California
Chapter 1
News Update February 1999
CATCH Program and the Sierra Foundation
By Arnold Gold, MD
(Dr. Gold is a practicing AAP member in Yuba City and Chapter 1 CATCH facilitator.)
The Sierra Health Foundation (SHF) has been working in 26 communities in Northern California to help areas where no help has been given before. They have not only given grants to these areas but have also trained people to write additional grants and to survey their communities to discover what it is their neighborhoods really need to improve them.
Recently the SHF has agreed to teach interested pediatricians the skills they have taught their 26 collaboratives in surveying and working to improve their communities. Included in these seminars would be instruction in grant writing, which was part of the material presented at the Northern California CATCH meeting in October. This instruction will be open to pediatricians in all of California (not just Northern). At this time I believe I’m the only pediatrician in Chapter 1 working with the Foundation.
The Foundation would like to include the skills of the physicians and dentists in their collaboratives and begin new collaboratives throughout California by training physicians to work as partners with the community in which they live and work. They are well aware of time constraints on professionals and would not expect the physician to spend any more time working on these community projects than they can afford.
I would strongly urge our members to visit the SHF and discuss their concerns with Steve Barrow, the Foundation’s program coordinator. I would be more than happy to make arrangements for this meeting.
To lose this opportunity in our own backyard makes no sense when we say our job is to help the children in our community. What better way is there than to instruct our pediatricians and to improve their skills along with the health of the community?
Monterey Conference Hotel Phone Number Correction
The listing of the phone number for the DoubleTree Hotel was incorrect on our promotional brochure for the May 29-31 Annual Spring Meeting in Monterey. The correct phone number for the DoubleTree Hotel is (831) 649-4511. Please use this number when phoning in your reservation. Thank you.
Passing the Torch
By Tom Long,
MD
Last October General Collin Powell, the champion of “America’s Promise,” addressed the members of the Academy in San Francisco. He came to endorse, encourage, and thank the members for their CATCH commitments. I have heard General Powell speak previously. He tells us that every child needs a mentor, a caring loving responsible adult.
Not only children need a mentor. Most of us had a mentor and usually it was a parent. As young students a teacher or a favorite relative may have been another mentor. In scouting perhaps it was the scoutmaster or in sports maybe the coach. It could have been a minister. Did we not experience something similar as house officers? At the very least there was a hierarchical organization. We learned and shared our knowledge with those below us. Then the clock struck midnight and we all became independent, either as private practitioners or as contracted employees. We moved outside the system that had nurtured and nudged us along for so many years.
Do you ever look back recalling those training days? Recall the camaraderie, maybe the relative poverty, maybe the simple needs and pleasures, and the milestone events? I do. We all moved on growing with our families and apart from most of our old friends. There are some aspects of the “old days” we all miss.
It has been respectfully suggested that wisdom comes with age. A nice definition I recently heard is, “Wisdom is the ability to exercise good judgment about important but uncertain matters in life.” That sounds to me like something we need in medicine today. How do we share it? How do we pass it along? It is our turn to be the mentors. The “We” I am talking about is all of us. We need to encourage one another. We need to bring a Fellow with us to an Academy or Chapter function. We need to support the Chapter and the Academy with our dues and our ideas. We can help our elected officers get the job done on committees and in local projects.
With new faces in Sacramento we have an opportunity to renew our commitment to children. Mentoring is not strictly an emeritus function. Wisdom is an emeritus quality that needs to be shared. We can all be mentors and we can all encourage the continued participation of our emeritus members.
Passing the torch is an essential quality of being a physician. The Hippocratic Oath compels us to share our knowledge and skill. Sharing our gifts and nurturing the talents of our colleagues can only enhance the legacy embodied in the mission statement of the Academy. It is the job of each Fellow to ensure that the tradition and discipline we inherited is passed to each of our younger members. Do it by example.
District Chair’s Report January 1999
New Year’s Resolutions
By Lucy S. Crain, MD
Along with all those resolutions more likely to be broken, let’s keep resolve in this New Year to try even harder to be more effective advocates for children and our profession. If you’ve not done so already, phone or write your state and local legislators and share with them the following CHILDRENS’ HEALTH PLATFORM, an even dozen of priority issues identified by our officers and members in California. Follow up and talk as an individual constituent, as well as a pediatrician, with your legislator(s) and/or their staff, bringing these issues to their attention and offering the District and the AAP as educational resources to them in their efforts.
