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NYCCAP News A publication of the New York Council on Child and Adolescent Psychiatry New York Council Inside this issue: on Child and Adolescent Psychiatry 2021-2022 NYCCAP Board President’s Message Officers M. Carolina Zerrate, MD........................................................................ 3 President, M. Carolina Zerrate, MD President-Elect, Maalobeeka Gangopadhyay, MD Hulsee Evemt with Dr. Vera Feuer Treasurer, Melvin Oatis, MD Scott M. Palyo, MD................................................................................ 4 Secretary, vacant Immediate Past President, Vera Feuer, MD Board Members Youth Mental Wellness Status Update Amid Shaily Amin, MD Ongoing Pandemic Angel Caraballo, MD by Jose Vito, MD, Eric Whitney, MD, and Akeem Marsh, MD................... 5 Vanessa Disla, MD Christy Duan, MD UpcomingEvents.................................................................................. 5 Tzvi Furer, MD Cathryn Galanter, MD Rakin Hoq, MD The New York Council Reception at AACAP Iliyan Ivanov, MD “Honoring a New York Giant” Sarah Klagsbrun, MD Scott Palyo, MD...................................................................................... 6 Olga Leibu, MD Annie Li, MD Akeem Marsh, MD Advocacy Hour 2022 with NYCPS, NYCMS and NYCCAP Asha Martin, MD Gabrielle Shapiro, MD and Colleen Turek, MD..................................... 7 Veena Muthusamy, MD Yiu Kee Warren Ng, MD AACAP PAC Jennifer O’Keeffe, MD Scott Palyo, MD Scott M. Palyo, MD................................................................................. 7 Richard Pleak, MD Shervin Shadianloo, MD NYCCAP-AACAP Letter in Support of S.4051 A.4982021............ 8 Scott Shaffer, MD Gabrielle Shapiro, MD Jessica Simberlund, MD Dr. Marsh Publishes Book: Not Just Bad Kids............................... 10 Oliver Stroeh, MD Colleen Turek, MD Dr. Tim Becker with Mentors Drs. Ivanov and Rice win Jose Vito, MD NIDA-AACAP Resident Training Award in Substance Amanda Wallace, MD Use Disorders.................................................................................... 10 Zooming in the Kitchen: Cooking & Connecting............................. 11 NYCCAP News Publication Photo Gallery........................................................................................ 12 Editor-in-Chief Jose Vito, MD Editorial Board Akeem Marsh, MD Shervin Shadianloo, MD Tzvi Furer, MD Managing Editor Earl Magee New York Council on Child and Adolescent Psychiatry 141 Mulberry Street, Apt D1 New York, NY 10013 info@nyccap.org www.nyccap.org If you would like to submit an article for publication in our next newsletter, please contact us info@nyccap.org. Classified ads are FREE for NYCCAP members. For non-members or advertisers, 2 please contact us at info@nyccap.org for rates and guidelines.
President’s Message D ear N Y C C AP f a mily, A fter tw o ye a r s of the COVI D 19 pa nde mic , we a r e s ta r tin g th is y e a r w ith a n in c r e d ib le challenge, yet hope f ully with a sha r e d se nse of e mpowe r m e n t g iv e n th e r e c o g n itio n n a tio n w id e of the m ental he a lth c r isis we a r e f a c ing. Following AA CA Ps jo in t d e c la r a tio n in th e f a ll, the U S S urgeon’ s Ge ne r a l Advisor y r e le a se d a t the e nd o f 2 0 2 1 f u r th e r h ig h lig h te d th e n e e d for com prehensive , syste mic , a nd multile ve l inte r ve ntio n s to b e g in to a d d r e s s th is c r is is . A s C hild and Adole sc e nt Psyc hia tr ists ( CAPs) , we a r e aw a r e o f th e tr e me n d o u s g a p s in o u r systems of ca r e to f ully be a ble to suppor t a ll youth a nd f a milie s in th e ir r e c o v e r y jo u r n e y s . We have w itne sse d how those ga ps ha ve e xpone ntia lly g r o w n th e s e p a s t tw o y e a r s a n d h o w m arginalized a nd BI POC c ommunitie s a r e dispr opor tion a te ly imp a c te d . W ith a c le a r c a ll to act i o n t o o u r l egislators, I am hopeful this will be a ye a r to se iz e oppor tunitie s to r e v ita liz e a n d r e ima g in e s e r v ic e s fo r t h e y o u t h a nd fam ilies w e care for a nd to r e - e ne r giz e a nd pr ote c t the wor k w e d o a s CA Ps . W e a r e a ll p a r t o f th is chang e , a n d t h e N ew Y ork C ouncil o n Child a nd Adole sc e nt Psyc hia tr y ( NYCCA P) is g r a te f u l to b e a b le to b e o f s erv i c e t o a l l o f you in this process as it ha s be e n up to now. Duri n g t h e se c ond semester of 2021, we c ontinue d to thoughtf ully c onside r h o w to c r e a te s p a c e s to s u p p o r t a n d cel eb r a t e t h e w ork you do. T his past summe r , we ha d the luxur y of ge tting toge th e r in p e r s o n f o r o u r a n n u a l W e lc o me Ni gh t a n d e n j o y a perfect N Y C sunset on the Hudson Rive r a s we r e c onne c te d w ith c o lle a g u e s a n d