December • 2020
Wrapping Up in December

Wrapping Up in December
We understand the circumstances are so different for our members,
But with grit we bring to you,
Much work in preparedness, child abuse, and ACEs to expand our view.
President's Column
Raelene Walker, MD, FAAP
We are now in December, approaching the new year. Usually this time of year is full of holiday gatherings, parties, and festivities. Instead, we are struggling with a horrible and challenging resurgence of COVID-19 cases, hospitalizations, and deaths. In addition, we are increasingly aware that there are significant and ongoing health consequences for many people who have “recovered” from COVID-19. Amidst all this discouraging news with ongoing suffering, incalculable losses, and the catastrophic politicization of this pandemic that has profoundly and unfairly exacerbated suffering on so many levels, we now have the reality of effective vaccines and a potential solution to this crisis. I have and continue to look for “silver linings” of our current times and would like to offer three:  

  1. Science! This novel virus emerged, was identified, had its genome sequenced and studied, and multiple effective and safe vaccines developed. In about a year. This is amazing and inspiring. Personally, I am so eager to have the first vaccine to which I have access.   
  2. Community and learning! Our chapter Pediatric Puzzles annual CME was Saturday, December 5. Given our current times, this was a completely virtual event. Nonetheless, the speakers were amazing, inspirational, and educational. I offer sincere gratitude and appreciation to our featured speakers Drs. Aparna Bole, Colleen Kraft, Pearl Kwong, and Adiaha Spinks-Franklin as well as our CME committee and our entire crew. It is inspiring and invigorating to be with this amazing community of pediatric advocates.  
  3. Further hope for an effective, science-based and humane exit strategy! The members of the COVID-19 task force announced by President-Elect Joe Biden and Vice President-Elect Kamala Harris are a powerful group of knowledgeable, smart and thoughtful experts who can and will hopefully lead our nation out of this pandemic. I would like to highlight Dr. David Kessler, pediatrician and California Chapter 1, AAP member and Co-Chair of the Biden COVID-19 Advisory Board. Congratulations and thank you!
I also want to express my personal grief for the loss of Dr. Mary Jones, pediatrician and chapter member of many years who passed on November 21. Dr. Jones was an amazing pediatrician in the East Bay and co-founder and medical director of Katie’s Clinic, a specialty clinic for kids with Rett’s Syndrome, named after one of her patients. As a community pediatrician, she continued to come into the ED to see her patients and to care for them when they were hospitalized. A personal memory for me is that as an outpatient pediatrician in the 1990’s she came to see an infant patient of hers who needed a lumbar puncture. I was the intern in the ED at the time. My senior resident asked if she would like to do the LP and she immediately agreed and completed a flawless “champagne tap”. My sincere condolences to her family and friends. May her memory be a blessing. Read her obituary here.

In closing, I offer my best wishes to all of you for a holiday season and new year with happiness and joy. I also offer my thanks and gratitude for all you do and who you are. 
Disaster Preparedness Chat Recording & Recap
Nelson Branco, MD, FAAP
Vice President
The past eight months have pushed all of us to plan, prepare and adapt to the latest challenge, both personally and professionally. In addition to the pandemic, we all need to make sure our practices are ready to help care for our patients and the children of our communities if another disaster should arrive. In the past several years, our chapter members have experienced natural disasters, fires, power outages both planned and unplanned, poor air quality due to smoke from wildfires and climate change-related changes in temperature and weather. We all expect this to continue and to test our resilience.

We are fortunate to have many passionate authorities on these topics as chapter members. On November 5, I was joined by several of these experts who graciously shared their knowledge and expertise with us. I’d like to once again thank Drs. Mark Miller, Scott Needle, Lisa Patel and Amanda Millstein for participating in “Preparing Your Office for Climate Change Related Natural Disasters and Emergencies.” The presentation and the Q&A helped answer many questions and provided excellent resources.

