2018 - September Edition
Alice Kuo, MD, PhD, MBA, FAAP   President, AAP-CA2    2018 - 2020 
I hope everyone enjoyed a safe, relaxing and restful Labor Day weekend! I was able to spend some time with my children, and we visited Grandma who is temporarily in a nursing home after a bad fall a week ago. It's nice to be able to spend time with family!
I wanted to acknowledge the passing of a true American hero-John McCain died on August 25, after a long and distinguished career in the Senate. A little over a year ago, he voted against repealing the Affordable Care Act, ensuring continued health insurance access to millions of Americans. He did so against the prevailing opinion of his party, and that took a lot of courage.
At the federal level, politics is more partisan than ever. Here in California, we are in the second-year of a two-year legislative cycle, which means that our State Government Affairs (SGA) committee is busy advocating for or against bills that are still being heard in the legislature in Sacramento. One such bill is SB 328, introduced by a Senator in our own chapter, Anthony Portantino from La CaƱada-Flintridge, which advocates for school start times no earlier than 8:30 AM for adolescents (i.e., middle and high school students). This bill is based on a policy statement "School Start Times for Adolescents" published by the AAP in August 2014 and supported by the Centers for Disease Control and Prevention (CDC) to address chronic sleep deprivation and potential effects on adolescent mental health. After lengthy debate and advocacy by all four AAP chapters of our district, the bill was finally passed on Friday, August 31 and now goes to the Governor's desk for his signature. Thanks to all of the members of our chapter-your chapter dues allow us to do this type of important work, bringing the latest science to improve child health in our state.
To follow up from last month's newsletter, our chapter is co-sponsoring (with the Los Angeles County Office
of Immigrant Affairs) a Town Hall meeting on Thursday, November 15 from 12-4 pm at the East Los Angeles County Library. Immigration attorneys from up to 16 different firms will be present, as well as members of our chapter representing child health. This Town Hall will be an opportunity for lawyers and pediatricians to discuss what is happening to immigrant children in our chapter and how pediatricians can better help lawyers with their cases to petition the courts for asylum on behalf of these children. Please come to the Town Hall if you want to learn more or if you have experience that you would like to share.
Within our chapter, our annual Symposium agenda is shaping up-if you have never attended, maybe 2019 will be the first time we see you at our annual meeting! It's a great way to spend a Saturday, gaining some clinical pearls about the latest in adolescent mental health and office emergencies, learning more about our immigrant health committee and also hearing more about Adverse Childhood Experiences (ACEs). Our featured Plenary Speaker will be Julie Linton, MD, FAAP, current chair of the national Immigrant Health Special Interest Group of the AAP. We will also have a chapter business meeting for our general membership during the lunch hour. Please mark your calendars for March 2, 2019 and join us at the Sheraton Universal-hope to see you there!
Finally, I wanted to mention the hard work of our Section on Pediatric Trainees (SOPT). Under the leadership of Christine Thang, MD, pediatric chief resident at UCLA, SOPT has had a poster session at our annual meeting for the past two years, allowing our chapter members and fellows to mingle with pediatric residents from various training programs in our chapter. While SOPT will continue to have its poster session are our Symposium in March, we are bringing back "Life After Residency"-an evening reception at the Sheraton Universal for all pediatric trainees in our chapter and an opportunity for more seasoned pediatricians to share their wisdom. We are planning for this event in late January and will send out details in the October newsletter. If your practice is looking for a residency graduate to fill a locum tenens, part-time or full-time position in 2019, come meet the class of 2019 at this "Life After Residency" event-they definitely want to meet you!
Please check out the rest of our newsletter for information on 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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California Immunization Coalition -  Pertussis Update     
California Infant Dies of Pertussis
Pia S. Pannaraj, MD, MPH, FAAP  
Pia S. Pannaraj, MD, MPH, FAAP | Associate Professor 
Pediatrics | Molecular Microbiology and Immunology
Keck School of Medicine | University of Southern California
Division of Infectious Diseases | Children's Hospital Los Angeles
Program Director | Pediatric Infectious Disease and Global Health
The California Department of Public Health recently confirmed that the first infant since 2016 has died from pertussis. This death serves as a tragic reminder that it is imperative for pregnant women to receive a Tdap booster as early as possible in their third trimester to deliver protective antibodies from the mother to the fetus, thereby protecting young infants from severe or fatal pertussis.