f r ie n d s a n d me t t h e n e w e st g e n e ration of C A P s. We sta r te d the f a ll with a Townha ll me e ting b r in g in g to g e th e r le a d e r s f r o m a c r o s s d i ffe r e n t se t t i n gs to discuss how C A Ps in NYC we r e impa c te d by the 2021 “ Gr ea t Re s ig n a tio n ” . D u r in g th e A A CA P ann u a l m e e t i n g , w e had the privilege of c e le br a ting Dr . Cla r ic e Ke ste nba um’ s 6 5 y e a r s in me d ic in e , a n d le a r n e d abo u t h e r Y o u Tube series, “Words of W isdom with Dr . K.” I n Nove mbe r , we g a th e r e d o n lin e f o r th e 5 4 th W ilf r e d C. H u l se L e c t u re A w ard given by D r . Ve r a Fe ue r who ma ste r f ully sha r e d with u s h e r o u ts ta n d in g c o n tr ib u tio n s to t h e fie l d . O n January 25, w e joined o ur c olle a gue s f r om the Ne w Yor k County Ps y c h ia tr ic So c ie ty a n d th e N e w Y o r k Cou n t y M e d i c a l Society for a convers a tion with our sta te le gisla tor s dur ing “ Adv o c a c y H o u r , ” a mo n g o th e r th in g s w e rei nfo r c e d t h e message of urgency to a ddr e ss the me nta l he a lth c r isis. F i n all y , a n d t o bring to context our n e wsle tte r c ove r , we wa nt to sha r e tha t thro u g h o u t th e s e c o n d h a lf o f 2 0 2 1 th e NY CC A P b o a r d significantly expanded. W e we lc ome d ha lf a doz e n ba bie s givin g u s 6 a ma z in g r e a s o n s to p a u s e a n d s m i l e w i t h e a c h arrival. A s in parenthood, our wor k a s CAPs is be st susta ine d w h e n w e a r e min d f u l a n d in te n tio n a l abo u t t a k i n g c a r e of ourselves. A s you r r e giona l or ga niz a tion, we a r e inve ste d in s u p p o r tin g y o u r w e llb e in g a n d e a g e r t o he a r f r o m y ou how w e can continu e to impr ove your me mbe r ship e xpe r ie nc e to u p lif t y o u r w o r k a n d s e lf - c a r e in 2022! In s o l i d a r i t y , M . C a r o l i n a Z e r rate MD , MH S NY C C A P P re si d ent Con n e c t w i t h us: Em ail u s a t : i n f o@ nyccap.org F o l l o w u s: T w i tter, Instagram , F aceb ook, Linke dI n Chec k o u t o u r r esources on C O V ID -19 a nd Ra c ia l Justic e : we bsite links! 3
WILFRED C. HULSE AWARD Hulse Event with Dr. Vera Feuer by Scott M. Paylo, MD On November 17, Dr. Feuer, an Associate Professor of Child and Adolescent Psychiatry and is the we were honored Psychiatry, Pediatrics and Emergency immediate past president of the NY Council of to have the Hulse Medicine at the Zucker School of Medicine Child and Adolescent Psychiatry. Her interests Presentation at Hofstra/Northwell Health, completed include access to mental health care for by Vera Feuer, her training at Drexel University and children, suicide prevention and collaborating M.D., this year’s Hofstra-Northwell Health. She has been with schools and primary care providers. awardee. The on faculty at Northwell for 12 years and The event this fall allowed us to hear from Dr. Wilfred Hulse has experience in Pediatric and Adult MD Award is an Addiction-, Consultation-, and Emergency annual award the Psychiatry. She participated in developing New York Council the Northwell Health Emergency presents to one individual who embodies the Telepsychiatry network and led the opening role of a fantastic child psychiatrist as our of Behavioral Health Urgent Care at CCMC former President, Dr. Hulse. The awardee as well as community embedded school is someone who contributes to the local serving urgent care centers- the Behavioral community, our regional organization, as Health Center at Rockville Centre and at Feuer about her passion of expanding mental well as AACAP. Mineola. She has been collaborating with health care to her local community in Long school districts to expand access to mental Island with services including telepsychiatry, Dr. Feuer’s many outstanding achievements health care for students as well as to provide school based mental health care and urgent include clinical accomplishments, academic community education and professional care centers. It was an inspiring lecture to experience and expertise in the field of development to school communities. She see how much has been achieved in the past child and adolescent emergency psychiatry, has been involved with local and national few years. Many audience members who have as well as her ongoing commitment and workgroups developing care standards for been a part of the program noted that Dr Feuer excellence in service administration and pediatric crisis behavioral health care and was vital to its implantation and to its current leadership and her contributions to local she is a Distinguished Fellow of Child and success. We are all excited to see its continued and national workgroups and committees Adolescent Psychiatry. She serves as the growth and greatly appreciate Dr Feuer’s have helped demonstrate unequivocal peer co-chair of the Emergency Child Psychiatry leadership and inspiration in our field. recognition. Committee of the American Academy of To view, click icon 4
