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Employers Learning how to Mitigate the Effects of ACEs in Their Workforce


(far left - Margaret Feierabend attends the Johnson City, SAMHSA Forum, September 2018)

The following interviews tell the story of innovative work being done to mitigate the impact of ACEs across generations in a unique community that bridges two states. Bristol’s iconic State Street in Historic Downtown is the “Main Street” and is the official state line for Tennessee and Virginia.

Q: How did you become involved in ACEs and Trauma Informed Care?

A: Becky Haas is a national presenter on trauma informed care and the Adverse Childhood Experiences (ACEs) study as well as a pioneer in successfully developing trauma informed communities:

In 2014 when I first heard about the Adverse Childhood Experiences Study, I knew from the start that this information was significant.  It’s been so significant, at the time of authoring this article, it’s changed the path of my career.  When first hearing of ACEs I was working for the local police department overseeing prevention programs aimed at reducing drug related and violent crime. It seemed to me ACEs science provided an important new resource for impacting community challenges and had been overlooked.  I enlisted the help of East Tennessee State University Psychology Professor, Dr. Andi Clements, and we set out to share this message throughout Johnson City, Tennessee.  While presenting on ACEs at “A Tough Pill to Swallow” symposium at ETSU in 2016, it was there I met Margaret Feierabend for the first time.  

Margaret has served on the Bristol Tennessee City Council for 22 years.  Most recently she just completed a two-year term as Mayor.  Regionally she is a recognized and respected leader.  Shortly after the symposium, Margaret attended a Trauma Informed Care training that Dr. Clements and I led followed by attending a Train the Trainer session a few months later.  In 2017 she invited me to introduce the subject of ACEs to a non-profit, Bristol’s Promise, which she founded and now leads.  Since that time, Margaret has been a dominant force in expanding the Northeast Tennessee ACEs Connection beyond the city limits of Johnson City, Tennessee.    

When I accepted a role to promote trauma informed practices for a regional healthcare system in 2018, my goal was to expand the Northeast Tennessee ACEs Connection regionally.  Again, it was Margaret who led the way as an early partner in this work.  Together, we collaborated to provide training opportunities for numerous organizations within Bristol Tennessee.  Among these organizations are the Housing Authority, the Bristol Tennessee Police Department, Bristol City Schools, the United Way, and numerous non-profits.  She applied for and was awarded a Tennessee Building Strong Brains innovation grant to pilot Bristol Connect workforce sustainability program adapted from other models, but seems to be a first of its kind trauma informed workforce program in the southeast. Our collaboration also led to the launch of a second “Trauma Informed System of Care” based on the Johnson City model I helped to pioneer and that was recognized by the Substance Abuse Mental Health Services Administration (SAMHSA) in 2018 as a model other cities should follow.  Following the steps of “advocate, educate and collaborate” as described in the Building a Trauma Informed System of Care toolkit, and recommended for use by ACEs Connection, Growing Resilient Communities 2.1 there is now a committed group in Bristol Tennessee advancing this work.  

Q: What was the driving force behind picking up the ACEs and Trauma Informed Care work for Bristol, TN/VA?

A: Margaret Feierabend has served on the Bristol, TN City Council for 22 years with several of those as mayor. She is the founding President of Bristol’s Promise.

Hearing about ACEs at the ETSU symposium, “A Tough Pill to Swallow” is where my “ah-ha moment” began. Learning about ACEs, trauma informed care, and how trauma derails brain development as presented at that symposium by Becky Haas and Dr. Andi Clements, set the recent course of my life and is now a major driving force for my work. Learning this through the perspective as mayor/elected official, I could see having a trauma informed lens and operating with a universal precautions approach, would be a lens of great value to a community.

Having served for 22 years as an elected official in Bristol, Tennessee, I am passionate about my city, and the citizens of both Bristol Tennessee and Bristol Virginia. Much of my work is spent with the nonprofit, Bristol’s Promise. Bristol’s Promise began as a networking effort following a community-wide visioning exercise. This work expanded to embrace America’s Promise’s Five Promises, which are recognized as key for building resilience in children and youth. These promises are: Caring Adults, Safe Places, A Healthy Start, Effective Education and Opportunities to Help Others. Bristol’s Promise was instrumental in initiating the Sullivan County Anti-Drug Coalition (SCAD) when it became evident our community was facing an opioid epidemic. Once SCAD was launched, we began raising awareness of the effects of substance abuse on brain development.  

After learning about ACEs and trauma informed care, these provided the next step for understanding how the drug epidemic affected families within our community. Through Bristol’s Promise we began hosting programs on ACEs, offering training's in TIC, following with the development of our own Trauma Informed Care Community. We have focused on community outreach education, with the intent of drawing in new partnerships from our business community. Typically, ACEs work has included the community at large, educational institutions, public safety officers, healthcare, and the faith community but we found that few efforts had been focused on helping business owners understand how ACEs might be impacting their employees.

We then began activities to raise awareness of ACEs within our business sector. These activities included partnering with our Chamber of Commerce to reach their membership, particularly at a First Friday Business meeting with about 200 attendees. Additional business contacts are made through Industrial Development boards, the United Way, and outreach to other civic organizations.  

From this work grew the Bristol Connect Workforce Sustainability program. This pilot was made possible after receiving a two-year grant from the Tennessee Building Strong Brains Program as well as additional funding from United Way of Bristol TN/VA. Our goal with this pilot program is to implement a practical, sustainable approach whereby employers can better support their employees and mitigate the effects of ACEs. In turn, this will create a stronger workforce and less turnover for the employer. As Bristol Connect advances, we expect that program evaluation and data analysis will indicate a significant return on investment for the employers. We believe we will also see the lives of employees will be stabilized by helping connect them to resources, problem-solving and contributing to a more compassionate workplace by training supervisors and leaders. These outcomes have been realized by other such models like The Source (Michigan), Working Bridges (Vermont), and WorkLab (Colorado). Each of these has a similar focus on ACEs and reducing the effects of trauma in the lives of employees and their families.  Bristol’s Promise is excited to be leading this work with great hope of an emerging model for impacting our community workforce.  