Here are things you can do to help protect infants in your community:
  • Vaccinate infants with DTaP promptly between 6-8 weeks of age. The first dose is typically given at 2 months, however it can be given as early as 6 weeks to offer protection sooner when mom was not immunized during pregnancy.
  • Use prenatal interviews as an opportunity to educate pregnant women on how prenatal vaccination with Tdap protects infants. You can say, "I highly encourage you to ask your prenatal care provider for the whooping cough shot, Tdap. Whooping cough is a serious disease that can cause babies to stop breathing or die. By getting immunized, you are passing on protective antibodies to your baby. This is the best way to protect your baby against whooping cough in early life. This shot is also very safe for you and your baby."
    • Take every opportunity to speak to your colleagues providing prenatal care about the importance of maternal immunization with Tdap as early as possible during 27-36 weeks gestation. A California study provides evidence that young infants whose mothers were immunized against pertussis during pregnancy are less likely to become ill with pertussis, and if they do develop pertussis, they have less severe disease. 
    • Think of creative ways to help your partners in obstetrics provide Tdap vaccine if they aren't already. Consider sharing fridge space or inviting them to join your  group purchasing organization to obtain Tdap at a lower cost. Providers can also visit the prenatal Tdap toolkit page on EZIZ to download additional resources.
Thank you for your help in protecting our most vulnerable through vaccination and helping prepare our community for the next epidemic.
Separated Immigrant Children   -  Update  
OIA, L.A. Justice Fund, and AAP-CA2 - East Los Angeles 
The County of Los Angeles Office of Immigrant Affairs (OIA) and the Los Angeles City Mayor's Office of Immigrant Affairs met for the 3rd Regional Immigrant Families Separation Convening on Thursday, August 9, 2018 at the East Los Angeles Service Center. The purpose of this meeting was to update stakeholders on the County and City efforts to identify, welcome and assist separated immigrant children and their families due to the Administration's zero-tolerance policy.  Approximately 1,500 separated children are still expected to arrive to Los Angeles County through the Office of Immigrant Affairs. However, because of SB 75 that went into effect in 2016 (all children are eligible for Medi-Cal regardless of their immigration status), children may seek health services at County clinics or any practice seeing patients with Medi-Cal. With this in mind, our Chapter has been promoting training opportunities for pediatricians to become forensic examiners to better assist in cases of immigrant children seeking for asylum.
(Left) AAP-CA2 President Alice Kuo, MD, PhD, MBA, FAAP with Rigo Reyes, Acting Executive Director for the Los Angeles County Office of Immigrant Affairs 
During the meeting, AAP-CA2 president Dr. Alice Kuo provided an overview on the AAP's position and involvement in regards to separated immigrant children, referencing the March 2017 Policy Statement: Detention of Immigrant Children, and the 2009 Immigrant Child Health Toolkit, which includes templates for letters of support for asylum cases. In this regard, Rigo Reyes, Acting Executive Director for the Office of Immigrant Affairs, and the 16 law firms that make up the L.A. Justice Fund have asked our Chapter for pediatricians to assist with forensic examinations and letters of support for asylum applications.  
Dr. Kuo added that approximately 24 pediatricians are trained and ready to assist. The September 22nd Forensic Examination training at UCLA is open to any physician who would like to volunteer in assisting with these cases. The lawyers have asked us to look beyond the obvious signs of physical abuse, and to look for behavioral challenges: anxiety, depression, suicidality. Pediatricians and lawyers will convene on November 15 (Addressing the Health Needs of Immigrant Children - Half Day Conference) in East Los Angeles to discuss the need and best ways to approach the most commonly seen asylum cases. Finally, Dr. Kuo announced Dr. Julie M. Linton, co-author of the AAP "Detention of Immigrant Children" policy statement as the keynote speaker for the AAP-CA2 30th Annual Pediatric Symposium on March 2, 2019 to highlight immigrant health.
Immigrant Health Initiative   -  IHI  
Advocating for Immigrant Children: Join the AAP-CA2 Immigrant Health Initiative!
Join the AAP-CA2 chapter Immigrant Health Initiative (IHI)! The IHI will be a dynamic local network for advocacy, education and mentorship for chapter members caring for our diverse immigrant children. We will also partner with the national AAP Immigrant Health Special Interest Group to engage in national advocacy campaigns and share resources for promoting immigrant health.
Click here to join the IHI!
Resident's Corner
Christine Thang, MD 
Call for Abstracts for AAP-CA2 Advances in Pediatrics Symposium
March 2, 2019 at the Universal Sheraton in Los Angeles, CA

