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In March, the nation celebrates Women’s History Month. So in this month’s ACEs Aware newsletter, we turn our attention to critical opportunities to support women’s health and the well-being of families.
We know that Adverse Childhood Experiences (ACEs) have different impacts on men and women, and that women experience certain traumas at greater rates, such as being the victims of sexual abuse and intimate partner violence. Trauma and adversity can lead to toxic stress that, if not offset by buffering supports and protective factors, can negatively impact health. Research indicates that women who experience four or more ACEs are more likely to report a history of depression and being in poorer health than women with low ACE scores.
As child bearers, women with high ACEs are at increased risk of perinatal complications. Women of color are at even greater risk -- African American mothers die and have more complications in childbirth than women of other races due to a host of risk factors including prolonged exposure to racism and toxic stress.
By screening for ACEs and responding with trauma-informed care, California health care teams are providing an “upstream intervention” that can improve the health and well-being not only of women, but also of future generations.
In the words of Sarah Ross, Vice President of Operations for Open Door Community Health Centers, an ACEs Aware PRACTICE grantee: "If we can help support pregnant women, postpartum women, and children earlier in their journey, the more tools they'll have for resiliency and for a healthier life."
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ACEs Aware Implementation with Intention Webinar Series | |
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Registration is now open for Webinar #3:
Determine Who & How You Will Screen
March 23, 2023; 12-1 p.m.
This webinar will help participants understand and advance the key decisions that must be made in selecting their clinic’s approach to ACE screening and the clinical response. We will focus on helping participants determine who they will screen and how, prepare their clinical response for treating toxic stress, and map out how they will integrate ACE screening into their workflow.
Learning Objectives:
- Describe the key features of screening administration, including who and when to screen, which screening tool to use, and how and where to screen.
- Explore key considerations to conduct the clinical assessment and response related to ACEs and toxic stress, including patient education, interventions, and access to additional support services.
- Identify how the process of screening for ACEs can be incorporated into your clinic’s in-person workflow from start to finish.
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The ACEs Aware Implementation with Intention” webinar series is designed to help California clinics implement ACE screening and response. Through live webinar sessions, experts provide practical, step-by-step guidance, as well as resources and tools, to help clinics advance in their journey to implement ACE screening. | |
New Medi-Cal Services Benefits Available for Dyadic Care and Doula Services | | |
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On January 1, 2023, a new Medi-Cal benefit became available for dyadic care services. It is designed to support models of care that work within the pediatric clinic setting to identify and address caregiver and family risk factors for the benefit of the child.
As described in this info sheet on Dyadic Behavioral Health, created by Kate Margolis of the UCSF Center for Advancing Dyadic Care in Pediatrics: “With 12 natural touch points in the first three years of life, pediatric well-baby visits make up the most frequent point of contact with the health care system for families with young children, providing an opportune space to address the caregiver and family context and provide behavioral health early intervention, connect families to resources, support early child development, and mitigate intergenerational trauma and the harmful effects of toxic stress.”
The California Department of Health Care Services (DHCS) has also added doula services to the list of preventive services covered under the Medi-Cal program. Doula services are aimed at preventing perinatal complications and improving health outcomes for birthing parents and infants. Services now reimbursable by Medi-Cal include health education, advocacy, and physical, emotional, and nonmedical support provided before, during, and after childbirth or end of a pregnancy, including throughout the postpartum period.
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ACEs Aware February 2023 Data Report: 998,870 Medi-Cal Members Screened for ACEs | |
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The ACEs Aware initiative has released a new annual data report detailing the number of Adverse Childhood Experience (ACE) screenings conducted for children and adults in California, and the number of individuals who have completed the “Becoming ACEs Aware in California” training.
The ACEs Aware Screening, Training, and Certification Progress: February 2023 Update highlights data from the launch of the initiative in December 2019 through November 18, 2022.
Between January 1, 2020, and March 31, 2022, Medi-Cal clinicians conducted more than 1,345,000 ACE screenings of nearly 1 million unique Medi-Cal members.
Between December 4, 2019, and November 18, 2022, more than 28,000 individuals completed the ACEs Aware training, including more than 12,400 Medi-Cal clinicians in California who are ACEs Aware-certified and are eligible to receive Medi-Cal payment for conducting ACE screenings.
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Need Support to Implement ACE Screening and Response? | | |
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Did you know that the UCLA-UCSF ACEs Aware Family Resilience Network (UCAAN), which implements the ACEs Aware initiative on behalf of DHCS, offers expert technical assistance to clinics at any stage of their implementation journey?
In addition to the monthly “Implementation with Intention” webinars, UCAAN offers virtual support to California health care teams on such topics as billing and reimbursement, screening tools, clinical response, training, and more.
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Sara Johnson, Obstetrician Gynecologist, La Clínica de la Raza
Sara Johnson is an Obstetrician Gynecologist at La Clínica de la Raza in Contra Costa County. She is interested in advancing trauma-informed care in reproductive health and focusing on supporting patients' power to create health and wellbeing across the life course and across generations. Dr. Johnson was the team lead for La Clínica's CALQIC project, and with an ACEs Aware grant developed a supplemental training titled ACE Screening and Trauma-Informed Care in Reproductive Health.
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Putting Implementation into Action | |
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Now Available!
