January • 2023
In January, we weather through

In January, we weather through this viral storm while remaining strong,
Creating resolutions and wishing for good health that lasts us yearlong,
Excited for new events, initiatives, and leadership nominations,
With no better time than a new year to work on strategies of prevention.
President's Column
Nelson Branco, MD, FAAP
The beginning of a new year - a time when many take time to evaluate the year past and set goals for the year ahead. I’m guessing that for many of us the goal is to get through the current viral season and hope that we return to when the busy times were more predictable and less overwhelming. I sincerely hope that you were able to take some time to relax and spend time with your loved ones doing something that you enjoy. I’m personally grateful to my colleagues who were available to my patients while Nell and I took a few days to enjoy time with my kids who were home from college and jobs in distant cities.
Here at Chapter 1, we have been busy. I won’t list all of the accomplishments and changes of 2022, but I do want to focus on two things that kept our new executive director, Yolanda Ruiz, quite busy in the past month. The first involves welcoming our newest chapter staff - Sana Sayyid. Sana will be working as a Project Assistant, and helping with not only grants and projects but also day-to-day activities of the chapter. She is a recent graduate of UC Davis with a BS in Biological Sciences and a BA in Spanish, and is very interested in health advocacy and public health. Please join me in welcoming Sana to the team. Another event that kept us all busy in December was our annual Pediatric Puzzles CME, held on December 10 in San Francisco. It was a great meeting, with excellent presentations and an opportunity to once again see each other in person. Many thanks to Dr. Mika Hiramatsu, Dr. Yasmin Carim and the rest of the CME committee for your hard work and commitment to educating us all.
The next year will be filled with more Chapter Chats, committee events, CME meetings and new initiatives that will help us support you in caring for the children in your practice. We are working on some grants, and have been awarded several others. Dr. Diane Dooley and Dr. Renee Wachtel are collaborating with our colleagues at AAP California on a grant to develop a mental health advocacy platform and educate our members about children's mental health reform in California, including the Children and Youth Behavioral Health Initiative (CYBHI). This initiative will provide much-needed resources to address the huge need in behavioral health we’re all seeing in our practices. Not only are we planning to educate you about the CYBHI, we are adding pediatricians’ voices to the decision-making process about how those resources will be used. Dr. Wachtel will also be helping with an AAP Section on Developmental and Behavioral Pediatrics Grant intended to enhance collaboration between general pediatricians, developmental behavioral pediatricians and other child-centered professional disciplines. Stay tuned for more information about these efforts over the next few months.
We are also pleased to have been awarded a sizable grant from California Department of Health and Human Services to work on a Data Exchange Framework educational initiative. I must thank Dr. Resham Theti, Dr. Seth Bokser, Dr. Diane Dooley and Yolanda Ruiz for pulling together an impressive grant application in a short time. I’m looking forward to learning more about Health Information Exchanges (HIE) and the California state initiatives to help us share data more effectively among all of the clinicians caring for children in our communities.

I’ll end with some suggestions for those whose New Year’s resolutions include getting more involved with AAP CA1. There are lots of opportunities to work with your colleagues on a committee, task force or a special project. Take a look at our website for some ideas and to see if there is something there that you are interested in. In addition to that, we still have several opportunities in the chapter leadership including:

Please let us know if you are interested in any of these positions or if you’d like to talk about how you can get more involved with the chapter!
AAP Committees Seek Nominations!
Nominations are being solicited to fill member vacancies for AAP National committee positions. Terms begin July 1 for open positions on these committees:  


Requirements, the statements of needs for each position, and the application materials are here (member login required). As part of the AAP Equity Agenda, the Board of Directors is committed to increasing the percentage of members from groups underrepresented in medicine that are serving in Academy leadership positions. Diverse candidates in terms of race, ethnicity, religion, sex, sexual orientation, gender identity, disability, or national origin are encouraged to apply. The deadline for nominations is February 17. The AAP Board of Directors will meet in May to review nominations and make final appointments. 
What is the Data Exchange Framework?
Resham Kaur, MD, MHS, FAAP, Diane Dooley, MD, FAAP,
and Seth Bokser, MD, FAAP 
How many times have you seen a patient in your clinic with mental health concerns and discovered at the end of the visit that they were already seeing a therapist? Or had a family come into the ER who can’t remember what medications the child has been taking for asthma? In response to the crisis of inadequate access to crucial medical information, California has created a ground-breaking new framework requiring all medical providers and hospitals to share confidential health information through a Data Exchange Framework. The Data Exchange Framework (DxF) is an opportunity to create equitable and affordable health information exchange, so that patients, providers, and other healthcare entities can access the health information they need, wherever they are and whenever they need it.