Abstract Submission Deadline: January 4, 2019 at 11:59PM PST

General Information:
  • The AAP California Chapter 2 will accept abstracts on scholarly projects by pediatric and medicine-pediatric residents from CHLA, Harbor-UCLA, Kaiser LA, Loma Linda, UCLA, and USC.
  • New this year, students from medical schools in the Southern California counties of Kern, Los Angeles, Riverside, San Bernardino, San Luis Obispo, Santa Barbara and Ventura are also invited to submit their abstracts!
  • Abstracts can be on original research, quality improvement, clinical cases, or any other scholarly project conducted during residency training.
  • Abstracts will be accepted for poster or oral presentation.

New Food Allergy Prevention Updates: Scientific Guide by Dr. Gary Rachelefsky  

Gary S. Rachelefsky M.D.
Dr. Gary Rachelefsky, renowned Allergist & Immunologist and former President of the American Academy of Allergy, Asthma and Immunology distills his 46 years of experience as an investigative researcher, professor, and clinician into a short guide that explains why we are seeing a paradigm shift in food allergy prevalence and prevention.


In The Community  

July 31, ICLAC - Los Angeles  
Immunization Coalition of Los Angeles County 

AAP-CA2 Immediate Past President Edward Curry, MD, FAAP and AAP-CA2 QI Team ID Specialist Ozlem Equils, MD, FAAP were the guest speakers at the Immunization Coalition of LA County (ICLAC) general session meeting on July 31, 2018 at The California Endowment in Los Angeles. Their presentation covered their experience with the recent HPV Vaccine Initiation MOC QI Project, specifically on overcoming challenges and the interventions applied to improve immunization rates.

(From left) Wendy Berger, Research Analyst and Immunization Coalition Coordinator at the Dept. of Public Health, Los Angeles County Immunization Program, AAP-CA2 Immediate Past President Edward Curry, MD, FAAP, and AAP-CA2 QI Team ID Specialist Ozlem Equils, MD, FAAP
Help ICLAC Better Understand the Barriers to Immunizations
The results of this survey will inform the development of a culturally and linguistically sensitive vaccine communication toolkit designed to help LA County doctors and health care providers answer common questions about the age-recommended vaccines and schedule.    The survey should only take 10 minutes to complete. 

August 2, First 5 LA - Los Angeles  
Policy Leadership Meeting   
Representatives from AAP California Chapters met with State and local First 5 leadership for an afternoon of policy-based conversation and strategic planning to identify and develop legislative ideas for early childhood.

