By Kathryn Stewart, Shauna Olsen, Lisa Tadlock, and Sue Grinnell, Northern California ACEs Collaborative, July 2021
Executive Summary
Communities across California are impacted by Adverse Childhood Experiences (ACEs) and toxic stress, although regions are affected differently. This paper focuses on the six-county region in Northern California served by Public Health Institute's (PHI) Population Health Innovation Lab's (PHIL) Northern ACEs Collaborative (NAC) where exist some of the highest rates of ACEs per capita in the entire state. NAC works in Butte, Colusa, Glenn, Shasta, Tehama, and Trinity counties through a multisector collaborative of 28 agencies.
In addition to high rates of ACEs, rural communities in Northern California face unique challenges with increased rates of poverty and a shortage of primary care and mental health services. The region has experienced devastating wild fires in the past five years which, while distinct from ACEs, contribute to the collective trauma of the region. The COVID-19 crisis has also contributed to stress in the region while simultaneously exacerbating existing barriers to ACE screening and increasing strain on a healthcare system with demonstrated shortages.
Through key-informant interviews, Medi-Cal providers shared barriers for implementing ACE screening including 1) time, 2) referral resources, 3) clinical infrastructure & workflow, and 4) skilled support staff. Providers also identified factors that helped support screening such as 1) the presence of a champion that advocates for ACE screening and 2) availability of an inventory of local referral resources.
*Practice paper attached below.
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