Tagged With "Screening and Response in Pediatrics"
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5 Things to Know as California Starts Screening Children for Toxic Stress [californiahealthline.org]
By Barbara Feder Ostrov, California Healthline, January 7, 2020 Starting this year, routine pediatric visits for millions of California children could involve questions about touchy family topics, such as divorce, unstable housing or a parent who struggles with alcoholism. California now will pay doctors to screen patients for traumatic events known as adverse childhood experiences, or ACEs, if the patient is covered by Medi-Cal — the state’s version of Medicaid for low-income families. The...
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8 Myths About Screening For Adverse Childhood Experiences
I’d like to take this opportunity to address some of the objections to screening for ACEs that I have come across. It is true that some areas of research are still emerging, such as protocols, but in other ways we are twenty years behind using the information we have to make a positive difference in our patients lives and in training new physicians to be more comfortable addressing social and experiential determinants of health.
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9 Big Questions as California Starts to Screen Kids for Trauma, ACEs [salud-america.org]
By Amanda Merck, Salud America!, February 12, 2020 Early childhood adversity like abuse and divorce is a root cause of many of the greatest public health challenges we face today. But doctors don’t even screen children for exposure to adversity. That’s changing in California, thanks to Dr. Nadine Burke Harris and other child advocates. As of Jan. 1, 2020, almost 100,000 physicians in 8,800 clinics will be reimbursed for routinely screening Medi-Cal patients for adverse childhood experiences...
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A Health Problem and An Opportunity: Screening for Adverse Childhood Experiences [medium.com]
By Dayna Long, Medium, May 19, 2020 A consensus of scientific research demonstrates that cumulative adversity, especially when experienced during critical and sensitive periods of development, is a significant contributing factor to some of the most harmful, persistent, and expensive health challenges facing our nation. Adverse Childhood Experiences (ACEs) are highly prevalent, experienced in all communities, and are likely to increase during the COVID-19 emergency [i] [ii] [iii] [iv] [v].
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CA ACEs Aware Initiative webinar provides roadmap for ACEs screening
What is the economic toll of ACEs in the State of California? $112.5 billion , said California Surgeon General Dr. Nadine Burke Harris to attendees of a webinar on February 26. That cost, she said, was one clear reason that she and other early adopters of screening for Adverse Childhood Experiences are urging their fellow health care providers in California to join the ACEs Aware Initiative that launched at the beginning of the year. In January, the State of California put screening...
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California has Begun Screening for Early Childhood Trauma, But Critics Urge Caution [sciencemag.org]
By Emily Underwood, Science, January 29, 2020 On 1 January, California became the first U.S. state to screen for adverse childhood experiences (ACEs)—early life hardships such as abuse, neglect, and poverty, which can have devastating health consequences in later life. The project is not just a public health initiative, but a vast experiment. State officials aim to cut the health impacts of early life adversity by as much as half within a generation. But critics say the health benefits of...
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California healthcare providers adapt ACEs screening from in-person to virtual environment
Dr. Amy Shekarchi, a pediatrician based in Los Angeles, CA, was helping to lead the rollout of ACEs screening among 50 health care providers at six clinics affiliated with the L.A. County Department of Health Services when the COVID-19 pandemic hit—days before she was set to launch the effort. “We had trained everybody in doing face-to-face [ACEs screening], and when COVID-19 happened we thought, let’s not throw the screening out. Everybody was ready,” says Shekarchi, who is the pediatric...
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Webinar Oct. 17 — Integrating ACEs science in pediatrics: Early adopters share lessons from the field
An ACEs Connection webinar co-sponsored with 4 CA In 2017, California became the first state in the country to pass a law supporting universal screening for adverse childhood experiences (ACEs) in the 5.3 million children in the state’s Medicaid program. As clinicians around California await the state’s announcement of what this new policy will entail, many are wondering what it takes to integrate ACEs science in a pediatric practice. Meet Drs. Deirdre Bernard-Pearl, R.J. Gillespie and...
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Webinar Oct. 17 — Integrating ACEs science in pediatrics: Early adopters share lessons from the field
An ACEs Connection webinar co-sponsored with 4 CA In 2017, California became the first state in the country to pass a law supporting universal screening for adverse childhood experiences (ACEs) in the 5.3 million children in the state’s Medicaid program. As clinicians around California await the state’s announcement of what this new policy will entail, many are wondering what it takes to integrate ACEs science in a pediatric practice. Meet Drs. Deirdre Bernard-Pearl, R.J. Gillespie and...
