2020 - January Edition
Alice Kuo, MD, PhD, MBA, FAAP   President, AAP - CA2    2018 - 2020 
President's Message
Happy New Year! I hope everyone enjoyed a wonderful holiday break with your families and friends. A new year brings opportunities, resolutions and activities-and for us in the AAP, more chances to fight for children's health issues. 2020 is a leap year, an election year, and the beginning of a new decade! Let's hope 2020 brings great tidings for children all over.
ICYMI - With the holidays, you may have missed this piece of good news. The Food and Drug Administration has said that it will ban mint- and fruit-flavored vaping products for electronic nicotine delivery systems (ENDS). However, menthol is still allowed, as are flavored vaping products for tank-based systems (more commonly known as "hookah"). This is a huge win for us in child health because the overwhelming majority of children who vape are drawn to vaping because of the flavors.
Also, right before the holidays, Manhattan Beach became the second city in the country to consider a total ban on all tobacco products within the city limits. The City Council voted 4-1 in favor of a total ban to go into effect by January 2021, the same time that the Beverly Hills ban would go into effect. Tomas and I testified at the Manhattan Beach City Council meeting, as did Tony Kuo from Los Angeles County Department of Public Health and Ruth Malone from UCSF Center for Tobacco Control Research and Education. As I have said, "One city is an anomaly; two is a trend. A third city to ban the sale of all tobacco products would be a movement." Dr. Malone says that countries around the world are watching what we are doing in Los Angeles County with great interest, and she says that we are starting the Tobacco Control Endgame to rid our communities of tobacco once and for all.
The flu is upon us! For any of you who worked this last week of 2019, you know that the number of flu cases took a dramatic jump right before the end of the year. According to the CDC, most cases are the result of influenza B. The California Department of Public Health says that flu cases, hospitalizations and deaths are all higher than anticipated this year, with 54 deaths in California from the flu so far. As usual, the groups most at risk of the flu are older adults, very young children, pregnant women and those with certain chronic medical conditions. It is not too late-please encourage your patients to get the flu vaccine and remember to encourage good handwashing practices!
I wanted to include a public service announcement on behalf of Dr. James Cherry, and recognize all of the great work he has done around pertussis and decreasing infant mortality from this terrible disease. He messaged me recently that " Maternal Tdap with each pregnancy has caused a major reduction in pertussis deaths in young infants. Unfortunately only about 50% of pregnant women in California are being vaccinated." As practicing pediatricians, we often see pregnant women come into the office with their children, so I encourage you to encourage them to receive the Tdap vaccine with every pregnancy.
Our Adverse Childhood Experiences (ACEs) Committee is hard at work, planning a Town Hall meeting scheduled for February 25th and applying for one of the first ACEs Aware initiative grants put out by the Department of Health Care Services and the Office of the California Surgeon General. The ACEs Aware initiative is a first-in-the-nation statewide effort to screen children and adults for ACEs in primary care, and to treat the impacts of toxic stress with trauma-informed care. If you are interested in joining our chapter's ACEs Committee, please contact Adam Schickedanz ( aschickedanz@mednet.ucla.edu ) or Tomas.
2019 was a tough year for immigrant child health issues. Our Immigrant Health Committee worked hard to lead advocacy efforts and to bring awareness on the issues and challenges facing immigrant children and families. I wanted to give a shout out to both Sural Shah and Lisa Gantz and everyone on the committee for their tenacity and dedication to this issue and for making sure that the humanitarian rights of these children and families are at the forefront for our chapter. Please see the speakers series that they have put together on behalf of the Immigrant Youth Task Force at UCLA - anyone and everyone is welcome to attend these events.
Finally, this past week in clinic, I took care of two babies in foster care, one only 3 weeks old, and the other 4 months old, both who had been exposed in utero to heroin and methamphetamine. The opioid epidemic is ravaging children and families across the country, and we are seeing increased rates of babies born with neonatal abstinence syndrome (NAS) in all of the delivery rooms in our state. I read an LA Times article on this last month, and I thought about the article again when I took care of these two babies ( https://www.latimes.com/science/story/2019-11-14/when-pregnant-women-who-abuse-opioids-are-treated-like-criminals-their-babies-suffer). If anyone is interested in exploring what our chapter can do to address the issue of the opioid epidemic and NAS, please contact me or Tomas.
Our Life After Residency event will be held later this month on the 30th at the Andaz West Hollywood Hotel. It promises to be an amazing job fair for our third-year pediatric residents, recent graduates and mid-career professionals looking for a career change. If you are looking for a job or looking for a new pediatrician in your office or practice setting, please consider coming to this networking extravaganza!!
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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The True Risks of Measles in the Developed and Developing World
James D. Cherry, MD, MSc
James D. Cherry, MD, MSc
Department of Pediatrics
Mattel Children Hospital
David Geffen School of Medicine at UCLA
Recent Epidemics of measles in Europe, and the U.S. indicate that the public and many health care workers are not aware of the true risks of measles. The specific risks are: (1) diarrhea, otitis media,pneumonia, encephalitis, seizures, death; (2) SSPE, (3) and post measles immune amnesia. Our extended group has studied SSPE in California, and post measles immune amnesia in the DRG and in Switzerland. In this communication, I will present these overlooked data.  Read more...  
ACEs Committee - Resilience 
Denise M. Nunez, MD
ACEs Bulletin Vol. 4
Denise M. Nunez, MD
Resilience is a concept that is gaining relevance and intensity in the field of medicine. Patient and providers are impacted by stressful and adverse experiences that threaten to destabilize the mental and physical wellness of an individual receiving or providing care. The potential to sustain the impact of formerly mentioned events is described as resilience. Lack of resilience leads to mental illness, emotional turmoil, and adverse health outcomes among other devastating effects. Read more ... 