If you were not able to watch the webinar, take a look at our chapter website disaster preparedness page, where the recording is available, along with many resources that you can use to protect yourself, your family and your practice, as well as links to share with your patients and their families. The recording of the chapter chat is also linked below. I’d also like to encourage you to continue this important work and advocacy by joining our Climate Change and Health Task Force or the Practice Support Task Force. As a chapter, and as pediatricians and as leaders in our communities, we need to continue these discussions and help each other prepare for the next challenge.
Changes Coming to AAP California
After over two decades of invaluable work with the AAP California, Kris Calvin will be leaving her position of CEO. “My last day as CEO of the (AAP CA) will be January 6, 2021. It is definitely bittersweet. I am grateful that for over two decades I was able to partner with AAP leadership and other dedicated advocates to accomplish meaningful work on behalf of children and pediatricians,” she replied. 
 
One new venture Kris will pursue is to continue with her gift of writing and launch 2 new fiction books, one of which you can pre-order today! “I can’t say yet whether being an author will be my new career,” she said. “But to give it the best chance, I want to show my new publisher that I can create a “buzz” around my first book with them by jump-starting sales.” See below for information about pre-ordering “All That Fall: A Thriller”, by Kris Calvin.
All That Fall: A Thriller (Emma Lawson Mystery) 
By Kris Calvin

Kris Calvin's book All That Fall is now available for pre-order through December 31, 2020. 100% of royalties from your pre-order will go to address child hunger. Funds will go to No Kid Hungry.
 
You can pre-order All That Fall now.
·     Amazon
Kris Calvin has tirelessly partnered with AAP leadership and other dedicated advocates to accomplish meaningful work. We extend our greatest appreciation to Kris for the impacting work she has accomplished in AAP-CA amongst our members and community.

Congratualtions! We wish you the greatest success!
Upcoming Events
The Life Cycle of an Idea to a Community Project:
“You Are Not Alone” PSA 
Aparna Kota, MD, FAAP
Child Abuse Prevention and Education Committee Co-Chair
At the beginning of the pandemic, reports of the unreported and unseen abuse occurring in families was heartbreaking. How could we reach these families already dealing with the stress of the pandemic, children at home, amplifying violence in households? Chris Stewart, MD, a child abuse pediatrician at UCSF and Stanford, on the board of Safe and Sound verbalized an idea percolating amongst other pediatricians, (Michele Evans, MD, MHS Medical Director of Child Abuse Services and Prevention for Kaiser Permanente Northern California). How about a PSA? So far so good, we had identified a need and a potential idea. 
CATCH Applications Are Open!
Janice Kim, MD,MPH, FAAP, Aparna Kota, MD, MPH, FAAP & Judy Lin, MD, MPH, FAAP
CATCH Facilitators
The CATCH program is a national initiative of the AAP that supports pediatricians to collaborate within their communities to plan and/or implement projects that advance the health of all children. The CATCH Call for Proposals is open through January 27, 2021 at 3pm CT. Pediatricians and residents with innovative ideas to plan or implement initiatives that address critical child health issues in their local communities may apply for $10,000 and $2,000, respectively. This cycle there is targeted funding opportunities for rural health initiatives. The Resident Call for Proposals guidelines include targeted funding opportunities for oral health, community pediatrics, environmental health, developmental and behavioral pediatrics, emergency medicine, and mental health initiatives. Questions? Reach out to CATCH staff at catch@aap.org. To learn more about CATCH visit aap.org/CATCH.
Committee on Medical Liability and Risk Management Meeting Update
Richard Oken, MD, FAAP
The Committee on Medical Liability and Risk Management (COMLRM) had a biannual virtual meeting on Friday, November 13. The most prominent issue of concern were the multiple Committee responses to the COVID-19 crisis via recent articles in Pediatricians and the Law as well as a review of current AAP policy statements under development or pending review. These documents have been authored by Committee members and approved by the AAP Board of Directors. Dr. Anne Edwards, Chief Population Officer for the AAP, presented the Academy Blueprint for Child Health. The group discussed with Dr. Edwards the Academy’s plan for child health advocacy with the incoming administration. In addition, the group decided on appropriate topics for AAP news articles, webinars, and potential NCE presentations in the coming year. We were joined by Patrick Johnson, AAP Federal Government Affairs and Ian Van Dinther, AAP State Government Affairs, to update us on current issues during the tense administration transition.
The SGA Side
Your Key to State Government Affairs
Nora Pfaff, MD, FAAP and Zarah Iqbal, MD, MPH, CFAAP
SGA Chapter Representatives

The legislature is currently in recess. The SGA will have an update next month! 

