DECEMBER • 2019
Developments in December

The developments in December
Pleasingly include introductions to new board members
First hand take on disaster planning and implementation
Pediatric malpractice lessons learned, Children's Fund Act of Sacramento and more information.
President's Column
Raelene Walker, MD, FAAP
This month, I’d like to highlight several people and activities from our chapter, and offer appreciation to all the people involved with these activities. To start, I’d like to formally introduce our three newest board members, Dr. Thiyagu Ganesan , North Valley Member at Large, Dr. Lauren Steele , North Coast Member at Large, and Dr. Tashya Whitehead , Early Career Physician representative. We are glad you’ve joined us and look forward to working with you!

On November 9, we held our 2nd Mental Health Day conference, this time in Madera at Valley Children’s Hospital and I’m very pleased to say it was a big success. The attendance was so great we sold out and the feedback has been extremely positive from the attendees. Congratulations and thank you to the planning team, speakers, community resource presenters, and co-sponsors. Well done! Please see Dr. Diane Dooley’s report on the conference below. 

To find out more about what our chapter is doing and get engaged, or to give us ideas and suggestions of what would be helpful from our chapter for our members and patients, please visit our website .
A Warm Welcome to Our Newest Board Members
North Valley Member At Large
Thiyagu Ganesan, MD, FAAP, MMM
Dr. Ganesan has been an outpatient and hospitalist pediatrician in Yuba/Sutter County, CA since 2016 and is a medical director of the NICU in Rideout Regional Hospital Center in Marysville, CA. He is originally from a rural district in the state of Tamilnadu, India. He went to medical school in Thanjavur and did his post-graduation residency in pediatrics in Madras Medical College, Chennai. His residency was followed by a two year fellowship training in Pediatrics and Neonatology at the Queens Hospital in Greater London, UK. In order to practice pediatrics in the US, he did his residency in pediatrics at Georgetown University in Washington, DC. Since he has always been interested in learning physician leadership, he completed a Masters in Medical Management (MMM= Executive MBA for physicians) at the University of Southern California (USC) in 2019. Due to his interest in working with the underserved, he has been working in a Federally Qualified Health Center since he completed his residency. He has been a proud AAP member since 2012.

He is married to his beautiful wife and has a wonderful daughter; he likes traveling, spending time at the gym, and is passionate about reading about Siddha Medicine to learn how food can be used as medicine to benefit him personally as well as his patients.
North Coastal Member At Large
Lauren Steele, MD, FAAP
Dr. Steele is a pediatrician for Open Door Community Health Centers in Eureka, CA. She originally hails from Denver, CO, attended medical school at Mount Sinai in New York, and eventually made it to the great state of California to complete residency at UC San Diego. Dr. Steele was a Chief Resident at UCSD and moved to Humboldt County in 2017 to practice general pediatrics in a rural setting. She and her husband have one son and love hiking and exploring coastal Northern California in their free time.
Early Career Physician Representative
Tashya Jayasuriya Whitehead, MD, FAAP
Dr. Whitehead is a pediatrician in the heart of California’s Central Valley. Originally from the East Coast, she went to the University of Michigan for undergraduate, where she studied biopsychology and French. She then stayed in Ann Arbor and attended medical school at the University of Michigan, where she was awarded a National Health Service Corps Scholarship. After medical school, she completed her pediatric residency training at the Children’s Hospital of Pittsburgh, where she later became chief resident of the primary care track. Outside of work, she loves traveling, eating good food, sleeping, reading, running, hiking, and being outdoors.
Vice President's Column
Nelson Branco, MD, FAAP
Disaster preparedness is a topic that has been on everyone’s mind lately. The AAP resources include the Council on Disaster Preparedness and Recovery, and a website dedicated to information about how to prepare your office and counsel your patients about disaster preparedness. Our offices are located in Marin County, just north of San Francisco. With several recent wildfires allegedly caused by our public utility PG&E, in early June we received notice that we may be affected by PG&E Public Safety Power Shutoff (PSPS) in the case of a nearby wildfire or elevated fire danger. During a PSPS, we were informed, our electrical power could be turned off for extended periods – days at a time. Our initial concern was how we would protect our vaccines in the case of an extended power outage. Then came the crucial thinking about whether we would need to close one or both of our two offices, and how we might manage in the case of a multi-day power outage.

