UCSF’s Center to Advance Trauma Informed Healthcare led the California ACEs Learning and Quality Improvement Collaborative (CALQIC), an 18-month statewide learning collaborative to integrate screening and response for ACEs1 into healthcare settings.
CALQIC Evaluation Results
“Findings from implementing ACEs screening and response at 48 clinics across California serving 250,000 Medi-Cal patients” presented on March 24, 2022 by Maggie Jones, MPH, director the Center for Community Health and Evaluation at KP Washington; Nicole Eberhart, PhD, senior behavioral scientist, RAND; Edward Machtinger, MD, director UCSF CTHC and co-primary investigator for CALQIC.
In January 2019, California Governor Gavin Newsom appointed Dr. Nadine Burke Harris — a national leader in pediatric medicine, research scientist, and a national voice elevating issues around adverse childhood events (ACEs) and toxic stress — as California’s first-ever Surgeon General.
Surgeon General Harris, in partnership with Governor Newsom, the California Department of Health Care Services (DHCS), and health and community leaders, led system reform that recognizes, and responds to, the effects that ACEs have on our biological systems and addresses the lifelong impacts of ACEs. (Dr. Harris stepped down as Surgeon General in 2022).
Key to that roll out is the ACEs Aware initiative. Starting on January 1, 2020, DHCS began providing a payment to Medi-Cal providers for screening their patients for ACEs. The Office of the California Surgeon General and DHCS committed to providing organizations and providers across California’s healthcare system and communities the training, tools, and resources they need to effectively and equitably incorporate ACEs screening into patient care.
As part of this effort, the UCSF Center to Advance Trauma-informed Healthcare led the California ACEs Learning and Quality Improvement Collaborative (CALQIC). The goal of CALQIC was to integrate screening and response for ACEs in healthcare settings in a way that enhanced connection between patients and providers, helps connect patients to services that they want and need, and led to better outcomes, reduced disparities, and more positive experiences of care for all involved.
CALQIC led an 18-month statewide learning collaborative of pediatric and adult clinics in seven of California’s eight regions. CALQIC identified promising practices, tools, resources, and partnerships that are informing future phases of California’s ACEs initiative.
The clinics that participated in the program are:
- La Clinica de la Raza Inc.
- Marin Community Clinics
- Petaluma Health Center
- Santa Rosa Community Health
- Sonoma County Indian Health Project
- Harmony Health Medical Clinic and Family Resource Center
- Long Valley Health Center
- Northeast Valley Health Corporations
- The Regents of the University of California San Francisco – Fresno
- Family Health Centers of San Diego
- Eisner Pediatric and Family Medical Center
- LA County Department of Health Services
- Los Angeles Christian Health Centers
- Santa Barbara Neighborhood Clinics
- Borrego Community Health Foundation
The learning collaborative ran from July 1, 2020 to October 31, 2021.
In this collaborative, participating organizations received coaching, and the opportunity to learn from experts and other organizations who are implemented ACEs screening. The participated in learning sessions with the aim of successfully implementing ACEs screening in clinics sites serving both pediatric and adult populations.
Clinic support included coaching (content and process); expert training and peer-to-peer sharing of promising approaches, challenges and solutions; and funding support.
- ACEs – adverse childhood events – are stressful or traumatic events experienced by age 18 that relate to adversities across three domains; physical, emotional, or sexual abuse; physical or emotional neglect; and household dysfunction (e.g., a parent with a mental health condition or substance use disorder, absence due to separation or divorce, or intimate partner violence).