Background <p>Adverse Childhood Experiences (ACEs) screening in pediatric primary care is gaining momentum, yet few studies have tracked the referral pathways from positive screens to social work and behavioral health over time. The current study examined the stability of rates of referrals to social work and the visits to social work and behavioral health across one year.</p> Methods <p>Data came from the electronic health records of children and adolescents between 2 and 18 years old who were members of a large integrated healthcare system serving Southern California and completed ACEs screening (<i>N</i> = 150,808). Poisson regression was used to compare the rate of referrals and visits to social work and behavioral health visits June 1-October 31 2023 for clinics that began ACEs screening June 1 2022 (Phase 1; <i>n</i> = 28) versus clinics newly initiating ACEs screening June 1 2023 (Phase 2; <i>n</i> = 61).</p> Results <p>Adjusted rates for Phase 1 versus Phase 2 clinics were not significantly different for the three outcomes: rate of referrals to social work, rate of visits to social work, or rate of visits to behavioral health.</p> Conclusion <p>The lack of significant differences between Phase 1 and Phase 2 clinics supports the long-term feasibility of this particular screening and referral pathway and may inform other pediatric providers looking to begin ACEs screening.</p>