Calvin C.J. Sia (born Calvin Chia Jung Sia on June 3, 1927) is a primary care pediatrician from Hawaii who developed innovative programs to improve the quality of medical care for children in the United States and Asia. Two particular programs have been implemented throughout America: the Medical Home concept for primary care that has been promoted by the American Academy of Pediatrics[1][2] and the federal Emergency Medical Services for Children program administered by the U.S. Department of Health and Human Services’ Health Resources and Services Administration, Maternal and Child Health Bureau.[3] His Medical Home model for pediatric care and early childhood development began to take root in several Asian countries in 2003.[4]
Sia is also creator of Hawaii Healthy Start Home Visiting Program to prevent child abuse and neglect[5] and co-founder of Hawaii's Zero to Three program and Healthy and Ready to Learn Center. The Hawaii Healthy Start program, which targets expecting and new parents who may be at risk of abusing or neglecting their children, became the model for the Healthy Families America home visiting program that the United States Department of Justice's Office of Justice Programs identified in 2010 as a "promising" approach to child abuse prevention.[6]
In addition, Sia spearheaded the creation of the Variety School for learning disabled children, a Honolulu-based educational institution for children ages 5 through 13.[7] Sia, who has been a professor of Community Pediatrics at University of Hawaii,[8] retired from his Honolulu-based medical practice in 1996, after almost 40 years of treating patients.[9]
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Sia is a 1945 graduate of Punahou School in Honolulu and a graduate of Dartmouth College in 1950. He received his medical degree at Western Reserve University School of Medicine in 1955 and did a general rotating internship as a lieutenant in the U.S. Army Medical Corps at William Beaumont Army Hospital in El Paso, Texas from 1955-1956. Sia served his pediatric residency at Kauikeolani Children's Hospital in Honolulu. He received an honorary Doctor of Humane Letters degree from the University of Hawaii in 1992.
Among the early cadre of American Academy of Pediatrics consultants for Head Start and Parent Child Centers in Hawaii in the 1960s, Sia helped established the Variety School for Learning Disabilities in 1967.[10] In 1978, he brought together representatives from the Hawaii AAP Chapter, the University of Hawaii John A. Burns School of Medicine, the Hawaii Medical Association, and Kapiolani Medical Center for Women and Children to develop a Child Health Plan for Hawaii.
This was the birth of the Medical Home concept for primary care, to which Sia attached the slogan, “Every Child Deserves Medical Home.” Under this idea, which the American Academy of Pediatrics later adopted as a policy statement,[11] the medical care of all infants, children and adolescents should be accessible, continuous, comprehensive, family-centered, coordinated, compassionate, and culturally effective. It should be delivered or directed by well-trained physicians who provide primary care and help to manage and facilitate essentially all aspects of pediatric care. The physician should be known to the child and family and should be able to develop a partnership of mutual responsibility and trust with them. As Sia and his co-authors of a 2006 monograph on the medical home noted, this new model broadens the traditional focus on acute care to include prevention and well care at one end of the continuum and chronic care management of children with special health care needs at the other.[12][13] One expert observed, for example, that for a child born with spina bifida, Sia's Medical Home model calls for the family and its health care provider to compose a list of specialists and therapists who will be caring for the child and a timeline of anticipated surgeries and interventions. The aim is to have as few emergencies and unanticipated events as possible.[2]
By 1984, Sia had begun to implement the Medical Home concept in Hawaii beginning with the Hawaii Healthy Start Home Visiting Program for the prevention of child abuse and neglect. A year later, the Hawaii Medical Association was awarded a grant from the U.S. Maternal and Child Health Bureau, under the Special Projects of Regional and National Significance (SPRANS) initiative,[14] to train primary care physicians to provide a "medical home" for all children with special health care needs. The demonstration project—which sought to help first-time families give their newborn children the best start in life—was so successful it was expanded from a small part of Oahu to other areas of Hawaii, and as word of the demonstrated positive outcomes spread, Hawaii’s Healthy Start became a model for parenting education programs nationwide.[15] In the early 1990s, Healthy Families America and the National Healthy Start Association began to standardize and credential programs to ensure effectiveness and research-based practices. Across the United States, according to the MCHB, the home visiting program has shown that it can reduce child maltreatment and increase children’s readiness for school.