With the common goal "All children are supported by an accessible early intervention system that ensures they achieve their greatest potential", the group brainstormed high-level ideas that can result in systematic changes, such as s trengthening the Early Childhood Education System by educating child care providers on developmental screening, requiring developmental screening in QRIS, the Quality Rating and Improvement System used to assess, improve, and communicate the level of quality in early and school-age care and education programs , and advocating for health plans to tie Quality Measures to developmental screening as an incentive for providers.
In conclusion, First 5 LA expressed that the AAP and First 5's policy and collaboration goals should focus on three areas:  
    • Improving screening rates by supporting and incentivizing primary care pediatricians to use standardized developmental screening tools, and the use of the timely administration of these tools as quality indicators
    • Improving timeliness of referrals to Early Start (Regional Centers) and Help Me Grow
    • Improving care coordination including feedback to referring physicians
The workgroup will convene again on September 28 to brainstorm about strategies that can effectively address the three policy and collaboration goals listed above.
August 14, Town Hall - Westlake Village 
AAP-CA2 Member-At-Large Ken Saul, MD, FAAP hosted a Town Hall at Tuscany Il Ristorante, in Westlake Village. Jennie Depatie Ph.D. (Top left on image below) presented on Clinical applications of Psychiatric Pharmacogenomics, showing how key pharmacogenomic genes (pharmacokinetic and pharmacodynamic) influence psychotropic drugs (antidepressants in the study shown) and improve outcomes.   
"The National Institutes of Health defines pharmacogenomics as the use of information about a person's genetic makeup, or genome, to choose the drugs and drug doses that are likely to work best for that particular person.
This personalized approach can help healthcare providers make objective, individualized treatment decisions, minimizing trial and error prescribing by getting more patients on the right mediation faster."  -  Dr. Depatie.
You may visit www.genesight.com for more information.    
Developmental Pediatrics Conference in Anaheim
Developmental Behavioral Diagnosis and Management in Pediatrics
September 14, 2018 in Anaheim
SDBP and NAPNAP are teaming up to provide a full day symposium for  pediatric primary care providers and those working in DB Peds. There are two  4-hour cases that will cover autism versus global developmental delay in a younger child, and ADHD versus mood disorder or learning disability in a teen.
Upcoming AAP-CA2 Events
September 6, 2018 in Woodland Hills -  Town Hall / Dinner 
Ken Saul, MD, FAAP Member-At-Large 
Please join AAP-CA2 Member-At-Large Ken Saul, MD, FAAP for an evening of professional development and networking at Ruth's Chris Steak House.
Prevention of RSV
- Sponsored by AstraZeneca
SPEAKER:  Ken Saul, MD, FAAP  

DATE:  September 6 at 6:30 PM   
LOCATION:  Ruth's Chris Steak House   
6100 Topanga Canyon Boulevard
Woodland Hills, CA 91367 

