Becoming ACEs Aware in a Challenging Year
Adverse Childhood Experiences (ACEs) and toxic stress represent a public health crisis that has been, until recently, largely unrecognized by our health care systems and society, but there is hope.
On January 1, 2020, eligible Medi-Cal providers began to receive a $29 payment for conducting qualifying ACEs screenings for children and adults up to age 65 with full-scope Medi-Cal.
As many of you know, this is part of the ACEs Aware initiative, a first-in-the-nation joint effort by the Office of the California Surgeon General and Department of Health Care Services to screen Californians for ACEs and to treat the impacts of toxic stress with trauma-informed care.
The ACEs Aware initiative is built on the consensus of scientific evidence demonstrating that early detection and evidence-based intervention improve outcomes. The bold goal of this initiative is to reduce ACEs and toxic stress by half in one generation, and to launch a national movement to ensure everyone is ACEs Aware.
It’s been a busy year for ACEs Aware, which has been an integral part of the Medi-Cal program’s response to the COVID-19 public health emergency, helping providers identify, treat, and prevent the secondary health effects associated with stress caused by the pandemic.
Since its launch in December 2019, the ACEs Aware initiative has worked to equip providers with the knowledge, tools, and resources they need to effectively incorporate ACE screening into patient care. Our primary goal this year has been to train health care providers to screen patients for ACEs and to recognize and respond to the symptoms of toxic stress.
We have achieved substantial early success in building a network of providers who are crucial to advancing the ACEs Aware initiative across the state. As of December 4, more than 15,000 individuals have completed the ACEs Aware core training, including more than 9,200 Medi-Cal providers. Many of these providers can be found on our ACEs Aware provider directory. Our outreach for health care providers to complete the ACEs Aware core training will continue in 2021.
ACEs Aware also awarded $14.3 million in grants to 100 organizations in California to support the ACEs Aware initiative and broaden the availability of provider training. The grants currently fund a range of provider training, engagement, and communications activities across the state to inform and educate Medi-Cal providers about the importance of screening for ACEs and responding with trauma-informed care.
Earlier this month, to promote the importance of establishing Trauma-Informed Networks of Care across the state, we released a Request for Proposal for up to $30 million in ACEs Aware grants. The grant funds will target communities that want to build upon or grow a robust system to support Medi-Cal providers and their communities in effectively responding to ACEs to interrupt the toxic stress response in children and adults. Ultimately, these grants will strengthen and formalize networks of care that include primary care practices, while also leveraging existing community collaboratives to address ACEs and toxic stress.
Lastly, we issued a draft Network of Care Roadmap that provides practical steps that health care providers and health and human services organizations can take within their own communities to grow cross-sector networks of care that support providers, individuals, and families in preventing and addressing the impact of ACEs and toxic stress on health. The roadmap is also intended to help guide grant activities. The roadmap is currently open for public comment until January 15, 2021.
COVID-19 has exposed vulnerabilities and gaps among our child, adult, and family serving systems and has further shown the disproportionately negative social determinants of health impacting communities of color and minority groups.
Building upon the success of the first year, the ACEs Aware initiative will continue to support Medi-Cal providers and their teams with educational events, clinical ACE resources, and a provider toolkit that includes information on how to screen for and respond to ACEs and trauma-informed strategies to treat ACEs and toxic stress.
Thank you for all you have done and will continue to do to help care for Californians in need.
The ACEs Aware Initiative,
Nadine Burke Harris, MD, MPH
California Surgeon General
Office of the California Surgeon General
Karen Mark, MD, PhD
Medical Director
Department of Health Care Services
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