2021 Updates

New ACEs Awards Announced

The 2021-22 California State Budget, signed by Governor Newsom on June 28, 2021, expands the state's investment in preventing and treating Adverse Childhood Experiences (ACEs) by $12.4 million to drive innovative, community-driven research. This additional funding will support seven collaborative demonstration projects total across the state for three years, building on the first round of awards announced by the California Initiative to Advance Precision Medicine (CIAPM) in March 2021.

This critical investment is part of Governor Gavin Newsom's broad-based California Comeback Plan to transform California’s behavioral health system for children and youth into an innovative, prevention-focused system with early, targeted screenings and intervention. It is also a key priority of California Surgeon General Dr. Nadine Burke Harris, who aims to cut ACEs and toxic stress in half within a generation. Advancing the science of ACEs is a core element of the state's sweeping approach to explicitly address childhood trauma and toxic stress through complementary investments that extend resources and support evidence-based practices at the doctor’s office, schools, and social services across California's communities. All seven ACEs demonstration projects begin this summer as part of CIAPM, in partnership with the Office of the California Surgeon General.

"If we're going to reduce the burden of ACEs and toxic stress in a generation, we need research to inject fresh, ambitious ideas into the health care pipeline so our clinicians, social workers, and other frontline providers have a modern set of options to prevent, diagnose, measure, and treat the health impacts of ACEs and toxic stress," said California Surgeon General Dr. Nadine Burke Harris, MD, MPH. "Precision medicine is how we get there: moving from a one-size-fits-all system to an individualized approach that harnesses technology and data to address the root causes of health and social conditions, not just symptoms. In California, not only are we investing in cutting-edge research, we're also making sure that diverse communities play a role in accelerating the research agenda in a manner and direction that serves all Californians."

Research teams are co-led by academic research institutions and one or more community- or county-based organizations that serve individuals with ACEs. The new projects are listed below.

  • Systems-based, Multidisciplinary Assessment of Adversity and Toxic Stress for Individualized Care (The SYSTEMAATIC Project) – Stanford University; Center for Youth Wellness
  • Advancing a Precision Population Health Approach to ACEs to Reduce Health Disparities – UC San Diego; San Diego County Behavioral Health Services; Scripps Mercy Hospital Chula Vista; Community Information Exchange - 211 San Diego; Rady Children's Hospital; University of San Diego; San Diego State University; YMCA of San Diego County
  • Identifying Social, Molecular, & Immunological Processes for Mitigating Toxic Stress & Enhancing Personalized Resilience – UCLA; The Scripps Research Institute; UCSF; Los Angeles County Depart. of Health Services

2020 Annual Report Released

The Governor's Office of Planning and Research is pleased to announce the release of CIAPM's 2020 Annual Report to the California Legislature.

In a year defined by a pandemic, a national reckoning over racial injustice, and increasing climate-related disasters including devastating wildfires and several months of extreme heat, CIAPM continued to lead and participate in wide-ranging, cross-agency efforts to further medical sciences, elevate community partnerships, and engage experts in helping to shape the next chapter of health and wellbeing in a modern era of scientific and inclusive leadership.

CIAPM staff have prepared this report to showcase 2020 programmatic and project highlights, which include:

  • Advancing the State's response to COVID-19 by contributing time and expertise as members of the Governor's COVID-19 Testing Task Force and the Governor's Future Opportunities Task Force
  • Establishing and convening the California Precision Medicine Advisory Council, in coordination with the Senate, Assembly, and California Health and Human Services Agency
  • Launching two Advisory Council working groups focused on 1) integrating data about Social Determinants of Health into electronic health records, and 2) engaging with underrepresented communities to increase participation in biomedical research
  • Co-authoring and supporting the release of the first-ever California Surgeon General's Report
  • Adding to OPR's capacity to address systemic racism by participating in the Capitol Collaborative on Race and Equity, and continuing to fund research that directly addressed health disparities
  • Expanding programmatic communications and outreach with a new monthly newsletter and public-facing resources on our website
  • Engaging the wider precision health community by speaking at national and international conferences and participating on panels

The full report is available to download. Briefings on the report were delivered to the legislature and stakeholders on June 17, available to view here.

California Legislature Allocates $12.4 Million for ACEs Research

On June 14, the California State Legislature passed a state budget that includes Governor Newsom’s proposed $12.4 million investment to expand CIAPM's ACEs research program. The investment will build on the first round of awards announced in March 2021, to launch a total of seven demonstration projects across the state. All projects begin this summer. The Governor has until the end of June to sign the budget bill.

