Thank you for clarifying that the proposed incentive payments will include providers in fee-for-services scenarios and also in Medi-Cal managed care health plan (MCP) capitation scenarios. It is particularly important that the capitated providers in MCP be incentivized to conduct these Developmental and Trauma Screenings. Comments on Developmental Screenings: 1. This is an excellent proposal and ties directly to the AAP criteria, which are broadly used by most providers of pediatric care. 2. I appreciate that a standardized screening tool which meets APP and CMMS criteria must be used. I suggest you list a few recommended tools to choose from. 3. The rate of $59.90 per screening is, I think, sufficient to encourage participation by providers in this effort. Comments on Trauma Screenings: 1. Another great proposal to encourage active screening for Adverse Childhood Experiences in both children and adults. Screenings of this type are starting to reach a tipping point in the pediatric provider community, although much less common among adult providers. 2. Suggest that adults be able to be screened two or three times in adulthood. Some adults may not answer accurately until they have known the adult provider for a few years and have more trust. 3. Recommend the rate of $29 per screening be increased. Could this be $59.90 like the developmental screenings? 4. The Bay Area Research Consortium tool may be an excellent choice to screen children, but is not currently publicly available. I recommend that several evidence-based or evidence-informed tools be acceptable for the pediatric population until one tool becomes the clear standard of care. Value Based Payment Program: I have provided comments in the grid provided by DHCS. Kind regards, Anand Chabra, MD, MPH, FACPM Medical Director Family Health Services San Mateo County Health System 2000 Alameda de las Pulgas, Suite 200 San Mateo, CA 94403 650.573.3469 (usually Tu/Th) 650.616.2502 (usually M/W/F) FAX 650.573.2042 achabra@smcgov.org Warning : The information contained in this message may be privileged and confidential and protected from disclosure. If the reader of this message is not the intended recipient, you are hereby notified that any dissemination, distribution or copying of this communication is strictly prohibited. If you have received this communication in error, please notify us immediately by replying to this message and then destroy this communication in a manner appropriate for privileged information.