Welcome

Adverse Childhood Experiences (ACEs) and toxic stress represent a public health crisis that has been, until recently, largely unrecognized by our health care system and society. Repeated or prolonged activation of a child’s stress response, without the buffering of trusted, nurturing, caregivers and safe, stable environments, leads to long-term changes in the structure and functioning of the developing brain, metabolic, immune, and neuroendocrine responses, and even the way DNA is read and transcribed. This is known as the toxic stress response. Development of the toxic stress response is influenced by a combination of cumulative adversity, buffering or protective factors, or predisposing vulnerability. Screening for ACEs, assessing for toxic stress, and responding with evidence-based interventions can significantly improve the health and well-being of individuals and families. Tulare County Public Health will be working with local providers to increase awareness of this issue.

For Providers:

Follow these steps to receive Medi-Cal payment for ACEs screenings:

Step 1: Get Trained & Attest to Completing Training. Take a free 2-hour, online training for 2 CME or MOC credits, and self-attest to completing the training. 

Step 2: Screen for ACEs, Assess Risk for Toxic Stress, Respond with Evidence-Based Interventions, and Implement Trauma-Informed Care. Learn about screening for ACEs and clinical assessment and treatment planning.

Step 3: Receive Medi-Cal payment. Submit one of two billing codes based on the results of the screening, and document certain information. Payment is in addition to the payment for the accompanying office visit. Get payment information.

Step 4: Help Advance the Health Care System. ACEs Aware is hosting a series of activities and providing grants to promote shared learning and quality improvement among Medi-Cal providers.

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