2019 - April Edition
Alice Kuo, MD, PhD, MBA, FAAP   President, AAP-CA2    2018 - 2020 
President's Message
 
The California legislative season is well underway, with our State Government Affairs (SGA) committee reviewing over 2700 bills to determine which ones the AAP will prioritize to support. Please refer to the district website (here) for specific information on the AAP position on these bills. Huge thanks to Mona Patel, SGA Co-Chair, who is from our chapter, for all of her hard work reviewing these bills!
 
Listed below are our Chapter Advocacy Priorities, which are closely aligned with district and national priorities as well. These are the child health areas in which our chapter is putting effort and resources. Please contact Tomas if you'd like to get involved with any of the following:
 
Teen Vaping
We are firmly in the midst of an epidemic of teen vaping. Together with the Los Angeles County Department of Public Health's Tobacco Prevention and Education Unit, we co-sponsored a Town Hall at El Camino College in Torrance on March 21, 2019 that was well-attended. Parents and community members learned about teenage vaping and the response of local governments as well as public health departments. I presented on treatment options for teens already addicted to liquid nicotine. We are currently planning our next community Town Hall in Culver City, which is considering an ordinance to ban the sale of flavored tobacco.
 
In addition, AAP members and fellow physician advocates spoke at city commission meetings on March 25 in Beverly Hills and on March 27 in the city of Los Angeles (see below). I have sent letters to each of the five Supervisors for Los Angeles County in anticipation of a hearing on banning the sale of flavored tobacco products in the entire county that should be happening at the end of April/beginning of May.
 
At the end of March, we submitted a Healthy People 2020 grant for $20,000 to set up trainings for pediatricians to learn more about teen vaping and to feel comfortable treating nicotine-addicted children.
 
Finally, at the state level, three bills were introduced in December to address teen vaping: AB 131 (Cunningham) that would prohibit electronic smoking device manufacturers from advertising in a manner that is attractive to children and youth under 21 years of age; SB 38 (Hill) that would prohibit a tobacco retailer from selling, offering for sale, or possessing with the intent to sell or offer for sale, a flavored tobacco product; and SB 39 (Hill) that would require sellers deliver tobacco products only in conspicuously marked containers, as specified, and to obtain the signature of a person 21 years of age or older before delivering a tobacco product. Our chapter will be watching these three bills closely and send out advocacy alerts as needed.
 
Immunizations
After the recent pertussis outbreak involving nearly 100 students in 12 private schools in Los Angeles, we realized that the waning immunity from acellular pertussis vaccine is a contributing factor. Although ACIP recommends a Tdap booster for women with each pregnancy to protect the newborn, there are siblings in a family who can carry pertussis despite being fully vaccinated. We are collaborating with local pediatric infectious disease experts and the Vaccine Preventable Disease Control at LAC DPH to be in a position to collect data with the next outbreak to determine whether additional DTap or Tdap boosters could prevent transmission of the bacteria in children 7-10 years and over 14 years. With the next outbreak, we will need to collect clinical information to match the lab samples that DPH has. The AAP will coordinate the collection of this information when the time comes.
 
The CDC has reported 387 cases of measles in 15 states for the first three months of 2019. This is the second-greatest number of cases reported in the U.S. since measles was eliminated in 2000. We have had 17 cases in California, one of which was in our chapter in Los Angeles county. We, along with other public health entities, are monitoring the situation closely.
 
Finally, last month, Senator Richard Pan (D-Sacramento) introduced SB 276, which would require the State Department of Public Health to develop and make available for use by licensed physicians and surgeons a statewide standardized vaccine medical exemption request form, which would be the only medical exemption documentation that a governing authority may accept. The bill would also require the department to create and maintain a database of approved medical exemption requests, and to make the database accessible to local health officers. AAP is co-sponsoring the bill, along with the California Medical Association and other vaccine-related organizations.
 
