August • 2020
August Seems to Have Adapted

August seems to have adapted
To the challenges that today has commanded.
Read of all the changes and developments
A display of our grit, evidence.

President's Column
 Raelene Walker, MD, FAAP
As challenging as this year continues to be, I find solace and joy with the numerous and impressive activities going on in our chapter right now. To begin, I would like to offer a very warm welcome to our new Member-at-Large board members, elected last month. Congratulations and thank you in advance to Alameda MAL Dr. Reshem Agarwal , North Valley MAL Dr. Thiyagu Ganesan , San Mateo MAL Dr. Neel Patel , Santa Clara MAL Dr. Meera Sankar , North Coastal MAL Dr. Lauren Steele , and South Valley MAL Dr. Nicole Webb . Please see below for more detailed introductions.  

As we’ve announced earlier, our chapter received three significant grants this spring to fund chapter projects, and all are now underway. To make it easier to obtain information about these projects as they progress, they are now listed as a new tab, “ Initiatives ” on our chapter website, under the home page tab “About”. Please check them out to learn more about the ACES Aware Communication grant project, Ashew QI project, and Healthy People 2020 grant project.  

I would also like to announce the formation of our new chapter Practice Support Taskforce. This group will help pediatricians with pediatric practice related issues of all kinds, in all types of practice settings. This topic will be the subject of our next Chapter Chat so please look for that upcoming information to learn more about how to get the support you need, as well as how to participate if you are interested.  

We have multiple events and conferences coming up that I encourage you to get on your schedule, if you have not already. Please join us for our second annual ACT (Advocating for Children Together) conference Saturday, September 12 .  Our ECP (Early Career Physicians) committee is having a town hall on August 25 focusing on Boards and MOC. Our annual chapter CME Pediatric Puzzles will be Saturday, December 5. All of these events will be virtual and the planning committees are working diligently to make these events exceptional. 

I also want to thank our phenomenal panelists and chapter leaders that presented for our Chapter Chat on Diversity, Equity, and Inclusion on July 21. It was amazing and if you missed it, please look for the recording on our DEI webpage to hear from Dr. Shaquita Bell , Dr. Rhea Boyd , Dr. Raul Gutierrez , and Dr. Tiffani Johnson . Our chapter will be doing more work on this topic as a chapter priority. Please let us know if you would like to be involved.  
In addition, please join me to celebrate and acknowledge Dr. Tom Newman , winner of the 2020 AAP Education Special Recognition Certificate for an amazing and ongoing career that has contributed so much to pediatric education. Congratulations for this well deserved national award!

Thank you to all of our members who are active and engaged in these challenging times.
Vice President's Column: The Navajo COVID Experience
Nelson Branco, MD, FAAP
It is obvious that the novel coronavirus pandemic has exacerbated and revealed racial inequities in our country and our communities in a way that many of us have never seen. Those of us who work with these children and families may be unsurprised, but it remains to be seen what our country will do to address these issues. Do we have the political will to spend our resources in a way that improves the health of those communities? I heard last week that there may be a recommendation for a COVID vaccine to be used first in BIPOC (Black, Indigenous, and People of Color) communities, providing protection in the places where it is needed most. Having worked in and advocated for Native communities, I have seen firsthand how a vaccine program that prioritizes protection for those at highest risk can change the health of a community and I would support prioritization of those communities for protection against COVID.
Virtual ALF is ON!
John Takayama, MD, MPH, FAAP
Immediate Past President
If you want the Academy to act on a particular issue, idea or concern that it has not yet addressed, don’t wait, submit a resolution! Given the continuing COVID-19 pandemic, the Annual Leadership Forum (ALF) has been delayed and will now take place virtually on August 16 and 17. The ALF is where leaders of chapters, committees, sections and councils discuss the merits of submitted resolutions and vote to determine the “Top 10.”

This past fall, members of our chapter submitted resolutions on topics critical to children and families we care for, pediatricians and trainees, and our organization; and these include early childhood education, school nutrition, LGBTQ rights and protection, styrofoam, rapid response to ICE, racism/discrimination/bias, climate change, preventive mental health care, and political misinformation on social media and correct spelling and pronunciation of names.
Incoming Members-At-Large
Alameda Member-At-Large
Reshem Agarwal, MD, FAAP
Reshem Agarwal is a general pediatrician at Marin Community Clinics in San Rafael, California. She grew up in the Mojave Desert and completed both her undergraduate studies in Biology and medical school at the University of Southern California. She then moved to Washington, D.C. for residency at Children’s National Health System where her training emphasized community health and advocacy. Since completing residency in 2017, Reshem returned to her home state and enjoys residing in Oakland. She worked in primary care pediatrics for Alameda Health System from 2017-2019 before transitioning to her current position.