If you’d like more background information, or if you’re not familiar with the AAP guidelines re: how to appropriately represent the Academy, phone Kris Calvin or Elena Gardella at our District office in Albany 510-559-8383 for that information, or to discuss an issue of particular legislative import to children or pediatric practice which you want shared with me, Bob Black, Quynh Kieu and our Committee on State Government Affairs. We’re in the process of recruiting for a new lobbyist, but often the most effective lobbyists for child health related issues are pediatricians, so take the following list with you and take your legislator out to lunch. Let me know how it goes. Thank you for being such effective advocates for children.
The following platform with expanded discussion was shared with all California, state, and national office candidates and elected officials in the November 1998 election, and their adoption of the tenets of the platform was solicited on behalf of the health and well-being of California’s children.
California Candidates Platform for Children’s Health
The American Academy of Pediatrics (AAP)
California District IX
1. Ensure universal access to quality, comprehensive health care in a “Medical Home” for all children living in California. (A medical home implies consistent, ongoing appropriate health care, rather than episodic care at various sites.)
2. Support needed services and assistance with the health care administration for children with special health care needs. (As many as 15-30% of California’s children have special health care needs, ranging from chronic illness such as asthma to dependence on technology such as ventilators for support of life.)
3. Support prevention
of unintentional and intentional injuries, leading
causes of morbidity and mortality among California children and youth. (This includes the
compelling need for California to lead the nation in immediately passing and enforcing
legislation to limit child and youth access to guns of all types and to ensure that guns
manufactured and/or sold in our state have effective safety features, including trigger
locks. It also includes support of a variety of other water, vehicular safety, and child
abuse regulations, and improving emergency medical services for children throughout the
state.)
4. Promote policies that foster early brain development and early intervention, focusing on the critical first 3 years of life.
5. Battle the epidemic levels of youth substance abuse, including alcohol, drugs, and tobacco.
6. Reduce California’s escalating levels of teen pregnancy through education, family planning promotion, and maintenance of the right to abortion as a legal, medically viable option for teens.
7. Recognize the link between good health and learning at any age, pledging to support high quality education and health care as complementary goals, rather than competing pulls on resources.
8. Prioritize availability of quality, safe childcare for every child who needs child care in California.
9. Improve California’s immunization rate, so that we may meet the national public health goal of 90% of 2-year-olds fully vaccinated in the year 2000. (Currently, only 78% of California’s 2-year-olds are up to date on vaccinations.)
10. Prioritize the availability of mental health and health services for children and youth with emotional, developmental, and/or physical disorders or disabilities as medically necessary. (Some health insurance plans have essentially eliminated mental health benefits, and these are especially crucial for children because of the potential for early intervention to prevent a future of more severe dysfunction and dependence. Legislators should be encouraged to demand parity of mental health benefits for children.)
11. Promote a healthy environment for children by supporting air and water quality standards that address the needs of their developing bodies, and appropriately fund prevention, screening, and treatment programs that address environmental toxins, including lead.
12. Promote policies, which support the healthy and loving family structure in which California children deserve to be raised, while recognizing, respecting, and appreciating the many diverse definitions of today’s family.
Remember that elected officials are in a unique position to improve the health of all children living in California. This can be accomplished by addressing the individual health needs of each child and also by meeting the public health needs of children on a societal level. Let’s pledge ourselves as pediatricians to better use our unique positions as experts in child health to better utilize that expertise in being educational resources to our fellow advocates in elected office, so together we can more effectively accomplish improved health for the children of our state.
First Annual AAP Resident Toy Drive
By Anand Sekaran, MD
For most of us, the holidays are a time of cherished days with loved ones and the inevitable exchange of gifts. For much of our population, however, these privileges are not such an easy assumption. In the hopes of making this season more joyous for the less fortunate children in our community, the pediatric residents at Children’s Hospital Oakland (AAP Chapter 1) hosted the “First Annual AAP Resident Toy Drive.”
