In California, psychiatric reasons have remained the number one cause of hospital admissions among youth for the last few years. Addressing the crisis requires collaborative leadership that fosters alignment among stakeholders, legislators, patients, families, and communities to advocate for the mental health and well-being of every youth in the state.

For over 40 years, CALACAP has collaborated with our partners to advocate for the over 9 million youth in the state of California. Just this past year, we were proud co-sponsors of AB 2711, and for this year, we are co-sponsoring two bills; SB 531 (Rubio) and SB 363 (Wiener). We are supporting many other bills, which affect youth mental health.

We are liaising with our parent organization AACAP to navigate the current climate of major potentially harmful changes within our health agencies and institutions at the federal level. These include issues related to Medicaid cuts as well as the unwarranted attacks on psychotropic medication use in children. We issued call to action letters to our senators urging them to protect gender affirming care as well as family unity and full access to schools, places of worship, and healthcare facilities given the onslaught of executive orders including those affecting DEI and immigration.

We encourage and welcome ideas/ways to support our membership, our profession and the vulnerable population we serve. Get involved through our current committees Government Affairs and Advocacy (GAA) and Committee on Anti-Racism and Equity (CARE) or consider getting one off the ground. It is my hope that we can all work together because we need every member’s contribution (ideas/resources), cooperation and collaboration to move the needle in the right direction. There is a youth mental health crisis, and it needs all of us working together to resolve it and keep our young mentally healthy in California.

The spring advocacy day, scheduled for Monday May 12, 2025, at the Capitol between 9am and 5pm, is an opportunity to join our community of child and adolescent psychiatrists as well as our allies in advocating for youth mental health in California. You may register HERE. Hope to see you there.

CALACAP President

The founding group included:

• Dr. John Leonard (Southern California), CAL-ACAP’s first president,
• Dr. George Hexter (Northern California),
• Dr. Joseph Mawhinny (San Diego),
• Dr. Stewart Teal (Central California).

CAL-ACAP was established with a clear structure: each AACAP regional organization in California would send two representatives—a primary and an alternate—to participate in decision-making. Every region had equal voting power on policy issues, while fiscal votes were weighted based on membership numbers. The organization met quarterly, alternating between Northern and Southern California, often in conjunction with the CPA children’s committee. This close collaboration allowed for coordinated efforts on reviewing legislation, supported by CPA’s lobbyist and staff, and helped ensure timely, well-informed responses to statewide policy developments.

Early Accomplishments and Impact

From the outset, CAL-ACAP proved to be a driving force for children’s mental health advocacy. Dr. George Hexter led the charge in organizing reviews and developing positions on hundreds of bills impacting children across the state. In 1987, CAL-ACAP began hosting statewide child advocacy conferences under the leadership of each new president. These conferences became a hallmark of the organization for nearly a decade.

The first, titled “Speaking for California’s Children: Societal Abuse and Policy Reform,” tackled pressing topics such as children testifying in court, residential treatment standards, and reform of California’s Lanterman-Petris-Short (LPS) Act. The event was a major success, attracting more than 125 child advocates and earning the support of legislators, private foundations, and state agencies. It even generated a financial surplus, allowing for future advocacy efforts.

Subsequent conferences addressed issues like:

• The needs of vulnerable infants and young children,
• Adoption policies and practices, and
• Children’s developmental capacities to remember, communicate, and testify.

CAL-ACAP’s work earned statewide recognition, including the Distinguished Service Award from the California Professional Society on the Abuse of Children.

Legislative Leadership: SB 595 (Presley)

One of CAL-ACAP’s most influential policy efforts was its leadership role in Senate Bill 595 (Presley). The bill emerged in response to a proposal to implement judicial-style hearings for all youth ages 14–17 entering psychiatric hospitals. CAL-ACAP, in partnership with CPA and the California Hospital Association, helped craft an alternative approach—one that preserved the rights of youth while ensuring appropriate access to care. The resulting legislation allowed adolescents to obtain a second psychiatric opinion if they objected to their admission, balancing due process with clinical needs. It was a defining moment in CAL-ACAP’s policy legacy.

