This summer we have been facing a humanitarian crisis when it comes to children in our country. As you have probably heard, as a result of our current federal administration's brief policy of separating children from their parents at our borders, about 3,000 children were separated during the six weeks that this policy was in effect. Although some have been reunited, many have not for various reasons.

 

The American Academy of Pediatrics has been recognized as a leading voice on behalf of children during this crisis. I have been personally thanked by non-physician child advocates on behalf of the Academy for its leadership during this time. Each one of you should feel proud to be part of the AAP's efforts to support children through these difficult times.

 

Tomás and I have attended several meetings regarding the separated children who were originally sent to one of the four Office of Refugee Resettlement (ORR) shelters in our area, as well as previously separated children who are expected to reunify with an adult in our chapter. About 100 children were sent to these shelters but will be reunified with adults not in California, i.e., they will be sent out of our area. However, we are expecting about 1,500 recently separated children to come to the Greater Los Angeles area as they await removal proceedings.

 

On behalf of the chapter, we are identifying resources for these children and families to receive health care when they arrive. As a result of SB 75 that went into effect in 2016, all children under the age of 19 (including undocumented children) in California are eligible for full-scope Medi-Cal. We are working with the LA County Office of Immigrant Affairs to develop a system of care to support these children and families as they enter our communities. The LA County-USC Wellness Center and the Asylum Clinic at Olive View-UCLA Medical Center have verified that they are able and willing to care for these children; we hope to identify a few more sites in the next few weeks. Please see the article on the Sanctuary status of all Los Angeles County sites here that assures that all county staff have or will undergo training that will not allow the sharing of identifying information with federal agents without a court injunction. We will also be gathering information about the other counties in our chapter and their efforts to address these issues.

 

We have also met with some of the immigration lawyers on the front line working with these children and families on their asylum applications. As we have heard in the media, it is becoming increasingly difficult for children and families to be granted refugee status, despite the often horrifying conditions they are fleeing from their native countries. Thanks so much to the two dozen chapter members who have volunteered to perform forensic examinations for these cases to strengthen their legal applications. UCLA will be holding a training for those physicians interested in learning how to perform asylum examinations-more information can be found here.

 

If you encounter any child in your practice who has been traumatized by immigration-related actions or activities and you need a curbside consultation or just have questions about clinical signs, symptoms or potential referrals, please review the AAP Immigrant Child Health Toolkit, which can be accessed here. You can also contact our Immigrant Health Committee, which is a vibrant community of chapter members passionate about these issues who have been meeting regularly for the past 18 months. Please access information about the Immigrant Health Committee here, and you can contact Tomas if you have any clinical questions you would like help with. Our chapter Immigrant Health Committee is partnering with the LA County Office of Immigrant Affairs to organize a Town Hall meeting in mid-November with pediatricians, lawyers and other child advocates to address the issues surrounding immigration in our chapter. Please stay tuned for more information in next month's newsletter.

 

In other chapter news, we are continuing our strong partnership with First 5 commissions both locally and at the state level to support the early identification and referral of young children with developmental problems. Our chapter has been a leading player (thanks to Past-President Ed Curry's efforts) in this area, and we are helping First 5 and others address systems-level issues to make it easier for children and families to connect to needed resources such as diagnostic and early intervention services. We are also developing a partnership with the LA County Department of Public Health in creating guidelines that will help our members in their practices. For example, we have heard many of you ask for guidelines about appropriate medical exemptions for vaccines, and we are hoping to work with DPH to develop these guidelines this upcoming year.

 

Please look through the rest of this newsletter for reports from the Joint District Meeting that occurred in July, and recognition of individual chapter members accomplishments in their local communities. Finally, please save the date for our Annual Symposium, which will be at the Sheraton Universal on Saturday, March 2, 2019. I hope to see you all there!

Thanks for all that you do on behalf of children in our communities!

 

Alice Kuo, MD, PhD, MBA, FAAP

Chapter President