EIIC Remembers Dr. Calvin Sia

Dr. Calvin Sia, 93, an influential pediatrician and the driving force behind the creation of the Emergency Medical Services for Children Program, passed away on August 19, 2020.

EMS for Children celebrates the life and contributions of Dr. Calvin Sia. Without the tireless efforts [FP(1] of Dr. Sia, the EMS for Children program may have never been born. He is both the father of EMSC and the grandfather of the Medical Home concept. Dr. Sia developed innovative programs to improve the quality of medical care for children across the United States.

In 1972, Calvin Sia, MD, president of the Hawaii Medical Association, urged the American Academy of Pediatrics (AAP) to develop and ensure emergency care systems meet the needs of critically ill and injured children. Dr. Sia worked with Senator Daniel Inouye who later was joined by Senators Orrin Hatch and Lowell Weicker in sponsoring the first Emergency Medical Services for Children (EMSC) legislation, which passed in 1984. This landmark legislation authorized federal grant funds beginning in 1985 to assist states to improve emergency care provided to children suffering from life-threatening illness or injury. EMSC funding continues largely due to the work of national professional organizations, including the American Academy of Pediatrics and the Emergency Nurses Association, that continue to advocate for EMSC.

In addition, Dr. Sia spearheaded the creation of the Variety School for children with learning disabilities, a Honolulu-based educational institution for children ages 5 through 13. Dr. Sia’s advocacy work over decades led to the formation of Hawaii’s child protective services and school health services programs. He helped create the home visiting Healthy Start Program and Zero-to-Three. He retired from his Honolulu-based medical practice in 1996, after almost 40 years of treating patients.

Dr. Sia's obituary can be found here for those interested in learning more about Dr. Sia's impact on pediatric emergency care.

Funding Opportunities & Announcements

HHS Awards over $35 Million to Rural Health Programs In August, the U.S. Department of Health and Human Services (HHS), through the Health Resources and Services Administration (HRSA), awarded over $35 million to more than 50 rural organizations across 33 states as part of a sustained federal effort to increase access to high quality care in rural communities.

COVID-19 FAQs and Funding for HRSA Programs Find all funding and frequently asked questions for programs administered by the Health Resources and Services Administration (HRSA).

SAMHSA Training and Technical Assistance Related to COVID-19 The Substance Abuse and Mental Health Services Administration (SAMHSA) created this list of resources, tools, and trainings.

HRSA Rural Health Network Development Planning Program The Health Resources and Services Administration (HRSA) will make 20 awards of up to $100,000 each to plan the development of networks among at least three separately owned local health care providers. Eligible applicants include public, private, and nonprofit entities with the capacity to serve rural populations. The closing date for applications is November 16, 2020.

Call for Applications: Telehealth Collaborative

The EMS for Children Innovation and Improvement Center Telehealth Collaborative will launch in January 2021 and continue through June 30th, 2021. The primary purpose of this collaborative is to evaluate the impact of public health crises on children and youth with special health care needs (CYSHCN) and children with behavioral health emergencies, assess telehealth capacities, and provide guidance and support to improve access to emergency pediatric services particularly in rural, tribal, and territorial areas. Participating states/ territories will be eligible for additional funding to support implementation efforts. Participating teams will:

1. Identify at least three challenges facing these vulnerable populations due to public health crises
2. Complete an environmental scan of the state/territory infrastructure to support the use of telehealth in the target population
3. Develop a strategic plan for the implementation of telehealth services for the target population

If State Partnership Grantees are interested in participating in the collaborative, applications open September 15 and close October 31 at 11:59 PM CT. Click here for a direct link to the application. State Partnership Domain Leads will hold Office Hours for assistance on September 29 from 4:00 pm – 5:00 pm ET and October 6 from noon – 1:00 pm ET. If you missed the introductory webinar and would like more information visit https://emscimprovement.center/collaboratives/telehealth/.

Catch-Up to Get Ahead on Childhood Immunizations

During National Immunization Awareness Month, the U.S. Department of Health and Human Services (HHS) is urging healthcare providers and parents to “catch-up to get ahead” on childhood immunizations.

