兰德-加州大学洛杉矶分校-加州大学旧金山分校ACE意识家庭复原力网络（UCAN）的早期影响评估（英）-2025.4_84页_5mb

UCAAN Impact Evaluation Summary

Introduction
The UCLA/UCSF ACEs Aware Family Resilience Network (UCAAN) is a multi-campus initiative funded to promote trauma-informed health care (TIHC) by advancing screening for Adverse Childhood Experiences (ACEs) in Medi-Cal beneficiaries. The evaluation assessed UCAAN’s impact across clinical skills, systemic capacity, and delivery of TIHC, funded by Medicaal and executed through RAND Health Care.

Major Findings

1. BAA Training Impact:

   • Over 40,000 individuals (including ~12,000 Medi-Cal clinicians) completed the Becoming ACEs Aware (BAA) training, enhancing provider skills and ACE screening capacity.
   • 92.4% of surveyed clinicians reported improved trauma-informed care knowledge; ~90% continued using ACE screening, with 75% confirming positive patient impacts.
   • Pediatric screening rates (~31%) exceeded adult rates (~6.3%), indicating implementation gaps in adult primary care.

2. Systemic Capacity Building:

   • Training extended beyond clinicians to include non-clinicians, driving broader health-care delivery support.
   • Pilot projects tested scalable models (e.g., integrated screening in NICUs, community navigation), identifying barriers like workforce shortages, referral network inaccessibility, and reimbursement limitations.

3. Quality of Care and Patient Outcomes:

   • Project interventions demonstrated improvements in patient engagement, reduced parental stress, and enhanced care continuity (e.g., 211LA navigation program).
   • Pilot projects emphasized trust-building, cultural responsiveness, and community partnerships.

Recommendations

1. Expand Training:

   • Target underserved regions (e.g., Inland Empire) and develop tailored support for adult clinics.
   • Incorporate feedback into training topics (e.g., ACE integration with other clinical workflows).

2. Strengthen Implementation Guidance:

   • Develop actionable resources informed by pilot project data, focusing on sustained CE screening and referrals.

3. Streamline Technical Assistance:

   • Standardize TA responses to address recurring queries (e.g., billing, referral coordination).
   • Leverage partnerships with MCOs and CBOs to expand referral networks.

4. Policy Adjustments:

   • Enhance Medi-Cal reimbursement policies for ongoing ACE screening and TIHC beyond initial lifetime limits.
   • Align CalAIM reforms to integrate health services and address social determinants of health.

Conclusion
UCAAN has significantly strengthened provider skills and ACE screening rates but faces systemic barriers. Pilot projects provided foundational knowledge for scaling TIHC. Ongoing policy and resource investments, along with tailored implementation strategies, are essential to sustain and expand these efforts statewide.