September 23, 2022
According to a recent report in the Journal of the American Board of Family Medicine, California’s expansion of childhood trauma screening is being viewed as a model for other states.
The briefing, authored by researchers at UC Davis Health and other Institutes of California, said screenings have the potential to reveal the current prevalence of adverse childhood experiences (ACEs) and their impact on adult health.
Adverse childhood experiences (ACEs) are a group of potentially traumatic events that occur before adulthood, including various types of abuse, neglect, parental divorce, separation or death, domestic violence, and mental illness of a family member. is included. ACEs and toxic stress are the root causes of some of the most damaging, persistent, and costly social and health challenges facing the world today. Research has found that people exposed to negative childhood experiences are more likely to suffer from chronic illnesses and have a shorter lifespan.
Because 62% of California adults have experienced at least one ACE and 16% have experienced four or more, California is taking aggressive steps to address ACEs and toxic stress through ACE Aware, a country that is the first initiative to establish regular screenings in development Network of primary care and nursing.
In October 2021, California enacted the ACEs Equity Act. The law expanded ACE screening to require it to be covered by commercial insurance. Screening for Medi-Cal patients has been mandatory since early 2020.
The UC research team analyzed the impact, benefits, and risks of universal screening for ACE in children and adults. He highlighted several policy considerations:
Screening and health equity: Access to effective interventions for each patient who scores high on the ACE questionnaire is critical to screening for equitable health benefits across communities. Otherwise, screening may become a well-intentioned intervention that does not provide the support and services intended.
Weight all aces equally: There is currently no evidence that each ACE has the same effect on an individual’s health outcome. While overall higher ACE levels are associated with a higher risk of adverse health outcomes, additional research is needed at the individual level. A person may do well on the ACE screening, but there is still little evidence that the person will have any specific negative health outcome.
Cost: Using estimates from Medi-Cal enrollees, the authors estimate reimbursement at $29 per ACE screening for commercial plans and policies, a 0.03% increase in total costs.
Possible disadvantages: Providers must be adequately trained to administer and discuss screening and have adequate resources to refer patients for follow-up.
The researchers also said that awareness of the potential advantages and disadvantages is critical to determining how healthcare systems can better meet patients’ needs for ACE screening as a tool to deliver trauma-informed care. can use
Get ACE Awareness Training Today (Free!)
The California Medical Association (CMA) encourages all physicians, especially Medi-Cal providers, to do so Get a free two-hour training session Learn how screening, risk assessment and evidence-based care can effectively intervene in toxic stress.
By screening for ACEs, providers can better determine if the patient is at increased health risk due to the harmful stress response, which is an important step in the response. trauma-informed care This connects patients to a supportive care network to reduce the impact of ACE.
Physicians can — and do — earn 2.0 Continuing Medical Education (CME) and 2.0 Certification Maintenance (MOC) credits reach Reimbursement for providing ACE screening to Medi-Cal beneficiaries.