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Why the Nation Should Screen All Students for Trauma Like California Does [theconversation.com]
By Sunny Shin, The Conversation, November 18, 2019 As the first person to hold the new role of Surgeon General of California, Dr. Nadine Burke Harris is pushing an unprecedented plan to implement universal screenings for childhood trauma within the state’s schools. Childhood trauma is defined by the National Institute of Mental Health as an “emotionally painful or distressful” event that “often results in lasting mental and physical effects.” Burke Harris’ plan is already more than a dream:...
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SAVE THE DATE! ACEs Aware Initiative Webinar [acesaware.org]
Wednesday, February 26, 2020 Noon – 1 p.m. Join a live webinar with: Dr. Nadine Burke Harris, MD, MPH – California Surgeon General Dr. Karen Mark, MD, PhD – Medical Director, Department of Health Care Services Dr. Melissa Merrick, PhD – President & CEO, Prevent Child Abuse America Dr. Brigid McCaw, MD, MPH, MS, FACP – Clinical Advisor, ACEs Aware The webinar will provide an overview of the ACEs Aware initiative; why providers should screen for Adverse Childhood Experiences (ACEs); the...
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Screening for Adverse Childhood Experiences (ACEs) in California: Insights and Perspectives (Webinar) [ncg.org]
From Northern California Grantmakers, February 2020 Since January 1, 2020, Medi-Cal providers have been eligible to receive payment from the California Department of Health Care Services (DHCS) to screen patients for Adverse Childhood Experiences (ACEs). This program is part of an initiative led by the Office of the California Surgeon General and DHCS and is the product of several legislative efforts, including the passage of AB340, that have facilitated the momentum around universal...
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Screening for Adverse Childhood Experiences and Trauma
This new technical assistance tool from the Center for Health Care Strategies (CHCS) offers a variety of approaches for screening adults and children for adverse childhood experiences and trauma, including examples of screening protocols used at several provider practices that have embraced trauma-informed care.
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Screening for Childhood Trauma
Dr. Ken Epstein has been in the social services sector for nearly four decades and has witnessed firsthand the long-term effects of trauma. As both the son and father of fellow social workers, the work runs in his blood. Now, he’s helping Bay Area health clinics screen for and address childhood trauma through the Resilient Beginnings Collaborative (RBC), led by Center for Care Innovations (CCI) and made possible by Genentech.
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Survey: Healthcare providers, community organizations weigh in on California's ACEs screening program
In January, California took a historic leap forward to promote universal ACEs screening of the state’s 13 million adults and children in the Medi-Cal program. The eventual goal is to promote ACEs screening for all patients, but this is a first step in dealing with a major issue that ACEs science has identified: that many children will develop serious health problems later in life because the healthcare system is not currently set up to detect the roots of those problems. The term ACEs, which...
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Trauma-informed Care: It Takes More Than a Clipboard and a Questionnaire
California is about to launch an ambitious campaign to train tens of thousands of Medi-Cal providers to screen children and adults up to age 65 for trauma, starting on January 1, 2020. It is well-established that the early identification of trauma and providing the appropriate treatment are critical tools for reducing long-term health care costs for both children and adults. Research has shown that individuals who experienced a high number of traumatic childhood events are likely to die...
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Trauma Screenings Advisory Group (AB 340) Hosts First Meeting
On Friday, April 20, 2018, the AB 340 Workgroup, otherwise known as the Trauma Screenings Advisory Group, met for the first time to discuss the legislative charge to update, amend, or develop, if appropriate, tools and protocols for screening children for trauma as defined, within the Early and Periodic Screening, Diagnosis, and Treatment (EPSDT) benefit in Medi-Cal. Both Children Now and Center for Youth Wellness were appointed members of the Trauma Screenings Advisory Workgroup, and we...
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Understanding Gaps in Developmental Screening and Referral [pediatrics.aappublications.org]
By Mei Elansary and Michael Silverstein, Pediatrics, March 2020 In this issue of Pediatrics, Lipkin et al describe trends in pediatrician-reported developmental screening and referral practices between 2002 and 2016. The authors compare data across serial American Academy of Pediatrics (AAP) Periodic Surveys conducted in 2002, 2009, and 2016. They demonstrate that pediatricians’ self-reported use of formal developmental screening tools increased from 21% in 2002 to 63% in 2016 and that...
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CYW's Provider Training Courses now available online
In response to an overwhelming demand for information about ACEs science, screening tools, and guidance on how to implement ACEs screening, CYW has developed a suite of online courses in order to make our training more accessible to a broader audience. Developed by a team of pediatricians, research scientists, public health experts, and clinical quality improvement experts, these courses are the first of four online courses that will aid medical providers/practitioners in understanding and...
