will begin in mid-August for this conference.
Our committee continues to address many of the access and quality issues identified by pediatricians as essential in providing mental health/behavioral health services to children and teens in our practices. The California Department of Health Care Services released a draft proposal to fund trauma (ACEs) screening in pediatric practices starting in January. We have been working with AAP California and advocacy groups to assure that pediatric practices have the training and support they need if they elect to begin these screenings. We’ve also worked with AAP California and other advocacy partners to develop position letters on important regulatory and quality issues impacting mental health access, including advocating for appropriate access to care for children needing mental health referrals, assuring appropriate authorization policies for mental health referrals, and the upcoming proposal to pay health systems to integrate behavioral health into their pediatric practices.
Come to our conference or join our committee (contact, and we’ll fill you in on more new developments including statewide and local efforts to enhance child psychiatry consultations for providers!
Alameda Member-At-Large Report
Notes from a Wannabe Climate Change Activist
Amanda Millstein, MD, FAAP

I don’t know if it’s the last two seasons of wildfires in Northern California. I don’t know if it’s that I now have two young kids whose futures are at the forefront of my thoughts and my every decision. But I cannot stop thinking about climate change and what it means for our kids, their kids, and the future of our planet.

As a primary care pediatrician, I am by nature a child advocate and therefore an advocate for the future. My training and my scope of practice has equipped me to think critically about how stress in a child’s home or school can impact his or her health. The threats of a changing climate -- increasing frequency of natural disasters, heat waves, extreme weather conditions -- are disproportionately going to affect my children and my patients. 

The truth is, more often than not, I feel paralyzed by the hugeness of this problem and unsure how to proceed. I want to be a climate change advocate, but I feel overwhelmed about where to begin. On a personal level, I am working to eliminate my plastic usage, driving an electric car, and walking whenever possible. I am using cloth napkins and buying second-hand clothes for myself and my kids. I am talking to my 3.5-year-old son about food and paper waste and the importance of taking care of the earth. But how do I talk to him about fires and floods and hurricanes that are the result of years of humans being poor environmental stewards? At work, many of the families I work with have such pressing concerns -- food insecurity, community violence, immigration status -- that it feels that the discussion of climate change and its associated threats are secondary to what is going on in their lives this minute and this week. 

I was recently talking to my own primary care doctor at Kaiser Oakland, who calls herself a climate change physician. She believes that physicians are uniquely positioned both by our training and also our respected status in our communities to educate people about climate change and help set into place policies that will ideally mitigate its effects. This idea resonates deeply with me. She and I also talked about how as physicians we have the ability to hold a long timeline in our heads. We have the unique privilege of worrying not about getting food onto our kids’ dinner plates tonight, but about what our kids will serve their kids for dinner decades from now.

I understand that there is a lot of work being done in this area. Recently the AAP and AMA as well as many other international and national organizations signed their names to “ A Call to Action on Climate and Health ”. There are federal and state-based organizations that are organizing around these issues, as well as local organizations. I recently joined “Health Care Without Harm.” This feels like a start, but I am still unsure of exactly how to leverage my role as a community-based pediatrician in a meaningful way.

My question is: how do we as pediatricians, especially those of us who are community based without the structure of a Kaiser-type organization behind us, talk to our patients in our clinics and our communities about these issues? How can we best leverage our position to not only educate our patients and families but also promote policies that will make a difference? 

I want to be a climate change advocate. The time is literally now -- if we as Americans and as a world don’t make some large changes now, the future for our kids and their kids is in serious jeopardy. I would love to hear what others in this group are thinking. Please email me at with any thoughts, ideas, or ways to engage around this topic with fellow pediatricians and with our patients.
The SGA Side
Your Key to State Government Affairs

40.5% of YOUR chapter dues go to the AAPCA district for legislative advocacy on behalf of all of the children in California with ONE voice. Thank you for making this possible! We encourage you to continue to familiarize yourself with the AAP California legislative advocacy priorities and view the positions we have taken on related bills

The legislature is currently in recess. In the meantime, feel free to visit the California Legislature website to search and read about the bills of your interest, monitor their progress, and much more. You can find the following information under these tabs:
Text : This is the actual text of the bill. Red cross-out marks mean the language was amended to be deleted. Blue means the language was amended to be added.  
Votes : Will tell you all of the votes in every committee that the bill has been heard in
History : Tells you the full history of the bill with the steps that it went through
Bill Analysis : A great place to read about the bill in "normal" language aka understandable by those not as familiar with legislative lingo; will also include author intent for the bill and a list of supporters/opposition; is usually populated prior to each committee hearing
Status : Will tell you the status of the bill (where and when it is being heard) along with a snapshot of the history.
And more ...
Opportunities for Your Benefit

Engagement Opportunities in Chapter Committees
If you would like to address a certain area of interest, we encourage you to get involved with our chapter committees and/or reach out to us with ideas.

AAP Hub & Spoke QI Opportunity
As an extension to the AAP HPV quality improvement (QI) initiative, there is an opportunity to gain additional QI knowledge and learn from each other at the upcoming AAP’s 2019 Hub and Spoke Quality Improvement Training August 23-24 in San Diego, CA: This training will have two tracks and two presenters. One track will be QI Basics 101 and the other will be QI Intermediate. If you are interested, please contact California Chapter 1 at
Pediatric Musculoskeletal Boot Camp for Primary Care Providers
The National AAP Section on Orthopaedics presents Pediatric Musculoskeletal Boot Camp for Primary Care Providers . The Boot Camp course combines case-based lectures, interactive physical exam and casting/splint workshops, and question and answer sessions to address frequently seen problems of the MSK system in children and key aspects of physical examination of the musculoskeletal system. Through coverage of key MSK topics, the course focuses on improving the musculoskeletal care of children. 
The Boot Camp course takes place on September 21, 2019 in two locations - one right in San Francisco!  Please join the pediatric orthopaedic faculty from UCSF for this high yield MSK course. Dr. Coleen Sabatini is the local course Director and faculty include Drs. Nirav Pandya, Mohammad Diab, Sanjeev Sabharwal, Jason Jagodzinski, Kristin Livingston, bone health expert Dr. Ellen Fung, Rheumatologist Dr. Nicole Ling and new MSK Pediatrician Celina de Borja. AAP Chapter 1 Past President Dr. John Takayama will give the lunchtime address and current President Dr. Raelene Walker will welcome everyone that morning!  It will be a wonderful day of learning and demystifying pediatric MSK conditions and physical exam. Please join us!
For more details on the course and for links to register visit

October 5, 2019:  Advocating for Children Together Conference, Oakland - Register Now

October 25-29, 2019:   AAP National Conference & Exhibition , New Orleans

November 9, 2019:  Pediatric Mental Health Day, Madera (Valley Children's Hospital)

November 21-24, 2019: AAP California 41st Annual Las Vegas Seminars - Pediatric Update

December 7, 2019:   4th Annual Pediatric Puzzles Interactive CME Conference , San Francisco

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