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Policy Considerations for Routine Screening for Adverse Childhood Events (ACEs)
Riti Shimkhada1, Jacqueline Miller2, Elizabeth Magnan2
1From Center for Health Policy Research, University of California, Los Angeles (RS); Institute for Health Policy Studies, University of California, San Francisco (JM, JC); Department of Family and Community Medicine and Center for Healthcare Policy and Research, University of California, Davis (EM); Center for Healthcare Policy and Research, University of California, Davis (MM); California Health Benefits Review Program, University of California, Berkeley (GC). riti@ucla.edu.
Journal of the American Board of Family Medicine : JABFM
|July 27, 2022
Summary
California
Area of Science:
- Health Policy
- Public Health
- Trauma-Informed Care
Background:
- Adverse Childhood Experiences (ACEs) screening is gaining policy attention due to increased stress and trauma.
- Disproportionate impact of ACEs on marginalized communities heightens urgency for policy action.
- Primary care providers are central to ACEs screening and trauma-informed care delivery.
Purpose of the Study:
- To analyze California's SB 428, the ACEs Equity Act, mandating commercial insurance coverage for ACEs screening.
- To examine key debates surrounding ACEs screening effectiveness and potential harms.
- To estimate changes in ACEs screening utilization and expenditures resulting from the legislation.
Main Methods:
- Health policy analysis of California's SB 428.
- Review of ongoing debates among policymakers, clinicians, and researchers regarding ACEs screening.
- Estimation of potential shifts in screening utilization and healthcare expenditures.
Main Results:
- California's ACEs Equity Act expands screening coverage beyond Medicaid to commercial insurance.
- The legislation addresses growing concerns about childhood trauma and its health impacts.
- Anticipated increase in ACEs screening utilization and associated healthcare costs.
Conclusions:
- California's policy is a pioneering step in expanding ACEs screening coverage.
- Lessons from California's implementation can inform other states considering similar legislation.
- Ongoing evaluation is crucial to assess the impact and effectiveness of mandated ACEs screening.
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