The COVID-19 pandemic has led to worrisome declines in well-child visits and routine immunization rates. Although we have made progress to reverse this trend, without high vaccination rates there is a risk for outbreaks and further strain on our nation’s healthcare system.

As a pediatric critical care physician, I know all too well the devastating consequences that diseases, like whooping cough and measles, can have on children and their families. It is tragic to see a child become sick, or even die, from a disease that we can prevent with safe and effective vaccines. In our fight against the COVID-19 pandemic, we cannot let down our guard against preventable childhood diseases. Now is the time to get every child back on track with recommended vaccines.

To increase childhood immunization rates and reduce potential outbreaks of vaccine-preventable diseases before flu season, HHS is coordinating the “Catch-up to Get Ahead” effort. Together a number of government and private sector partners will enhance access to essential immunization services by:

• Increasing immunization opportunities by encouraging extended office and clinic hours for the administration of catch-up vaccines;
• Informing parents about COVID-19 safety precautions and practices in place in healthcare settings and encouraging them to take their children to get vaccinated; and
• Catching children up on their immunizations to mitigate pressures on our healthcare system when the influenza and SARS-CoV-2 viruses begin co-circulating in the coming months.
• Promoting the importance of childhood immunizations.

It is imperative to make sure our children are vaccinated on time throughout their childhood before they are exposed to potentially life-threatening diseases. Vaccines are a safe and effective way to guard our children against 16 serious diseases, such as rubella, polio, and cancers caused by HPV.

Getting children back on track with recommended vaccines is safe, but there may be delays, as many children need to catch-up during this time. Additional precautions are in place in healthcare settings to prevent the spread of SARS-CoV-2, the virus that causes COVID-19. Most vaccines are also available at no or low cost to the parent. Parents should talk to their healthcare provider if they feel that cost is a barrier to getting their children vaccinated. Watch the video

To learn more about vaccines and vaccine-preventable diseases, visit vaccines.gov. You can also join us to help every child catch-up to get ahead, by using social media messages and graphics from the Catch-up to Get Ahead Toolkit

National Pediatric Readiness Project Assessment Pilot Launches

A pilot of the National Pediatric Readiness Project assessment has officially launched for hospitals in Colorado and Louisiana. It will run from September through November of 2020. All other states are encouraged to visit www.pedsready.org for more information about how to get ready for the national launch in May 2021. Be sure to click on the dropdowns below the picture on the homepage.

Pediatric Resuscitation Training

Do you work in an emergency department? Could you possibly be a part of a pediatric resuscitation event (including severe respiratory distress or seizures) if such a child presented to your ED? Do you NOT work in a quaternary care children's referral hospital? Are you interested in improving your pediatric resuscitation skills?

Help us test new online resources designed to help all emergency departments increase their pediatric resuscitation readiness. Click here to learn more and get started

The SAVE-PEDS project is a collaborative effort between the Children’s Hospital of Philadelphia and Yale-New Haven Children’s Hospital to assist and equip all hospitals for self-directed quality improvement in pediatric resuscitation. As part of this EMSC-funded project, we are evaluating several new web-based training courses in pediatric resuscitation topics. The courses offer FREE pediatric training for health professionals, created by pediatric experts.

Hidden Consequences: How the COVID Pandemic is Impacting Children

ASPR TRACIE and ASPR’s Pediatric Centers of Excellence are collaborating on a webinar series focused on how the COVID-19 pandemic may affect children. Topics will include impacts on child health and wellness, child emotional and social effects, the impact of COVID-19 on children with special healthcare needs, and how secondary/other disasters may affect children during the pandemic.

The first webinar in this series will focus on child health and wellness. Panelists will discuss resumption of routine care, missed immunizations, lead poisoning screening, sleep, and child neglect and abuse. This webinar will take place on Wednesday, September 30, 2020 from 1:30-2:45 PM ET. For more information, click here.

The second webinar will focus on the emotional and social effects of COVID-19 on children. Panelists will discuss food and financial insecurity, racial disparities, the impact of social determinant on children’s health, return to school and daycare, and alternate childcare. This webinar will take place on Friday, October 16, 2020 from 1:00-2:15 PM ET. Register today!

