October • 2020
October is About Outcomes

October is About Outcomes
with the State of the Chapter Report,
a number chapter events to come,
and a new ACEs Aware standing column for your support.

President's Column: State of the Chapter Report
Raelene Walker, MD, FAAP
Our chapter just held our annual Board Retreat and I’d like to share some highlights. This is a meeting of our chapter board, along with committee and task force chairs and grant project leaders to review finances, membership data, administrative issues and more importantly to look at where we are with our chapter activities, discuss where we want to be, and plan how to get there. We just completed the first year of a 3-year strategic plan and are proud to state that California Chapter 1, AAP is currently a robust, healthy and thriving chapter. Though there are always challenges, and this year has sent us all more challenges than usual, we have had an extremely active and successful year.  

To help frame this update, I’d like to start with reminding us of our chapter mission. Our mission is to promote the optimal health and development of the children and adolescents of Northern and Central California in partnership with their families and communities, and to support the pediatricians who care for them. In a practical sense, we organize and think of our chapter as focused on three key areas: Child Health, Chapter Health, and Member Health and I’ll provide updates on each area along with letting you know what our current priorities are within each area. 

CHILD HEALTH: Last year, as a chapter we decided upon the following as our priorities in the area of child health: Racism and Discrimination, Climate Change and Health, Addressing Toxic Stress and ACES/Social Determinants of Health, and Immigrant Health Issues. We have worked hard and made progress on all of these priorities. Some highlights to combat racism include our Chapter Chat on Diversity, Equity and Inclusion, our successful second annual ACT (Advocating for Children Together) conference, a position statement in support of the Black Lives Matter movement, COVID-19 Chapter Chat addressing racism, amplifying and supporting the work of champions in these areas, and furthering our chapter procedures to align with these goals. 

Regarding climate change, we established a new task force, Climate Change and Health under the leadership of Drs. Amanda Millstein, Lisa Patel and Sarah Schear. This is already a robust group that is actively working to educate and collaborate with others to combat climate change and the related health issues. To learn more details, please see the Climate Change and Health information on our website.   

We also made effective progress working on health issues related to ACES and toxic stress with particular attention to disparities that exacerbate mental health problems, including access issues. Our mental health committee continues to be active and the chapter also received two grants to address these topics: ACES Aware grant, ASHEW (Addressing Social Health and Early Childhood Wellness) grant. Again, our Initiatives webpage has details about these projects, and we will be updating as they progress.  

Regarding immigration issues, our chapter also established a new Immigration Health Task Force, under the leadership of Drs. J. Raul Gutierrez, Alexandria Valdrighi and our amazing Advocacy Committee. This group also received a Healthy People 2020 grant to combat harm to children and health, related to public charge.  

CHAPTER HEALTH: Our high priority goals for our chapter, established last year, regarding chapter health are to increase membership and further make AAPCA1 relevant and meaningful, to improve networking among members, to support local initiatives identified by members, and to increase revenue. The most significant ways we’ve made progress on these areas in the past year include the following: multiple chapter members have provided expertise to the media in print, TV and radio about a range of issues related to child health, we have developed 3 new task force groups (Climate Change and Health, Immigrant Health, and Practice Support), received 3 grants for specific projects (ACES Aware, ASHEW, and Healthy People 2020), hired 2 new part-time employees to assist with chapter work, developed a series of ongoing Chapter Chats, developed an outreach program for new pediatricians to our chapter geography who are not chapter members and outreach to pediatricians with lapsed membership. In addition, our committees are meeting and working hard. The details are highlighted both on our website and regularly in our newsletters. Finally, one of the most visible areas in which we have improved our chapter health was with the redesign on our website. It is now much more informative, useful and effective. Please check it out and come back regularly to see updates!  

MEMBER HEALTH: Our member health priority goals are to work on physician wellness, to improve mentoring and networking and to better address and improve support at career transitions (early career, mid-career, and Vintage Docs). Obviously, these are large tasks, particularly in the context of a global pandemic, a national anti-racism movement, and severe wildfires. As a chapter, we have worked hard to support each other and our members through our Chapter Chat series, initially related to various issues pertaining to COVID-19 but then branching into Diversity, Equity, Inclusion and Anti-Racism. Our newly established Practice Support Task Force, under the leadership of Dr. Niki Saxena is a mechanism to support us in all of our assorted practice settings and to share solutions. Our Early Career Physician Committee has been active and held a Life After Residency Program and other events focusing on relevant issues and connecting, and our Vintage Docs committee is reinvigorating as well, having participated in chapter mentorship opportunities. We have also identified a Chapter Wellness Champion and to help us do more to support Member Health. 

In closing, we are about a month from our upcoming national election, which will have profound implications for child health issues in our country. The outcomes of the election will very much influence our priorities and efforts moving forward and therefore, I strongly urge all of you to vote, and Vote Kids. Related to that, our annual AAP California Chapter 1 Member Meeting will be Thursday, October 15 and our special guest will be Mark Del Monte, National AAP CEO. Mark will discuss the AAP Election 2020: Vote Kids initiative. This AAP Get Out the Vote campaign is focused on the connection between health equity and voting. Please join us and learn how you can promote voting as a way to advocate for your patients as well as updates on the chapter.
Annual Membership Meeting
Thursday, October 15 at 6:30 PM
CME Committee Update:
Pediatric Puzzles Coming to a Computer Near You
Mika Hiramatsu, MD, FAAP
Co-Chair of CME Committee
When life gives you lemons, make lemonade! Despite feeling Zoomed out, the CME committee is optimistically and enthusiastically planning our fifth annual Pediatric Puzzles for the first Saturday of December as usual. This year, taking advantage of the no-travel situation, we have invited 4 of our favorite speakers from around the country to present important and current news to our attendees. 