Immigrant health
Our chapter immigrant health committee has been active in the last couple of months. Lisa Gantz, UCLA med-peds R4, secured a local grant to work on immigrant youth issues in Los Angeles. One of her proposed activities is to adapt the AAP Immigrant Health Toolkit (here) for our chapter and to make a more interactive web-based toolkit available to everyone.
 
The immigrant health committee is also looking at data and beginning analyses to better understand the scope and nature of the immigrant child health situation in Los Angeles. We continue to partner with the Los Angeles County Office of Immigrant Affairs on these activities. We should have some information to share in the next 6 months or so.
 
Adverse Childhood Experiences (ACE)'s
Huge thanks to our colleagues in Chapter 4 (Orange County) for inviting Tomas and myself to their trauma-informed care conference this past weekend. We had the opportunity to meet with Nadine Burke Harris, California's first Surgeon General, and hear her thoughts on how to address adverse childhood experiences (ACEs) in the state. In the next few weeks, we will be getting our ACEs committee up and running, and it looks like other chapters in California will be as well. I anticipate there will be opportunities to both work within our chapter and in collaboration with the rest of the state. Please contact Tomas if you are interested in joining this new committee.
 
Adolescent mental health
Our chapter may be taking the lead on support for SB 328 (Portantino) which would require that the school day for California middle schools and high schools shall begin no earlier than 8:30 am.  ("School day" does not include a "zero period," or an extra period offered before the start of the regular school day.) Senator Portantino is in our chapter, as is Manhattan Beach Unified School District, the only school district in the state that officially supported the bill last year when it passed in both houses of the legislature only to be vetoed by Governor Brown.
 
Later start times for middle and high school students is based on a 2014 AAP policy statement "School Start Times for Adolescents" (here). This recommendation is based on a substantial body of research that has demonstrated that delaying school start times is an effective countermeasure to chronic sleep loss and has a wide range of potential benefits to students with regard to physical and mental health, safety, and academic achievement. Opponents of the bill last year focused on lack of time after school for athletic events, extracurricular activities, homework or part-time jobs, and erroneously state that students will end up staying up even later and getting less sleep. We are planning to partner with Chapter 1 on a joint advocacy effort given their focus on mental health-this bill directly supports improving adolescent mental health through better sleep and less sleep deprivation. We will send out advocacy alerts as activity moves forward on the bill.
 
Childhood obesity
The district is co-sponsoring a number of bills addressing sugar-sweetened beverages. AB 138 (Bloom) is a soda tax; AB 764 (Bonta) is a ban on marketing/promotions of soda; AB 765 (Wicks) bans the placement of soda in checkout aisles; and AB 766 (Chiu) limits the size of unsealed beverage containers to 16 ounces. We have already sent out advocacy alerts to contact legislators as part of district strategy-stay tuned for more advocacy alerts as these bills move through committees.
 
As you can see, our chapter is very active addressing child health issues and supporting all of our work as pediatricians. Now is a good time to reach out to your pediatric colleagues who have not yet joined the chapter or paid their chapter dues. If there are pediatricians you know who would be willing to join the chapter, please direct them to our membership site (here). Also, it is possible to join our chapter to support local child health efforts without joining national AAP if there are cost prohibitions. Please contact Tomas for more information.
 
Please check out the rest of our newsletter for information on our Town Hall meetings and other CME opportunities, ways to get Maintenance of Certification (MOC) points with Quality Improvement (QI) projects, and statewide advocacy priorities that the AAP is working on behalf of children.
 
Thanks for all that you do on behalf of children in our communities!
 
Alice Kuo, MD, PhD, MBA, FAAP
Chapter President
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Calls To Action!
   
Addressing the Threat of Vaping Products/E-Cigarettes  
  
The County of Los Angeles Board of Supervisors will soon vote on an ordinance that could result in tobacco shops being prohibited in residential zones, within a certain distance of residential zones and within a certain distance from sensitive uses whose primary purpose is to serve children, such as elementary, middle and high schools, parks and youth centers.  
 
We need your support! 
  1. Call to Action! If you live in Los Angeles County, please call your District Supervisor.
Please visit http://aapca2.org/vaping for more information.
 
