ACEs Aware Data Reports

The mission of ACEs Aware is to promote universal screening for Adverse Childhood Experiences (ACEs) across the Medi-Cal population and train health care teams to prevent, identify, screen, and respond to childhood adversity and toxic stress.

We are dedicated to measuring and communicating data that tracks progress toward achieving our goals.

Healthcare provider consulting older patient

ACE Screening of Medi-Cal Members*:

Number of members screened
Number of screens conducted
Percentage of members screened with high ACE scores (4+ ACEs)

*Based on Medi-Cal claims data

Medi-Cal Claims for ACE Screenings

Medi-Cal clinicians conducted more than
5,918,450
ACE Screenings of
3,045,940
unique Medi-Cal members.

Of the 2,287,640 unique Medi-Cal beneficiaries ages 0 to 20 screened for ACEs, 8% had an ACE score of 4 or more.

Of the 758,300 unique Medi-Cal beneficiaries ages 21 to 64 screened for ACEs, 21% had an ACE score of 4 or more.

Data from: January 1, 2020 through June 30, 2025

From most recent data report (July 2026)

Training of Health Care Teams:

Becoming ACEs Aware in California training completions and attestations

Training & Certification

55,250
individuals completed the training

25,330
Medi-Cal clinicians are ACEs Aware-certified**

63% of participants indicated that they plan to implement changes in their practice based on the information presented in the training.

Before the training

26% of participants were not screening any patients for ACEs.

After the training

74% of participants who were not previously screening patients for ACEs indicated that they planned to implement routine ACE screening for children or adults.

Data from: December 4, 2019 through March 31, 2026

From most recent data report (July 2026)

Data Reports

PLEASE READ CAREFULLY: This End User Sublicense Agreement (the “Agreement” or “Sublicense”) is a legally binding agreement between you (an individual or an entity, hereinafter “You” or “Sublicensee”) and the Department of Health Care Services (“DHCS”) for the use of the Pediatric ACEs and Related Life-events Screener (“PEARLS”) for children and adults up to the age of 21.

BY WAY OF DOWNLOADING, COPYING, ACCESSING, OR OTHERWISE USING THE PEARLS TOOL, YOU ARE AGREEING TO BE LEGALLY BOUND BY THE TERMS OF THIS AGREEMENT. IF YOU DO NOT AGREE TO BE BOUND BY THE TERMS OF THIS AGREEMENT, THEN YOU HAVE NO RIGHTS TO THE PEARLS TOOL AND MAY NOT DOWNLOAD, COPY, ACCESS, OR OTHERWISE THE PEARLS TOOL.

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1. The PEARLS Tool. The PEARLS tool is a unique tool that assess for both Adverse Childhood Experiences (“ACEs”) such as abuse, neglect, and household challenges, and related events, such as discrimination, food insecurity, and community violence, thought to be risk factors for toxic stress. The PEARLS tool was made in the course of research under the auspices of the Children’s Hospital Research Center at Oakland (“BCHO”) and the University of California, San Francisco. BCHO has licensed the PEARLS tool to DHCS and provided DHCS with the right to sublicense the PEARLS tool.
2. Sublicensee Attestation. By agreeing to this Agreement, You attest that You are a provider of health care services to Medi-Cal beneficiaries, a Medi-Cal Managed Care Plan, a Medi-Cal beneficiary, a parent or guardian of a Medi-Cal beneficiary, or an Electronic Health Records (“EHR”) vendor.
3. The Sublicense. Subject to the terms of this agreement, DHCS hereby grants to Sublicensee a non-exclusive, royalty-free, non-assignable, non-transferable sublicense (the “Sublicense”) to the PEARLS tool. Under the Sublicense, Sublicensee may use the PEARLS tool as directed, and may save, download, print, copy, reproduce, or distribute the PEARLS tool to facilitate such use.
4. Use in a Remote Patient Portal. The PEARLS tool was developed as a screener of risk for toxic stress and has been tested for safe, reliable screening when used during in-person (i.e., synchronous) visits. The questions and responses of the PEARLS tool may be administered using the EHR as structured data fields to facilitate record and follow-up. Because the PEARLS tool was never studied under asynchronous screening formats, DHCS cannot provide recommendations regarding its use in a remote patient portal. This includes information around safety and adequate windows of response. Sublicensee acknowledges that DHCS is not responsible for providing any recommendations regarding the use of the PEARLS tool in a remote patient portal, and that DHCS is not responsible for overseeing implementation and use of the PEARLS tool in a remote patient setting. This includes information around safety and adequate windows of response.
5. Disclaimer of Warranty. This Sublicense and the associated PEARLS tool are provided WITHOUT WARRANTY OF MERCHANTABILITY OR FITNESS FOR A PARTICULAR PURPOSE OR ANY OTHER WARRANTY, EXPRESS OR IMPLIED. DHCS MAKES NO REPRESENTATION OR WARRANTY THAT THE PEARLS TOOL WILL NOT INFRINGE ANY COPYRIGHT, PATENT, OR OTHER PROPRIETARY RIGHT.
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