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MNAAP Newsletter

Statewide Project to Prepare for Pediatric Disasters

Paula Kocken, MD, FAAP, Pediatric Emergency Medicine, Children’s MinnesotaPaulaKocken

How would your local hospital respond to 15 pediatric victims of a disaster presenting to the emergency department (ED) in one hour?

A surge of pediatric patients can come from a mass casualty event like the Boston Marathon or from a chlorine spill at a pool.

The National PedsReady project from 2013 showed, on average, only 60 percent of Minnesota hospitals are sufficiently prepared for a pediatric surge of patients.

Through a grant from the AAP, I am working with a multidisciplinary group and the Minnesota Department of Health (MDH) to create and roll out an educational curriculum to improve the care of young patients during a large volume event.

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Endocannabinoids and Autism Spectrum Disorder: Facts, Not Hype

LucienGonzalezLucien Gonzalez, MD, MS, FAAP, Diplomate of ABAM, University of Minnesota

Autism spectrum disorder (ASD) has been added to the list of qualifying medical conditions for Minnesota Medical Cannabis. Patients certified to have ASD will be eligible to enroll in the program on July 1, 2018 and receive cannabis extracts from the state’s approved vendors beginning August 1, 2018.

Minnesota joins only Pennsylvania and Georgia in specifically including autism among their lists of qualifying conditions for young people. In Delaware, autism is a qualifying condition for adults only.

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Member Profile: Angela Erdich, MD, FAAP

Angela ErdichWhat made you decide to become a pediatrician? Describe your journey into medicine.
I am from a small town in North Dakota and we had some pretty great role models for doctors, very dedicated people. I am an enrolled member of the Turtle Mountain Band of Ojibwe. My mother really wanted her children to work for the Indian Health Service (IHS), and as it turns out, three of us ended up with dedicated careers in the IHS.

My pediatric rotation was on the Navajo Reservation in Arizona with a really great group of pediatricians. I met those people and felt immediately inspired to do what they were doing. My husband and I worked as pediatricians on reservations from 1997-2009, then he commuted to work on my home reservation in North Dakota until 2017. In 2010 I started working at the Indian Health Board (IHB) of Minneapolis, focusing on the urban American Indian population.

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Vaccine Exemptions: Where Does Minnesota Stand?

By Margo Roddy, MN Department of Health; Diane Peterson, Immunization Action Coalition

Compulsory vaccination for children enrolled in childcare facilities and schools has been a major contributor to the longstanding success of the immunization program in Minnesota and in programs across the country. The recent occurrence of large measles outbreaks has served to shine a bright light on the role that non-medical exemptors play in fueling the spread of disease in school, childcare and community settings.

A chart has been developed that provides detail on the variable ways that states implement their non-medical exemption procedures (i.e., the compulsory steps parents must complete to secure a non-medical exemption). You can view the chart at

Minnesota requires that the parent obtain a notarized signature to exempt from a vaccine requirement for non-medical reasons. Other states have moved to requiring more substantial steps, including receiving education from a doctor or public health prior to opting out. Meanwhile, California has eliminated the non-medical exemption as an option for their schools.

Statewide in Minnesota, non-medical exemptions for all vaccines for kindergarteners have been stable over the past 7 years, from 1.60% in 2010‒11 to 1.69% in 2016‒17. While the statewide non-medical exemption rate remains low, some Minnesota schools, school districts and counties have higher rates that leave more children vulnerable to disease.

To see a list of kindergarten exemption rates by county, school district, and individual school, visit


Pediatricians’ Voices on Equity Needed Outside the Clinic

By Nate Chomilo, MD, Minnesota Doctors for Health Equity

Nate ChomiloHere’s a statistic that may be hard to hear: Only 10 to 20 percent of health outcomes are attributable to health care.

For all our education, training and expertise, there is only so much we as physicians can do if we choose to only work within our clinics or hospitals.

We can highlight the ongoing health disparities (health differences that arise from economic, social or environmental disadvantages) that are worse in Minnesota than almost every other state, but putting a spotlight on the problem alone is not a solution. These disparities also arise from implicit bias, explicit bias and the structural racism intrinsic to many parts of our society, our healthcare system being no different.

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