Four AAP-CA supported bills will be voted on in Assembly Health Committee on Tuesday (4/9/2019):
 
  • AB138: would impose an excise tax on the purchase of sugary drinks. 
  • AB764: would stop sellers of sodas from deliberately undercutting the price of healthier drinks, including water.
  • AB765: would prevent soda from being stocked at check-out isles, where currently 90% of beverages are unhealthy.
  • AB766: would ban the sale of any unsealed beverages larger than 16 fluid-ounces.
 
Five members of the Assembly Health Committee have NOT yet committed to voting for these very important AAP-CA supported bills (Aguiar-Cury, Burke, Limón, Ramos, Santiago).  
Please call your legislator now!  
You may even leave a voicemail.
 
Upcoming AAP-CA2 Events  -  Save The Date

May 29 - Strategic Forum in Los Angeles



 

June 4 - Town Hall in Woodland Hills
  
Ken Saul, MD, FAAP AAP-CA2 Member-At-Large
 
   
Join AAP-CA2 Member-At-Large Ken Saul, MD, FAAP for an evening of professional development and networking.
 
Topic: Probiotics 
Speaker: TBA    
 
Date:
Tuesday, June 4,2019
Time: 6:30 PM 
Location: Maggiano's Little Italy 
6100 Topanga Canyon Blvd, Woodland Hills, CA 91367
RSVP by emailing to Dr. Saul: docksaul@aol.com 
 
Recent Events
March 14 - 17 in Itasca, Illinois
Annual Leadership Forum (ALF)  
     
Leadership representing 66 Chapters across the USA and Canada attended the 2019 Annual Leadership Forum (ALF) in Itasca, Illinois from March 14 through 17. Of 72 total resolutions, 59 were adopted and 13 were defeated. Furthermore, adopted resolutions were ranked to determine the Top 10 Resolutions.  
Resolutions provide a formal mechanism whereby the members of the Academy can give input concerning Academy policy and activities. All resolutions submitted to the ALF are considered by the Board, but are advisory and not binding.    
District IX leadership representing all four California Chapters provided perspectives and evidence in favor of several resolutions supported by AAP-CA.
 
President Elect Candidates
AAP candidates for president elect, Lee Savio Beers, M.D., FAAP, of Washington, D.C.,and Pamela K. Shaw, M.D., FAAP, of Kansas City, Kan., provided statements during the business luncheon. Voting will begin Sept. 7 and ends Sept. 21. You may learn about them by going to www.aap.org/election (Login required).
March 21 in Compton - Press Conference
California Public Interest Research Group (CALPIRG)  
 
AAP-CA2 president Alice Kuo, MD, PhD, MBA, FAAP provided a statement on the harmful effects of lead exposure during a press conference in Compton, on March 21, 2019.

(From left) Diane Hyland (1st District PTA Board Member), Ryann Lynn (CALPIRG Field Organizer), Nathaniel C. Holt (Chief Facilities Officer, Compton Unified School District), and Alice Kuo, MD, PhD, MBA, FAAP (President, AAP-CA2). 
Reacting to pervasive lead contamination in schools' drinking water, CALPIRG gave California a
C+ grade on March 21, 2019 for addressing the problem, according to a new national report. In the second edition of CALPIRG Education Fund's Get The Lead Out study, the state showed some progress since its F grade on a similar report card in 2017. The American Academy of Pediatrics, California State PTA, and Compton Unified School district all joined CALPIRG in calling for swift action to ensure lead-free water in California's schools and daycare centers.  
 