The process was really quite simple. We wrapped two huge cardboard boxes with holiday paper, posted signs, and the toys flooded in. We asked for donations of brand new toys, unwrapped so that they could be distributed age appropriately. We used the hospital e-mail and newsletter to help get the word out. Within one week, thanks especially to the attendings, we had filled the two boxes and the overflow was being heaped on the adjacent floor. The first shipment was taken by car to The Women’s Refuge, a local shelter for battered women and their children. Many of these families had quickly fled horrid home situations with no time to take very much in hand. Needless to say, the kids were ecstatic when the toys arrived. A second equally large delivery was taken to the Harrison House, another local homeless shelter. Both shipments were made in time for Christmas.
What was most striking to us was the ease with which such a project could be undertaken, and the enthusiasm which we encountered. It was obvious that there are many giving souls, particularly in our profession, waiting to be tapped once the opportunity presents itself. We hope that this event will become an annual tradition at our hospital for many holiday seasons to come.
Preschool Child, Dependent Care, and Adoption Committee
By Bruce Gach, MD
This committee has at least two meetings a year. The present goal of the members is to develop improved guidelines for childcare and preschool age groups such as:
We will be submitting a grant proposal for funding a unique pilot project. It is hoped that Chapter 1 pediatricians in this pilot project can use curriculum developed for the national AAP to improve parents’ and children’s childcare experiences.
Statistics indicate that childcare is more prevalent than pediatricians previously recognized. We believe that it is important to encourage pediatricians to become consultants for childcare. Unfortunately, a large number of pediatricians have said that their training in childcare is inadequate.
Our committee meetings provide a unique opportunity for pediatricians to connect with childcare providers and share usable information. Pediatricians, parents, and childcare providers can work more harmoniously when we all understand each other’s problems and plans – no matter what the age of the child. The solutions that are derived from these meetings will be applicable to all children, no matter their needs.
To join the committee contact: Bruce Gach at 925-455-5064 or by e-mail at: livplepeds@aol.com.
TUPE: a potential tobacco use prevention resource for pediatricians
By Eileen Yamada, MD
Member Substance Abuse Committee
Tobacco use is the leading preventable cause of death in the United States. Most smokers do not start smoking as adults, but instead start during their youth. Each day in the United States, it has been estimated that 6,000 youths try a cigarette, and 3,000 youths become daily smokers; approximately 90% of smokers start by the age of 18 years. Pediatricians can play an important role in the prevention of tobacco use by addressing tobacco use by the child or adolescent and his or her parents during office visits. Such messages and assistance can be very powerful. However, influences from the home, school, and community must also stress a smoke-free norm since the child spends most of his or her time in these environments. Thus, to best address this issue effectively, appropriate messages must come from multiple sources, including pediatricians and the community.
Our Chapter 1 Tobacco and Youth Task Force (Substance Abuse Committee) has met with the Tobacco-Use Prevention Education (TUPE) Program. The purpose of the TUPE program is to reduce youth tobacco use by helping them make healthful tobacco-related decisions through tobacco-specific educational instruction and activities that build not only knowledge but social skills. The school-based tobacco-use prevention education programs are administered by the California Department of Education and are funded by Proposition 99, the Tobacco Tax and Health Protection Act of 1988, which increased by 25 cents the tax on each pack of cigarettes sold in California.
The Chapter 1 Office has a listing of county TUPE. These coordinators can put you in touch with specific school district TUPE coordinators in your area. We hope that this will serve as a starting point for further communication and collaboration between you, your patients, and the school coordinators to more comprehensively address the problem of youth tobacco use. We encourage you to discuss what assistance the schools can provide to assist the teens in your practice to make the correct health and lifestyle decisions regarding tobacco use. You may wish to contact the school district coordinator to better understand and possibly provide pediatric expertise to the tobacco use-related prevention and intervention services at a local school in your area.
