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2011-2021—A decade of steady growth in ACEs and TI laws and resolutions in the states


Note on image above: Click here for a clickable version of this map.

Pushing a bill across the finish line is no small feat—the fate of most bills is to languish or be rejected because of the smallest objection, a budget restraint, time running out, or a controversial issue takes all the legislature’s oxygen.

In spite of these realities, state legislatures and Governors in dozens of states have enacted nearly 60 laws and resolutions that specially reference adverse childhood experiences (ACEs) or trauma in the years 2019 and 2020. Going back to 2011 when the first ACEs bill passed in Washington state, over 130 laws and resolutions (double the number prior to 2019) have passed in 39 states and the District of Columbia, including nine in 2021.

The fact that the National Conference of State Legislatures (NCSL) has tracked this type of legislation since 2018 is a strong indication of the importance to state elected officials of ACEs-related issues. According to NCSL, its database covers bills that address childhood trauma, child adversity, toxic stress or ACEs specifically. These parameters are fairly narrowly drawn given the vast universe of bills that have an impact on preventing and mitigating the impact of childhood adversity.

The NCSL database is a major source of information since 2018 for PACEs Connections' review of legislation. Click here for a PACEs. Connection post on how to access and use the NCSL database. The article also includes links to each state’s legislature and session calendars. Another way to link with state legislative websites is through the Library of Congress (click here). In some states, you can register to be notified by email if there is a change in the bill’s status.

The number of laws enacted has increased steadily, especially in recent years. In 2020 alone, 24 laws and resolutions passed in 14 states and the District of Columbia. In 2019, 35 laws and resolutions in 20 states were enacted. These numbers are based on information from various sources (including the NCSL, our own reporting, and tips from PACEs Connection members), and may not be exhaustive.  A search of the NCSL data base for pending legislation (not enacted) in the first months of 2021 yields 78 bills in 23 states.

Here are highlights of selected laws and resolutions:


Three bills have been enacted in New York related to ACEs training for mandated reporters, direct-care domestic violence staff, and day care providers. The budget bill (AB 3006, Chapter No. 56) approved in April of this year calls for mandated reporters to be educated about “ACEs, the importance of protective factors and the availability of services for children at risk for suffering from ACEs.” It also requires the Office of Child and Family Services to implement a statewide campaign to reach parents and others in positions to impact children and families. Click here for a PACEs Connection story on the bill. Two other training-related bills were enacted in 2019. AB 4990, ACT No. 391 requires all direct-care domestic violence staff undertake consistent state-approved training in adverse childhood experiences science so that they are better prepared to provide services to clients. The second 2019 bill (S. 4990, Act No. 675) requires training for day care providers with respect to adverse childhood experiences, focused on understanding trauma and on nurturing resiliency.


More than a couple of dozen states have passed laws relating specifically to schools, the earliest being the Massachusetts Safe and Supportive Schools act approved in 2014 to establish a framework for learning environments “that improve educational outcomes for students. [See ACEs Too High and PACEs Connection stories on this legislation and its implementation.] The most recent law enacted in 2020 in Pennsylvania (HB 1210, Act No. 30) makes COVID-19 disaster emergency school health and safety grants available, including to provide mental health services and trauma-informed care for students impacted by COVID-19.

Framing state policy

In 2014, Wisconsin led the way for other states with the passage of a resolution (Senate Joint Resolution 59) that states that the legislature will consider the principles of early childhood brain development, toxic stress, early adversity, and buffering relationships and note the role of early intervention and investment in early childhood years. California approved a similar resolution the same year, explicitly modeled after the Wisconsin resolution. These resolutions do not authorize programs or provide funding but rather establish aspirational goals for state policy.

Similar language made it into Alaska statutes, giving it more weight than a resolution. It reads:
“It is the policy of the state to acknowledge and take into account the principles of early childhood and youth brain development and, whenever possible, consider the concepts of early adversity, toxic stress, childhood trauma, and the promotion of resilience through protective relationships, supports, self-regulation, and services.”

Governors in Delaware and Pennsylvania have signed executive orders relating to trauma. Delaware Governor John C. Carney issued an Executive Order 24 “Making Delaware a Trauma-Informed State” on October 17, 2018 and Pennsylvania Governor Tom Wolf issued in 2019 an Executive Order that created the Office of Advocacy and Reform with a directive to create a Trauma-Informed Pennsylvania.

A number of states have established task forces or work groups to address trauma.  In 2018, Massachusetts passed S. 2371 (Chapter 69 of the Acts of 2018), creating a Childhood Trauma Task Force to “study, report and make recommendations on gender responsive and trauma-informed approaches to treatment services for juveniles and youthful offenders in the juvenile justice system.Click here for the task force website to see how the state is implementing this law.

Screening and assessments

Vermont was one of the first states in 2015 to pass legislation dealing with screening for ACEs. The law (S. 139, Vt. Act 54 of 2015, in Section 56 (See p. 67) requires a state entity to work on family-centered approaches and ACEs screening consistent with a report Integrating ACE-Informed Practice into the Blueprint for Health. A law in Hawaii (S. 388, Act No. 271) requires the Department of Education to evaluate and assess certain vulnerable children and in the District of Columbia, a law passed (B 203 , Law Number 22-179) to include screening patients and their families for adverse childhood experiences as part of health care. In Utah, a law (UT H 323, Act No. 202) passed that prohibits mental health screening without parental consent.

See the attached state-by-state list for short descriptions of all laws and resolutions from 2011-2021 or click on a specific state using the map on the “Laws and TI Resolutions” widget on State ACEs Action. Please contact me at with any additions and corrections as well as any background information from your experience on how the bill made it to enactment (i.e., what organizations worked to get the bill passed?, was there a specific legislative champion? etc.)  


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Comments (2)

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Thanks Carey! Imagine the collective effort that has gone into passing all these state laws and resolutions over the past decade—so much momentum is building in the states around trauma and resilience.  As you and others dig into this information, please use the comment box if anything is missing, wrong, incomplete, etc.  I also hope members will let me know if they were involved in getting something passed and willing to share their experiences. We'd all benefit from hearing more of the back stories about how these bills got approved and how they are or are not being implemented.  

Wow, Elizabeth Prewitt!

Putting together this story and amazing map was no small feat, either.

Thank you for doing what I know is a thorough and painstaking job on this. I am looking forward to digging into it.

Carey Sipp

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