November • 2020
Noteworthy in November

Noteworthy in November,
Is that advocating for kids is and always will be our center,
From finding meaning in chaos and building resilience,
To addressing gun violence and immigrant health to make a difference.
President's Column
Raelene Walker, MD, FAAP
As we enter further into fall, with many unknowns – election results, pandemic curves, flu season severity – we do know many things. One of them is that pediatricians, individually and as a chapter, will care for and advocate for children. An impressive and wonderful demonstration of that, on a chapter level, is the impressive list of doctors from our chapter who spoke at the recent NCE. I hope you were able to hear and learn from these leaders. They include: Drs. Seth Ammerman, David Becker, Shazia Bhombal, Rhea Boyd, Tonya Chaffee, Susan Fisher-Owens, Neville Golden, Arun Gupta, Ken Hempstead, Joan Jeung, Tiffani Johnson, Juliann Kim, Henry Lee, Yvonne Maldonado, James Marcin, Anna Meyer, Mark Miller, Scott Needle, Sonia Partap, and Courtney Wustoff. Congratulations and thank you!
I would also like to acknowledge and thank AAP CEO Mark Del Monte for speaking at our Annual Chapter Meeting on October 15 and presenting the AAP Get Out The Vote Campaign. As always, Mark was inspiring, educational, fun, and interesting. Thank you to Mark and to everyone who joined us. And thank you to everyone who is Voting For Kids and encouraging Voting for Kids. It is always important, but this year it is critical. The recording of this event is on our website. Please check it out here if you missed it.

Our ACES Aware grant project is ongoing and we have a standing call to all members to participate and learn at all times. You will continue to receive email updates. In addition, please see our website for additional information.

I also want to highlight our What’s Up Docs? Op Ed feature for our website. Always, but especially in these challenging times, we need to hear and elevate the voices of pediatricians and our members. This is an opportunity for all of us to have an audience in which to speak, to advocate, to muse, to educate, or maybe even to entertain. Please submit something you’ve written that you would like to share. The limits are small – keep it respectful and kind. Beyond that, please share your thoughts, ideas, wonderings. Be as creative as you like, but please share.  

In anticipation of Thanksgiving later this month, I wish everyone good company (*distanced if not already in your small pod!), delicious food, and the reflection of gratitude. And I’d like to express my gratitude toward my fellow pediatricians and child advocates.
For Your Wellness:
Radical Acceptance & Finding Meaning in Chaos
Nelson Branco, MD, FAAP
Vice President
Is it safe to assume that I’m not the only one who has learned about radical acceptance this year? Even if you haven’t heard the term, I’m sure you’re familiar with the concept. Radical acceptance is accepting reality as it is, even when it’s not what you want it to be. Rejecting reality doesn’t create change. Only by accepting can we begin to change our reality. This year has given all of us many opportunities to practice this, both personally and professionally. A global pandemic, racial injustice, wildfires, power outages, political divisiveness, magnified health inequities and the daily struggle to care for our patients and our communities have challenged each and every one of us. 

My wife, a middle school counselor, shared this article from the Greater Good Science Center with me recently. I really appreciate all of the strategies listed, in particular the seventh: “find meaning in the chaos,” by developing your sense of purpose and impacting the lives of others. As part of the chapter leadership, I get to see how our chapter members are radically accepting and working to change the reality of racism, lack of mental health resources, health inequities, poverty, food insecurity, climate change, misinformation and insufficient funding for children’s health care. It is truly inspiring. I hope that you are all finding purpose and looking for ways to care for yourselves and your families in these uncertain times. As for me, I’ll be voting, masking and trying to figure out what COVID + flu + in-person learning is going to look like over the next few months!
5th Annual Pediatric Puzzles
Register by 11/16 for an Early Bird Discount!
Season to Submit an ALF Resolution
John Ichiro Takayama, MD, MPH, FAAP
Immediate Past President
What’s a resolution? 
Every year, chapter members can submit a “resolution” to the Academy (national AAP) to advocate for change - to improve the health and well-being of children, youth and families; to support pediatricians; and to make AAP a better organization. ALF resolutions are reviewed, confirmed and prioritized by leaders of chapters, sections, councils and committees, at the ALF (Annual Leadership Forum) which usually takes place in March every year. In 2020, ALF was delayed and held virtually in August 2020 because of the COVID-19 pandemic.

When’s the deadline?
Last year, the ALF resolution submission deadline was November 1. This year, the deadline has been pushed back and we do not know yet when the new deadline will be. We’re sending this message to let you know that (a) this is the season to write resolutions, (b) the deadline is not November 1, and (c) if you need any help with crafting or reviewing a possible resolution, please let us know.

Who can write a resolution?
Anyone who is a chapter member can submit an ALF resolution. Resolutions should address...
Pediatric Gun Violence: What Can Pediatricians Do?
Nicole Webb, MD, FAAP & Graciela Wilcox, MD, MPH, FAAP
South Valley & Monterey Bay Area Members At Large
Do you remember where you were when you heard about the Sandy Hook shooting? Gracie and I will never forget. She was in the outpatient academic pediatric clinic where she worked at the time, and I was preparing for a night shift as a hospitalist, pregnant with my first child and worried about the world I would be bringing her into. When we compared our experiences, we realized we were both shocked, overcome with sorrow, and that we had difficulty processing it. We also both felt that surely this would be the moment that would spur meaningful change. Fast forward to today.

