ASSEMBLYMEMBER JOAQUIN ARAMBULA, M.D. 31ST ASSEMBLY DISTRICT
AB 2110: ACEs Screenings by Community Health Workers and Doulas
BLACK Wellness & Prosperity Center (BWPC) and the Fresno Community Health Improvement Partnership (FCHIP) are co-sponsoring this bill.
Help us urge policymakers to prioritize this important legislation:
Read the Fact Sheet: AB 2110 (Arambula) ACEs Screenings Fact Sheet.pdf
Use this template to encourage decision-makers: Customize the AB 2110 (Arambula) Template Letter of Support.docx, and
Review the instructions for submitting the letter on the California Advocate portal and submit your letter by Monday, March 11.
AB2110 can improve access to mental health services, reduce the stigma associated with mental health, and create healthier communities.
Summary
Everyone should have access to trauma-informed ACEs screening by health care providers they trust. Because community health workers (CHWs) and doulas are the trusted providers for many people, AB 2110 authorizes them to receive Medi-Cal reimbursement for providing ACEs screenings.
Background
Adverse Childhood Experiences (ACEs) are traumatic childhood experiences like abuse or neglect or exposure to violence, mental illness, divorce, substance abuse, or criminal activity in the home. A number of provider types, such as physicians, psychologists, and certified nurse practitioners, are permitted to bill for ACEs screenings to help providers assess patient risk of toxic stress.
While not eligible for Medi-Cal reimbursement, CHWs and doulas are uniquely positioned to conduct ACEs screenings because they are seen as highly trusted providers who emphasize the two-generation approach. This is crucial because ACEs can follow a pattern of intergenerational trauma where children of parents with ACEs can be at greater risk themselves.1 CHWs, in particular, incorporate into their practice their lived experience which improves the quality and cultural competence of their service delivery.2
Conducting ACEs screenings outside of the trusted provider-patient relationship can hinder patients’ willingness to share their history of adversity and may be re-traumatizing. 3 Experiencing multiple ACEs is associated with significantly increased risk for the leading causes of death in adulthood such as heart disease, stroke, cancer, chronic obstructive pulmonary disease (COPD), diabetes, Alzheimer's, and suicide
Related Legislation
Beginning January 1, 2020, DHCS started to pay Medi-Cal providers $29 per trauma screening for children and adults with Medi-Cal coverage. However, the list of eligible providers does not include CHWs or doulas.
This Bill
Directs the Department of Health Care Services to include community health workers and doulas as Medi-Cal providers eligible to receive payments for ACEs trauma screenings.
1 Intergenerational Associations of Parent Adverse Childhood Experiences and Child Health Outcomes
2 Community Health Workers Can Be a Public Health Force for Change in the United States
3 Screening for ACEs and Trauma