Help Us Address Adverse Childhood Experiences  
Last Chance to Participate! 

Our Chapter needs your help in understanding what you think about ACEs, how they impact your patients, and what you think about how best to address them. Please take just a few minutes to complete the following short survey and make sure your perspective is counted.    
Thanks to all who have already taken the survey!

Chapter Board Nominations - 2020 - 2022 Term 
Interested in participating on the 2020-2022 AAP-CA2 Board of Directors? 
It's time to develop a slate for the AAP-CA2 Board of Directors. There are several  opportunities for involvement.  Please take a moment to advise us of your interest in running for the elected positions, as well as the names of others you think may be interested or whose interest should be encouraged. Please note, those candidates selected to run for Executive Board positions will be expected to make a short statement at the Annual Business Luncheon on March 28, 2020 at the 31st Annual Advances in Pediatrics Symposium.

Please complete this Form by January 31, 2020 
Get Involved - Chapter Committees  
Chapter committees are great opportunities to get involved in areas that interest you the most. Furthermore, if you are a Fellow member (FAAP), local involvement could position you for leadership opportunities at National AAP. To learn more about our various Committees and Sections, and to sign up for any of the Committees/Sections listed below, please visit aapca2.org/committees 
Adverse Childhood Experiences (ACEs) Committee
Anti-Smoking/Vaping Committee   Immigrant Health Committee
 Immunizations Committee  Membership Committee  Physician Wellness Committee
 Practice Management Committee  Section on Early Career Physicians  Section on Pediatric Trainees
Advocacy Against Flavored Tobacco
In The News 
On January 2, 2020 the FDA announced that companies that do not cease manufacture, distribution and sale of unauthorized flavored cartridge-based e-cigarettes (other than tobacco or menthol) within 30 days risk FDA enforcement actions Read article
Read the response to this weak policy as written by Matthew Myers, President of the Campaign for Tobacco-Free Kids, here.  
Manhattan Beach
The City of Manhattan Beach City Council voted 4-1 in favor of a total ban on tobacco sales during its meeting on December 17, 2019. Having done so, Manhattan Beach became the second city in the country (After Beverly Hills) to consider a total ban on all tobacco products within the city limits. With consideration to retailers and the elimination of existing stock, the Manhattan Beach ban will go into effect in January 2021.  
(Above) Tony Kuo, MD, MSHS, Director of the Division of Chronic Disease and Injury Prevention in the Los Angeles County Department of Public Health said in his opening remarks that " in the US, tobacco is responsible for 1 in 5 deaths every year, or 1,300 deaths every day. In California, 40,000 adults die annually from smoking. And 440,600, California youth who are now age 17 and younger are projected to eventually die from smoking - a number that will increase considering the recent vaping epidemic."
(Above) AAP-CA2 President Alice Kuo, MD, PhD, MBA, FAAP addressed Councilmembers stating that "Vaping is increasing the chances of chronic lung disease three fold in people who smoke. Millions are addicted to vaping, and it's a gateway to becoming smokers. I urge you, Manhattan Beach, to be a part of history; to lead the country in a trend to make our cities healthier for residents."    
Upcoming - Events
January 29 in Camarillo - Financial Wellness for Physicians
Melissa Ruiz, MD, FAAP
Pallavi Kamra, MD, FAAP
Please join AAP-CA2 Members-At-Large Pallavi Kamra, MD, FAAP and Melissa Ruiz, MD, FAAP for a an evening of Financial Wellness and Planning in Ventura County.

