Problem Adverse Childhood Experiences (ACEs) are potentially traumatic events that cause overwhelming stress and have lasting negative effects on physical and mental health. Such experiences include abuse and maltreatment (physical, sexual, emotional/verbal); neglect (physical and emotional/psychological); and household dysfunction (parent mental illness; domestic violence; divorce or separation; incarceration; and alcohol or drug abuse). Traumatic events in childhood can be emotionally painful or distressing and can have effects that persist for years. Factors such as the nature, frequency and seriousness of the traumatic event, prior history of trauma, and available family and community supports can shape a child’s response to trauma For AltaMed pediatric patients assessed for ACEs, one of the most critical service gaps is a lack of timely access to mental health/behavioral services. Long wait times to see a mental/behavioral health professional have beleaguered Los Angeles County, California and the nation. AltaMed pediatric patient/families in need of mental health/behavioral services beyond case management often wait two to three month for an appointment. Goals and Objectives Goal 1: Advance AltaMed’s ACEs continuum of care through a Care Collaboration Model of ACEs Systematic Case Review. Objective 1. Four to six cases of children aged 6 months to 18 years screened through PEARLs and meeting the criteria of complex acuity for ACEs will be reviewed through a monthly interdisciplinary ACEs Systemic Case Review in Years 1 through 5. Goal 2: Enhance trauma informed wrap around behavioral health services for children/families with complex acuity for ACES. Objective 1. The Psychology Post-Doctoral Fellow will provide assessments, bridge counseling, and therapeutic treatment to approximately190 under resourced children aged six months to18 years and/or their parents/caregivers with identified complex co-occurring primary care and mental/beha
vioral health issues identified through the ACE screening tool (PEARLS) annually in Years 1 through 5. Methodology The proposed ACEs-Behavioral Health Collaboration (ACEs-BHC) project will be the initial catalyst to support the integration of pediatric primary care and behavioral health services. AltaMed has championed ACEs screening and is invested in implementing evidenced based approaches to address ACEs and toxic stress in its pediatric patient population. The ACEs-BHC project is a new component within AltaMed’s ACEs emerging continuum of care, enhancing behavioral health care access and utilization to pediatric patients with complex acuity for ACEs Through the ACEs-BHC, AltaMed will 1) establish an interdisciplinary systematic case review process to facilitate resources for pediatric patients and their families with complex physical and behavioral health ACEs co-morbidity, as well as promote workforce development in pediatric behavioral health services through case collaboration, coaching, and mentorship; and 2) host a Psychology Post-Doctoral Fellow from the Children’s Hospital Los Angeles USC/UCEDD Graduate Psychology Education Program to provide bridge counseling and short term psychological counseling to high risk under resourced children and youth, and their families. Evaluation Data collection and tracking tools will include, Epic AltaMed’s EMR to capture health-related services, provider referrals and case management notes, as well as Excel logs to track patient participation/results (i.e. participation in educational classes, patient survey results); and its Management Information Systems (MIS). Process evaluation will be completed by analysis of Epic reports and Excel reports. Outcome evaluation will center on patient/parent/caregiver surveys capturing patient satisfaction as well as knowledge and behavior change.