Case 2: 43-Year-Old Woman With Hypertension and Pre-Diabetes - ADDITIONAL CREDIT


  • Devika Bhushan, MD, Pediatrician and Chief Health Officer, Office of the California Surgeon General 
  • Ken Epstein, PhD, MSW; Principal at PREP for Change Consulting; Trauma Informed Systems Specialist, East Bay Agency For Children; Clinical Professor (WOS) at the University of California, San Francisco
  • Nancy Goler, MD, Obstetrician/Gynecologist and Associate Executive Director for The Permanente Medical Group
  • Leigh Kimberg, MD, Internist, Professor of Medicine at University of California, San Francisco (UCSF); Program Director of the Program in Medical Education for the Urban Underserved (PRIME-US) in the UCSF School of Medicine; Interpersonal Violence Prevention Coordinator for the San Francisco Department of Public Health (SFDPH)
  • Alicia Lieberman, PhD, Irving B. Harris Endowed Chair in Infant Mental Health; Professor and Vice Chair for Faculty Development at the University of California, San Francisco, Department of Psychiatry; Director of the Child Trauma Research Program at San Francisco General Hospital
  • Dayna Long, MD, Director, Center for Child and Community Health, UCSF Benioff Children's Hospital Oakland
  • Edward Machtinger, MD, Internist; Professor of Medicine; Director of the Women’s HIV Program (WHP) and the Center to Advance Trauma-Informed Health Care (CTHC) at the University of California, San Francisco
  • Brigid McCaw, MD, MPH, MS, Internist, The Permanente Medical Group (retired); former Medical Director of the Kaiser Permanente Family Violence Prevention Program
  • Connie Mitchell, MD, MPH, Deputy Director of the Center for Family Health at the California Department of Public Health
  • Sheela Raja, PhD, Project Co-Director, Office of Women’s Health Trauma-Informed Care Curriculum; Licensed Clinical Psychologist; Associate Professor; Director of Clinical Behavioral Sciences, Colleges of Dentistry and Medicine at the University of Illinois at Chicago
  • Leena Singh, DrPH, MPH, Program Director for the National Pediatric Practice Community on ACEs at the Center for Youth Wellness
  • Shannon Thyne, MD, Chief of Pediatrics at the Olive View-UCLA Medical Center; Professor of Pediatrics at the David Geffen School of Medicine at UCLA; Director of Pediatrics at the LA County Department of Health Services
  • Shairi Turner, MD, MPH, Project Co-Director, Office of Women's Health Trauma-Informed Care Curriculum; Florida Department of Health
  • Karen Mark, MD, PhD, Medical Director, California Department of Health Care Services
  • Nadine Burke Harris, MD, MPH, Pediatrician and California Surgeon General

Learning Objectives

After completing this case, you should be able to:

  1. Define Adverse Childhood Experiences (ACEs), their prevalence, and health disparities in the prevalence data; toxic stress physiology; and related impacts on health, including underlying biological mechanisms.
  2. Identify how to introduce and integrate ACEs and toxic stress screening into clinical care, aligning with trauma-informed care principles.
  3. Apply the ACEs and Toxic Stress Risk Assessment Algorithm for assessing risk for toxic stress, which includes a combination of screening for ACEs, identifying the presence and extent of ACE-Associated Health Condition(s), and identifying protective factors, in determining an appropriately tailored treatment and follow-up plan, including referrals, if indicated.
  4. Identify the Medi-Cal payment requirements for administering ACE screening as a part of assessing for risk of toxic stress.
CME/MOC Credits Available
Available credit: 
  • 0.50 AAFP Prescribed
  • 0.50 AAPA Category I CME
  • 0.50 ABIM MOC II
  • 0.50 ABP MOC
  • 0.50 AMA PRA Category 1 Credit™
  • 0.50 ANCC
  • 0.50 APA
  • 0.50 ASWB
  • 0.50 Attendance
Course opens: 
Course expires: 

Available Credit

  • 0.50 AAFP Prescribed
  • 0.50 AAPA Category I CME
  • 0.50 ABIM MOC II
  • 0.50 ABP MOC
  • 0.50 AMA PRA Category 1 Credit™
  • 0.50 ANCC
  • 0.50 APA
  • 0.50 ASWB
  • 0.50 Attendance
Please login or register to take this course.

Method of Participation and Request for Credit 

There are no fees for participating and receiving CME/CE and MOC credit for this activity. During the period from May 3, 2021 through May 3, 2022, participants must read the learning objectives, faculty disclosures, and complete the educational activity to receive credit.  

Those who have completed the "Becoming ACEs Aware in California" main training course are eligible to receive additional education credit for taking any additional cases they did not complete in the main training course.


  1. Enroll in case(s) that were not completed in the main training course, "Becoming ACEs Aware in California."
    1. Click the check box on the right hand column to select the case(s).
    2. Click the "Enroll" button.
  2. Complete case(s) enrolled.
  3. Submit case evaluation.

Once you have met the requirements above for each additional case completed, you will be able to claim credit and download your certificate of completion. You can find all of your completed activities and corresponding certificates under your account's "My Activities" page.

To access this case, click the ENROLL button above.

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