ACEs Aware Initiative Responds to COVID-19-Related Stress

By Dorsey Griffith, Director, Strategic Communications and Public Affairs and Carri Ziegler, Vice President, Strategic Communications and Public Affairs

As the coronavirus began to spread in our communities, California’s top health officials moved quickly to respond to the public health emergency on several fronts. One of those efforts has been to leverage the work underway through the ACEs Aware initiative to reach providers with information about how trauma-informed care interventions can help in responding to the stress patients are experiencing due to the risk of COVID-19 and the resulting social distancing requirements. Harbage Consulting has been proud to support the California Office of the Surgeon General (CA-OSG) and the Department of Health Care Services (DHCS) on this initiative.

ACEs are stressful or traumatic experiences people have b­­y age 19, including abuse, neglect, and household dysfunction. The long-term health impact of ACEs was identified in a landmark study by the Centers for Disease Control and Prevention and Kaiser Permanente using data collected between 1995 and 1997. Research has shown that cumulative adversity, especially during critical and sensitive periods of development, is a root cause of some of the most harmful, persistent, and expensive health challenges facing the nation.

Research also has demonstrated that incidents of acute stressors on communities, such as those brought on by natural disasters, can have short and long-term impacts on health outcomes. The COVID-19 response, including requirements to stay home, economic disruptions and hardships, and the abrupt displacement of support systems due to social distancing, is likely to create such a stress response for some, and could exacerbate the health impacts and prevalence of ACEs. Responding with trauma-informed care now, and into the future, can help prevent and mitigate negative health outcomes.

ACEs Aware is a first-in-the-nation effort to offer Medi-Cal providers training, screening tools, clinical protocols and payment for screening children and adults for ACEs. The initiative also offers resources to encourage the adoption of trauma-informed care in response to toxic stress created by ACEs and is now being leveraged to help respond to COVID-19-related stress for providers and patients.

Harbage Consulting’s Role

In collaboration with CA-OSG and DHCS, Harbage Consulting has helped develop and disseminate timely information to support providers as they respond to stress created by COVID-19. Those tools include:

  • Updates to the ACEs Aware website, including stress management resources for providers, their teams, and their patients;
  • A webinar featuring nationally-recognized trauma-informed care experts, that specifically explored practices to address stress during the COVID-19 pandemic;
  • Targeted digital communications with resources to support providers and their patients, including a message from California Surgeon General Dr. Nadine Burke Harris and DHCS Medical Director, Dr. Karen Mark.

While these efforts are the first in what will likely be a series of strategies that will be needed to mitigate the negative impacts of COVID-19, we are honored to play a role in supporting the ACEs Aware initiative as it supports those on the front lines of the pandemic working tirelessly on behalf of their patients and their communities.

For more information about California’s response to COVID-19, go to the state’s official website,