California's economy is coming roaring back. With the largest surplus in California history, we're using this once-in-a-generation opportunity to create an economic recovery that will leave nobody behind.
Governor Gavin Newsom on June 14, 2021

More about CIAPM's ACEs research

The California Initiative to Advance Precision Medicine looks ahead and envisions future needs for a healthier, more equitable state. This includes supporting precision medicine research projects that will deliver effective clinical and community-based solutions within five years. ACEs and toxic stress pose the sort of cross-cutting challenges that impact nearly all health departments and communities. And as the state emerges from the COVID-19 pandemic, the need continues to grow for next-generation prevention, detection, and treatments to address ACEs, toxic stress, and affiliated health conditions.

CIAPM Welcomes Graduate Student Interns

Following a competitive application process with many extremely well-qualified candidates, CIAPM is thrilled to bring aboard two new graduate student interns: Jessica Lumian and Affad Shaikh. Their primary project is building an updated California Precision Medicine Asset Inventory, with an improved user interface and greater functionality. The current Asset Inventory will remain accessible through this phase of development.

Jessica Lumian

Jessica Lumian is pursuing a PhD in Microbiology at the University of California, Davis in the Earth and Planetary Sciences department. She holds a bachelor's degree in Biochemistry and Molecular Biology from Michigan State University. Her thesis research focuses on environmental tolerance mechanisms of Antarctic cyanobacteria using a variety of bioinformatics techniques. She enjoys promoting data availability and reproducibility in scientific research and has served as a prior instructor for The Carpentries, a non-profit organization dedicated to teaching fundamental computational skills and fostering an inclusive data science community. She also assists with the organization of science outreach events through STEM for Girls at UC Davis and is interested in increasing science literacy for all ages. In addition to her graduate work, Jessica studied the accessibility of dialysis treatment centers in California using geographical and statistical analyses. She is enthusiastic about contributing to work promoting equity and accessibility in healthcare.

Affad Shaikh

Affad Shaikh is a business-oriented Data Scientist who recently completed dual master's degrees in Business Administration and Information Systems and Technology from Claremont Graduate University. He earned his bachelor's degree from the University of California, San Diego in International Studies and is currently finishing a Data Fellowship with The Data Incubator. He looks for solutions and uncovers stories that inform strategy and decision making, and he combines design thinking with a collaborative, multidisciplinary approach. His motivation is to be of service, and to that end he is currently a Board Secretary for the Interfaith Movement for Human Integrity, a California non-profit dedicated to advocating and serving marginalized communities at the intersection of immigration detention and criminal justice. Prior to his graduate studies, Affad built up the Civil Rights department in the Greater Los Angeles office of the Council on American and Islamic Relations, a national non-profit.

Governor Newsom's California Comeback Plan Supports CIAPM Research

As part of the Governor’s California Comeback Plan, CIAPM would receive $12.4 million to further the science of Adverse Childhood Experiences (ACEs) by supporting community-driven precision medicine projects focused on treating and preventing ACEs with scalable approaches. A total of seven collaborative research teams across the state would receive funding: expansion of the four inspiring projects announced in March, and initiation of three additional projects. These projects were selected and ranked from 39 original applications by CIAPM’s world-class, out-of-state Expert Selection Committee.

The challenges of addressing ACEs exist along a pipeline. At one end are health care and service providers responding to children and adults with acute and serious needs, bolstered by California's first-in-the-nation efforts to enhance ACEs screening and referral systems. At an earlier end of the pipeline are researchers and communities carefully studying the prevalence and physiological impacts of ACEs and toxic stress in diverse regions, developing innovative and cross-cutting strategies for preventing, detecting, and treating ACEs.

CIAPM exists at this earlier stage of research and looks ahead to visualize future needs for a healthier, more equitable state. To reach those goals, we set in motion competitively selected research projects that will deliver more effective clinical and community-based solutions within five years and well beyond.

Watch Governor Newsom's press conference on the budget via the Governor's YouTube channel. The Health and Human Services Summary and full budget proposal are also available online.

Redesigned CIAPM Website Launches

On April 22 CIAPM launched a redesigned website. The rollout was part of a larger website update for the Governor’s Office of Planning & Research. In addition to the educational content discussed below, the new site is easier to navigate and better highlights our funded projects, cross-agency partnerships, news and updates, and members of our staff, the California Precision Medicine Advisory Council, and Expert Committees.

We are also delighted to launch brand new content, including a primer on precision medicine and a curated resource library of external information for all audiences. In the near future we plan to add playlists of our favorite informative videos about precision medicine, public health, and other related topics, and a continuously updated list of relevant external funding opportunities.