Dinner will be served. Please RSVP as soon as possible so we can arrange the venue accordingly.   
Date: Wednesday, January 29, 2020
Location: Ottavio's Italian Restaurant. 1620 Ventura Blvd, Camarillo, CA 93010
Time: 6:30 PM - 8:30 PM 
6:30p - 6:45p: Social/ Dinner
6:45p - 7:15p: Financial Planning Presentation - Eric Smith ( www.lifetimeplanning.biz)
7:15p - 7:45p: Q&A for the financial planner
7:45p - 8:15p: Jornay PM TM drug presentation - Derek Ott, MD 
Long acting ADHD medication for ages 6 and older
8:15p - 8:30p: Q&A for Dr Ott
Sponsored by Justyna Huovinen, Ironshore Pharmaceuticals
Please RSVP and send any questions and topics for the financial planner or pediatric discussion to pallavikamra@gmail.com 

AAP-CA2 Presents:
Life After Residency &
Pediatric Career Fair 2020
January 30, 2020
6 PM - 9 PM  
The Event of the Year in Southern California for Pediatric Residents, Fellows, and Pediatricians looking for new opportunities 

Pediatric Residents/Fellowship Trainees/Pediatricians

  • If you're finishing your pediatric residency soon...
  •  If you're in need of a new pediatrician...
  • If you're looking for potential employers...
  •  If you're looking for Full-Time, Part-Time, or Locum Tenens...
  • If you want to have a fantastic time while learning about your options...
  •  If you want to meet the graduating class from seven pediatric programs...
This Event is For You!        
February 4, 2020
Immigrant Youth Task Force Speaker Series
Tuesday, February 4th at UCLA
Topic: DACA (formal title and speakers to be announced)  
Save the Date! 

February 5, 2020 in Woodland Hills - Town Hall/Dinner Lecture
Kenneth Saul, MD, FAAP 
Join AAP-CA2 Member-At-Large Ken Saul, MD, FAAP for an evening of professional development and networking.
   Pediatric Dentistry
Dental Health and Well Child Visits
Speaker: Dr. Lisa B. Nguyen  
Wednesday, February 5, 2020
At Maggiano's in Woodland Hills
What: Learn about preventive oral health services you can incorporate into well-child visits.
When: February 5, 2020 at 6:30PM
Where: Maggiano's Little Italy 6100 Topanga Canyon Boulevard, Promenade, Westfield, CA 91367
Why: February is National Children's Dental Health Month! To commemorate, join us for an evening about the importance of oral health for your patients. Dental caries is the most prevalent childhood disease, more than asthma or obesity.
Email Dr. Ken Saul at docksaul@aol.com
February 25, 2020 in Los Angeles - ACEs Training
Adverse Childhood Experiences (ACEs) Essentials, Screening Implementation, and Clinical Integration Training for Pediatric Providers
Tuesday, February 25, 2020
2 PM - 5 PM
At Magnolia Place
(Magnolia Community Initiative) 
1910 Magnolia Ave, Los Angeles, CA 90007
The AAP-CA2 ACEs Committee invites you to attend the first Town Hall on Adverse Childhood Experiences. All pediatricians and family medicine providers are encouraged to attend. 
We Will Cover:
1. Introduction to ACEs and Resilience - 45 minutes
2. The Role of Health Professionals and Trauma-Informed Systems - 30 minutes
3. Screening for and Addressing ACEs in Health Care Practices - 60 minutes
4. Avoiding Burnout and Vicarious Trauma - 30 minutes
Register Here to attend this event.   
March 12, 2020
Immigrant Youth Task Force - Speaker Series  
Thursday, March 12 at UCLA
Topic: Medical-Legal Parnterships and Academic Advocacy featuring Alan Shapiro, MD, FAAP, Medical Director and co-founder of Terra Firma  
March 28, 2020

31st Annual AAP-CA2 Pediatric Symposium    

Mobeen H. Rathore, MD, FAAP
of Jacksonville, Florida. 
Moira A. Szilagyi, MD, PhD, FAAP, of Marina Del Rey, California.
Both candidates for AAP president-elect, will be guest faculty at the 31st Annual Advances in Pediatrics Symposium at UCLA on March 28. 
Also, as candidates for AAP President-Elect, they will both speak during our Annual Business Luncheon.
Mobeen Rathore, MD, FAAP