Addressing the Workforce Crisis

In 2002, CAL-ACAP hosted another statewide summit, “Children and Youth with Psychiatric Needs: Improving Access to Care.” The event addressed the growing shortage of child and adolescent psychiatrists and the broader need for a multidisciplinary mental health workforce. Key speakers included:

• Assemblymember Darrell Steinberg,
• Dr. Stephen Mayberg, then Director of California’s Department of Mental Health, and
• Dr. Marilyn Benoit, President of AACAP.

The conference produced actionable plans to remove barriers to collaboration and grow the workforce to meet the needs of California’s children and families.

Challenges and Growth: A Turning Point

The early 2000s brought a period of transition. As CPA’s organizational demands and financial realities evolved, CAL-ACAP was asked to take on a greater share of administrative and advocacy responsibilities. These changes presented new financial pressures that limited the group’s ability to host in-person meetings and maintain its previous model of support.

Rather than step back, CAL-ACAP leaned forward. Under the leadership of Bill Arroyo, regional representatives launched a coordinated effort to strengthen the organization’s foundation. Letters went out to CAL-ACAP and ROCAP members explaining the evolving landscape and the need for renewed investment in statewide advocacy.

The response was extraordinary. CAL-ACAP members approved an increase in annual dues, providing the resources necessary to hire independent staff and a dedicated lobbyist. This milestone marked a new chapter in the organization's growth—one defined by increased independence, renewed focus, and a continued commitment to children’s mental health.

Continuing the Mission

Since its founding, CAL-ACAP has remained committed to its core mission: ensuring that the voices of California’s children are heard in public policy and that their developmental and mental health needs are met with expertise, compassion, and care. Through advocacy, education, and collaboration, CAL-ACAP continues to shape a healthier future for children, adolescents, and families throughout the state.

As we celebrate more than four decades of service, CAL-ACAP looks forward to a future driven by the same principles that inspired its founding: integrity, collaboration, and an unwavering belief in the importance of investing in our youth.

SYASL was contacted due to its extensive lobbying on behalf of what was then the California Mental Health Directors Association (now the California Behavioral Health Directors Association) on a variety of issues, but especially work done relative to the Children’s System of Care and AB 3632 services for children. After an extensive search and interview process, it was determined that SYASL would be the best fit for Cal-ACAP. SYASL is passionate about, and proud of, the work it has done for Cal-ACAP and hopes to continue improving children’s behavioral health services in California for patients, families, child psychiatrists, and their practices.

This year, we are proud to be cosponsoring two bills in coalition with trusted children and health advocacy organizations:

In partnership with Children Now and the CA Chronic Care Coalition, we are sponsoring SB 363 (Wiener), which requires health insurers to report to the Department of Managed Health Care (DMHC) and the Department of Insurance (CDI) any denials and modifications made to provider-recommended care. This information will be publicly published annually. In addition, the bill mandates fines for violations, including failures to report a modification or denial of treatment and unreasonably high rates of Independent Medical Review (IMR) overturns or reversals. By imposing these fines, SB 363 will incentivize health insurers to make sure that the denials they are making are reasonable and that they are transparent in their actions.

In coalition with a group of children’s advocates, we are also sponsoring SB 531 (Rubio), which would ensure that all California students receive mental health education in elementary, middle, and high schools by amending the California Education Code’s relevant course of study provisions to include mental health education. SB 531 will help increase awareness, empower students to seek support, and reduce the stigma associated with experiencing mental health challenges.

I look forward to keeping you informed and engaged as we navigate the 2025-26 legislative session. If you have any questions about legislation or the legislative process, please don’t hesitate to reach out to me via email, Lizzie@syaslpartners.com.

