A growing awareness around the impact of trauma on people’s health and wellbeing has underscored the need for trauma-informed and strengths-based approaches to working with patients and communities. Since 2018, the Center for Care Innovations (CCI) has offered programs aimed at supporting health care safety net organizations in being more trauma and resilience informed, particularly through its Resilient Beginnings portfolio.

Formal screening for adverse childhood experiences, or ACEs, is an increasingly common strategy for identifying and addressing toxic stress in pediatric care settings. In 2020, the State of California enacted a policy that provides reimbursement for ACEs screening among patients enrolled in Medi-Cal and has invested in establishing statewide infrastructure to support screening implementation. Given this context, the Resilient Beginnings Network (RBN) included ACEs screening and response as one core component of advancing more trauma- and resilience- informed pediatric care.

As part of the RBN evaluation, the Center for Community Health and Evaluation (CCHE) spoke with teams from nine organizations working on ACEs screening as part of their program participation. These organizations:

  • Consisted of seven independent Federally Qualified Health Centers (FQHC) and two FQHCs housed within public hospital systems
  • Provided services in seven Bay Area counties (Alameda, Marin, San Francisco, San Mateo, Santa Clara, Solano, and Sonoma)
  • Varied in size: one serving under 400 patients aged 0-5 annually, one over 17,000
  • Operated between 2 and 22 sites that provide primary care for children ages 0-5 years

Past evaluations of other CCI programs have documented promising practices related to general ACEs screening implementation. While this brief provides an overview on the practice of ACEs screening, it primarily focuses on what ACEs screening has looked like as part of RBN’s larger effort to advance trauma- and resilience-informed care.

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