Pediatric gun violence is an increasingly recognized public health epidemic, with guns now recognized as the second leading cause of death in US children1, and although school shootings rightly shock, sadden, and even horrify us, they account for a tiny fraction of pediatric gun deaths. Despite these very alarming facts...
Child Abuse Prevention, Education, & Treatment (CAPET) Committee Update
Casey Brown, MD, FAAP
Co-Chair of CAPET Committee
Greetings colleagues, COVID combaters, homeschoolers, and do-it-all champions. 

If you did not have the opportunity (or time between virtual and in-person visits and homeschooling your children) to peruse the AAPCA1 ACEs Aware Initiative email sent on October 17; we invite you to view it here. This article offers hope and resilience in a time of COVID-fatigue, climate and political instability, the empowering reemergence of social and racial justice movements, and was just what the doctor ordered (pun intended). 

To continue the discussion around hope and resilience, and finding power and voice in hard times, the CAPET and Foster Care Committee would like to encourage you to view our public service announcement (PSA). Recognizing that COVID was expected to exacerbate underlying social, economic, health, and racial disparities, as well as increase risk of child and family violence, we pushed for a multidisciplinary call to action to send some hope to struggling families (which is all of us at this point!). 

Watch the PSA below:
Immigrant Health Task Force Update
Alexandria Valdrighi, MD, FAAP
Co-Chair of Immigrant Health Task Force
The California Chapter 1, AAP Immigration Task Force was formed in June this year with a goal of promoting immigrant health and collaboration between physicians at different institutions. Since starting our group, we have started working on multiple exciting projects.

Our Community Partners working group led by Drs. Kyle Lakatos and Priya Pathak has been able to connect with multiple different community organizations including California Rural Legal Assistance Foundation (CRLAF), Pre-Health Dreamers, Carecen, San Francisco Unified School District, Clinica Martin-Baro, El Centro Bayview, Good Samaritan and many others. Through these partnerships, we have been working to lend physician support by providing policy statements and collaborating on educational projects.
The SGA Side
Your Key to State Government Affairs
Nora Pfaff, MD, FAAP and Zarah Iqbal, MD, MPH
SGA Chapter Representatives

As the legislative cycle is now closed, we took the opportunity at our last SGA meeting to review the new AAP-bills website. Kris Calvin demonstrated how to easily access all the bills that were “chaptered” (signed into law) by Governor Newsom. To easily locate these bills, go to the following link: and in the search box, sort by “position: chaptered.” 

We also discussed the process and tremendous effort that it takes for AAP-CA to sponsor and co-sponsor a bill from the ground up. Although we are approached by chapter members with lots of wonderful ideas about potential legislation surrounding an issue, CMA estimates that it can cost up to $50,000 in total efforts to sponsor a bill. On the other hand, if there is ever an issue that everyone agrees is of utmost importance to the health of children, we can choose to devote the entirety of our efforts to getting related legislation off the ground. Letters, op-ed pieces, and grassroots work by individual members are always encouraged.

Finally, we want to draw attention to the fact that thanks to the AMAZING climate change advocacy out of our own California 1 Chapter, all of AAP-CA will be more active with climate change advocacy efforts moving forward. In future legislative cycles, the SGA committee will consider ALL climate change-related legislation and welcome members to bring any such bills to our attention as well.
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.
November Initiative: Building Resiliency Continued
As part of our ACES (Adverse Childhood Experiences) AWARE grant, we have established a “Think Tank” of 6 pediatricians who are meeting regularly to craft messages to our chapter members about ACES screening and trauma informed care. One of our Think Tank members, Deirdre Bernard-Pearl, MD, a pediatrician and Medical Director of Santa Rosa Community Health was recently featured in a statewide educational webinar. An excerpt of her interview is below:

An Interview with Dr. Bernard-Pearl from the ACES Aware Educational Series
September 30, 2020

Before you started ACE screening, what were some strategies or steps that you took to implement? And, what were some of the lessons you learned from this process?

Dr. Deirdre Bernard Pearl: Before we started ACE screening here at pediatrics, we decided to do a pretty extensive training of all of our staff. We definitely wanted to train our medical providers and our nurses, but we also felt it was really important that the whole clinic understand this initiative. 

The way we thought about it from the beginning is that the ACE screening it's really not like other screening questionnaires, it's kind of unique and it asks such personal information. We thought it would make a lot of sense if everyone understood why we were asking all of these very personal questions, and kind of get everybody on the same page. We looked at it as a shift in our culture because we were really shifting the way we were approaching primary care.
You can access the full webinar below: Assessing Readiness & Building Resilience in the Clinical Workforce: A Foundation for ACE Screening Integration
Upcoming Event
December 5, 2020: 5th Annual Pediatric Puzzles - REGISTER!

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