Adverse Childhood Experiences (ACEs) and toxic stress are a root cause to some of the most harmful, persistent, and expensive societal and health challenges facing the world today.  

Repeated or prolonged activation of a child’s stress response, without the buffering protections 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.

California is taking aggressive steps to address ACEs and toxic stress through the first-in-the-nation ACEs Aware initiative, which aims to establish routine ACE screening in primary care and develop a network of care, including cross-sector coordination supports aligned with primary care.

The California Medical Association (CMA) is a proud grantee of ACEs Aware, and we support science-based prevention strategies, equitable response solutions and best practices that can be replicated or tailored to serve community needs.

By screening for ACEs, providers can better determine the likelihood a patient is at increased health risk due to a toxic stress response, a critical step in responding with trauma-informed care that connects patients with a supportive network of care to mitigate the impact of ACEs.

CMA encourages all physicians, particularly Medi-Cal providers, to receive the free, two-hour training to learn how screening, risk assessment and evidence-based care can effectively intervene on toxic stress. Physicians may receive 2.0 Continuing Medical Education (CME) and 2.0 Maintenance of Certification (MOC) credits upon completion - and can receive reimbursement for providing ACEs screening to Medi-Cal beneficiaries.