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Published: October 16, 2020

California's ACEs Aware Initiative Trains Nearly 14,000 Health Care Providers in Trauma-Informed Care

Nearly 14,000 health care providers have completed the ACEs Aware initiative’s core training program, a key finding included in a data report released today by the Office of the California Surgeon General (CA-OSG) and Department of Health Care Services (DHCS).

Becoming ACEs Aware in California” trains health care providers to screen patients for Adverse Childhood Experiences (ACEs) and to recognize and respond to the symptoms of toxic stress. The Provider Training September Data Update shows that of those trained, 8,300 are Medi-Cal providers now eligible to receive payment for providing ACE screenings.

The newly launched ACEs Aware Provider Directory offers patients a way to find and connect with trained ACEs Aware providers throughout California.

“The COVID-19 public health emergency has brought unprecedented levels of stress to families and communities across California. Individuals with a history of childhood adversity are at greater risk of developing both physical and behavioral health conditions as a result,” said California Surgeon General Dr. Nadine Burke Harris. “ACEs Aware trains health care providers on how to recognize a patient who may be at high risk for ACEs and to respond with trauma-informed care. As the data reflect, we are building a movement of trauma-informed clinical teams in communities across California and will continue to provide evidence-based practices through the ACEs Aware initiative.”

The first-in-the-nation ACEs Aware initiative, led by CA-OSG and DHCS, is a statewide effort to train providers on how to screen patients for ACEs and treat the impacts of toxic stress. The initiative has been an integral part of the Medi-Cal program’s response to the COVID-19 public health emergency, helping providers identify, treat, and prevent the secondary health effects associated with stress caused by the pandemic.

“This report clearly demonstrates substantial early success in building a network of providers – from primary care to obstetrics to mental and behavioral health – who are crucial to advancing the ACEs Aware initiative across the state,” said DHCS Medical Director Dr. Karen Mark.zs

Since its launch in December 2019, the ACEs Aware initiative has worked to equip providers with the knowledge, tools, and resources they need to effectively incorporate ACE screening into patient care. Effective January 1, 2020, qualified Medi-Cal providers who complete the certified “Becoming ACEs Aware in California” training and attest to completion can receive Medi-Cal payment for screening children and adults for ACEs.

Preliminary data on Medi-Cal claims for screening are expected to be available later this year. Providers are also encouraged to opt in to be listed in the ACEs Aware Provider Directory to help patients find a trauma-informed provider.

Key findings of the data report include:

  • Nearly 14,000 health care providers completed the core training.
  • 8,300 people attested to completing the training.
  • 58 percent of those who completed the training are physicians.
  • 49 percent specialize in pediatric or family medicine.
  • Of users who provided a National Provider Identifier, 86% are Medi-Cal providers.
  • Before providers took the training:
  • 7 percent reported screening all patients for ACEs.
  • 64 percent reported they had been screening less than 25 percent of their patients for ACEs.
  • 35 percent reported they do not screen patients for ACEs.
  • After providers completed the training:
  • 91 percent reported confidence that they would be able to make practice changes.
  • 97 percent reported that they planned to implement changes in their practice to address ACEs, or that their current practice had been reinforced.
  • 81 percent who were not previously screening patients for ACEs indicated that they planned to implement routine ACE screening for children and/or adults.
  • 71 percent anticipated time constraints as a potential barrier to implementing change.

Building on the success of the first nine months, the ACEs Aware initiative will continue to support health care providers and their teams with educational eventsclinical ACE resources, and a provider toolkit that includes information on how to screen for ACEs and respond with trauma-informed care.


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