As Member-At-Large for Alameda County, Reshem hopes to listen to what the community needs and help her fellow pediatricians work effectively to deliver on those needs. As we are in unprecedented times with regards to the global pandemic that is unfolding, we are seeing the stressors that impact our communities multiplying each day. The agenda may need to be dynamic during these times but often in the face of challenge, communities come together. Reshem envisions that through the unanticipated disruption of the systems we were once familiar with, there is opportunity for new directions and lasting positive change in healthcare and other sectors of society as well. Help her set the agenda by sharing your thoughts and insights--she is all ears!
San Mateo Member-At-Large
Neel Patel, MD, FAAP
Caring for the health of children brings me profound joy. Working together with like-minded colleagues brings me great joy. To join the AAP Chapter 1 Board as the Member at Large from San Mateo County certainly brings me joy—and is a blessing.   

My ties to San Mateo County are strong and rooted since my early childhood. San Mateo County is where I grew up, attending preschool through high school. Since completing my pediatric training at Children’s Hospital of Orange County and Children’s Hospital of Oakland, I have practiced as a pediatrician in San Mateo County at several institutions over the past 20 years--first as a NICU hospitalist for LPCH (Stanford Children’s), then at the San Mateo County Health System as a pediatric medical director in Redwood City, and now as a pediatrician and Tier 1 medical director in pediatrics at San Carlos Palo Alto Medical Foundation. Working in these different settings has taught me a great deal about our community networks of care and how to practice pediatrics while inspiring and leading change in the academic, public, and private sectors.
South Valley Member-At-Large
Nicole Webb, MD, FAAP
Hello from Fresno AAP CA-1! I am both excited and humbled to have the opportunity to serve you as the South Valley Member-At-Large. I am a board-certified pediatric hospitalist at Valley Children’s Hospital, a beautiful, freestanding children’s hospital in the heart of the San Joaquin Valley. While as an inpatient physician the hospital is my “home”, it is part of a much larger healthcare network, serving 13 of California’s most underserved counties, with a catchment area that encompasses 1.3 million children. We care for some of California’s most vulnerable children; over 70% are publicly insured or uninsured. Many of our families lack even the most basic of necessities, and we bear daily witness to the magnitude of health disparities that continue to affect children in underserved areas.

As a pediatric resident, I was fortunate to receive significant training in advocacy, and that continues to serve me well in my post-residency life. One of the main ways I try to advocate for the improvement of children’s health is through medical education.
Practice Support Task Force Launch
Nelson Branco, MD, FAAP & Amita Saxena, MD, FAAP
COVID-19 has upended much of what we used to think of as “normal”, and the healthcare system is both the epicenter and fallout zone of the chaos. Some parts of the healthcare system are stretched to the breaking point while other parts are in danger of shutting down completely. Pediatricians practicing in a state as diverse as California will face challenges that may be unique to our neighborhoods, but many of us are facing universal problems such as getting testing for our patients, sourcing PPE, managing the business side when visit volumes have dropped, just to name a few!

Our chapter leadership recognized that unique times call for unique solutions, and so the Practice Support Task Force was created! Our goal is to help pediatricians navigate the unprecedented challenges of these times by providing useful, timely and actionable information as well as advocating on behalf of our members. If you are interested in participating in the task force or have questions please feel free to contact Dr. Nelson Branco at [email protected] or Dr. Niki Saxena at [email protected] . We can and will get through this together!
Early Career Physicians Town Hall
Tashya J. Whitehead, MD, FAAP
Chair of Early Career Physicians Committee
Last month, ECPs from around the state gathered in our first ECP town hall, where we discussed transitioning to attending life and work-life integration. Based on the feedback we received, we are thrilled to invite you to our second town hall on Boards & MOC! This virtual town hall will take place on Tuesday, August 25 from 6:30-8:30pm. Save the date and RSVP HERE ! The official invite will be sent out via the ECP listserv in the coming weeks. We hope to see you there!
The Climate Crisis and You
Sarah Schear, MS4
Co-Chair of Climate Change and Health Task Force
As pediatricians and trainees, we have all experienced moral awakenings that compelled us to take action to protect children. These reckonings may come through confronting health injustices, systemic racism, and other entrenched problems in our society.