The last two webinars in this series will take place at the end of October. Check back often for announcements and registration information.

Caring for Children and Youth with Special Health Care Needs During the COVID-19 Pandemic

Children and youth with special healthcare needs (CYSHCN) are defined as those who have or are at increased risk for chronic physical, developmental, behavioral, or emotional conditions and who also require health and related services of a type or amount beyond that required by children generally.

CYSHCN are more likely to have disruption to health care, education, and community life as a result of the coronavirus disease 2019 (COVID-19) pandemic with consequences such as delayed development, reduced learning, and mental health challenges. Interruptions to services affect subpopulations of CYSHCN, such as those of younger age, those with medical complexity, and those with behavioral health conditions, in different ways. Inequities attributable to poverty, racism, immigration status, ableism, health conditions, geography, health care access, educational access, childcare access, and other factors make these disruptions particularly dangerous for some CYSHCN.

A subgroup of CYSHCN, yet to be precisely defined, of children with certain chronic conditions are more likely to have a diagnosis of severe acute biological effects of severe acute respiratory syndrome-coronavirus 2 (SARS-CoV-2) infection requiring admission to the hospital or intensive care unit. Black and Latino children with chronic conditions experience a disproportionate burden of hospitalization thus far. Data on the risk of infection, as well as detection of its acute and chronic effects, continue to evolve as the pandemic spreads, affecting different locations with different demographic characteristics at different times[FP(2] . Given data limitations, it is essential to use precaution in the extrapolation of early pandemic epidemiologic data to the circumstances of the upcoming fall and winter period and specific patient contexts.

A related article for parents is available on HealthyChildren.org. Drs. Ellie Hirshberg and Linda Siegel participated as SOCC representatives on the AAP work group that developed the guidance.

Visit the COVID-19 web page on AAP.org to find clinical guidance, practice management resources, including telehealth and coding, educational resources for clinicians and families, data reports, a discussion board, and details on AAP advocacy efforts. For questions or comments related to the pandemic, email COVID-19@aap.org.

Just Published! EMSC Program Manager's Role in the PRQC

Click this link https://emscimprovement.center/collaboratives/prqc/ to download a copy of the white paper.

Welcome New Texas FAN Rep Angela Nelson!

My name is Angela Nelson and I am the parent of 3 special children (22, 20 and 14). I became a family faculty for Texas Parent to Parent in 2017 and have been involved in both individual as well as group presentations to medical students and residents as part of their MedEd Program. My interest in the MedEd Program and EMSC comes from my passion to educate and share information. There are so many resources available, but people don’t always know where to look or maybe don’t even know that they are missing something. People don’t know what they don’t know. For me personally, the challenge has been that 2 of my children have invisible disabilities. One of my son’s diagnosis’ is Adrenal Insufficiency so it has been important for me to educate those that interact with my son on what to watch for and most importantly what to do if he experiences an adrenal crisis. I have met with the chief of EMS in the communities we have lived in to get medical orders on file so they can properly treat him if they respond to our home or his school and so they have an awareness around what they are walking into when responding. We also meet annually with school administrators, medical professionals and teachers in his school. A couple of areas that I feel strongly about are:

• If I had to call EMS would they have the equipment, medication and/or orders necessary to provide emergency care to my child and other children with special health care needs
• Children with complex medical needs many times need to convey more information than will fit on a standard medical alert bracelet (if the child will even wear one). I have found that emergency personnel and physicians are not aware of the many types of medical alert bracelets and tags available today and the vast amount of information that can be provided.
• Some children and adults due to their medical diagnosis may not be able to effectively communicate with emergency personnel at the scene of an accident or upon presenting in the ED. How do we bridge that communication gap?

My goal in volunteering my time and talents is to have an impact on the emergency care that children receive both in the field and in the ED. If my interactions and sharing of our story leads one provider to understand that not all disabilities are visible and that some kids that don’t “look too sick” can be in danger of a fatal outcome if not properly treated in a timely manner there is the potential to positively impact how children are cared for now and in the future. If you have any questions at all, please feel free to reach out at angelanlsn@yahoo.com.