Adverse Childhood Experiences

The Office of the California Surgeon General and Department of Health Care Services (DHCS) are working to reduce Adverse Childhood Experiences (ACEs) and treat the impacts of toxic stress through the ACEs Aware initiative. ACEs Aware is a first-in-the-nation statewide effort to screen children and adults for ACEs in primary care and to treat the impacts of toxic stress with trauma-informed care.

ACEs are stressful or traumatic events experienced in childhood that relate to abuse, neglect and/or household dysfunction. Research shows that individuals who experienced ACEs are at greater risk of nine of the 10 leading causes of death in the United States, including heart disease, stroke, cancer and diabetes. When someone experiences many ACEs without necessary supports, it can cause prolonged activation of the stress response system or toxic stress. Toxic stress can have damaging effects on learning, behavior and health across the lifespan.

ACEs Aware also offers Medi-Cal providers training, clinical protocols and payment for screening children and adults for ACEs. On January 1, 2020, eligible Medi-Cal providers began receiving a $29 payment for conducting ACEs screenings for children and adults with Medi-Cal coverage. By July 1, 2020, Medi-Cal providers must take Becoming ACEs Aware in California training and self-attest to completing the training to receive Medi-Cal payments for ACEs screenings. Additional policy guidance can be found in All Plan Letter 19-018 issued by DHCS on December 26, 2019.

CalOptima looks forward to supporting you in integrating ACEs into your office setting. If you have any questions, call CalOptima Provider Relations at 714-246-8600, Monday through Friday, from 8 a.m.–5 p.m.

What is Trauma-Informed Care?

ACEs Screening Tools View the DHCS-approved ACE screening tools: Pediatric ACEs Screening and Related Life-events Screener (PEARLS) and Adult ACE Assessment tool.

Becoming ACEs Aware in California Complete the free 2-hour certified ACEs training and then self-attest to completing the training on the DHCS website by July 1, 2020, to continue receiving payments.

Training Opportunities


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