Youth Mental Wellness Status Update Amid Ongoing Pandemic by Jose Vito, MD, Eric Whitney, MD, and Akeem Marsh, MD different ways. When systematically studied, COVID-related stress has been found to be associated with higher rates of depressive symptoms, suicidal ideation and attempts. Similar trends have been observed throughout the world. With the profession having turned primarily to virtual service, lack of access to telepsychiatry has also been identified as a serious challenge. In consideration of the trends described Prior to the onset of COVID-19 pandemic, are no longer regular. Things that we used above, the American Academy of Pediatrics the dearth of services to address children’s to take for granted such as self-care and (AAP), American Academy of Child and mental health had been recognized. For child relaxation are now hard to come by – social Adolescent Psychiatry (AACAP), and and adolescent psychiatrists, the critical gatherings, indoor dining, movies. Kids have Children’s Hospital Association (CHA) have shortage is deeply appreciated as we regularly been expected to attend school virtually declared a national emergency in children’s advocate for recruiting and expansion of without the socialization they really need for mental health. NYCCAP strongly agrees service provision. While this has been the proper development and stress relief. with this action and believe that governments case, there has been a steady increase in rates and policymakers need to follow suit. of depression, suicidality, and other mental Given all of this, it’s reasonable to expect that Some examples of actions that could be health concerns among youth exacerbating one would have to be affected in some way. taken include increasing federal funding the fragile system to a critical breaking point. Indeed, the pandemic has been recognized for services, allowing for increased access for its increased stress on kids from lower to telehealth, improving community-based The COVID-19 pandemic and its income and minority communities. Those of systems of care, and addressing workforce ramifications remain unprecedented in the us in clinical practice have seen an uptick challenges, among other things. We have modern era. Millions have gotten sick and in related referrals. From school refusal, to our work cut out for us going forward but many of them actually passed away. Family increased depression, anxiety or suicidal there is reason to hold on to hope with these units were disrupted. Our ‘regular’ routines ideation, many children are struggling in organizations taking a bold stand. Updates in the Treatment of Anxiety Disorders March 9, 2022, 7:00-9:00 pm ET Career Night 2022 March 22, 2022, 7:30 pm ET Autism Spectrum Disorder: Piecing Together the Puzzle A Child Psych Cat - Autism Awareness Month Edition April 13, 2022, 7:00-8:30 pm ET AACAP Assembly of Regional Organizations April 9, 2022, 12:00-3:30 pm ET AACAP Legislative Conference Training Day May 5, 2022 (half day) AACAP Legislative Conference Congressional Meetings May 11, 2022 (all day) 5
The New York Council Reception at AACAP “Honoring a New York Giant” by Scott M. Palyo, MD that were recorded over the pandemic from Dr. K’s home. This was conceived by Olga Leibu, M.D., and myself. Janel Smietana, M.D., a trainee from Delaware assisted in producing these videos which were filmed by her son, John Stone. During the reception, Dr. Leibu interviewed Dr. K about her many years in medicine with a focus on Dr. K’s lecture, “Women in Medicine.” This extremely well attended event was very special for Dr. K as many As we attended AACAP’s virtual annual meeting, many of us had the amazing experience during NYCCAP’s reception evening. AACAP’s Former Executive of listening to Clarice Kestenbaum, M.D. Director, Ginger Anthony, commented discuss her recent endeavors during the that one of Dr. K’s secrets is that she’s pandemic. In honor of her 65 years in always looking for a new adventure and medicine, she introduced her series on always finds happiness whatever comes Youtube, “Words of Wisdom with Dr. K.” her way. As many of us know, Dr. K still works seven days a week with clinical patients, supervision, and teaching. But during the pandemic, she took on a new challenge and embraced the time at home with a new way of connecting to physicians and other mental health clinicians far and of the physicians in attendance were her wide. What a remarkable human being prior students, residents and fellows from and an inspiration for all of us. A true the past 50 years. It was an inspiring New York Giant! In this series, she shares stories from her life, her lectures on child development and psychotherapy, leads clinical consultations with fellow CAPs and trainees, and demonstrates how to engage with children in interviews. The first season will include at least 15 episodes 6
