California Launches ACEs Aware Initiative

By Hilary Haycock, MPP, President, Tanya Schwartz, MPP, MSW, Principal & Senior Director, Medicaid Policy, and Carri Ziegler, Vice President, Strategic Communications & Public Affairs

This week, California became the first state to launch a statewide effort – “ACEs Aware” – designed to systematically address the negative impact of adverse childhood experiences (ACEs) and toxic stress on health. ACEs are stressful or traumatic events experienced before age 18 that relate to ten categories of adversities across three domains: physical, emotional, or sexual abuse; physical or emotional neglect; and household dysfunction (e.g. a parent with a mental health condition or substance use disorder, absence due to separation or divorce, or intimate partner violence).

ACEs affect all of us – regardless of income, gender, race, and ethnicity. Research shows that people who have experienced ACEs are at significantly increased risk of serious health consequences, including 9 of the 10 leading causes of death. Individuals with six or more ACEs have a life expectancy that is 19 years shorter than individuals with none.

The California ACEs Aware initiative is calling on all Medi-Cal providers to get trained on and perform routine screening for ACEs and toxic stress. Beginning on January 1, 2020, Medi-Cal providers will be able to receive payment for conducting ACEs screenings for children and adults.

This week, California took the first step by launching a new training to educate Medi-Cal providers about the importance of incorporating ACEs screenings into their clinical practices, as well as how to conduct screenings, use clinical protocols to determine treatment plans, and provide trauma-informed care. The training is free, provides Continuing Medical Education (CME) and Maintenance of Certification (MOC) credits, and is accessible for a wide variety of health care providers.

California also announced the launch of This website will serve as a hub of information for providers and other stakeholders who want to join the movement to ensure that everyone is ACEs Aware. The website includes the provider training curriculum, screening tools, clinical protocols for assessment and treatment planning, and Medi-Cal reimbursement information.

Harbage Consulting Role

Harbage Consulting is providing comprehensive support on the design and implementation of ACEs Aware for the California Office of the Surgeon General and the Department of Health Care Services. Our team worked to develop the website and educational materials, as well as the online provider training that qualifies providers to receive Medicaid payment for performing ACEs screenings. We are managing the stakeholder Advisory Committee and Subcommittees that provide guidance on the initiative. Throughout 2020, Harbage Consulting will be hosting sessions for providers to share lessons learned and best practices on the implementation of ACEs screenings. Additionally, we are developing and executing a strategic outreach plan to educate providers about ACEs Aware – in collaboration with stakeholder partners across the state.

To learn more about ACEs Aware, visit Stay tuned for updates as the initiative progresses.