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PACEs in Pediatrics

Alternative IHEBA with ACEs for California (and Other) Pediatricians

If you are a pediatrician serving Medicaid managed care patients in California, then you are required to use the Staying Healthy Assessment or an alternative IHEBA (Individual Health Education Behavioral Assessment) at all well-child visits.  The bad news is that getting approval to use an alternative IHEBA is a tedious process.  The good news is that as of October 27, 2016 the Whole Child Assessment (WCA) is available for use in English and Spanish.  Most importantly, the WCA has been developed to include screening for ACEs (Adverse Childhood Experiences).  The questions about ACEs include both history of ACEs and risk for maltreatment.  The WCA tries to improve sensitivity through multiple questions and answer choices, as well as integration of questions about ACEs into a whole child evaluation by age group.

If you are a California physician and would like to use the WCA, then you may make this request through your local managed care plan and, since the WCA has already been approved by the State, the process should be quite simple.  If you are serving non-Medicaid patients or practicing outside of California, you have the option of using the WCA in its current form, or modifying it to fit your practice.

The WCA is currently being used and studied at Loma Linda University.  It is anticipated that “version 2” will be distributed upon completion of our research and will reflect changes based upon which questions are most effective.  However, for those of you who don’t want to wait for further research and want to get started with incorporating ACEs screening, the WCA has been attached in English and Spanish to this report.

For further questions about the development or use of the WCA, please contact Ariane Marie-Mitchell at Loma Linda University,


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