Bristol proclamation3

(l to r Margaret Feireabend, Melissa Roberts, Becky Haas, Jill Stott; Mayoral Proclamation, ACEs Awareness Month) 

Q: Do employers really need to learn about ACEs and Trauma Informed Care?

A: Melissa Roberts serves as Program Coordinator for the Bristol Connect Program.

Research shows us that ACEs can have a negative impact across a person’s lifetime. Awareness and training are two ways to mitigate those negative impacts, but how do we build resilience in our adult populations. According to The Economic Cost of Adverse Childhood Experiences in Tennessee report from The Sycamore Institute, between 2014-2017, “Over half of adult Tennesseans reported at least one ACE and about 17% had experienced 4 or more ACEs. Furthermore, ACEs have a nearly $5 billion annual economic impact on the state of Tennessee through cases of worker absenteeism and medical costs.” 

Bristol TN and VA employers, and many employers across the country, struggle not only to find but to retain its workforce. A recent report from the Manpower Group, The Talent Shortage, indicated that, “nearly 7 in 10 employers reported talent shortages in 2019 which is a jump of 17 percentage points from just a year ago. It’s also more than three times higher than a decade ago.” Even when employers find workers to fill jobs, keeping them is difficult. Average annual turnover rates hover around 19% nationwide with that number increasing over the past 3 years. Our local rates hover around 20%.

When looking at statistics such as these, they have ACEs written all over them. Armed with the data, Bristol’s Promise began seeking solutions that could reduce the impact of ACEs, strengthen the workforce and community by supporting those who are already part of the workforce. The Bristol Connect Workforce Sustainability Program seemed to be the answer and work began building the program in August 2019. 

Workforce sustainability programs are not new, but they are few and far between. Bristol’s Promise reached out to Working Bridges in Vermont, WorkLife Partnership in Colorado, and the most well-known of them all, The Source in Michigan. Upon extensive research, there were no similar programs identified in the Southeast, so we began taking steps to build a program that met the needs of our workforce and community. Each of the programs listed above provided insight and information on their experiences in developing these models. They shared not only successes but hindrances and barriers which proved invaluable. Despite navigating the challenges of COVID-19, in March of 2020 Bristol Connect partnered with a first employer providing support to the workers and education to the management to create a more resilient workplace.   

Q: How does a workforce sustainability program work?

A: Brandi Peters is the “boots on the ground” Community Resource Navigator:

A Community Resource Navigator is someone who becomes well versed in the resources available in the local community and how to access them. The Bristol Connect Navigator works one-on-one with employees of the partnered business to ensure that they become self-sustainable, engaged and maintain employment at their workplace. ACEs science has provided us the framework for understanding that experiencing challenges and difficulties outside of one’s job can dramatically impact days missed at work and even job loss. Community Resource Navigators are on the job site once a week with the partnered business. This serves to build relationships with the employees of that business. The Navigator also becomes an extension of the current benefits package that the employer offers. This benefit greatly outweighs and augments that of the standard Employee Assistance Program (EAP) that most employers offer. 

Before partnering with the employers, the Navigator receives training in using a trauma informed approach. This ensures that they carry out their role with the employees in a non-shaming or blaming way. This helps create a safe place for employees to go to get help with various barriers to maintaining long term employment. Employees become comfortable and know that the Community Resource Navigator is a confidential service and challenges discussed will not be disclosed to the human resources department. Navigators are equipped to identify resources that address various issues including transportation, food insecurities, housing, childcare, counseling and a myriad of other options. While the employee continues to focus on work and job safety, the Navigator is focused on finding resources for their clients to help them succeed. 

Recently we had the opportunity to help a family find permanent housing all while maintaining their employment. While working through this challenge we had to identify temporary shelter, food, gas for transportation to and from work, and baby supplies. By helping this employee establish secure housing they have begun a journey to a more stable life for themselves and their family. However, not only does the Resource Navigator role connect employees to resources, this program is designed to give them the tools to increase their resilience and ability to navigate the storms life sends their way. The Navigator also provides ongoing coaching and training for employees in basic life skills, financial education, and a wide range of support. It is most rewarding to have these services be a “win/win” for both the employer and employee as the employee becomes a self-sustaining worker and contributor to the community. ACEs science will help us be more successful in our journey to establish workforce sustainability and job retention.

Q: What are long-term goals for Bristol in regard to mitigating ACEs and building a Trauma Informed Care Community?

A: All

Through the Bristol Connect program we hope to build a network of employers and businesses who recognize the effects of ACEs and who actively work to reduce those effects through education, family-friendly work policies, and wages that reflect their employees value and worth. While this social and culture change develops, support with an eye toward resilience-building is provided to employees while continuing education for the community as a whole and businesses in particular continues.  


Much of the information currently available on how best to respond to ACEs is focused on our children. However, we know that 1 out of every 4 adults in Tennessee (and likely more than that!) have at least one adverse childhood experience in their history. We have multiple generations of adults who deserve the same level of response we are giving our children so they can build their resilience and better teach their children how to build resilience. Only through a multi-generational approach can we decrease the incidences of ACEs and build a stronger, healthier community.

For more information about the Bristol Connect Workforce Sustainability program, contact Melissa Roberts (



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  • Bristol proclamation3

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