AAP CA Chapter 1 recently received a grant from California Human and Health Services to inform and support pediatric health care providers and systems in this transformative set of policies and procedures that will allow us to share health records electronically in a private and secure manner. Chapter members Resham Kaur, MD, Seth Bokser, MD, Diane Dooley, MD and Executive Director Yolanda Ruiz wrote the grant and plan to recruit Chapter members to support the leadership team. We will also be working with the California Health and Human Services Department to educate everyone about specific pediatric concerns regarding sharing of confidential information.  

  • Take Action and More Information- The Data Exchange Framework is asking all hospitals, physicians and medical groups to sign an agreement to share patient information safely. For more information, refer to this website: https://www.chhs.ca.gov/data-exchange-framework/

  • The CalHHS Health and Human Services Data Exchange Framework (DxF) comprises a single Data Sharing Agreement (DSA) and common set of Policies and Procedures (P&Ps) that will govern the exchange of health and social services information among health care entities and government agencies beginning January 31, 2024. 

  • Finalized on July 1, 2022, the DxF was developed with input from a broad set of stakeholders, including a Stakeholder Advisory Group as required by AB 133. The legislation mandates that a broad spectrum of healthcare organizations execute the Framework’s DSA by January 31, 2023, and exchange or provide access to health information with other mandated organizations by January 31, 2024. 

  • The DxF DSA Signing Portal is now open for providers and healthcare entities to take the first step for better health information exchange. The DSA is a signed agreement between hospitals, physician organizations and medical groups, skilled nursing facilities, health plans and disability insurers, clinical laboratories, and acute psychiatric hospitals to share patient information safely. California Health and Safety code requires most providers and healthcare entities to sign the DSA by January 31, 2023. Visit the https://signdxf.powerappsportals.com/ to sign the DSA.


  • This data set is compatible with current federal regulations for health data sharing and excludes 1) Psychotherapy Notes and 2) "Information compiled in reasonable anticipation of, or for use in, a civil, criminal, or administrative action or proceeding." (Title 45 of Code of Federal Regulations) 

  • Participants with support of their electronic health record vendor partners must use the standard, federally-compliant formats of electronic data exchange: HL7 Messaging Standard Version 2.5.1, HL7 Clinical Document Architecture Release 2, and/or HL7 Fast Health Interoperability Resources (FHIR) Release 4.0.1. 


You will hear more about this initiative in the coming months. AAP CA Chapter 1 will be working towards bringing this information to you. Stay tuned for more!
Suicide Prevention and Parenting Support Grants
Diane Dooley, MD, MHS, FAAP and Renee Wachtel, MD, FAAP
Mental Health Committee Chair and Developmental & Behavioral Pediatrics Committee Chair
California AAP Chapter 1 was recently awarded a grant by national AAP to participate in the AAP’s Suicide Prevention Program. The AAP has developed a Blueprint for Youth Suicide Prevention, which describes the best practices to support youth at risk for suicide. The AAP is engaging Chapter ambassadors to participate in an eight-month Project ECHO (Extension for Community Healthcare Outcomes) training program to increase their knowledge and self-efficacy about strategies to prevent youth suicide. This is consistent with the US Surgeon General’s “Call to Action to Implement the National Strategy for Suicide Prevention”, which highlights the important role that health care providers play in suicide prevention. Drs. Amy Dolinar and Renee Wachtel will be our Chapter’s Ambassadors in the project, which will result in an Action Plan that the Chapter can implement. If you are interested in further information, or participating in the project, please contact Dr. Wachtel at drrwachtel@aol.com. 

The California Department of Health Care Services’ Children and Youth Behavioral Health Initiative recently released a funding opportunity for provider clinics, community-based organizations, hospitals, and other agencies interested in increasing support for parents and caregivers of children and youth with emerging or existing mental health and/or substance use disorders. Applicants can apply for up to $750,000 to start or expand upon an evidence-based practice. Examples of this are:

  • HealthySteps/Dyadic Care Services
  • Incredible Years
  • Parent-Child Interaction Therapy
  • Positive Parenting Program (Triple P)
  • Other practices and programs for Parent and Caregiver Support and training that align with the objective of the RFA

