There are several states that have federal grants to provide trauma screens to children in foster care. So it's wider than ACES alone. In NH we screen for trauma exposure, trauma symptoms and MH symptoms. It's more in depth than just the ACEs screening tool. It is Child Protection and Juvenile Justice workers who are responsible for the screening and they have training on the impact of trauma so they can talk to the youth and family about the impact, where to go for help, etc. I think anyone providing screening should be trained on how to respond as well. And having a system for what to do with the screening tools (if a score of X or higher, do you refer for MH treatment?; Who is talking to the youth about ACEs and the impact?). In our state the results are shared with the family, CASA, and MH providers (with releases). We also trained MH providers in trauma treatments so we have a system of who to refer to. And there are separate efforts in our state to train school personnel. It really takes a system level approach. I'm happy to provide further details if that's helpful.