Browse the primer for answers to questions like How does precision medicine affect me? and How will data change health care? If you are a researcher, teacher, student, or community member, there are additional resources that have been carefully curated with you in mind.

We will continue to update the resources to capture new developments and represent diverse voices in the field. If there is a link or topic you would recommend including on the webpage, please share it with us.

California Precision Advisory Medicine Council Working Groups Launch

February marked the kickoff for both of the Council's working groups. Each is focused on addressing specific health disparities: integrating social determinants of health data into electronic health records, and creating a framework for an equitable consent process that brings more undderrpresented minority groups into medical research.

The first meeting of the Data Integration working group took place on February 8. The group discussed several existing efforts to standardize social determinants of health for electronic health records, and possible partnerships and synergies between public, private, and nonprofit organizations. The Data Integration group is chaired by Hakan Sakul, PhD, who is a Vice President and Head of Diagnostics at Pfizer.

A traditional medical record doesn't give a health care practitioner a complete picture of the many factors that contribute to a patient's health and wellness. Risk factors such as food or housing insecurity have an enormous impact on a person's health, but at present there is no consensus about the best way for health professionals to capture, assess, store, or access data about social drivers of health so that the information can be used in clinical decision making. We're looking forward to connecting with partners across the state and country to break down data integration barriers for the benefit of Californians.
Dr. Hakan Sakul
Chair, Data Integration Working Group

The first meeting of the Equitable Consent working group took place on February 19. The members contributed ideas on the development of an equitable framework for the informed consent process that takes place in the course of research on human subjects, and strategized how to maximize the impact of the project. The group is chaired by Kenneth Kim, MD, a physician who is the founder and Chief Medical Officer for Ark Clinical Research.

Part of the reason health disparities persist is that the communities experiencing disparities have historically been preyed upon by medical researchers, so they are understandably reticent to participate in research that may benefit them. It's the responsibility of the researchers to reach out to minority groups that are currently underrepresented in medical research, learn from them their reasons why they may hesitate to participate, and work with those communities on strategies to build trust between researchers and potential research subjects. A step in that direction is to design an equitable framework for the informed consent process so that it is accessible to a wider array of potential participants.
Dr. Kenneth Kim
Chair, Equitable Consent Working Group

Each working group will meet every other month, and meetings will be open to the public. Check the Meetings page for agendas and registration details.

Setting a Statewide Research Agenda for Disaster Resilience

The California Council on Science & Technology (CCST) engaged CIAPM in an agenda-setting workshop on February 18 as part of their new Disaster Resilience Initiative, an effort to bridge science and technology experts with state policymakers. Sharing the virtual panel with California Health and Human Services Assistant Secretary Marko Mijic and Assemblymember Dr. Bill Quirk, CIAPM Co-Director Dr. Julianne McCall presented to deans, chief science officers, chief innovation officers, professors, and other experts representing California's world-class research institutions, including CIAPM Advisor Dr. Bonnie Maldonado. Discussion about the most pressing policy and research challenges in our state touched on the digital divide, an impending mental health crisis, rampant public health misinformation, economic strains, workforce development, and data infrastructure. Policy Fellows Aiyana Emigh Cortez and Hyunsoo Gloria Kim contributed to post-panel discussions and exercises.

2020 Updates

First-ever California Surgeon General's Report Released

The first-ever California Surgeon General’s Report was released, titled Roadmap for Resilience: The California Surgeon General’s Report on Adverse Childhood Experiences, Toxic Stress, and Health. This report was co-authored by CIAPM Co-Director Dr. Julianne McCall, with contributions from Co-Director Dr. Shannon Muir, former Science Fellow Dr. Ken McCullough, and Policy Fellow Gloria Kim, design by Science Communications Specialist and Administrator Megan Varvais, and reference management by Policy Fellows April Booth and Aiyana Emigh Cortez.

The 438-page report is a product of experts across specialties and geographic areas. Organized around primary, secondary, and tertiary prevention strategies, the report includes stand-alone summaries for various sectors, including health care, education, early childhood, justice, and social services.

California Surgeon General Dr. Nadine Burke Harris presented key findings from the report in a public webinar, recorded and accessible here.

We at CIAPM were honored to partner with the Office of the California Surgeon General to develop this important resource and look forward to continuing to advance the science of ACEs with the announcement of awardees of our ongoing Request for Proposals for ACEs research in March.

