Case Study of California’s ACEs Aware Initiative
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This case study highlights California’s ACEs Aware initiative and its key elements. The ACEs Aware initiative provides education, training and clinical protocols for the state’s Medicaid program (Medi-Cal) providers on screening for ACEs and covers the cost of screenings and related services under Medi-Cal. The goal of ACEs Aware is to identify and improve the health and well-being of Californians enrolled in Medi-Cal and who have experienced ACEs and toxic stress, providing a sustainable path to integrating identification and response to ACEs and toxic stress into the state’s Medicaid program.
This case study is the latest in a series from a partnership between NASHP, the National Governors Association, the Duke-Margolis Center for Health Policy, and a former state policy leader from Building Strong Brains Tennessee.
For individuals living with complex, often chronic conditions, and their families, palliative care can provide relief from symptoms, improve satisfaction and outcomes, and help address critical mental and spiritual needs during difficult times. Now more than ever, there is growing recognition of the importance of palliative care services for individuals with serious illness, such as advance care planning, pain and symptom management, care coordination, and team-based, multi-disciplinary support. These services can help patients and families cope with the symptoms and stressors of disease, better anticipate and avoid crises, and reduce unnecessary and/or unwanted care. While this model is grounded in evidence that demonstrates improved quality of life, better outcomes, and reduced cost for patients, only a fraction of individuals who could benefit from palliative care receive it. 
