The AAP also recognizes that the financial challenges pediatricians face in practice impact the children and families we serve. Recently there has been heightened awareness of the need to address the problem of inadequate payments for the services pediatricians provide. The number two resolution adopted at the ALC urges the AAP board to support pediatric payment advocacy: “Resolved, that the Academy support an Extension for Community Healthcare Outcomes (ECHO) program or learning collaborative to give state chapters the subject matter expertise and support to advance pediatric payment advocacy as a needed lever to promote pediatric health equity.” As a chapter, we look forward to collaborating with national AAP on any initiatives they develop to promote improved payments for pediatricians.

 

Payment is more than just an issue of financial well-being for individual pediatricians; inadequate payments lead to systemic inequities for children and families. Without adequate payments, primary care pediatricians can’t sustain their practices, hospitals can’t keep their pediatric floors open, and pediatric specialty care remains unavailable to children living in the wrong geographic location or having the wrong kind of coverage. Access to care decreases for all children but disproportionately impacts those most vulnerable.

 

California Chapter 2 is working hard to advocate for improved payments for our member pediatricians. At the state level, this has already been a part of our joint advocacy efforts with the other three chapters in California. At the local level, we are seeking to build relationships with payers through the establishment of a pediatric council.

 

The purpose of a pediatric council is to provide a forum where pediatricians can meet directly with representatives from health insurance plans to share knowledge, discuss logistical barriers to providing care and processing claims, and collaborate on projects that can improve the quality of care. While negotiating individual contracts is outside the scope of a pediatric council, the relationships created with payers can ultimately lead to better payments for pediatricians.

 

Earlier this month, the chapter had its first planning meeting for our new pediatric council. The meeting was attended by pediatricians from Los Angeles, Riverside, Ventura, and San Bernardino counties. Representatives from national AAP with experience leading pediatric councils also joined the meeting to provide guidance. Ideally, we would like to have pediatricians from all seven counties attend as we move forward with our first meetings with payer representatives. Any chapter member is eligible to participate. If you would like to participate in our pediatric council, please email our Executive Director, Tomas Torices, at chapter2@aapca2.org.

This month’s member spotlight features Dr. Jim Tedford of San Luis Obispo. In the Trainees Corner we have Dr. Emma Towslee of Santa Barbara.

I would also like to welcome our new chapter members and encourage them to get involved by joining a chapter committee. Information about our committees and other resources are available on our website, aapca2.org. Your support makes the work of this chapter possible!

On August 8, 2023, a series of wildfires, referred to as the Hawaii Firestorm, broke out in the state of Hawaii, predominantly on the island of Maui. The wind-driven fires prompted evacuations and caused widespread damage, killing at least 97 people and leaving at least 31 others missing in the town of Lahaina, Hawaii. In this journal entry, Dr. Felicitas Livaudais, Member At Large with the Hawaii Chapter of the American Academy of Pediatrics, shares her thoughts during these difficult times. Read more ...

AAP-CA2 Climate Change Committee

California is no stranger to wildfires, which have been historically thought of as uncontrolled fires that typically burn wildland vegetation in forests, grasslands, and other ecosystems (Wildfires, 2022). They have occurred over millions of years and are essential to the survival of certain plant and animal species and keeping ecosystems healthy.. Read more

With the 2023 portion of the legislative session coming to a close, now is a great time for us to get updated on what is happening with key policies that we are tracking across the state. The bills which have passed both the Assembly and the Senate, are now on their way to Governor Newsom, Read more...

Starting January 2024 there will be an increase in Medi-Cal payments to 87.5% of Medicare rates for primary care outpatient services in CA. The California Department of Health Care Services (DHCS) has made public a list of codes chosen by the state for this targeted payment increase.

Please access the DCHS website to learn more, and be sure to review the Medi-Cal Targeted Rate Increase Codes List to verify the codes used in your practice are included.