Key Steps to Reduce Racial Cancer Disparities Include Supporting Minority Scientists, Diversifying Medical Schools and Clinical Trials

Former CIAPM Advisor John Carpten, PhD, addressed Congress this month as the Chair of the inaugural AACR Cancer Disparities Progress Report 2020, published September 16 by the American Association of Cancer Research. In his presentation to Congress and a recent interview for the American Journal of Managed Care (AJMC), he discussed the root causes of racial inequality in cancer care, how inequality in research leads to disparities in outcomes and mortality, and how cancer researchers can change these circumstances.

By diversifying the cohort, we learn more about the efficacy of the therapy, or perhaps the toxicity profile...by diversifying trials, we help everyone. The whole concept of interdisciplinary and transdisciplinary research will probably be part of the answer. And we have to break down the barriers, break down the walls, and break down the silos, and begin to work together and come up with novel study designs that bring to bear various disciplines to address these issues.
Dr. John Carpten

Dr. Carpten is the Chair of the Department of Translational Genomics at the University of Southern California (USC) and co-leads the Translational and Clinical Sciences Program at the USC Norris Comprehensive Cancer Center. Dr. Carpten was a member of the Precision Medicine Advisory Committee, which produced the 2018 report Precision Medicine: An Action Plan for California.

Further reading: AACR Cancer Disparities Progress Report 2020

Former CIAPM Investigator Celebrates Anniversary of Major Genome Breakthrough

This summer, the National Human Genome Research Institute celebrated 20 years since Dr. David Haussler and his team at UC Santa Cruz uploaded the first working draft sequence of the human genome. Not long after, the UCSC Genome Browser was released, enabling graphical visualization of the data. The framework continues to provide researchers the opportunity to contribute their findings for others to use. Since its release, the UCSC Genome Browser has been used extensively, nearing 40,000 citations in the literature.

In the early days of the pandemic, Dr. Haussler's team worked to adapt the UCSC Genome Browser to provide researchers around the world with a common platform to access the latest molecular data characterizing the SARS-CoV-2 genome and proteins. Scientists can use the community resource to analyze how the virus has mutated, compare the genome with other coronaviruses, and upload their own findings to further shared understanding. A manuscript was recently posted with full details.

Dr. Haussler is the Scientific Director of the UC Santa Cruz Genomics Institute and was one of CIAPM's first grantees in 2015.

California Precision Medicine Advisory Council Holds First Meeting

The California Precision Medicine Advisory Council (CPMAC) held its first meeting on May 12 and 15, 2020. Both sessions were virtual. The Council selected Clara Lajonchere, PhD to be Chair and Keith Yamamoto, PhD for Vice Chair. Dr. Lajonchere is the Deputy Director of the Institute for Precision Health at UCLA's David Geffen School of Medicine. Dr. Yamamoto is Vice Chancellor for Science Policy and Strategy at UCSF.

Information about the CPMAC's meetings, including minutes, can be found on the Meetings page.

CIAPM-Supported Research Advances Pandemic Response

Sequencing the Virus

A CIAPM grant recipient is using the techniques he refined and expanded as a Principle Investigator to sequence viral genomes from hundreds of COVID-19 patients, informing health officials of how the virus is mutating and spreading around the world. Charles Chiu, MD, PhD, an infectious disease physician and professor of laboratory medicine at University of California San Francisco, received the grant in 2015 for his project “Precision Diagnosis of Infectious Diseases.” Dr. Chiu conducted the research in collaboration with four other Universities of California, the Department of Public Health, a number of California-based companies, and other partners.

Read more in the press:

Identifying Lesser-Known Symptoms of COVID-19

New research from Dr. Brennan Spiegel, MD and a Wuhan-based medical team sheds light on a lesser-known form of COVID-19. While the coronavirus pandemic continues to unfold, doctors and scientists around the world are rapidly developing diagnostic tests, searching for possible treatments, testing vaccine candidates, and caring for patients using every medical tool and technique available. Those critical efforts depend on a comprehensive understanding of how COVID-19 impacts all patients, not just the majority. Dr. Spiegel serves as Director of Health Services Research at the Cedars-Sinai Health System in Los Angeles and is a 2017 CIAPM grant recipient for research in cardiology and remote biosensors.

While the most prevalent and threatening symptoms of COVID-19 are respiratory, the research team found that some patients with a more mild form of the disease experience gastrointestinal problems before or entirely without any of the commonly associated symptoms, like fever, cough, and shortness of breath. Such patients tend to be diagnosed later than others, and are at-risk of spreading the virus for days without suspecting they would test positive for the disease.

Read the pre-published study made available by the American Journal of Gastroenterology and national press coverage:

For more information about this content, please contact:

Megan Varvais
Megan Varvais is the Science Communication Specialist for the California Initiative to Advance Precision Medicine. She coordinates CIAPM's web content.