By Yanni Rho, MD, CARE Co-Chair

CARE (Committee for Anti-Racism and Equity) of CAL-ACAP is focused on addressing racial justice, anti-bias, and equity for marginalized populations in mental health practices for children and their families.  Our committee consists of members from across California including from academic settings, training programs, private practice, community-based organizations, and public health clinics.  

During meetings, we work closely with our legislative advocate in identifying and/or creating bills that are aligned with our mission, providing support and opportunities in moving equitable legislation forward.   We also strategize and seek out areas in child psychiatry and mental health service provision that are in need of reform and improvement from an anti-bias lens.

We are members of the California Racial Equity Coalition who provides guidance to and works closely with the Racial Equity Commission, created by Governor Newsom's Executive Order N-16-22, helping to institutionalize and advance equitable programming and policy in California government.

New members are always welcome!  If you would like more information on CARE and the work we do, please reach out to info@calacap.org

By Robert Holloway, MD, GAA Co-Chair

Are you satisfied with your child psychiatry practice? Have you thought about the reasons you became a child and adolescent psychiatrist and whether you can freely contribute in the way you planned? Many child and adolescent psychiatrists, and physicians in general, recognize that there are significant gaps and barriers in our system of care. We also recognize that the system developed as a cottage industry with hospitals and clinics existing where they could be financially viable rather than being planned as a system based on efficiently and effectively meeting needs. We see the gaps and barriers daily and they weigh on us and our patients. We may not recognize that our patients see us as being part of the system, and therefore, complicit with its failings. We find ourselves explaining the failings and trying to work around them. We validate our patients’ frustrations and those of our peers, families, and friends. That gives us some relief, but wouldn’t it be better if we could fix the system?

Advocacy can mean a lot of things to you, including letters to schools, courts, social service agencies. It may also include tedious work like prior authorizations and communicating with pharmacies regarding prescription availabilities and errors. However, there is also the concept of systemic advocacy to try to minimize the potential gaps and barriers. The California Academy of Child and Adolescent Psychiatry has an advocacy role for healthcare in California and in the US. We collaborate with medical and public organizations to attempt to make changes. Within CALACAP we have the Government Affairs and Advocacy Committee (GAA) that meets monthly to review proposed legislation and current pressing issues to try to create the best outcomes as possible for the population, our patients, and ourselves. It would be wrong to say it’s easy, but it is rewarding in that we are with like minded peers looking for problems to solve and offering solutions. Only by uniting our efforts with each other and allied organizations and those in our government can we make the changes we need.

Over the years (decades) that we’ve been working, we’ve been able to help block dangerous bills from becoming law and reshaped bills into becoming better laws. However, there’s another extremely important accomplishment: building relationships. Over the years we’ve collaborated with legislators, California Medical Association, Children Now, and California NAMI, to name only a few of our very important allies. Building these relationships allows us to have a power that is both extremely emotionally rewarding, but effective in creating change. When legislators and other allies hear our stories, passion, drive, and determination, they recognize we want to work with them for positive change and a better future. We have learned that relationships are as important in influencing people as expertise.

I have been happy to cochair this committee with Alonso Cardeñas, M.D. Together, with all our volunteer committee members, we continue to work to make changes and make our system of care slowly a more holistic and beneficial system. Let us know if you have questions or would like to be part of our committee.

By Divya Krishnamoorthy, MD, SDROCAP President

AACAP is the leading professional medical organization dedicated to advancing the mental health of children, adolescents, and families through research, education, and advocacy. The San Diego Regional Chapter of AACAP welcomed a new Executive Committee! We have a robust membership of over 150 members. Some of us have contacted our local representatives to advocate for our patients especially during current difficult socio-political current and developing situation. 