Read the CALPIRG press release here.
Read the Spanish article: La Opinión 
March 21 in Torrance - Town Hall
Addressing Teenage Vaping 
Community leaders and parents gathered at El Camino College on March 21 for a community-wide Town Hall addressing Flavored Liquid Vaping Products/E-Cigarettes use in youth.
  • Tony Kuo, MD, MSHS, Director for the Division of Chronic Disease and Injury Prevention, Los Angeles County Department of Public Health presented compelling data reflecting a national vaping epidemic and its projected course.
  • Jeff Duclos, Councilmember - City of Hermosa Beach discussed the successful strategies that lead to a citywide ban of all tobacco products in his city. 
  • Mark Hernandez, Program Coordinator, Los Angeles County Office of Education (LACOE), Tobacco Use Prevention Education presented the alarming tobacco use statistics from LAUSD, as well as an overview of the types of vaping devices commonly used by teens.
  • AAP-CA2 president Alice Kuo, MD, PhD, MBA, FAAP discussed the therapeutic approach for youth with nicotine addiction.
 
(From left) Dr. Alice Kuo (AAP-CA2), Dr. Tony Kuo (LACDPH), Councilmember Jeff Duclos (Hermosa Beach), and Mark Hernandez (LACOE)
 
Over 70 attendees were present. The event concluded with an hour of highly interactive discussion between concerned parents and the panel. Resources and a Call to Action may be found on our website: http://aapca2.org/vaping 
March 25 - Beverly Hills City Hall
Public Hearing
 
The City of Beverly Hills Health and Safety Commission held a public hearing on March 25, 2019 to receive public comments on the development of an ordinance to ban the Sale of All Tobacco Products in Beverly Hills. After hearing public comments for over five hours, the Commission made the following decisions for recommendations to the City Council:

1. To carve out the three cigar lounges in the city of Beverly Hills, meaning that they will not be affected in perpetuity and may continue to conduct business as is. This was a 4-1 vote. These businesses operate as a club for members only and they are not in public view or access to anyone who is not a member or a minor.   
 
2. To allow hotels to sell tobacco to guests only. Hotels are already allowed to have a smoking designated area for guests only.

3. Anyone else who holds a current tobacco license would be phasing into the ordinance of a ban on the sale of tobacco starting as early as one year after the implementation of the ordinance. This includes convenience stores, gas stations, pharmacies, liquor stores, and the only news stand in town.  
 
  
 
Additionally, the Commission put an immediate moratorium on any new licenses for the sale of tobacco products.

Prior to the hearing, the Commission received 111 letters. 106 letters were against the tobacco sales ban (of which 102 were in support of keeping The Grand Havana Room - Cigar Lounge open). Only five letters were in favor of the ban, including that submitted by the Chapter.
 
If adopted, the ordinance would become effective in early July of this summer. 
 
March 27 - Los Angeles City Hall  
Public Hearing 
 
The City of Los Angeles Health, Education, Neighborhoods, Parks, Arts, and River Committee held a public hearing on March 27 to accept comments on the proposed strategy to restrict the sale of flavored tobacco products to youth and young adults. Chair Councilmember Mitch O'Farrell, and Councilmembers David E. Ryu and Curren D. Price Jr, allowed one minute statements from the general public.


Nearly a third of attendees, wearing yellow shirts, were against the restriction and strongly defended their rights to consume flavored tobacco products. AAP-CA2 representatives provided concise statements highlighting the current vaping epidemic and the detrimental effects of nicotine addiction in the youth population.

Ilan Shapiro, MD, FAAP addresses Councilmember David E. Ryu in support of a ban of flavored tobacco products.
In The News

Interview on CNN's HLN
     
Watch AAP-CA2 Member-At-Large Cori Cross, MD, FAAP speaking on the risks of spreading out vaccines. 
 
  



Previous Issues  - Peds@CA2 e-News 

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Click to view the February 2019 Issue
 
Click to view the March 2019 Issue 
 
    


Other Upcoming Events  -  Community Partners
April 26, 2019 in Pomona
San Gabriel/Pomona Regional Center

April 26, 2019 in Santa Barbara
2nd annual Child Abuse Symposium at UCSB

 



For more details...

to visit the Event Page



Friday, May 31, 2019 | CHLA
9:30am - 3pm

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Please contact Tomás Torices, MD (Chapter executive director) for all Chapter 2 related matters.
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