Please RSVP by 9/3:    
To register, please call or email Valerie Page
Tel. (818) 642-3952
Email: valerie.page@astrazeneca.com
September 20, 2018 in Victorville -  Dinner/Lecture - Town Hall
Please join AAP-CA2 Vice President Damodara Rajasekhar, MD, FAAP for September' s AAP High Desert Area Townhall meeting.
Damodara Rajasekhar, MD, FAAP AAP-CA2 Vice-President, and Area Representative in San Bernardino County/High Desert
DATE:  Thursday, September 20th, 2018 @ 6.30pm 
LOCATION: Thai Dawn Bistro                        
14317 Bear Valley Road , Victorville, CA 92392
"Tuberculosis in Children, and Its Management"
SPEAKER: Jane M Bork, MD
Associate Professor of Pediatrics
Division of Pediatric Infectious Diseases
Loma Linda University School of Medicine.
Also, there will be an update on AAP, CMA, and SBCMS.
Please RSVP to drajasekharmd@gmail.com  
We need the number of physicians attending to arrange for dinner.
October 10, 2018 in Woodland Hills -  Town Hall / Dinner 
Ken Saul, MD, FAAP Member-At-Large 
Please join AAP-CA2 Member-At-Large Ken Saul, MD, FAAP for an evening of professional development and networking.
This event is at Maggiano's.
TOPIC: Vaccine Update 
DATE: October 10, 2018 at 6:30 PM
LOCATION: Maggiano's Little Italy 
6100 Topanga Canyon Blvd, Woodland Hills, CA 91367
RSVP: Please email Dr. Saul at docksaul@aol.com 
November 15, 2018 in Los Angeles
Addressing the Health Needs of Immigrant Children
Half-Day Conference 
Please join the AAP-CA2 Immigrant Health Initiative group and the Los  Angeles County Office of Immigrant Affairs for an afternoon of discussion, collaboration, and networking on the topic of immigrant children separated from their families, their needs and ways to help them. Also in attendance will be representatives from various law firms (L.A. Justice Fund) sub-contracted by LA County to represent these children. Please join us!
TOPIC: Addressing the Health Needs of Immigrant Children 
DATE: November 15, 2018
TIME: 12 - 4 PM
LOCATION: East Los Angeles County Library 
Other Events
October 6, 2018 at UCLA -  Oral Health Innovation Forum 
The  UCLA Center for Children's Oral Health  will be holding an Exciting Interprofessional "Oral Health Innovation Forum". This interactive forum would be the first of its kind: a cross-collaboration of five major UCLA Schools to discuss and find policy solutions for oral health issues (with a focus for Early Childhood Caries-ECC) through a lens of social equity & social justice. 
This is a pioneering event for systems-change approaches in both the delivery of oral health care and primary care.
Saturday, October 6, 2018
8:00 AM -1:00 PM (Continental breakfast included)
Luskin Conference Center
Registration and information is found on the following site:
Save The Date -  2019
March 2, 2019
Saturday, March 2, 2019 at the Sheraton Universal Hotel
UCLA QI Project - Free CME/MOC 
Join Us for a 6-Month Primary Care Practice Quality Improvement Offering for Medical Providers
Receive Free CME & MOC Credit and Help Transform Oral Health for 
LA County Children

Over half of California's children experience tooth decay by kindergarten. You can help reduce that number and improve oral health for Medi-Cal children. More LA Smiles (a UCLA Dental Transformation Initiative funded by the California Department of Health Care Services) is offering a   6-Month Primary Care Practice Quality Improvement for Medical Providers to integrate oral health services into well-child visits for children ages 0-6.
Eligible Medical Providers can participate in free onsite or virtual training to receive 30-50 CME and 20-25 MOC credits with six months of support from a dedicated Quality Improvement Specialist. Providers learn to integrate preventive oral health services into their practice settings; these services include screening and risk assessment, fluoride varnish, and dental home referrals. This offering is open to Medical Providers, including pediatricians, family medicine physicians, nurse practitioners, physician assistants, and clinical support staff.
Please note: Free CME and MOC credits are available to Medical Providers only. Clinical staff who participate will receive a certificate of completion.
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AAP-CA  Statewide Advocacy
LA-HPAC: Sac Capitol office
Have you visited the AAP-CA website lately?
Advocacy efforts on behalf of the four California Chapters is conducted from the office of AAP-CA CEO, Kris Calvin.

Advocacy Priorities
Universal ACCESS to quality, comprehensive pediatric care in a medical home, including access to vaccines and behavioral and mental health treatment for every child in California, including vulnerable populations such as children with special health care needs, foster children, children of immigrant families, LGBTQ youth and the list goes on.

Please visit AAP-CA.org/Advocacy to learn more about the current Advocacy Priorities and the list of High Priority Bills.
AAP-CA2 Video: We Are The AAP-CA Chapter 2 -  2017

CDC Updates & LAHAN Alerts
Join the CDC Listserv
The Centers for Disease Control and Prevention (CDC) is happy to offer a free email subscription service, which allows CDC.gov users to receive alerts by e-mail when new information is available. With a subscription profile, you get the updated information on the items of interest to you automatically without having to return to the Web site and check for changes. Click to Subscribe 

Join the LAHAN Listserv  
To receive communications from the Health Alert Network, Sign-up here.
It takes less than two minutes to sign up.  
Visit the LAHAN website.

Submitting Articles for Publication in Our Newsletter


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For article submission guidelines, please click here.


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For advertisement rates and guidelines, please   click here.
If you are interested in advertising, please  email the Chapter.
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.

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