During these trying times we also recognize the need to have balance and self-care. There are trainees and early career psychiatrists taking active interest in the Executive Committee and have planned exciting events like movie night in which we saw & subsequently discussed the Movie “Didi” which is about a teen boy coming of age telling a relatable story of an immigrant Asian family dealing with family dynamics, acculturation etc. It was cringy, funny and thought provoking; would recommend it. We started the year with a collaborative social with the San Diego Psychiatric Society and hope to strengthen our partnership over the years.

SDACAP sponsored the 5th annual Birth of Brilliance conference and cultural fair in February. This year’s theme revolves around the legacy of healing. The conference was conceived to raise the collective consciousness around the effects of racial disparities and implicit bias in mental health, social services, developmental services, early childhood education, and medical care.

Planning is in full force for the 10th annual Critical Issues in Child and Adolescent Mental Health (CICAMH) conference: Reinstalling Hope & Connection in Youth Mental Health scheduled for April 25th at the beautiful campus of USD, it is a multidisciplinary conference attended by psychiatrists, therapists, pediatricians, and educators. 

By Tim Thelen, Executive Director, in collaboration with Sabrina Reed, MD, SCSCAP President

The Southern California Society for Child and Adolescent Society (SCSCAP) has sponsored the following various activities for its membership during the first quarter of 2025.

One was a joint meeting with the district branch of the APA, Southern California Psychiatric Society which featured speakers: Emily Wood, M.D, and Sid Puri, M.D.  The topic was The Stimulant Shortage.  It was held by zoom on January 16th; 44 members were in attendance.  

The second was a new effort of mentorship.  The event was a mixer which was attended by both mentors and mentees.  It was held on February 16th at Cafe Amici in Beverly Hills.  Approximately 20 were in attendance.

The third event was the regularly held SCSCAP Spring Meeting with speaker, Shawn Sidhu, M.D. from UCSD.  The title of presentation was: Silenced Voices: The Untold Story of Psychosocial Adversity in Migrant Youth and Families.  It was held on March 8 at UCLA; approximately 40 attended.

The most recent one was a mixer held by the Orange County committee on March 13th at The Peel Crafter & Kitchen in Orange, CA.  There were approximately 25 attendees.

By Veronica Searles Quick, MD, NCROCAP President

We recently held elections for new officers, and our Executive Committee Officers and Staff for the coming year will be the following:

National Delegates: Dr. John Leikauf, Dr. Haining Yu and Dr. Manasi Rana
Members at Large: Dr. Roger Wu, Dr. Mandeep Kapur and Dr. Smita Thakkar
Secretary-Treasurer: Dr. Andrew Connor
President: Dr. Veronica Searles Quick
Executive Secretary: Vanessa Smith

In February we held the NCROCAP annual meeting. The year's theme was “The Power of Understanding: Cultural Humility in Child Psychiatry”, and featured multiple captivating local speakers and panelists, as well as a trainee dinner. February events also included a trainee mentoring dinner themed "Life After Training", with presentations on career paths in CAP followed by a Q&A session.

We are planning to host multiple additional events for members and trainees during the coming year, details pending!

CMA Sponsored Bills Package

CMA released its sponsored bill package for the 2025 legislative session. The seven-bill package tackles issues relating to bureaucratic delays in providing care, private equity’s influence on medicine, the use of artificial intelligence in health care, and increasing the physician workforce.

SB 351 by Senator Christopher Cabaldon (SD 3): Private equity

AB 489 by Assemblymember Mia Bonta (AD 18): AI chatbots

AB 967 by Assemblymember Avelino Valencia (AD 68): Licensing for out-of-state physicians.

