In recent years, many states have focused on addressing adverse childhood experiences (ACEs) — stressful and potentially traumatic events, such as violence, abuse, or neglect, that occur prior to age 18. Some states have adopted cross-sector statewide plans to address ACEs. In other states, governors’ executive orders have put a priority on mitigating the effects of ACEs.
California and New Jersey are leading examples of states pursuing groundbreaking efforts and making substantial investments to address ACEs. California is the first state to prioritize mitigating the effects of ACEs and toxic stress across its programs, and New Jersey is the first state to stand up an Office of Resilience to coordinate statewide ACEs-related efforts. This blog post highlights these two states’ approaches for preventing and mitigating the effects of early adversity on children and families as well as supporting resilience-building in their communities.
Encouraging Providers to Screen for ACEs and Adopt Trauma-Informed Care in California
In 2019, California appointed its first Surgeon General, Nadine Burke Harris, MD, MPH, FAAP — a longtime champion for promoting strategies that address ACEs and toxic stress. With this announcement, it came as no surprise that the Office of the California Surgeon General emphasized early childhood, health equity, and ACEs and toxic stress as key priority areas for the state. These priority areas align with the Surgeon General’s overarching and ambitious goal of reducing ACEs and toxic stress in half in one generation.
To support this effort, the Office of the California Surgeon General and the Department of Health Care Services launched ACEs Aware, a first-in-the-nation effort focused on encouraging Medi-Cal (Medicaid) providers to screen for ACEs in children and adults, provide appropriate follow-up services and supports, and embrace trauma-informed care. Through ACEs Aware, a variety of supports have been made available to providers and their care teams to encourage ACE screening and response, including training materials, implementation tools, information on supplemental payment for implementing select screening tools, and guidance on how to build trauma-informed networks of care to support patients and families. The state also supported stakeholders to develop resources and create learning networks to facilitate peer-to-peer exchange and spread best practices. For information related to implementation of ACE screening under ACEs Aware, check out a recent Center for Health Care Strategies (CHCS) report that details perspectives from Medi-Cal providers.
Of note, ACEs Aware recently transitioned to a new organizational home within the University of California. The University of California ACEs Aware Family Resilience Network (UCAAN) is co-led by the Department of Pediatrics at the David Geffen School of Medicine at University of California, Los Angeles and the Center to Advance Trauma-Informed Health Care at the University of California, San Francisco. UCAAN will build on the investments made through ACEs Aware and related efforts and will focus on supporting health professionals in understanding and addressing toxic stress and promoting resilience in clinical and community settings.
Thank you, @Kamala Allen for all you and the CHCS staff do.
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