In this episode, Dr. Robert Sege and Dr. Baraka Floyd welcome back Dr. Nadine Burke Harris for a powerful conversation on transforming systems to support children and families. Building on the science of toxic stress, Dr. Burke Harris discusses how to scale positive childhood experiences (PCEs) from the clinic to statewide policy. She shares insights from her time as California's Surgeon General, highlighting the economic cost of adverse childhood experiences (ACEs) and the groundbreaking policy shift that allowed Medicaid to fund buffering care based on risk rather than waiting for a clinical diagnosis. Finally, the hosts explore the realities of vicarious trauma and the importance of building personal support networks to sustain this critical work. For more on the HOPE framework, visit positiveexperience.org.