Please contact the chapter if there are any missing codes for the services that you are providing. Our Chapter and District IX Government Affairs Committees will need to advocate immediately if any pediatric practice codes are left out.

AAP-CA2, in collaboration with Anti-Vaping Champions at UCLA, is recruiting practices interested in participating in a Quality Improvement project. The focus is to incorporate vaping screening, counseling, and treatment referrals during visits for pediatric patients.

Receive 25 points of ABP MOC Part 4 credit for your participation, $400 at the end of the 4th cycle, plus up to $300 for participating in the Clinic Learning Collaborative meetings every other month ($50 Amazon card per meeting attendance x 6).

Please contact ucla.avc@mednet.ucla.edu or complete this Interest Form.

View all the details, Here

A 17 y/o female presented to the ED with complaints of tachycardia, fatigue, polyuria, polydipsia, and weight loss. She was found to have a blood glucose of 453 and HbA1C of 12.1, but a normal anion gap. She was admitted to the pediatric floor... Read more

Please complete THIS FORM to be considered for a future Member Spotlight in the AAP-CA2 Newsletter!

By Delesa Barnes

Reach Out and Read Inland Empire Program Coordinator

The extensive presence of Reach Out and Read (ROR) across the United States presents an unique opportunity to give children a success foundation on a large scale. Pediatricians are a trusted-source with the potential to engage 90-91% of all U.S. children during well-child visits... Read more.

Guidance on Protection from Seasonal Respiratory Viruses   

RSV 

Nirsevimab, a long-acting monoclonal antibody, is recommended for all for infants <8 months, born during -or entering - their first RSV season. A single dose of nirsevimab is also recommended for children 8 through 19 months of age who are entering their second RSV season and are at increased

risk of severe RSV disease.

For more information on nirsevimab, the maternal RSV vaccine, as well as resources for new products to protect older adults from RSV, refer to Los Angeles Health Alert Network on this topic. 

Flu 

Routine annual influenza vaccination is recommended for all persons aged ≥6 months. Ideally, persons who need only 1 dose should receive their annual flu shot in September or October. Some children aged 6 months through 8 years need 2 doses and these children should receive the first dose as soon as possible after vaccine is available. ACIP now recommends that persons with egg allergy may receive influenza vaccine (egg-based or non-egg-based) that is otherwise appropriate for their age and health status, regardless of severity of previous reaction to egg. 

COVID-19 

Over the past several weeks, COVID activity has increased in Los Angeles County with higher numbers of COVID-19 cases and associated hospitalization. Vaccine is still the best protection from serious illness. The FDA

recently approved the updated 2023-2024 COVID-19 vaccine, and on September 12^th the CDC recommended the updated COVID-19 vaccine for everyone 6 months and older. The U.S. Government COVID-19 Vaccine Program will transition to COVID-19 vaccine being procured, distributed and paid by established processes with public and private payers this month. Please plan to order the 2023-2024 COVID-19 vaccine now.

For information regarding how to order, see the COVID-19 Vaccine Provider Hub. Eligible children and adolescents will continue to have vaccines made available to them for free through the VFC program. For further guidance refer to COVID-19 Commercialization at Glance: Provider Transition Guide. 

For more information on the updated COVID-19 vaccine refer to Los Angeles Health Alert Network on this topic. 

If you have clinical concerns or require guidance regarding a specific patient, please email Dr. Nava Yeganeh, NYeganeh@ph.lacounty.gov. 

For specific guidance and recommendations, please refer to the following resources

Gasol Foundation (founded by NBA Champions Pau and Marc Gasol) is a nonprofit that works through evidence-based programming, evaluation and research, and advocacy to promote children’s wellness, with a focus on eliminating childhood obesity.

View our fall programming map

The Department of Pediatrics, David Geffen School of Medicine at UCLA and UCLA Mattel Children’s Hospital seeks a faculty member to join the Department of Pediatrics Health Science Series in the Division of General Pediatrics. Academic rank will be commensurate with experience. Duties include patient care, teaching of fellows and residents, and participation in research or other scholarly endeavors that will lead to academic promotion. Read more...