Feeling unsettled from our recent Armageddon-like no-sun day, we are looking forward to Dr. Aparna Bole in Cleveland, speaking to us about Climate Change and how to make a difference for our patients. Former AAP National President Dr. Colleen Kraft, now living in Southern California, will share her experience with immigrant children at the border and child advocacy. Distinguished dermatologist and hilarious stand-up comedian Dr. Pearl Kwong will entertain us from Jacksonville, Florida, while providing the most current updates on pediatric dermatology. Perennial favorite Houston-based Dr. Adiaha Spinks-Franklin promises to make us address racism and determine how we can do better. In between, our chapter CATCH (Committee Access to Child Health) grant awardees will inspire us with their projects to help their patients thrive.

And we know how you all like to get together at the annual December meeting, so we will be putting together chat rooms by residency programs and medical schools. It’s definitely not the same as cocktails at the hotel bar, but we hope you will find the socialization fun during these uncertain and stressful times.

We look forward to seeing you all virtually on December 5! View the event page form more information here: https://aapca1.org/event/5th-annual-pediatric-puzzles/. We will inform you when registration opens.
ACT 2020: On Being a Mentor
Lucy Crain, MD, MPH, FAAP
Past Chapter President, Past District IX Chair
Dr. Martin (Marty) Gershman was one of my most significant mentors after completion of my pediatric residency. Like my husband and myself, he and his wife were Kentucky natives and we were both committed to legislative advocacy and teaching. When we first moved to San Francisco, I was referred by national AAP to Dr. Saul Robinson, a former National AAP president who introduced me to Marty and told me of the importance of becoming a member of local Northern CA Chapter 1. (As the late Congressman Tip O’Neil said: “All politics is local!” I soon learned that Marty and his wife both grew up in Hopkinsville, KY, only 30 miles away from my hometown of Madisonville, and that they lived 2 blocks from where we’d just bought our first home here in San Francisco. I was already involved in a voluntary health education project for my son’s elementary school and Marty taught me about expanding this advocacy effort to other activities. 

After obtaining my MPH at UC Berkeley and serving locum tenens in several private practice settings, my first “job” in San Francisco was as a staff physician at Golden Gate Regional Center. In those days, there was a quasi- epidemic of near drowning in our state. With UC Berkeley professor Dr. Helen Wallace and other AAP members, I gathered data on this issue and co-authored a study which was published in the now defunct Western Journal of Medicine on Near Drowning. We used these findings and much testimony to convince the Legislature to enact regulations on swimming pool safety leading to standards in our state and elsewhere. Looking back 50 years, it seems amazing that fences and latched gates around swimming pools were not always required.
Annual Leadership Forum 2021
Marsha Spitzer, MD
District IX Chapter Forum Management Committee Representative
As an AAP member, you have the opportunity to advocate for and influence national AAP policy and priorities through the resolution process. Any member or trainee can write a resolution. Some examples of “Top 10” resolutions in recent years addressed gun safety, immigrant health, safe dental anesthesia, and immunization strategies. In fact, in the last year, two of our chapter’s resolutions were added to the Top 10 resolutions for National AAP. These resolutions addressed racism in healthcare and families. For more information and examples, please visit our ALF Webpage. The ALF resolution deadline is November 1st.

Here are some guidelines to get you thinking and writing:

AAPCA1 & ACEs Aware
ACEs Aware in Action
AAPCA1 is working with the CA 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. 

California has awarded about 100 grants throughout the state to organizations to promote this initiative, and CAC1 has a “Communication Grant” to get the word out to our members. The state has begun providing supplemental payments of $29 per ACES screen for MediCal patients, if their pediatrician (or other health provider) has taken the ACES Aware core training and attested to their completion of the training. Further details are below and more will be coming regularly to our chapter. 

Have You Completed the ACEs Aware Training?
Eligible Medi-Cal providers: It’s not too late to self-attest to completing the ACEs Aware training. As a reminder, eligible Medi-Cal providers must self-attest to completing the certified ACE training to receive payment for ACE screenings conducted after July 1, 2020.

Don’t Forget to Self Attest:
ACEs Aware has answers to your attestation questions at ACEsAware.org/FAQ. After finishing your training at Training.ACEsAware.org, you can find the attestation form at: Medi-Cal.ca.gov/TSTA/TSTAattest.aspx.
Upcoming Event
The SGA Side
Your Key to State Government Affairs
Nora Pfaff, MD, FAAP and Zarah Iqbal, MD, MPH
SGA Chapter Representatives

Your SGA (State Government Affairs) committee continues to be hard at work representing pediatricians! August 31 represented the end of the 2019-2020 legislative cycle, and was the deadline for the Assembly and Senate to pass bills for the year. As September 30 is the last day for Governor Newsom to sign or veto those bills that had passed, we have been busy advocating for our priority bills to be signed into law. Additionally, we have been carefully monitoring regulations and policies around school re-opening, and continue to push for prioritizing children and families in our policies by allowing for school re-opening over higher risk indoor adult activities. 

Additionally, Sept 22 was National Voter Registration Day, and our AAP is dedicated to spreading the word to #VoteKids. You can register to vote online through October 19 at http://registertovote.ca.gov/. This year in California, ALL registered voters will receive a mail-in ballot at their mailing address. If you miss the October 19 online registration deadline, you can also do same day voter registration in person on Election Day at your local polling place. 

For the most up to date information on AAP California bill positions, letters & outcomes from the current CA Legislative year, go to aap-ca.org/bill (See our new AAP-CA website!). 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 info@aapca1.org.
October 10, 2020: UCSF's ACEs & Trauma-Informed Pediatric Care in
October 15, 2020: Annual Membership Meeting - REGISTER!
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