ADVOCACY Advocacy Hour 2022 with AACAP PAC NYCPS, NYCMS and NYCCAP by Scott M. Palyo, MD This past year, the government by Gabrielle Shapiro, MD and Colleen Turek, MD affairs team at AACAP has evolved and we are very appreciative of including our societal mental health crisis the new government affairs team with a focus on the impact of COVID-19 headed by Alexis Geier-Horan. on our overburdened system. Members Our government affairs team will were receptive and optimistic to increasing continue to focus on grass roots services with access to care and funding advocacy and highlight the role of in the coming year, and were aware of the the PAC within advocacy. particular needs of vulnerable populations including minority children, adolescents, AACAP-PAC is the voice of child veterans and their families, and seniors. and adolescent psychiatry on Capitol Hill. As the only PAC representing Additional concerns were raised about the child and adolescent psychiatrists. cost of coverage, including parity laws, access The PAC’s mission is: To educate, to adequate mental services and advocacy support, and elect candidates for Over the last year there has been an increasing for improved access to care for many New Congress who advocate for child recognition and call to action regarding Yorkers. Assembly Member Gottfried and and adolescent psychiatry and the crisis in mental health in this country, Senator Rivera discussed their the push child mental health. AACAP-PAC’s including the joint Declaration of a Nation for a single payer system, the NEW YORK vision for the future is that child Emergency in Child and Adolescent Mental HEALTH ACT, which they believe will help and adolescent psychiatry will have Health by the AAP, AACAP and Children’s alleviate some of the concerns raised, and strong relationships with legislators, Hospital Association in October, and the U.S. are open to feedback from attendees and so that Congress acts to improve Surgeon General’s Advisory on Protecting constituents regarding any further needs. child mental health. Youth Mental Health in December. Already existing and under resourced systems are Questions from members included what In the past year, Congress has acted drown under the increased demand with plans did legislators have for addressing the to support children and families the rise in need and acuity of mental health increase in suicides in BIPOC children and with Advanced Child Tax Credits, needs. Our current systems are not able adolescents, awareness about the dangers Economic Impact Payments as well to meet the needed services currently, but of non-physicians prescribing psychotropic as with hospitals and health centers with increasing recognition of these needs medications without physician oversite or with funds to expand telehealth provides us with the opportunity to speak coordination of care, asking about how to services. In addition, Congress louder to advocate for our patients, families, enforce parity laws, as well as questions has continued to integrate mental friends and healthcare communities. about telemedicine laws and compliance. health into primary care services Assembly Member Rosenthal was very On January 25th the New York Council concerned with mental health and substance for children through the Pediatric on Child and Adolescent Psychiatry co- abuse treatment, and recognized school Mental Health Care Access Program. sponsored an annual legislative event with providers as an important role in children’s These major achievements start with the NYCPS and NYCMS, highlighting mental health services. She also discussed her smaller local advocacy initiatives. areas of importance to our communities. support of Medication Assisted Treatment Though we missed seeing each other in access, including through telehealth during AACAP PAC has raised over $57,000 person, our second Zoom legislative event the COVID-19 pandemic. Senator Rivera in 2021 to support and educate was a success, allowing physicians from the additionally, provided recommendations on Members of Congress. We are very metro NYC area and legislators in Albany who to contact in the Senate about mental appreciative of the many members of to come together in a virtual setting for health and developmental disability issues AACAP who contribute and support lively discussion. During this event local particularly and we look forward to working us each year. Since we started over physicians joined with our New York State with these legislators to continue discussion 5 years ago, we are impressed with legislative representatives to explore areas on important points that were raised. the number of new members who of need and support for New Yorkers—our