March • 2021
In March We Embark

In March We Embark
Upon elections, membership transcendence, and school reopening statements.
With committee updates and new initiatives in stock,
To ensuring advocacy opportunities to make a difference.
Treasurer's Column
Nivedita More, MD, FAAP
I am grateful to all of you, our members, for your continued support through a difficult past year! Our Chapter would not be fiscally sound without you! Thank you!

Our revenue has continued to grow through 2020, mainly through our membership, our grants and our conferences. Majority of our revenue continues to come from our membership. We are 2,232 members strong currently and one of our nation’s largest AAP Chapters! This past year our chapter received four grants. The ACE Aware grant, the ASHEW grant, the AAP Healthy People 2020 grant, the Project Firstline grant and the SODBP grant. Details about all of these grants can be found on the Initiatives page of our website. With the help of our committees, we were able to put together two virtual conferences this past year, including one Advocacy conference and our annual Puzzles conference.

We had a lot of plans for 2020 in terms of revenue building, but all of those had to be put on hold due to the pandemic. We also must be able to do all the revenue building remotely moving forward, till all members of our community get vaccinated.

We have a few plans for 2021 as we look forward to growing our Chapter and its revenue. We will do our best to add value to our sustaining members and we are hoping to add new members in the coming year. We have been reaching out to our lapsed members this past year, which has helped with sustaining our membership. If you have a colleague in your practice or at your local hospital who is not a Chapter member, please encourage them to join our Chapter and direct them to our website to see all the excellent work we are doing. As the treasurer of the chapter, I am always looking for ideas to grow our revenue stream, to help us grow our advocacy efforts at the State and National level as a Chapter. A finance taskforce or committee is one such idea along with fundraisers and grants. If any of you are interested in being part of this new initiative, have connections with the big corporations or institutions in the area, or have expertise in grant writing, please reach out to us at info@aapca1.org. We would be happy and grateful for your help!
Elections for AAPCA1 2021-2022 Board
Nomination Deadline: April 7

Interested in a leadership role in AAP California Chapter 1? Consider running for Vice President or an open MAL (member-at-large) board position in the following regions (you must either live or work in the region to be eligible):
  • Region 2: Sacramento Valley Member-At-Large - Includes El Dorado, Nevada, Placer, Sacramento, Yolo counties
  • Region 3: Central Valley Member-At-Large - Includes Alpine, Amador, Calaveras, San Joaquin, Stanislaus and Tuolumne counties
  • Region 5: San Francisco Member-At-Large - Includes Daly City
  • Region 11: Contra Costa/Solano Member-At-Large - Includes Contra Costa and Solano counties

The AAPCA1 board consists of the President, Vice President, Immediate Past President, Secretary, Treasurer and representatives from our 11 Northern California regions referred to as Members at Large (MAL). The MAL position is for a 2 year term.
If you are interested in any of the above positions, please complete the application by going to https://www.surveymonkey.com/r/nominations2021-22. The deadline to submit an application for consideration for an open position is April 7 and the term for the positions begin on July 1, 2021.
Elections for AAP District IX

AAP District IX will have an election for both District Chairperson (DC) and District Vice Chairperson (DVC) in 2021. The term for any new Fellow elected to either position is 4 years. District Nominating Committee is seeking AAP members interested in being considered as a candidate to run for either District Chairperson or District Vice Chairperson Position. 

