Ready, Resilient, & Rising! Network (R3) 

A trauma-informed coordinated care system that partners with low-income families with children aged zero to three to improve behavioral health outcomes as well as to prevent and mitigate the impact of toxic stress. 

The Ready, Resilient, Rising! Network (R3) seeks to transform early childhood healthcare services for low-income children between the ages of zero to three in Alameda and San Francisco Counties. Led by an innovative team from UCSF, this network of educators, health plans, health providers, and social service agencies reimagines early childhood systems of care by prioritizing the behavioral health and wellbeing of the whole family, not just the child. R3 works across sectors and siloes to make the prevention, detection, and treatment of childhood toxic stress a standard part of pediatric primary care practices. To date, R3 has collaborated to institutionalize the screening of unmet basic needs and trauma, embed behavioral health specialists in primary care, and introduced State-wide MediCal payment reform to support holistic services for families. This trauma-informed approach creates pathways for families to heal and develop resilience against toxic stress in early childhood. 
 
R3 will scale their approach by working to align metrics and best practices in the current early childhood care systems, while identifying and eliminating persistent service gaps faced by primarily low-income families of color.

The Collaboration

The Problem

  • Toxic stress is a neurobiological response that is developed when a child is significantly exposed to Adverse Childhood Experiences (ACEs). Children with four or more ACEs face a 70% higher risk of kidney disease, more than double the risk of heart disease, and triple the risk of chronic lung disease as someone without ACEs. Higher rates of depression, likelihood of dependency on substances, and increased risk of homelessness are also consequences correlated with toxic stress. [1]
  • Siloed systems of care and persistent service gaps create barriers for low-income families of color to be able to access medical care as well as community and social services they need to meet basic needs and build resilience in the face of trauma.  
[1] https://osg.ca.gov/wp-content/uploads/sites/266/2022/05/Roadmap-For-Resilience_CA-Surgeon-Generals-Report-on-ACEs-Toxic-Stress-and-Health_12092020.pdf
"The Hellman Collaborative Change Initiative GROWTH Award enables us to deepen our clinical work to help all children grow to reach their potential. Our work is grounded in anti-racist and trauma informed care and addressing adversity through a strength-based framework focused on relationships, mental health and resource referral navigation. The work on the ground informs our system thought leadership to advocate for policies that uplift children and families." - Dayna Long, M.D., FAAP, Professor of Clinical Pediatrics, Department of Pediatrics, UCSF
For more information, contact:
Cassandra Vega, MPH
UCSF Center for Child and Community Health
cassandra.vega@ucsf.edu