As always:
  • For the most up to date information on AAP California bill positions, letters & outcomes from the 2020 CA Legislative year, go to aap-ca.org/bill 
  • 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, FAAP at info@aapca1.org
AAPCA1 & ACEs Aware
AAPCA1 is working with the California ACES AWARE initiative to provide California pediatricians with information they can use in their practice to screen for Adverse Childhood Experiences (ACEs) during well child visits. This initiative will help pediatricians support families by identifying stressors that can lead to developmental and behavioral problems in children, and are risk factors for adult onset chronic diseases.
December Initiative:
Why should Pediatricians screen for ACES in their patients?
Answer: Because Adverse Childhood Experiences (ACEs) are associated with the Toxic Stress Response.

Several decades of scientific research have identified the biological mechanisms by which early adversity leads to increased risk of negative health and social outcomes through the life course. Repeated or prolonged activation of a child’s stress response, without the buffering protections of trusted, nurturing caregivers and safe, stable environments, leads to long-term changes in the structure and functioning of the developing brain, metabolic, immune, and neuroendocrine responses, and even the way DNA is read and transcribed. This is known as the toxic stress response.  

These biological changes play an important role in the clinical progression from ACE exposure to negative short- and long-term health and social outcomes. Further, both the disrupted biology and the associated negative outcomes demonstrate a pattern of high rates of intergenerational transmission. Development of the toxic stress response is influenced by a combination of cumulative adversity, buffering or protective factors, and predisposing vulnerability.
Upcoming Event
Opportunities for Your Benefit
CDC Needle/Syringe Resources
The CDC received inquiries from the public regarding a perceived shortage of flu vaccine and from healthcare providers experiencing difficulty obtaining syringes for vaccine delivery. In response, the Seasonal Influenza Vaccine Supply for the U.S. 2020-2021 Influenza Season webpage was developed. This site provides insight into the flu vaccine supply, including the total amount purchased, distribution, and types of flu vaccine available. Additionally, the CDC developed a Needle Resource Guide that addresses questions on types of needles to use, questions to ask supply distributors, and contact information for CDC and FDA to report issues or ask technical questions. AAP Members can access the COVID-19 supply store (including needles) with the AAP Amazon Business Account.

Practical Approaches for Addressing Adolescent Substance Use and Prevention ECHO
The AAP Screening, Brief Intervention, and Referral to Treatment (SBIRT) Substance Use ECHO program invites pediatric practices to join this recently launched learning community. Monthly, one-hour virtual sessions occur the 3rd Tuesday of the month at 12:00 pm ET. Flexible options for participation are available and include CME and MOC Part 2 and Part 4 offerings.
For more information or to enroll, email aapecho@aap.org.

Two New Oral Health Resources
The AAP is excited to share new oral health promotion resources for families and anyone working with children and caregivers. Preventing tooth decay is more important than ever. These resources will help you help families with tooth brushing technique and healthy habits for everyone, from babies to grandparents. Download and print or share electronically.
For more information, contact Hollis Russinof in Pediatric Practice & Health Care Delivery
 
New Developmental Surveillance Training for Pediatric Clinicians and Practices
Identify and discuss the best developmental surveillance practices in your office setting. This free training, developed with support from the Centers for Disease Control and Prevention, includes a ready-to-use PowerPoint presentation, facilitator script, and case study. The training can be facilitated by providers or staff in various roles, and is specifically designed to “spark” discussion and reflection. Facilitators can anticipate the training to last approximately 15-30 minutes, and can be presented anywhere from staff meetings to professional development opportunities. Content in the training is grounded in the recently published AAP clinical report, “Promoting Optimal Development: Identifying Infants and Young Children With Developmental Disorders Through Developmental Surveillance and Screening.” Download a copy to present to your team today!
For more information, contact Krysta Gerndt in Systems of Services for Children and Youth with Special Health Care Needs
December 16: ACEs Training and the COVID-19 Pandemic: Reflections From Dr. Eric Ball Chapter Chat - REGISTER!
January 6: Reducing the Burden of Influenza on Children: Lunch-Time CME Event - REGISTER!
January 13: Public Charge Misinformation Chapter Chat - SAVE THE DATE!
January 23: Life After Residency Part II - SAVE THE DATE!
April 24: Chapter Spring Meeting: Adolescent Medicine - 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