If you are interested in being considered as a potential candidate, please email Edward S. Curry MD, FAAP, District IX National Nominating Committee Representative at curryaapca2@gmail.com with your name, the position you would like to be considered, and a 200 word Biography. Attached the Job description for both positions. The deadline for nominations is March 8.
Committee on Substance Use Prevention Update
Seth Ammerman, MD, FAAP, FSAHM, FASAM
COSUP Committee Chair
At our last meeting (Zoom of course) on January 21, discussion highlights included:
  1. The National AAP E-Cig 2021 Advocacy Effort, which is a major effort by National to confront the public health epidemic of Adolescent Vaping. Seth and Valerie Gribben, MD, FAAP are the official CA District “E-Cig Champions” for this effort. The effort involves educating health care providers, parents, teens, and others working with adolescents about the harms associated with vaping. Another major focus will be to fight the Tobacco Cartel’s ballot measure to overturn CA’s Flavor Ban on Tobacco Products – Senate Bill (SB) 793 -- more to come as this effort progresses. 
  2. Note that on January 29, Seth and Valerie led a Chapter Webinar on Vaping: "To Vape or Not to Vape: That is the Question.” And coming up on Tuesday, March 9, Valerie and Seth will be leading a chapter chat on vaping titled: "Vaping Myths and Misconceptions.” Please join in if you’re available. 
  3. Prop 64 Youth Subcommittee Update: The focus of grants to date has been prevention around youth cannabis use. 
  4. All members of COSUP are willing to give presentations concerning substance use topics to providers, parents, youth, and other interested groups. If you would like a presentation by one of our members, please email Seth at sethamm54@gmail.com and he will help sort out details. 
  5. We are always open to new members. If you are interested, or know someone who is, please contact Seth. Meetings are quarterly with ongoing communications between meetings as needed.
Upcoming Event: Vaping Myths and Misconceptions
AAPCA1 & ACEs Aware
AAPCA1 is working with the California ACES AWARE initiative to provide California pediatricians with information they can use in their practice to screen for Adverse Childhood Experiences (ACEs) during well child visits. This initiative will help pediatricians support families by identifying stressors that can lead to developmental and behavioral problems in children, and are risk factors for adult onset chronic diseases.
March Initiative: Prevention and Early Intervention for ACEs
A recent article by Barnes AJ et al (Ped Res 2020, Jan;87(2):362-370) reviews the data about childhood adverse experiences, which include abuse and maltreatment (physical, sexual, emotional/verbal); neglect (physical and emotional/psychological); and household dysfunction (parent mental illness; domestic violence; divorce or separation; incarceration; and alcohol or drug abuse) . The original ACEs study, which demonstrated the effect of ACEs upon chronic adult health conditions, also did not include other psychosocial factors that can increase health risk, such as immigration status, food insecurity, and the effects of the COVID 19 pandemic, to name a few. The 2016 US National Survey of Children’s Health estimates that 46% of all US children 0-17 years of age have experienced at least one ACE and 29.9% have experienced 2 or more ACES. Children who have experienced at least one ACE are at increased risk for chronic physical health problems during childhood and adolescence (e.g. obesity, chronic headaches) learning problems and developmental delays, and behavioral problems.

Yet, many pediatricians are under the impression that ACEs are only present in families with lower social-economic profiles, and therefore not relevant to their practices. The reality is different, however, and issues such as domestic violence, or emotional abuse, or even negative parenting practices can be seen in all strata of our pediatric population. For this reason, the implementation of ACEs screening in a pediatric practice can identify potential avenues for early detection, early intervention and even prevention of the negative effects of these ACEs upon children and their families. 
More Resources
We have recently created a LinkedIn Page! Follow our page for the latest updates on ACEs!
ACEs Aware and AAP California have created a blog page to share resources and events across the AAP California Chapters engaging in the ACEs Aware grant. To gain access to the page, create an account with ACEs Connection below:
Project Firstline
Project Firstline is a Centers for Disease Control and Prevention (CDC) national health care workforce infection prevention and control (IPC) training collaborative that aims to educate all 6 million US health care workers with the foundational understanding of IPC to protect the nation from infectious disease threats, such as COVID-19. The AAP is one of several partners in this initiative. AAP-CA1 seeks to foster a collaborative space for pediatricians to discuss COVID-19 related concerns, and improve their capacity to better the health of children and their families during this turbulent time.
Protecting People from Pathogens
AAPCA1 and the CDC have partnered to present Project Firstline! Join this month's discussion forum on COVID-19 parental and provider related concerns. Once a month, we will be discussing information to help us pediatricians do what we can to safely care for our patients during the COVID pandemic. The purpose of this series is to consider the complexities and current state of knowledge related to keeping ourselves, our patients, and our staff safe from SARS-CoV-2/COVID-19.

Of course, we all know that the best way to stay safe from SARS-CoV-2 is to avoid coming into contact with it. But we’ve all experienced that in practice this is easier said than done. For us, the clinicians, three parts of this puzzle are:

How do we keep people out of the clinic/hospital who don’t need to be there?
For those who do need to be there, how do we minimize contact between individuals once they are inside?
How do we protect those who have no choice but to be inside near others?
In this blog post, we discuss a case study designed to look at some of the processes we might consider as we navigate care for sick children during the pandemic, followed by a discussion forum to share thoughts and resources.
Reminder: ALF Resolutions are Due on April 1
As an AAP member, you have the opportunity to advocate for and influence national AAP policy and priorities through the resolution process. Any member or trainee can write a resolution. Some examples of “Top 10” resolutions in recent years addressed structural racism, immigrant health, gun safety, and immunization strategies. The steps on how to write a resolution, including a template are available at aapca1.org/annual-leadership-forum/. The APL 2021 resolution submission deadline is April 1. If you would like the chapter to sponsor your resolution, reach out to us at info@aapca1.org.
AAP Advocacy Conference 2021
The virtual 2021 AAP Advocacy Conference - formerly named the Legislative Conference - will take place April 11 - 13. Join us for this year's virtual conference and learn how to become a strong voice for children! Participants will hear from distinguished guest speakers, attend advocacy skills-building workshops and learn about timely policy issues impacting children, families, and pediatricians.
 