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Dozens of stakeholders representing thousands of practitioners send public comments on Calif. ACEs-screening plan
Update: We posted this story on Tuesday evening and received a response from the Department of Health Care Services Wednesday that clarifies additional information. DHCS information Officer Katharine Weir said that subject to budget approval by the legislature and the governor: The reimbursement rate will be $29. Federally Qualified Health Centers will also be reimbursed for screening pediatric patients for trauma through Prop 56 funds and federal matching funds. In response to a question...
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Employing an Adaptive Leadership Framework to Childhood Adversity Screening [pediatrics.aapublications.org]
By Susannah Stein, Arin Swerlick, and Binny Chokshi, Pediatrics, January 2020 Providers of pediatric health care have been motivated and inspired by the research on childhood adversity, which has shown that in the early stages of life, critical neurodevelopmental pathways can be disrupted through exposure to adverse childhood experiences (ACEs) and resultant toxic stress.1,2 Early detection of ACEs and subsequent intervention has the potential to decrease the development of associated poor...
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journal article: Responding to Students with PTSD in Schools
Child Adolesc Psychiatr Clin N Am . 2012 January Responding to Students with PTSD in Schools Sheryl Kataoka, MD, MSHS, Audra Langley, PhD, Marleen Wong, PhD, Shilpa Baweja, MA, and Bradley Stein, MD, PhD The prevalence of trauma exposure among youth is a major public health concern, with a third of adolescents nationally reporting that they have been in a physical fight in the past twelve months and 9% having been threatened or injured with a weapon on school property. Studies have...
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Lesson learned integrating ACEs science into health clinics: Staff first, THEN patients
Nearly two years ago, a team of colleagues at LifeLong Medical Clinics jumped at the opportunity to integrate practices based on ACEs science to prevent and heal trauma in their patients when it joined a two-year learning collaborative known as the Resilient Beginnings Collaborative (RBC). A few months after training began, the staff realized they had to put on the brakes.
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Mark your calendar for March 10 tweet chat on CA ACEs screening!
Hey ACEs Connection communities! Please join us for a boisterous tweet chat about ACEs screening in California on March 10 at 10 am Pacific/ 1 pm Eastern for #SaludTues, hosted by @saludamerica and co-hosted by @CYWSanFrancisco, @acesconnection and @CHCShealth. Get your thumbs ready, and spread the word! What: Tweet chat Who: Salud America, co-hosted by Center for Youth Wellness, ACEs Connection and Center for Health Care Strategies. When: Tuesday, March 10, 10am Pacific/ 1 pm Eastern Why:...
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NEW BRIEF! Screening for Trauma Birth to 5
In light of the Governor's recent budget proposal to invest $45 million into trauma screenings, Children Now wrote a new brief, Screening Kids for Trauma Birth to 5. It highlights the importance of screening for trauma and provides recommendations for the state of California and providers to prevent and treat childhood trauma. If you have any questions, please reach out to Lishaun Francis: lfrancis@childrennow.org
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New organization calls all pediatricians to end crisis that's "hiding in plain sight"
When the question of screening patients for adverse childhood experiences (ACEs) was first raised a couple of years ago, Santa Barbara pediatrician Andria Ruth had mixed feelings about it.
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New Screenings for Childhood Trauma Raise Hopes, Questions [calhealthreport.org]
By Claudia Boyd-Barrett, California Health Report, December 20, 2019 California health officials are gearing up for the launch of a statewide screening effort that aims to help doctors measure children’s exposure to trauma and their risk of related health problems. Starting Jan. 1, California will become the first state in the nation to reimburse health care providers who screen patients enrolled in the Medi-Cal program for “adverse childhood experiences” or ACEs. The $40 million effort has...
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NFL Athlete Lawrence Phillips: The Broken Kid
http://blitzweekly.com/lawrence-phillips-the-broken-kid/ http://www.thenation.com/article/who-killed-lawrence-phillips/ Today NFL athlete Lawrence Phillips' death was ruled a suicide by the coroner. His ACEs score (Adverse Childhood Experiences) was by all accounts extremely high. By all accounts, he did not receive treatment for this unrelenting childhood trauma and attachment disruption. Abandoned by his father, abused by his stepfather, removed from his mother, placed in group homes, and...
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NPPC's Pilot Site Case Studies: Lessons Learned from ACEs Screening Implementation
The Center for Youth Wellness' National Pediatric Practice Community on ACES (NPPC) is a co-designed community committed to collaborative learning. To promote this learning, we have been working with six pilot sites over the last year, representing practices of various sizes and service delivery settings, to implement ACEs screening and intervention. Beyond supporting these practices with the logistics of implementation, the broader goal was to discover and share real-world best practices,...