January 26th Webinar Recording
Implementation with Intention: Getting Your Practice Ready
A recording and materials are now available for ACEs Aware's most recent webinar, Implementation with Intention: Getting Your Practice Ready, which shares foundational information to help California providers and health care teams understand the Adverse Childhood Experience (ACE) screening process at a high level and explore different approaches to implementation.
The webinar has been approved for AMA PRA Category 1 Credit(s)™, ASWB, ABP-MOC, and ABIM-MOC II Credit.
| The recording from Webinar #2 – Form Your Team & Get Buy-In – will be available soon. Stay tuned for an email in the coming weeks. | | | |
News, Events, Resources, and Research | | |
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ACEs Aware Implementation with Intention Webinar #3: Form Your Team & Get Buy-In
Thursday, March 23, 2023 | 12 p.m. - 1 p.m. PST | UCAAN
Join us for our continuing ACEs Aware “Implementation with Intention” webinar series dedicated to helping California clinics implement Adverse Childhood Experience (ACE) screening and response.
Sessions will be held on the fourth Thursday of the month, January through May 2023, and will offer Continuing Medical Education credit.
Register Now →
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Governors' Convening Highlights Ways Data Can Impact Maternal and Infant Health
The National Governor’s Association published an overview of their recent meeting that included a conversation with a panel of experts focused on improving and utilizing maternal and infant health data systems by incorporating data on maternal health experiences, linking state data and increasing accessibility to data to improve accountability.
Read →
An Upstream Intervention: Open Door Hopes State Grant Will Help Address Impact of Childhood Trauma
ACEs Aware PRACTICE grantee Open Door Community Health Centers is featured in this North Coast Journal article about “... going to the source and the root of the problem to prevent disease and unhealthy outcomes later in life.”
Read →
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New! The Office of the California Surgeon General Reproductive Health Resource Page
Reproductive health is an essential part of well-being and a key priority for the Office of the California Surgeon General. Perinatal disparities, contraception, abortion access and reproductive rights are all part of reproductive health.
Access →
Healing from ACEs: A Parent's Story
This video from the #FacesOfACEs Storytelling Series features public health leader Linda Baggio in conversation with California’s first Surgeon General, Dr. Nadine Burke Harris. Linda discusses her personal experiences with ACEs, and her commitment as a parent to disrupting intergenerational transmission.
Access →
Recorded Webinar: Supporting Patients in Pregnancy: ACEs and Maternal Health
This ACEs Aware webinar provides information for women’s health providers about the importance of ACE screening in improving maternal health. Speakers shared resources for providers looking to introduce ACE screening in their practice, examples of how to create a healing environment for patients, and case studies on how to respond to ACEs with trauma-informed care.
Access →
Recorded Training: ACE Screening and Trauma-Informed Care in Reproductive Health
Sara Johnson, an Obstetrician Gynecologist at La Clinica de la Raza in Contra Costa County, developed this supplemental training with an ACEs Aware grant.
Access →
Recorded Webinar: Layers of Healing: Moms, Babies, and Provider
ACEs-LA's Trauma-Informed and Wellness webinars are designed for LA County DHS staff currently screening for ACEs in their clinics. Watch for information on how healing happens through multiple layers, provided by OBGYN Sara Johnson and La Clínica de la Raza in Contra Costa County.
Access →
Recorded Webinar: The Impact of ACEs on Black Maternal Health
This webinar focused on effective approaches to address the needs of Black pregnant women, the impact of ACES, and its association with maternal health and poor birth outcomes for Black women, Medi-Cal recipients, and others. Hosted by the California Black Health Network.
Access →
Childhood Trauma has Lifelong Health Consequences for Women
In this resource from the Population Reference Bureau, the authors found that that the more ACEs women were exposed to as children, the more likely they were to have an early first birth (before age 25) or a first child outside of marriage, which in turn were strongly related to poorer health by around age 40.
Access →
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ACEs among Reproductive Age Women: Findings from the 2019 Behavioral Risk Factor Surveillance System
October 2022 | Women's Health Issues
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Adverse Childhood Experiences and Resilience among Adult Women: A Population-Based Study
February 2022 | eLife Epidemiology and Global Health
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Maternal ACEs and their Associations with Intimate Partner Violence and Child Mistreatment: Results from a Brazilian Birth Cohort
February 2022 | Preventive Medicine
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Females Have More Complex Patterns of Childhood Adversity: Implications for Mental, Social, and Emotional Outcomes in Adulthood
January 2020 | European Journal of Psychotraumatology
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"The Traps Started During My Childhood": The Role of Substance Abuse in Women's Response to ACEs
August 2019 | Journal of Aggression, Maltreatment, and Trauma
Read →
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Did you know that the case-based Becoming ACEs Aware in California online training includes two cases related to maternal and parental health? One features a pregnant woman with a history of ACEs who has a toxic stress response and peri-partum depression. The other features a mother who in the past experienced childhood sexual abuse and now experiences strong emotional or post-traumatic stress reactions in response to the examination of her 3-year-old son.
Take the training today to learn about trauma-informed practices in maternal health, pediatric, and other health care settings.
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Already completed the training?
Providers with National Provider Identifiers should attest on the DHCS website
so they can become eligible for Medi-Cal reimbursement for screening.
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“In order to improve maternal health, we have to focus on improving all women's health and access to care — not just during labor and delivery, but before and after pregnancy, and throughout our lives.”
– Leana S. Wen
Physician & Former President of Planned Parenthood
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Don't forget to add questions@acesaware.org to your safe sender list. | | | | |