On the final day of the conference, participants will attend virtual meetings with their congressional offices and others from their state to discuss a timely child health issue.
 
To learn more and to register, please visit AAP.org/AdCon. We hope to see you in the spring!
The SGA Side
Your Key to State Government Affairs
Nora Pfaff, MD, FAAP and Zarah Iqbal, MD, MPH, CFAAP
SGA Chapter Representatives

On February 9, the California chapters of the American Academy of Pediatrics joined together—representing over 5,500 pediatricians—urging collaboration for prompt and safe reopening of schools in letters released this morning. Evidence has shown that safe in-person education for grades TK-12 can be accomplished with properly implemented safety protocols even in areas of high community spread of COVID. 

“The number of visits, phone calls and messages I am getting about anxiety, depression and other behavioral health concerns has easily doubled or tripled. All of the pediatricians in my practice, and our behavioral health colleagues, have struggled to help kids cope with the stress and anxiety of the pandemic and social isolation." Nelson Branco, MD, FAAP, pediatrician at Tamalpais Pediatrics and AAPCA1 Vice President. 

Pediatricians strongly support the safe return of students to in-person education with appropriate mitigation measures in place such as mask wearing, hand washing, cohorting and social distancing as recommended by our trusted scientists in national, state and county public health. Elementary age students are facing a potentially staggering loss in expected literacy, H.S. graduation rates and ultimately life expectancy. Our teens especially are suffering from the near year of social isolation resulting in a 31% increase in proportion of children ages 12 to 17 presenting with mental health emergencies. Stories of communities dealing with a staggering number of youth suicides likely related to social isolation are heartbreaking.

“As the data throughout the country have shown, especially in North Carolina and Wisconsin, even in areas of high prevalence, the risk of transmission in schools is lower than in the community. Simply said, it is safer IN school than OUT.” Elizabeth Rogers, MD, Associate Professor of Pediatrics at UCSF.

Pediatricians urge action NOW to allow kids safely back to in-person school.

For more information, view the press release linked below:
Opportunities for Your Benefit
Advocating for Advocacy: Addressing Challenges and Building Community Partnerships:
Join us for a two-day virtual symposium for pediatricians and other child health experts to collaborate and learn how to best advocate for children in your community. This event will feature a wide variety of pediatric health experts and community partners speaking about health disparities and challenges faced by children and families in the Central Valley. They will share successful strategies for advocating for our kids, and provide guidance for meaningful community partnership.
This virtual event will focus specifically on the following topics:
  • The role of advocacy in enhancing the health of children and the responsibility of pediatricians to engage in advocacy activities
  • Identifying and developing partnerships with community-based organizations especially when time is limited and geographic catchment areas are large
  • Understanding of the legislative process and the opportunities with respect to child health
Register below:

Educational Presentations and Materials for Physicians and Medical Providers:
The California Department of Public Health, Childhood Lead Poisoning Prevention Branch (CLPPB), provides presentations for health care providers about childhood lead poisoning prevention and management. These presentations provide information on sources and effects of lead, lead screening, management of lead-exposed children, and state mandates for health care providers regarding childhood lead poisoning.  Since the onset of COVID-19 restrictions, these presentations are given via free live webinar by a CLPPB public health medical officer. Please contact us at: CLPPB_Provider_Outreach@cdph.ca.gov, or by phone at (510)-620-5600 to schedule a webinar.  CLPPB also provides free educational materials for providers to give to patients and families, and free informative guidelines and fact sheets for providers and staff. You can view these online at the links below:
https://www.cdph.ca.gov/Programs/CCDPHP/DEODC/CLPPB/Pages/edmatls.aspx
March 9, 7:00-8:30 PM: Vaping Myths and Misconceptions - REGISTER!
March 16, 6:00-7:00 PM: COVID Conversations with CIC and AAPCA - REGISTER!
March 23, 7:00-8:30 PM: School Reopening Chapter Chat - SAVE-THE-DATE!
April 14, 7:00-8:30 PM: Communicating with Families About Public Charge in a Clinical Setting - SAVE-THE-DATE!
April 24: Spring CME Conference: Adolescent Health - REGISTER!
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Your membership makes a difference for children in California, thank you!

The AAPCA1's ability to advocate on behalf of children is only as strong as the support we receive from our members. Encourage your colleagues to join today by visiting the AAPCA1 website.

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