This is the first of a planned series of six upcoming DHCS grant opportunities to scale evidence-based or community-defined evidence practices which focus on prevention, early intervention and/or resiliency/recovery for childhood behavioral disorders to be released by DHCS over the next year. A major goal of this opportunity is also to reduce health disparities. The deadline for the application for Round 1 is January 31. For more information, see:


AAP Chapter 1 is starting a listserv of members that would like to receive notification of new grants and possibly discuss partnerships and strategies with fellow AAP members. Please notify Sana Sayyid if you would like to be a member of this listserv.
In Case You Missed It! Pediatric Puzzles 2022
Mika Hiramatsu, MD, FAAP
CME Committee Chair
Enthusiastic chapter members and medical students enjoyed in-person education and networking again at the annual Pediatric Puzzles meeting at UCSF Mission Bay on December 10. Featured speaker Dr. Sujay Kansagra, pediatric neurologist from Duke University, entertained attendees with energetic talks on sleep and movement disorders. A highlight was a video featuring a dozing infant in arms who immediately falls upon being placed in the crib. The camera pans upward to reveal the parent — Dr. Kansagra himself! He spoke of repeatedly saying the same phrase and directing a toddler back to bed, up to (his experience) “212 times” in one night.

Drs. April Zaat and Prachi Singh brought folks up-to-date on neonatal sepsis and hyperbilirubinemia and the latest on COVID, flu and Mpox. Dr. Gila Dorostkar gave a dental run-down with lots of photos, and Warriors MD commentator Dr. Nirav Pandya quizzed the audience on a multitude of orthopedic conditions. Overall feedback was outstanding for this first meeting overseen by new chapter Executive Director Yolanda Ruiz. The CME committee returns to planning our Spring meeting, May 6 in Fairfield — save the date!

Pictured above: Attendees take a quick break by dancing to a warm-up video led by Dr. Yasuko Fukuda!
The SGA Side
Your Key to State Government Affairs
Nora Pfaff, MD, FAAP and Anna Kaplan, MD, FAAP
SGA Chapter Representatives
Amicus Brief in Support of Prop 31:

The campaign to support Prop 31 and uphold the ban on flavored tobacco products, in addition to several supporting organizations including AAP, is submitting an amicus brief against the Reynolds case (who is fighting the approved proposition). Our brief emphasizes the significant public health harms that would result if the Court were to prevent California from enforcing its flavors law, which both the residents of California and the state legislature overwhelmingly approved.  

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. 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 info@aapca1.org.
See All Available Pediatric Jobs on our Job Board!
Opportunities for Your Benefit
Reminder: Advocacy Training Grants for Pediatric Faculty-Resident Pairs – Applications Due January 13
The AAP Community Pediatrics Training Initiative (CPTI) provides support to 4 pediatric faculty-resident pairs to attend the AAP Advocacy Conference (March 26-28, 2023) and then implement an educational project to strengthen the advocacy skills of others in their program and enhance their residency program’s advocacy training/curriculum. Projects must be done in collaboration with their respective AAP chapter. Applications are due January 13. Interested individuals can review the full grant guidelines and complete the application on the CPTI Grants page.
 
Contact: Courtney Day, Manager, Community Health and Partnerships 
Virtual Pediatric Dermatology Course – February 11, 2023
The 2023 Pediatric Dermatology Pearls for the Pediatric Provider virtual course will be held February 11. Gain practical skills to effectively diagnose and manage various skin diseases and disorders commonly seen by pediatric providers. Learn from leading experts on a variety of topics, including newborn skin care, infestation update, atopic dermatitis update, and acute pediatric rashes. Earn 2.0 AMA PRA Category 1 Credits™. Register here.
Calling Physicians that Help Care for Pediatric Patients with Undescended Testes!
Description of our study:
The Pediatric Urology Team at Lucile Packard Children's Hospital at Stanford, led by Dr. Kunj Sheth, is interested in learning more about how pediatricians decide to order scrotal ultrasounds, including the parameters that guide their decisions, diagnostic outcomes, and the associated additional costs. By completing our brief online survey, we hope to learn more about what leads pediatricians to make decisions related to the use of scrotal ultrasounds in cases of undescended testicles.

To participate, you must be a currently practicing physician above the age of 18. 

Take our survey here (~5-10 minutes): https://redcap.link/aeq7s5n3  
January 24 - Climate Change and Child Health Committee Meeting - SAVE THE DATE
February 2 - Developmental and Behavioral Pediatrics Committee Meeting - SAVE THE DATE
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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: 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

Staff:
• Project Assistant: Sana Sayyid