financially contribute, especially local Child and Adolescent Psychiatrists, The evening overall had spirited discussions, our trainees. including our NYCCAP President Dr. an optimistic atmosphere, and was a great Members of the American Zerrate, made sure to give a voice to our success! Association of Child and Adolescent children’s needs. Please join our committee for more advocacy Psychiatry and their spouses are the In total, there were over 70 attendees. Senator efforts, as well as MSSNY for virtual Albany only people who can contribute. If Rivera, Assembly Members Gottfried, visits with legislators on March 9th, 2022! you are interested in learning more Rosenthal and Seabright answered many We look forward to fighting for CAPs, our or contributing, please visit us at questions about our common concerns, youth and families together! https://www.aacap-pac.com. 7
NYCCAP-AACAP Letter in Support of S.4051 A.4982021 May 5, 2021 The Honorable Jamaal T. Bailey LOB 609 Albany, NY 12247 The Honorable Andrew Hevesi LOB 626 Albany, NY 12248 Dear Senator Bailey and Assemblyman Hevesi: The New York Council on Child and Adolescent Psychiatry (NYCCAP) represents many of the 1,050 New York-based child and adolescent psychiatrists, residents, and medical student members of the American Academy of Child and Adolescent Psychiatry (AACAP). We are writing in support of S.4051 (Bailey) and A.4982 (Hevesi) as physician experts in children’s mental health and behavioral disorders, as advocates for the youth and families we serve, and as New Yorkers committed to help eliminate racial disparities in our communities. New York State currently allows for the arrest and prosecution of children as young as 7-years- old, the second youngest age in the U.S. This approach to addressing disruptive behaviors in childhood is ineffective and detrimental to children’s development and mental health. Furthermore, there is clear evidence of racial disparities in the legal system resulting in the disproportionate involvement of Black and Latinx youth with the juvenile justice system.1 Current law does not protect vulnerable youth and contributes to further disenfranchise already marginalized communities. There is clear scientific evidence that demonstrates how the brain continues to develop through adolescence and young adulthood through at least age 25.2 Areas that control judgement, planning and reasoning develop last. The younger an individual the more likely he or she is to act impulsively, act without reasoning, and to not fully consider or understand the consequences of their actions. These biological and developmental differences have been recognized over the years by the U.S. Supreme Court,2,3 further supporting the need to amend New York State’s current law. It has been well documented that involvement with the juvenile justice system increases the likelihood of negative life outcomes including dropping out of high school, long-term unemployment, involvement with the justice system as an adult, and risk of an early and violent death.4 The New York Council on Child and Adolescent Psychiatry 527 Third Avenue, New York, NY 10016 (212) 439-4665/Fax (212) 562-3273 http://www.nyccap.org/home.aspx Continued on next page 8
Dr. Marsh Publishes Book: Not Just Bad Kids One of our esteemed members, Dr. Akeem we are all united by our shared interest Marsh, is the co-editor of the recently in children’s mental health. The almost published book from Elsevier, Not Just 700-page book takes a deep dive into the Bad Kids: The Adversity and Disruptive nuance of kids’ lives and helps provide Behavior Link. He also co-authored a much-needed shift in perspective on several of the book’s chapters. To quote its behaviors that we usually see as disruptive, back cover, Not Just Bad Kids “explores oppositional, and difficult. Along with the principle that all behavior makes creating an understanding of the role sense in context.” The book explores the played by youths’ history and background, connections between experiencing trauma the book reviews best practices and gives and adversity and engaging in reckless, practical guidance for engaging with kids, risky, sometimes illegal behavior. This is emphasizing the vital role of relationships a topic of interest to our readership, as in promoting resilience. Dr. Tim Becker with Mentors Drs. Ivanov and Rice win NIDA-AACAP Resident Training Award in Substance Use Disorders Dr. Becker is MPH. The project aims to increase knowledge numerous trainees including medical students currently a resident of identification, assessment, and treatment of (MS3 and 4), residents from three residency in General Psychiatry adolescents with comorbid substance use and programs (MSH, MSW, MSBI), child/ at Mount Sinai East. mental health disorders among medical students, adolescent fellows, triple-board residents, Together, Dr. Becker