AB 510 by Assemblymember Dawn Addis (AD 30): Prior authorization denials

AB 539 by Assemblymember Pilar Schiavo (AD 40): Prior authorization

AB 512 by Assemblymember John Harabedian (AD 41): Urgent prior authorization

SB 306 Senator Josh Becker (SD 13): Prior authorizations requirement

Proposition 35

Proposition 35, which passed this past November with 68% of the vote has yet to be implemented.  Written by a broad coalition of partners including the CMA, Planned Parenthood, the California Hospital Association and others, it would fund a broad list of healthcare priorities based on the MCO tax and matching MedicAid funds.  The proposition created a 10 member advisory body to provide oversight.  However, the governor did not initially set a date for the first meeting and the state did not file needed paperwork with the Federal government by the March 31st deadline.  As a result, funds for Q1 of 2025 were lost.  A 10 day notice is needed to hold a meeting of the advisory board and is now set for the 14th of April.

MedicAid

The continuing resolution recently passed by the House noted an intention to obtain an $880B cut from the budget in order to largely fund President Trump’s tax cuts and make them permanent.  What was not said was that these cuts are most likely to come from Medicare, Medicaid and Social Security.  On February 27, a letter co-signed by all 50 state medical associations and the District of Columbia was sent to House leadership and members of the Energy and Commerce committee who will be debating the cuts urging that Medicaid be preserved.   Related to this effort, several states and in coordination with the AMA have created the following website:  www.physiciansformedicaid.org/.   This site is for both physicians and patients and will help draft letters of advocacy coordinated with the individuals Representatives and Senators.  In addition, there is a social media toolkit for physicians available here:  www.physiciansformedicaid.org/action/social/

Upcoming Events

Lastly here is a list of upcoming events that should be of interest to members of CAL-ACAP.

April 9, 2025 Sacramento.  Legislative Advocacy day.  This will have already occurred by the time you read this.  However, please plan to attend next year.  CMA engages with a great line of speakers and this is a great opportunity to work with our colleagues from other specialities to lobby for issues that our important to our patients and the practice of medicine.  CALPAC hosts a reception the evening prior that is often attended by state legislators.

May 6-7, 2025.  San Diego.  Health Information Technology Summit.  This meeting will focus on how AI is impacting healthcare.  The keynote speaker is from Aledade, the nation’s largest enabler for value based care.  More information and to register may be done here: cmadocs.org/HealthIT.

June 6-11 Chicago.  AMA House of Delegates. This is the AMA annual meeting, one of two a year that meets to set AMA policy. Many child psychiatrists participate either through AACAP, the APA or their state delegations.

July 10-11 2025 Pasadena.  Health Equity Leadership Summit.  Hosted by Physicians for a Healthy California.  This meeting fosters collaborative discussion and development of strategic action to advance health equity for all Californians.   For more information and register go here: phcdocs.org/equity-summit

Please feel free to email me with your questions, comments, or to become more involved with CMA: geofou@sbcglobal.net

By Rishi Parikh, MD, MPH, Editor, CALACAP Newsletter

Dear Colleagues,

Welcome to the inaugural edition of the CALACAP Newsletter—a new chapter in how we connect, communicate, and advocate together on behalf of California’s children, adolescents, and families.

This publication marks more than just a new format—it represents CALACAP’s commitment to deepening our relationship with our members and to building bridges across the broader community of child and adolescent psychiatrists in California. It is our way of sharing the important work being done in policy, education, and advocacy, while also celebrating the voices, values, and vision that guide us.

We are especially excited to use this first edition to highlight CALACAP’s origin story and legacy of impact. For over four decades, CALACAP has played a vital role in championing children’s mental health at the state level. From landmark legislation to workforce development to public policy reform, our efforts are driven by the belief that child development matters deeply in shaping public systems and outcomes.

At the same time, this newsletter is also an invitation—particularly to our ROCAP colleagues—to learn more about the work CALACAP does and the many ways we can collaborate to elevate advocacy for children across California. We share the same goals: advancing clinical excellence, shaping systems of care, and making sure the unique needs of young people are not overlooked in public policy conversations.

We hope this newsletter becomes a space for information, inspiration, and shared purpose. Thank you for your continued dedication to the field—and most importantly, to the children and families we serve.

Warmly,
Rishi Parikh MD, MPH
Editor, CALACAP Newsletter