Policy Considerations for Routine Screening for Adverse Childhood Events (ACEs)

Journal of the American Board of Family Medicine: JABFM

article

Riti Shimkhada¹  Jacqueline Miller²  Elizabeth Magnan³  Marykate Miller⁴  Janet Coffman²  Garen Corbett⁵ 

[1] Center for Health Policy Research, University of California;Institute for Health Policy Studies, University of California;Department of Family and Community Medicine and Center for Healthcare Policy and Research, University of California;Center for Healthcare Policy and Research, University of California;California Health Benefits Review Program, University of California

关键词: Adverse Childhood Experiences;    California;    Family Medicine;    Health Policy;    Primary Health Care;   

DOI  :  10.3122/jabfm.2022.04.210454

学科分类：过敏症与临床免疫学

来源: The American Board of Family Medicine

【 摘 要 】

In October of 2021, California enacted SB 428, the ACEs Equity Act, which mandates commercial insurance coverage of adverse childhood experiences (ACEs) screening in addition to ACEs screening already covered for the state's Medicaid enrollees. California is the first state to expand ACEs screening coverage, but it is possible other states may follow similar paths given the increasing interest in policy action to address ACEs. Increase in stress and trauma among Americans and evidence of the disproportionate impact ACEs have on historically marginalized and disadvantaged communities has increased the urgency with which policy makers, clinicians and researchers have sought to address ACEs and encourage trauma-informed care delivery to better meet the needs of patients. Family practice and other primary care providers are at the core of prevention and are arguably the largest group of stakeholders at the forefront of movements toward increasing ACEs screenings. However, debate persists among policy makers, clinicians, and researchers on whether the ACEs screening approach improves outcomes and avoids harms. In this health policy article, we describe key issues under debate with regards to ACEs screening and estimate potential change in screening utilization and expenditures due to the new ACEs legislation in California. The lessons being learned in California are applicable to other states and the US as a whole.

【 授权许可】

CC BY