residents, and fellows, through curriculum psychology externs and fellows, and nurse and his mentors, Drs. modules and a guide to facilitate referrals. practitioner externs. This curriculum will be Ivanov and Rice, were The team will develop and deliver educational further disseminated to child psychiatry and selected for their sessions to trainees to improve knowledge and addiction psychiatry fellows and other trainees proposal, “Assessment skills for treating comorbid substance use and based at the Family and Teen Recovery and treatment of adolescents with comorbid psychiatric disorders in adolescents, including Services (FuTuReS) clinic and psychiatric substance use and depression, ADHD, and screening and assessment methods validated ERs to promote family/patient education and trauma- related disorders,” to receive the 2021 in adolescents as well as evidence-based increases in referrals to existing community National Institute on Drug Abuse (NIDA) – treatments for SUD in youth. Specifically, substance use resources. Additionally, the team American Academy of Child and Adolescent they will review local resources for adolescent will complete a systematic review of treatment Psychiatry (AACAP) Resident Training Award substance use treatment to improve referrals of comorbid substance use and trauma-related in Substance Use Disorders (SUD). This from the different clinics in the Mount Sinai disorders in adolescents and will contribute project was chosen from a highly competitive Health System. The primary teaching site will to the AACAP Committee on Quality Issues field of candidates per the announcement letter be the inpatient child/adolescent psychiatry writing group in developing updated clinical from the AACAP President Warren Ng, MD, unit at Mount Sinai Morningside, which hosts practice guidelines for adolescent SUD. 10
Zooming in the Kitchen: Cooking & Connecting Hosted by Chef Sarah Steinhorn Winter Wellness Recipes brought to you by the Early Career Psychiatry Wellness Committee Compliments of Chef Sarah • Melt the butter in a large pot (3qt. Spiced Chocolate Polenta minimum) over medium heat. (If you Yields approx. 6 servings cooked your sausage in the pot first, make sure to scrape up any browned Ingredients: bits on the bottom as the butter melts) • 3 C milk, or non-dairy substitute • Add in onions and garlic, season lightly • 3 T sugar with salt, and cook until softened and • Pinch of kosher salt translucent, stirring frequently. • 2/3 C polenta, instant or fine-grained • Add potatoes and stock to the pot and • 1 1⁄4 t vanilla extract or paste bring to a simmer, stirring occasionally. • 6 oz bittersweet chocolate • Add in the kale and continue to cook • 1⁄2 t cinnamon (optional) at a simmer until the potatoes have • 1⁄4 t ancho chile powder (optional) softened. This should take about 30 • 1⁄4 t chipotle powder (optional) minutes. Caldo Verde • Add in your sausage to heat it through, • Dash of cayenne (optional) Yields approx. 4 servings season to taste, and enjoy! • Dash of nutmeg (optional) • Marshmallows (optional) Ingredients: Instructions: • 1-2 T unsalted butter (or butter substitute, just make sure it’s unsalted) • In a small-medium sized pot over • 1 medium yellow onion, finely chopped medium heat, combine the milk, sugar, salt, and desired wspices and bring to • 3 cloves garlic, sliced a simmer. • 2-3 medium Yukon gold potatoes, peeled and cubed • Rinse your polenta 3-4 times with • 1 russet potato, peeled and cubed lukewarm water. Whisk the polenta into the hot milk mixture and bring • 6 C vegetable or chicken stock, it all back up to a simmer. Cook the homemade or store bought…low or no polenta over medium-low heat, stirring sodium frequently, until it thickens and the • 1 large bunch curly kale (washed and polenta is tender, about 5 minutes. torn/roughly chopped) • ¾ lb sausage of your choice (linguica • Whisk the chocolate and vanilla is traditional, I have enjoyed using spicy into the hot polenta, then taste for Italian) seasoning. • Kosher salt, to taste • For service, reheat the polenta, if it • Extra virgin olive oil, as needed has cooled down significantly. If it’s too thick, you can loosen it up with Instructions: a little milk. Spoon the polenta into • If you are using uncooked sausage, ramekins, or other oven-safe serving this will be the first thing to go into your dishes, and decorate the top with pot. Either slice the sausage to desired marshmallows. Adjust an oven rack thickness or remove the casing and to near the top and turn the broiler crumble into a large pot over medium on high. Place the serving dish(es) heat. Once the sausage is cooked through onto a sheet pan and put it in the oven and lightly browned, remove it from the until the marshmallows have toasted pot and set it aside. to your desired doneness. Enjoy! 11
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