To help with planning what we would do with our vaccines, we hired an electrical engineer to consult on backup power options. We have an Accuvax unit in each office with a backup battery that is meant to last 8-10 hours, plus one large vaccine refrigerator. The consultant provided us with some options, including battery backups and generators. The most appealing option, a battery backup, was also the most expensive, and would still require generated power during a multi-day outage. Plus, the likelihood of both of our offices, fifteen miles apart, losing power at the same time seemed remote. So the decision on power backup was relegated to the back burner while we discussed what we would do with staffing, how we would decide if we could continue seeing patients, and other issues.

Several months later, the Kincade fire started in neighboring Sonoma County.
Photo caption: Equipment purchased for the power outage, including extension cords, gasoline powered generator and fuel. Extension cords were hooked up to the generator and run through the office.
Pediatric Mental Health Day CME Conference Update
Diane Dooley, MD, FAAP
Where is Madera? This was the first question the members of our Chapter 1 Mental Health Access Committee asked after Carmela Sosa MD invited us to give a Pediatric Mental Health Conference in her city in the Central Valley. We soon discovered that Madera is a beautiful city with wineries, fine food, access to beautiful Yosemite and Valley Children’s Hospital, a beautiful 330-bed Children’s Hospital with an NICU and a Starbucks! We also found that the mental health resources are extremely limited in this area, which has both the highest concentration of poverty in California and the lowest rates of children and teens receiving needed mental health treatment or counseling.

Following the success of the Spring Chapter 1 Mental Health CME program given by the CME and Mental Health Access Committees, we took on the challenge of presenting a similar conference on November 9 in Madera. The conference planners, Diane Dooley MD, MHS , Carmela Sosa MD , Jolie Limon MD and Isra Uz-Zaman MS developed a curriculum using AAP Mental Health Competencies and a pre-assessment of the enrolled attendees.
Top - Left: Local organizations/resources. Middle: Attendees listening to the speakers. Right: Dr. Carmela Sosa at the AAP Book Table. Bottom - Left: Isra Uz-Zaman at the AAP Book Table. Middle: Local organizations/ resources. Right: Attendees listening to the speakers.
All Ready to Learn at the AAPCA 41st Las Vegas Seminars
Vidhi Jhaveri, MD, FAAP
As the recipient of the Abbott Nutrition Scholarship, I had the opportunity to attend the 41st annual Las Vegas Seminar. I walked in and was immediately floored at how many people were there. It was rows and rows of pediatricians from all over the country, and some PAs and NPs. There had to be more than 400 people in the room, all ready to learn. 

The seminar itself was geared toward the generalist and was full of both practical, clinical information as well as lots of new developments in all the speakers’ respective fields. Continue reading... 
Pediatric Malpractice: Lessons Learned
Richard L. Oken, MD, FAAP

The subject of malpractice is not often discussed in pediatric residency training or at educational conferences, but the reality is that one in five pediatricians will be sued for malpractice in their career. Surveys on the medical liability experience of Academy members and research on closed malpractice claims demonstrate the reality and risks of malpractice.

Here are some sobering facts:
  • The average pediatrician will have an open, unresolved malpractice claim for 7 percent of his or her career compared to 11 percent for all physicians (Seabury, Chandra, Lakdawalla, and Jena. Health Affairs. 2013). 
  • While pediatricians are not sued as frequently as other specialists, when they are, the costs are high. One study finds that the mean pediatric malpractice payouts ($562,000) are the highest among all specialties (Jena, Chandra, Seabury. Pediatrics. 2013). 

