Developing Services and Workforce in Response to the California Advancing and Innovating Medi-Cal (CalAIM) Initiative: Learnings from Primary Care Clinics and Their Partners in the ACEs Aware PRACTICE Collaborative

Format:

Book

Author/Creator:

Chen, Peggy G.

Contributor:

Alvarado, Gabriela

Diguiseppi, Graham

Estrada-Darley, Ingrid

Gandhi, Priya

Gomez, Chloe

Hawkins, Wendy

James, Kortney Floyd

Schultz, Dana

Yi, Stacey

Language:

English

Other Title:

Developing Services and Workforce in Response to the California Advancing and Innovating Medi-Cal

Place of Publication:

RAND Corporation 2024

Summary:

The ACEs Aware initiative is a groundbreaking effort by the state of California to improve health for all and promote health equity through screening for and responding to adverse childhood experiences (ACEs) and toxic stress. The authors identified promising practices for implementation and sustainability of four key California Advancing and Innovating Medi-Cal (CalAIM) services to fill gaps in care and address ACE-related health disparities: (1) adult enhanced care management (ECM), (2) pediatric ECM, (3) the community health worker (CHW) benefit, and (4) dyadic services. They also evaluated the entire Preventing and Responding to ACE-Associated Health Conditions and Toxic Stress in Clinics through Community Engagement (PRACTICE) collaborative, including activities and progress across all 25 PRACTICE teams. The findings show that despite being in early developmental phases, numerous clinics effectively integrated adult and pediatric ECM and were able to bill and secure reimbursement via CalAIM benefits. However, clinics and community-based organizations (CBOs) were still making progress on billing and reimbursement for CHW and dyadic benefits under CalAIM. Both patients and providers cited important benefits of key CalAIM services, with patients feeling empowered, supported, and hopeful and clinicians experiencing lower stress levels and improved ability to provide care. Teams in the PRACTICE collaborative made substantial progress implementing CalAIM services and developing an effective workforce to help respond to toxic stress. Teams enhanced their ability to provide trauma-informed care, bolstered their capacity for ACE screening, trained more than 3,200 staff with ACEs Core Aware Training, and improved their ability to provide referrals to services.