As I step outside each day, putting on my mask reminds me of a particular time of moral awakening for me: the fall of 2018, when the Camp Fire raged through Paradise, CA. I remember the sharp smell of smoke seeping through my apartment windows in San Francisco, and wearing an N95 mask as I walked through haze to and from the Labor and Delivery unit for my third year OB-GYN rotation. It felt so wrong to me that the babies born in that unit would soon breathe such air.
Mental Health Committee Update
Diane Dooley, MD, MHS, FAAP
The Mental Health Committee continues to meet every 2-3 months, with 8-10 active Chapter members participating in our numerous initiatives. One of the best parts of our virtual meetings is the opportunity to share the projects that committee members are engaged in to improve access and quality of care for children and teens with mental health concerns. At our June meeting, John Takayama shared his involvement with the ASHEW (Addressing Social Health and Early Childhood Wellness) grant , led by Chapter members Gena Lewis and Dayna Long . This is a national AAP grant dedicated to assisting practices in initiating ACEs screening and support for families. We also have many members of our Committee involved in the California ACEs Aware grants to encourage adoption and implementation of ACEs screening and trauma-informed care practices in primary care offices. Our previous work in developing AAP training in primary care mental health has helped us identify and support Chapter members with tremendous skills and expertise in both mental health and adverse childhood experiences.

We’re looking forward to the upcoming posting of the “Mental Health” issues page on our Chapter website. Members from our Committee have worked together to generate topic pages and invaluable description lists of resources for pediatricians interested in learning more about...
News from National AAP
AAP Official Podcast Now Available:  The American Academy of Pediatrics has launched its podcast, Pediatrics On Call. Listen at . Pediatrics On Call is supported by Johnson & Johnson, the global health care company.

AAP Chapter Chat: AAP hosts weekly chapter chats on Wednesdays at 10AM PST to provide the latest COVID-19 and other updates for chapters. If you are interested in joining, contact: Connie Schmidt in Chapter and District Relations.

#AskThePediatrician Facebook Live: To help parents stay up to date with news and recommendations for children's health and parenting during COVID-19, Healthy Children hosts an #AskThePediatrician Facebook Live chat every Wednesday at 12:00 pm CT.
In Memoriam of Dr. Bert Lubin
Gena Lewis, MD, FAAP
Dr. Bert Lubin died June 27 at the age of 81. It is hard to say anything about Bert in the past tense because his immense energy powers so many of us in the field of Pediatrics and the worldwide community that cares about children. 

Like so many of us, after my first connection with Bert I was forever part of his expanding circle of connections and innovation. He was gifted in so many ways: as a physician and scientist, as a jazz musician and tennis player, as a generous mentor, teacher and friend but what will always stand out to me as his quintessential ability was his art of connecting the right people together to advance the mission to improve the health and wellbeing of children.
The SGA Side
Nora Pfaff, MD, FAAP and Zarah Iqbal, MD, MPH
SGA Chapter Representatives

Your SGA continues to work hard representing pediatricians! The biggest issue this month has been surrounding school reopening. AAP National had put out a statement at the end of June encouraging schools to reopen if it was safe to do so, with specific guidelines around masking, classroom cohorting, and other practices to try to mitigate the spread of COVID. Unfortunately, this message became politicized and pediatrician interviews were at risk of becoming distorted in the media. AAP National has asked that all requests for interviews be deferred to AAP National for the time being. 

AAP-CA is working with local groups to help come up with further guidance around school reopening vs. support for distance learning for communities. Stay tuned—this is an evolving situation.
In July, we joined thousands of doctors, nurses, and healthcare providers in calling on Congress to ensure all Americans have the right to vote without risking their health this November. Many among us have spent the last two months focused on the overlapping crises of COVID-19 and systemic racism. Ensuring that every American is able to cast their ballot from home is critical for health equity and racial justice. As frontline health and medical professionals that are seeing first-hand the impacts of the COVID-19 pandemic, our collective voice on this issue is powerful and necessary. We hope you will read the letter , share on social media, and send it directly to your elected officials at the state and federal level. Join us in asking our elected officials to support universal vote-by-mail ➡️

Additionally, SGA has been reviewing bills and offering letters to indicate our positions. There are too many to list, but here are some bills we reviewed and voted on, that deal specifically with issues of equity and civic engagement:
  • Prop 16: SGA voted in support. This would repeal Prop 209 (from 1996) which had banned Affirmative Action.
  • Prop 25: SGA voted in support. This proposition deals with abolishing cash bail in California and replacing with a risk assessment for release instead. Evidence shows that this would reduce poverty and keep families together without increasing crime.
  • Prop 17: SGA voted in support. Prop 17 would give voting rights to persons on parole.
  • Prop 18: SGA voted in support. This would give 17-year olds who would turn 18 by the November general election, the right to vote in primary elections. 