Pediatric malpractice claims are more expensive than other specialties because:
A Stable Funding Source for Children and Youth Services: Sacramento Children's Fund Act of 2020 AKA Measure G
Isra Uz-Zaman, MS
Executive Director
Our chapter joined the Sacramento Kids First coalition, Sacramento’s largest grassroots coalition, in support of Sacramento Children’s Fund Act of 2020. The act requires the city to set aside a modest 2.5% of its general fund each year for child and youth services (does not raise taxes), including for after school and summer programs, mental health counseling, support for homeless youth, and the needs of youth of color and LGBTQ youth and more (read more about the measure here ). I spoke to the Sacramento City Council along with over 150 youth and adult leaders, making the case from the perspective of children's health and prevention to add the Children’s Fund Act of 2020 to the March ballot and we were successful! This act has been added to the March 2020 ballot as Measure G, three city council members -- City Councilmember Jay Shenirer, Vice Mayor Eric Guerra and City Councilmember Allen Warren -- joined yes on the measure and current efforts are in getting community support to vote Yes on Measure G. If you’d like to join these efforts, you may request a yard or window sign or donate . If Measure G passes, we estimate over 20,000 Sacramento kids will benefit each year and Sacramento will have taken a big step forward in investing in prevention!
Youth from the coalition organizations and myself at the podium speaking to the City Council Members.
Oral Health Update - Fluoride: The Myths, Facts and Best Practice Recommendations
Kim Nichelini, D.M.D.
Director North and AAP Liaison, California Society of Pediatric Dentistry
kimnichelini@gmail.com
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Reminder: Community Access to Child Health (CATCH) Grant

A reminder that the Call for Proposals is open as of November 1, 2019 -- with a deadline of January 15, 2020. The application can be found here . If you have questions, please reach out to our CATCH Chapter Facilitators Aparna Kota, MD, FAAP and Judy Lin, MD, MPH, FAAP at info@aapca1.org , or contact the general CATCH staff at CATCH@aap.org . Thank you for what you do on behalf of children!

We urge you to consider applying for a CATCH grant if you have an idea to make a difference in your community. 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 SGA Side
Your Key to State Government Affairs
Nora Pfaff, MD, FAAP and Zarah Iqbal, MD, MPH
SGA Chapter Representatives

The legislature is currently in recess until January but your State Government Affairs Committee is still hard at work! Here are some recent updates:
  1. Most recently, we have been working with our Climate Change and Health Committee to develop a legislative strategy for climate change, both on the local and national levels of the AAP. As we continue to see with fires that affect our state, climate change is an issue with huge implications for the health of children.
  2. Jacques Corriveau, MD, CA Chapter 1 member and Chair of the AAP California State Govt Affairs Committee, represented the 4 AAP CA Chapters at a legislative hearing in Sacramento convened by Senator Pan on an audit of preventive services for kids. The results showed that less than 50% of Medi-Cal kids are receiving their mandated preventive care. 

Reminders:
1. To view updated AAP California bill positions, letters & outcomes from the 2019 CA Legislative year, go to aap-ca.org/bill.  
2. For latest organizational advocacy updates follow @AAPCADocs on twitter
3. Registration for the 2020 AAP Legislative Conference is now open ! The conference will take place April 5-7, 2020 in Washington, DC at the Capital Hilton Hotel.
4. If you have questions and/or are interested in knowing more about a certain legislation, reach out to our State Government Affairs Chapter Representatives Nora Pfaff, MD, FAAP and Zarah Iqbal, MD, MPH at info@aapca1.org . 


Opportunity for Your Benefit
AAP Adolescent Health Statements
AAP released two new adolescent health statements in their December 2019 issue of Pediatrics . The new statement on the Unique Needs of the Adolescent emphasizes the need for preventive care and counseling for this population during the critical years of development—both physically and emotionally. The Emergency Contraception policy statement was revised to provide the latest information and data on the safety and efficacy for emergency contraception use and reviews the available methods.

AAP Volunteer Network
For member engagement and volunteerism opportunities along with opportunities for grants/scholarships and awards, visit the AAP V olunteer Network here . (Please note that you’ll have to log into your AAP.org account)

CalHealthCares Loan Repayment Program
CalHealthCares Loan Repayment Program (funded by Prop56 and Senate Bill 849) offers loan repayment up to $300,000 in exchange for a five-year service obligation to eligible physicians. All awardees are required to maintain a patient caseload comprised of a minimum of 30% Medi-Cal beneficiaries and within 10% of the Medi-Cal patient caseload. Second Application Cycle Opens January 13, 2020! Visit the site: https://www.phcdocs.org/Programs/CalHealthCares-LRP

April 25, 2020: Spring CME Conference, Fairfield (Topic: Adolescent Health) - SAVE THE DATE

Our mission is to promote the optimal health and development of children and
adolescents of Northern California in partnership with their families and communities, and to support the pediatricians who care for them.


President: Raelene Walker • Vice President: Nelson Branco
• Secretary: Janice Kim • Treasurer : Nivedita More • Past President: John Takayama
Executive Director: Isra Uz-Zaman