Meanwhile, Sia launched the Hawaii Early Intervention Program for infants and toddlers in 1986 and also became actively involved with Hawaii’s Early Intervention Coordinating Council for Zero to Three, placing this under Hawaii’s Department of Health instead of Department of Education. The focus of this effort was to support the medical home system of care with prevention and early intervention programs.
From the early 1990s, Sia focused on implementing family-centered Medical Home as a comprehensive system of care for early childhood. The pace of activity led to his decision to close his private medical practice in 1996 so he could devote his time as principal investigator on various early childhood grant projects promoting the Medical Home and integrated system of care. He launched several initiatives, including a MCHB Health Education Collaboration grant in support of interprofessional training in early childhood, Carnegie Corporation of New York's Starting Point early childhood planning grant, and Consuelo Foundation of Hawaii's Healthy and Ready to Learn grant – all with the emphasis on integrating the continuum of care of the Medical Home with other health, family, and community services from a holistic approach. Sia, who served as chairman of the American Medical Association's Section Council on Pediatrics and other AMA- and AAP-related posts, used those platforms and his network of contacts with other groups to help introduce the Medical Home concept into the care of adults as well as children, although his primary focus has remained on pediatric care. The term Medical Home now regularly shows up in the literature of parent groups such as Family Voices, in family practice journals and on the websites of state public health and medical agencies.[2]
Beginning in 2000, Sia expanded his efforts related to early child development and the Medical Home to Asia. In 2003, he created the Asia-US Partnership, a think tank based at the University of Hawaii medical school whose mission is to improve child health in Asia and the United States through cross-cultural exchanges with leaders in pediatrics. That same year, Sia initiated and chaired the first of several AUSP Early Child Development and Primary Care conferences, bringing together pediatric and early childhood development experts from Asia and the United States to translate the science of early child development into policy and action. Participants have come from China (Beijing, Shanghai and Hong Kong), the Philippines, Singapore and Thailand and the United States. According to conference reports, these international exchanges have stimulated translation of the science on early child development and primary care into action programs in the broad areas of advocacy, service delivery, research, and training among the Asian early childhood professionals leadership.[4] Sia has continued to serve as co-chairman of these events, including the sixth international conference, held in the Philippines capital of Manila, in May 2011.[16] After hosting the earliest AUSP conferences in Hawaii, Sia decided to move the 2009 event to Shanghai and tapped a team of Chinese doctors to serve as conference host, signaling what he called a new phase of activity aimed at developing greater shared leadership and stronger "country teams."[17]
As the lead author of an often-cited article published by the journal Pediatrics in May 2004, Sia traced the development of the Medical Home concept.[18][19]
While planting the seeds of the medical home concept in Hawaii in 1986, Sia embarked on a related advocacy campaign focused on emergency care for children. He worked closely with Senator Daniel Inouye, whom he happened to meet on a flight to Washington, D.C.,[2] to enact a National Emergency Medical Services for Children System (EMSC) demonstration grant program to address acute injuries, illnesses and other childhood crises. States receiving these demonstration grants established an emergency medical care service system for children with upgrading first responders and emergency departments training and equipment for children. Hawaii received one of the first grants to initiate its own emergency care system for children that improved care coordination with the primary care physician, the medical home. EMSC is now an established statewide system of care for children in all 50 states and territories.[3][20]
Several national and state organizations have recognized Sia for developing innovative and responsive family-centered grassroots services.[8] Among the awards he has received are these:
Sia was born in Beijing, China to Dr. Richard Ho Ping Sia, a former Rockefeller Institute researcher whose work laid the groundwork for the Avery–MacLeod–McCarty experiment on DNA and bacterial transformation[27] and Mary Li Sia, a Honolulu-born author of several Chinese cookbooks.[28] Sia grew up in Hawaii, where his family settled in 1939 after living under Japanese occupation for nearly two years.[2][9]
Sia married Katherine Li Sia in 1951. Sia has three sons, Richard H.P. Sia, a journalist;[29] Jeffrey H.K. Sia, a Honolulu-based attorney and former president of the Hawaii State Bar Association;[30] and Dr. Michael H.T. Sia, a pediatrician and chairman of Pediatrics at Kapiolani Medical Center for Women and Children;[31] and six grandchildren.