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WEBINAR: NPPC's Pilot Site Case Studies: Lessons Learned from ACEs Screening Implementation
The Center for Youth Wellness' National Pediatric Practice Community on ACES (NPPC) is a co-designed community committed to collaborative learning. To promote this learning, we have been working with six pilot sites over the last year, representing practices of various sizes and service delivery settings, to implement ACEs screening and intervention. On Monday, December 2nd at 1pm PT , we will be holding a webinar to discuss the findings of these pilot site case studies. Please register...
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Opinion: Screenings Alone Won’t Prevent Adverse Childhood Experiences—We Must Address Community Trauma [calhealthreport.org]
By Rachel A. Davis and Howard Pinderhughes, California Health Report, December 19, 2019 Earlier this month, California’s Surgeon General Nadine Burke Harris launched an ambitious campaign to reduce adverse childhood experiences, which can cause lifelong health problems. With more than 60 percent of Californians saying they were exposed to a traumatic childhood event, adverse childhood experiences are at crisis levels in the state. The ACEs Aware campaign will train and pay health care...
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Prevalence of Adverse Childhood Experiences From the 2011-2014 Behavioral Risk Factor Surveillance System in 23 States (www.jamanetwork.com) & Note
Cissy's note: Melissa Merrick, PhD (pictured above), is a Senior Epidemiologist with the Surveillance Branch in the Division of Violence Prevention at CDC’s National Center for Injury Prevention and Control. She will be the keynote speaker at the Massachusetts Essentials for Childhood summit and share about new ACEs data (see below) about which populations have the highest levels of ACEs on average. An except from this article published on the JAMA Network can be found below. Please follow...
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Registration Deadline for Virtual Screening of Cracked Up is Friday, June 7th
The exclusive virtual screening to all ACEs Connection members of the new, acclaimed film, CRACKED UP is fast approaching. The registration deadline is Friday, June 7th at 5pm PST / 8pm EST To register , please complete this form . This documentary film is about the long term effects of childhood trauma, told through Saturday Night Live veteran Darrell Hammond’s journey in discovering adverse childhood experiences at the root of his lifelong battle with self-harm, addiction, and...
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Request for Proposals - Addressing Health Impacts of Adverse Childhood Experiences through a Collaborative Precision Medicine Approach [opr.ca.gov]
California Governor's Office of Planning and Research, December 4, 2019 We are pleased to announce the 2019 Request For Proposals (RFP). This RFP will serve as a means to identify collaborative proof-of-principle Demonstration Projects with the aim to improve care for Californians who have been impacted by Adverse Childhood Experiences (ACEs). This RFP incorporates demonstration project selection criteria codified by AB 1602, Chapter 24, Statutes of 2016, which establishes the California...
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Children to be Screened for Toxic Stress, Trauma Under new State Initiative [bakersfield.com]
By Stacey Shepard, Bakersfield.com, January 11, 2020 Children in Kern County and throughout California may be screened for childhood trauma and toxic stress during routine pediatrician visits starting this year. The screenings are part of a new state initiative to identify adverse childhood experiences, known as ACEs, which a growing body of research shows can significantly increase the risk of poor health outcomes later in life, ranging from suicide, alcohol addiction, depression and drug...
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California's First Surgeon General: Screen Every Student for Childhood Trauma [nbcnews.com]
By Patrice Gaines, NBC News, October 11, 2019 Dr. Nadine Burke Harris has an ambitious dream: screen every student for childhood trauma before entering school. "A school nurse would also get a note from a physician that says: 'Here is the care plan for this child's toxic stress. And this is how it shows up,'" said Burke Harris, who was appointed California's first surgeon general in January. "It could be it shows up in tummy aches. Or it's impulse control and behavior, and we offer a care...
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California’s Surgeon General Readies Statewide Screening for Child Trauma [chronicleofsocialchange.org]
By Jeremy Loudenback, Chronicle of Social Change, September 19, 2019 Soon after being appointed California’s first-ever surgeon general, Nadine Burke Harris took off on a barnstorming tour across the state to talk about adverse childhood experiences and toxic stress, an issue she calls “the biggest public health crisis facing California today.” Before the pediatrician was appointed to her position in January by Gov. Gavin Newsom (D), Harris had founded and led the Center for Youth Wellness,...
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California Selects UCSF Trauma Screening Tool for Statewide Initiative to Combat Adverse Childhood Experiences [ucsf.edu]
By Lorna Fernandes, University of California San Francisco, December 4, 2019 The California Department of Health Care Services (DHCS) has approved the use of a screening tool for Medi-Cal patients that helps pediatricians identify Adverse Childhood Experiences (ACEs) that can lead to increased health risks in their patients. It is the only tool of its kind to qualify for pediatric Medi-Cal payments. Known as PEARLS, for Pediatric ACEs and Related Life-Events Screener, the tool was developed...
