This document addresses ways that providers can implement ACE screenings in practice.

This document includes the following materials developed by the Office of the California Surgeon General for both pediatric and adult patients: ACE Screening Clinical Workflow, ACEs and Toxic Stress Risk Assessment Algorithm, and ACE-Associated Health Conditions. (ADA Version)

This ACEs Aware-developed workflow provides tips and sample scripts for approaching conversations with patients about ACEs and toxic stress. It covers how to introduce the ACE screening purpose and tool to patients/caregivers, review screening results and the treatment plan with them, and following up on the treatment plan.

In partnership with its Family Medicine Residency Program, Saint Agnes Medical Center launched an ACEs Aware training and implementation program. This pilot program aims to reduce the burden of chronic diseases in the patient population and create an interdisciplinary model that can be scaled to residency programs across California.

The “ACEs Aware Clinical Team Toolkit: Preventing, Screening, and Responding to the Impact of ACEs and Toxic Stress” offers clinicians and practices comprehensive information and resources. This toolkit is composed of a series of fact sheets that are designed to be read individually.

The Department of Health Care Services approves specific tools to be used and questions to be asked for both pediatric and adult screenings.

This fact sheet explains why providers should screen for ACEs and describes the tools that should be used to screen children, adolescents, and adults for ACEs.

Policy statement on addressing ACEs in clinical practice.

This joint letter from the California Department of Social Services, the California Department of Health Care Services, and the Office of the California Surgeon General provides clarifying guidance on the responsibilities of health care clinical teams who conduct screenings for Adverse Childhood Experiences (ACEs) in the context of the state’s mandated reporting requirements.

This case study describes the experience of FPA Women’s Health in getting multi-clinic ACE screening implementation off the ground and provides an example of how to pilot ACE screening at one clinic and then expand to other clinics over time. This case study reinforces the importance ACEs Aware places on ongoing training and education and giving clinicians and staff the tools and language to discuss sensitive issues with patients.

This case study describes the experience of Marin Community Clinics in obtaining buy-in for piloting and designing the implementation process for organization-wide ACE screening. It reinforces the importance ACEs Aware places on developing a robust implementation team, training staff on trauma-informed care and ACE screening, and expanding internal and external resources to respond to ACEs and toxic stress.

The User Guide outlines how the Center for Youth Wellness Adverse Childhood Experiences Questionnaire is used at Bayview Child Health Center (BCHC-CYW).

Provider handout on ways to approach families when screening for ACEs.

This paper expands on existing best practices around ACE screening, with a focus on family and local CBO experiences, to inform large-scale systems change of incorporating ACE screening into systems of care for children and families in L.A. County and other similar jurisdictions.

This practice paper provides strategies for planning and implementing ACE screening in community-based clinics and organizations, including practical tools and templates.

National Pediatric Practice Community is an initiative of the Center for Youth Wellness. This network brings together pioneering pediatric practitioners interested in integrating ACEs screening and response into clinical care. This is a training and technical assistance guide for providers.

Article about treating people who have ACEs published on January 30, 2018:

ACEs Aware-developed resource on using a tiered clinical response framework to determine the patient education, level of intervention, and additional supports that may be needed for patients at different levels of risk for toxic stress.

This page lists the provider types eligible for Medi-Cal payment for screening for Adverse Childhood Experiences (ACEs).

This practice paper examines ACEs and ACE screening with immigrant youth, including qualitative research conducted with adolescent health providers and adolescents to understand their perspectives on this topic, and offers recommendations for adolescent health providers to effectively implement ACE screening with immigrant youth in primary care settings. This paper is a companion document to the authors’ practice paper entitled Screening Adolescents for Adverse Childhood Experiences (ACEs): Incorporating Resilience and Youth Development.

This practice paper examines ACEs and ACE screening with adolescents, including qualitative research conducted with adolescent health providers and adolescents to understand their perspectives on this topic, and offers recommendations for adolescent health providers to effectively implement ACE screening with adolescents.

This practice paper identifies the needs and experiences of trauma and resilience specific to Native communities in California. This paper explores how screening tools and trauma-informed care responses could be more responsive to Indigenous experiences and communities.