LA County Health Services is seeking 5 pediatricians/nurse practitioners for its Antelope Valley clinics, for full- or part-time work. Pay is competitive. Hours are flexible. There is no weekend or overnight call. We are an evidence-based practice, with stellar clinicians that work with multidisciplinary teams. We have on site radiology, and multiple sub-specialties. Contact Amy Shekarchi for inquiries/interest: ashekarchi2@dhs.lacounty.gov

New Registry Requirement to Submit Immunization and TB Data 

AB 1797, a new California bill effective January 1, 2023, requires providers to enter immunizations and TB tests they administer, as well as a patient’s race and ethnicity, into a California immunization registry (CAIR OR RIDE/Healthy Futures).

Many of your questions can be answered by visiting the AB 1797 Immunization Registry FAQs page.

Not Yet Enrolled? Enroll Now!

Joining CAIR helps providers meet requirements for AB 1797, Medi-Cal, and the Vaccines for Children (VFC) program. There are many other benefits to participating in an immunization registry: save time, improve patient care, boost immunization rates, and quickly run vaccine reports to access data for reporting.

Refer to the How to Enroll in CAIR2 page for guidance on the CAIR2 setup that works best for your practice and contact your Local CAIR Representative with any questions.

Don’t miss this informative webinar with Dr. Natalie Cruz, Dr. John Harlow, and Professor Jean Reisz. September 28th, @ 7PM.

Topic: Migrating Toward Resilience: Models of Care for the Newcomer Child

Join Dr. Anjan Batra, a UC Irvine Health pediatric cardiologist who specializes in electrophysiology, arrhythmia management and device implantation.

Topic: Sudden Cardiac Death in Athletes: Epidemiology, Prevention and Sports Clearance.

Dr. Batra’s research and scientific findings are reflected in more than 60 publications in prestigious national journals and text books. He is an internationally recognized lecturer who is known for his work on the prevention of sudden cardiac arrest in children and adolescents. He sees patients at the UC Irvine Health Pediatric Cardiopulmonary Clinic, as well as at Miller Children’s Hospital in Long Beach and CHOC Hospital in Orange.

Please join AAP-CA2 Area Representative René Bravo, MD, FAAP for an afternoon of networking and fun on the rooftop bar of Hotel San Luis Obispo. Pediatricians, pediatric sub specialists and allied health professionals are welcome to attend. Members of other AAP California Chapters, join us as well!

Join Dr. Ken Saul for another educational town hall, October 25th @ the Maggiano's in Woodland Hills. This event will include a discussion on the top issues effecting practicing Pediatricians today, including hot topics in Dermatology, Ophthalmology, ENT, and more! The featured speaker will be Dr. Jerome Sigua, a Senior Medical Science Liaison with US Medical Affairs.

Meeting Time: October 25th @ 6:30PM

Location: Maggiano’s - 6100 Topanga Canyon Blvd, Woodland Hills

A date has been set for next year's Pediatric Symposium, hosted at UCLA. Next year's event will be on April 27th, so make sure to mark your calendars! More details to come.

Fridays at 8 AM

Contact Help Me Grow LA leadership via email: HelpMeGrowLA@ph.lacounty.gov. We look forward to working with you!

Signing up your entire practice (clinical and non-clinical staff) qualifies for a 20% discount on Chapter membership dues. Contact us for details.

The Immigrant Youth Task Force (IYTF) at UCLA and the American Academy of Pediatrics California Chapter 2 (AAP-CA2) invite you to visit The Los Angeles County Immigrant Youth Resource Toolkit, a website consolidating community resources in the greater LA area for immigrant youth and families. Our goal is to help professionals from all disciplines address the needs of their immigrant youth patients/clients with regards to health care, legal services, education, social services, and more. As our toolkit continues to evolve, we encourage you to explore and use it in your practice going forward.

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, please visit aapca2.org/committees.

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