As always, for the most up to date information on AAP California bill positions, letters & outcomes from the current CA Legislative year, visit . For latest organizational advocacy updates follow @AAPCADocs on twitter. If you have questions and/or are interested in knowing more about a certain legislation, reach out to our State Government Affairs Chapter Representatives Nora Pfaff, MD, FAAP and Zarah Iqbal, MD, MPH at [email protected]
Opportunities for Your Benefit

Stanford Virtual PrEP Program for Adolescents and Young Adults - Geoff Hart-Cooper
The Primary Care for Preterm Infants & Children Toolkit prepares the pediatric primary care provider with the skills and Stanford recently launched Stanford’s Virtual PrEP Program for Adolescents and Young Adults . The goal is to make it easier for adolescents and young adults in California to access pre-exposure prophylaxis (PrEP) to prevent HIV.

About 1 in 5 new HIV infections are in youth (<25 yrs). PrEP reduces HIV risk by about 99%, and the FDA recently expanded its approval for PrEP to include adolescents. However, California youth have the greatest PrEP unmet need. There are also significant racial and ethnic disparities in both new HIV infections and PrEP access.

Stanford is now accepting any patients 25 and younger within California. They have pediatricians and adolescent providers connect with patients through a secure, confidential and free initial virtual visit. They build continuity by having all follow up visits with the same PrEP Doc. For those who would like to learn more about PrEP, visit the posted provider education slides to the website ( PrEP101 ). A recording of the recent webinar will be posted soon. Referral information is at the bottom of this email. 

Referral information
Referring Providers*
Call (800) 995-5724, or fax (650) 721-2844
*Please be sure to include a patient’s confidential phone and e-mail
Call (650) 497-2701
ECHO Autism - Robin Hansen, MD, FAAP, UC Davis School of Medicine
This is a program with the main purpose of improving specialized care in underserved and rural areas by connecting experts from an academic center to community practitioners. During this teleconferencing program participants will learn about relevant topics related to ASD such as early identification, supporting access to services and treatment of common medical issues. The group at the MIND will be helping providers give the best autism care for all children.
TeleECHO clinic will occur the first and second Thursday s of each month at noon time via Zoom. CME for health professionals is offered at no cost , and MOC 2 credits for pediatricians .

Student Scribes
Student Scribes is a registered 501(c)(3) non-profit organization, in which we set up pre-med undergraduate students with medical professionals for volunteer or paid scribing opportunities. We are a completely student-run organization. We provide a tailored scribe training curriculum that has proven effective with the placement of over 70 scribes throughout California. We hold our students accountable to the high values and standards that Student Scribes encompasses. Our students are fully vetted and are dedicated and passionate about a future career in medicine.

We set up our scribes for both volunteer or paid scribing opportunities. If you're interested in a scribe, give us a call (7145885107) or send us an email ( [email protected] ). For more information, please visit our website:

Research Project: Looking for Pediatric Practitioners - Phoebe Trout
My name is Phoebe Trout, I am a graduate student and research assistant at the University of Michigan School of Public Health, Child Health and Development Lab ( ). I am interviewing pediatric practitioners about social needs and concerns of families, specifically social determinants of health. The main purpose of these interviews is to hear from pediatric practitioners about their views regarding screening patients for social determinants of health in clinical settings. By “social determinants of health” we mean the conditions in the environments in which people are born, live, learn, work, play, and worship that affect a wide range of health, functioning, and quality-of-life outcomes and risks. Examples of social determinants of health could include things like access to safe and stable housing, job opportunities, and transportation options.
Participants will receive a $20 gift card for taking part in a 15-30 minute phone interview . We’re hoping to learn what you think the potential benefits, barriers, and/or unintended consequences are of asking patients about these non-medical conditions that influence health.
If you are interested in participating in the interview, please email me at [email protected] to determine your eligibility for the study and arrange an interview time. 
August 25, 2020: ECP Virtual Town Hall - RSVP
September 12, 2020: ACT 2020 CME Conference - SAVE THE DATE!
December 5, 2020: 5th Annual Pediatric Puzzles - SAVE THE DATE !

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