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How do these pediatricians do ACEs screening? Early adopters tell all.
Last week, three pediatricians — with a combined experience of 15 years integrating ACEs science into their practices — reflected on the urgency they felt several years ago that prompted them to begin screening patients for childhood adversity and resilience when there was practically no guidance at all. Along their journey , they accumulated a list of lessons learned for other pediatricians and family clinics to use. The three pediatricians participated in the ACEs Connection webinar,...
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Re: NEW BRIEF! Screening for Trauma Birth to 5
The attached article may fit in somewhere here. Please feel free tp pass it on.
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Re: NEW BRIEF! Screening for Trauma Birth to 5
Excellent brief which raises important issues! The document referred to below about screening young children for trauma is an excellent one. Please read if you can! The references that follow the document are great, too. The document asks California to step up to implement trauma-screening policies for our youngest children. Such policies can alleviate physical and mental health illnesses and help to prevent future trauma. We should consider how to implement resilience against trauma in our...
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Re: California's First Surgeon General: Screen Every Student for Childhood Trauma [nbcnews.com]
I hope she focuses some of her energy on the primary prevention of unsupportive, harmful parenting. In other words a new kind of parenting education...one that reaches everyone, everywhere, all the time. Visit advancingparenting.org.
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Re: Survey: Healthcare providers, community organizations weigh in on California's ACEs screening program
Thank you for writing this article, and sharing the results of the survey. I was disappointed however to not see any mention of the potential perpetuation of structural and systemic racism as a result of conducting screenings. It is widely understood that the adult ACEs screening tool does not work well for all populations and may result in inaccurate findings for people of color. And, what about the requirement that providers include the label "toxic physiology" in patient files if their...
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Re: Survey: Healthcare providers, community organizations weigh in on California's ACEs screening program
Sarah thanks for reading the report and sharing your insights! These are exactly the kinds of conversations we hoped to spark with this effort. One of the disadvantages of using a convenience sample, and a short survey window, is that we may not have tapped into a full range of views. Knowing that the Office of the Surgeon General would soon launch ACEs Aware and that the clinical reimbursement program for ACEs screening would begin, together with the backbone of 4CA, we thought it was...
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Re: 5 Things to Know as California Starts Screening Children for Toxic Stress [californiahealthline.org]
And, after asking about these experiences, the asker (physician, screener, etc.) should be ready to refer the child to a skilled trauma therapist.
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Re: 5 Things to Know as California Starts Screening Children for Toxic Stress [californiahealthline.org]
As always, Dr. Finkelfor says things others might be too afraid to say: Here he points out that although it's a good thing to recognize the impact of adversities on child wellbeing, we are moving too fast and don't yet know what best practices are. He cautions that this could have "disastrous consequences.” It flies in the face of trauma informed care to possibly add injury to those already burdened with adversity.
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Re: 5 Things to Know as California Starts Screening Children for Toxic Stress [californiahealthline.org]
I am new to this community. I completely understand the worry for this overloading the current system. We are beginning a full fledged systems change for medical care, because the research demands that we pay attention to what we now know about ACEs, serious health risks and an attack on resiliency. We need everyone to be versed in trauma and resilience language and actions. My passion is in understanding and maximizing resiliency across the lifespan. I think Dr. Finkelfor is right, there...
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Re: California has Begun Screening for Early Childhood Trauma, But Critics Urge Caution [sciencemag.org]
Screenings alone won't prevent adverse childhood experiences. Physical, sexual, verbal, and psychological child abuse as well as a host of other parenting behaviors and practices generally recognized as not supporting and/or disrupting the healthy development of children are such a serious problem that the solution requires a public health approach that employs primary prevention...something Vincent Felitti, co-author of the ACE Study, has repeatedly called for.
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Re: 8 Myths About Screening For Adverse Childhood Experiences
Physical, sexual, verbal, and psychological child abuse as well as a host of other parenting behaviors and practices generally recognized as not supporting and/or disrupting the healthy development of children are such a serious problem that screenings should accompany a public health approach that employs primary prevention...something Vincent Felitti, co-author of the ACE Study, has repeatedly called for.
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Re: 4CA Policymaker Education Day is Back!
I can't make the meeting on May 1 but the attached chapter has information starting in p211 that shows the profound effect that skillful asking about ACEs has on subsequent medical care. The implications for the MediCal budget are in the multi-billion dollar range.