Another mechanism to get involved with tobacco use prevention in your community is to become a part of your local tobacco control coalition. These coalitions are also funded with Proposition 99 moneys and are organized by city and county health departments. A list of local lead agencies will also be sent to the Chapter 1 office so that you can get further information about programs and coalitions in your community. For those teen smokers who wish to quit and need additional counseling assistance, you can refer them to the Smokers’ Helpline (1-800-7-NO-BUTTS), which provides telephone counseling and other information to both youth and adult tobacco users. There is also a helpline to help people quit chewing tobacco (1-800-844-CHEW).
You can also become more involved by joining your Chapter AAP Substance Abuse committee. Chapter 1 has an active substance abuse committee currently. Please contact Beverly Busher, AAP Chapter 1 Executive Director, for further information (415) 459-4775). You can make a difference in helping to decrease youth tobacco use and ultimately tobacco-related morbidity for your patients and community.
Electronic Registration for the Spring Monterey Meeting
By Mark M Simonian, MD
Members who have Internet access now have another simple method to register for meetings. Our Chapter 1 website now allows entry of your registration and credit card information so that you can fill it out and submit it without printing out a hard copy and faxing or mailing it to Beverly Busher at the chapter office in San Rafael. This electronic registration will first be offered for the Annual Spring Meeting in Monterey at the end of May this year.
Agnes I. Kisch, MD, a Board Eligible pediatrician. Pediatric private practice for the last four and a half years in Houston. University of Texas Health Sciences Center, Houston in 1993 followed by CHOSEN Clinic Chronic Care Facility affiliated with the University of Texas. I am looking for a position in a Health Professional Shortage Area (“HPSA”) or Medically Underserved Area (“MUA”) in California. 5215 Barons Cove, Houston, TX 77041, (713) 983-7788
Check out the link to Candidates and Recruiting information on the website
California Chapter 1 AAP Winter Session Report
On December 5, 1998 Chapter 1 AAP held a one-day conference which focused on school health issues. School health professionals, school nurses, school health educators, school administrators and teachers, and school board members met with approximately one hundred pediatricians in a collaborative discussion of school health issues creating a lively conference described as a stunning success.
Dr. Duncan, Chair of the AAP School Health Committee and principal assistant to the State of Vermont Secretary of the Agency on Human Services, described the research of Peter Benson PhD, which measures ‘a student’s assets’ and compares those qualities to school achievement or risk-taking behaviors. Dr. Duncan discussed the effects of community actions, which strengthen those assets, and their therapeutic effect on school performance. Access to this information may be gained at an Internet site: www.search-institute.org.
Delaine Eastin, California State Superintendent of Public Instruction, emphatically and enthusiastically described her vision of a public school system in which “every child enters school ready to learn.” Preschool programs, afterschool daycare, on site health care availability are instruments which she would propose address the needs of our communities, especially those children of dysfunctional families.
Drs. Brad Berman and J. Lane Tanner teamed to describe the differential diagnosis of disruptive classroom behaviors. Methods that gather sufficient accurate data for a therapeutic evaluation of each student and the collaborative efforts with school and community health professionals prior to the implementation of drug therapies were described.
Using audience participation, Dr. Ed Emling dramatized the methods which allow him to assess a child’s kindergarten readiness. Age appropriate developmental measurements, sensitivity to cultural and environmental factors, and an ability to recognize the relationships of these values within the cohort of measurements constitute the body of this assessment.
Dr. Ann Loeffler reviewed current information regarding communicable disease and school exclusion. Shigella, Salmonella, Tuberculosis, and the ubiquitous head louse Pediculosis capitus were the focus of her attention. She currently supports a nit-free policy for readmission to the classroom.
Dr. Maxine Sehring moderated a panel discussion, ‘Improving Communication and Collaboration between School Personnel and Health Care Providers.’ A first grade teacher Jennifer Gysin; school nurse and health consultant, Jovine F. Hankins, RN, PHN; elementary school principal, Karen Sakata; and school board member Dan Kelly, MD described their activities and responsibilities. The opportunity for an audience question and answer exchange was provided.
In summary, this assembly offered an opportunity for dialogue, and invited collaboration among individuals whose professional organizations share common interests – students’ well being and school health issues. It offered tools to educate and to facilitate a dialogue essential to that collaboration, e.g. web site access to Peter Benson’s Assets
This page create 2/9/99 Last Updated 01/08/04
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