Dr. Rathore will speak on infectious diseases.
Moira A. Szilagyi, MD, PhD, FAAP

Dr. Szilagyi will speak on
Childhood Trauma and Resilience

CATCH Grants - Deadline: January 15   
Planning, Implementation and Resident Grants
Christine Thang, MD, FAAP
If you have an idea to make a difference in
Melissa Ruiz, MD, FAAP
your community,
consider applying for a CATCH grant! The CATCH Program is a national initiative of the AAP that supports pediatricians to collaborate within their communities to advance the health of all children. Through the CATCH Program, pediatricians are empowered to identify promising solutions that work in their individual communities.  
The Call for Proposals ends on January 15, 2020. The application can be found here. If you have questions, please reach out to your CATCH Chapter Facilitators Christine Thang ( cthang@mednet.ucla.edu ) or Melissa Ruiz ( ruizmj@gmail.com ), or contact the general CATCH staff at  CATCH@aap.org . Thank you for what you do on behalf of children!

QI Opportunities - CME and MOC Part 4
More LA Smiles CME and MOC Part 4 Opportunities
In a state-funded effort to improve the oral health of Los Angeles County children on Medi-Cal, UCLA's More LA Smiles Dental Transformation Initiative invites medical providers and their staff to participate in clinical trainings and improvement opportunities.  
Oral Health Integration in Primary Care
Primary Care Practice Quality Improvement is a program led by UCLA More LA Smiles focused on integrating oral health preventative services in well-child visits.  Participating providers receive up to 30-50 CME and 20-25 MOC Part IV credits at no cost upon meaningful participation in the program.  Participation includes the implementation of oral health assessments and fluoride varnish applications during primary care with the help of a quality improvement specialist.  
Email QI@morelasmiles.org to learn more!    
Overview Training: This 1-hour training explains the Medi-Cal 2020 Dental Transformation Initiative and provides contemporary understanding of dental caries and systems-based approaches to improving children's oral health. Participating providers may earn 1 CME credit online by visiting https://morelasmiles.org/medicaloverview or can request an in-person training for their office by emailing training@morelasmiles.org.

Advanced Training: The 3-hour training includes in-depth instruction on performing caries risk assessments, applying fluoride varnish, utilizing self-management goals and contemporary approaches for prevention and management of dental caries as a chronic infectious disease. Participating providers earn 3 CME credits. We welcome the opportunity to provide an in-person training for your organization; please email training@morelasmiles.org to coordinate.
Join today!
Stay Connected!  @moreLAsmiles    


Did you attend the ACEs Aware Initiative Unveiling webinar on December 4th? Here are a few highlights from Dr. Nadine Burke Harris:

Goal: To decrease ACEs in CA by 50% in one generation.  
  • Reimbursement: $29 per screening of Medi-Cal patients starting in January 2020. For FQHCs, the reimbursement is in addition to the regular payment. Roll out to private sector? Not at the present time but being considered for the near future.
  • Screening tools of choice: PEARLS for children and adolescents (0 - 19); ACEs Assessment Tool for adults ages 18 and older. Either PEARLS or ACEs for ages 18-19. Re-screening is allowed once per year, per provider, per managed care plan for patients under age 21 if medically necessary. Only one adult (Over 21) lifetime screening is reimbursable. Why screen adults? Addressing a toxic stress etiology may improve a chronic condition outcome.
  • Training: Training is already available online by creating an account here. Get trained now to be reimbursed for screenings beginning January 1st.
  • Billing Codes: G9920 (ACE score 0-3, lower risk); G9919 (ACE score 4 or greater, High risk). Medi-Cal requires the use of the tools recommended by ACEs Aware for reimbursement. 

The ACEs Aware initiative is a first-in-the-nation statewide effort to screen for childhood trauma and treat the impacts of toxic stress. The bold goal of this state-wide initiative is to reduce Adverse Childhood Experiences and toxic stress by half in a single generation, and to launch a national movement to ensure everyone is ACEs Aware. For more information, visit ACEsAware.org or submit your questions by emailing info@acesaware.org .

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Please Donate
AAP-CA2 is a 501(c)(3) non-profit organization. Please consider a tax-deductible charitable donation to one of our many programs
  • The Medicine-Biological Sciences Scholarship Program, which awards scholarships to exceptional high school students each year.
  • The Committee on Service, Education, and Mentoring, which awards scholarships to pediatric residents for outstanding research projects. 
  • The S. Michael Marcy Memorial Lecture, which helps sponsor a portion of our annual Advances in Pediatrics Conference in his honor.

Please contact Tomás Torices, MD (Chapter executive director) for all Chapter 2 related matters.
Cell. (818) 422-9877
Mailing Address: 
PO Box 94127  
Pasadena, CA 91109

Please visit our website at  http://aapca2.org/