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Delaware ACEs Action (DE)

The mission of the Delaware ACEs Action group is to advance trauma-informed initiatives in Delaware, including trauma-informed approaches in any and all settings where people are served.

Recent Blog Posts

"A Better Normal" Community Discussion Series- Our Reckoning with Race and Equity at ACEs Connection

At noon on  Tuesday, October 27, ACEs Connection staff invite you all to join us as we share about our race and equity journey.

Click here to register.

We are hardly experts in race and equity- in fact, we are really just beginning. But by putting in consistent effort over the past several months, we have already made important shifts both internally as an organization, as well as through the content we reflect on the network. We have a long way yet to go.

Our journey started with not reckoning. Then, we took that first step; stumbling; then ultimately recommitting. We’d like to share with the ACEs Connection community about our process of incorporating equitable practices in our organization, and in becoming more purposeful in addressing racial  and historical trauma as an organization. We hope that you will dialogue and share with us as well. We know we have much to learn from you all.

A Brief Background on our Journey

In July 2019, ACEs Connection staff held our first race and equity workgroup meeting. We met to brainstorm an approach, and our colleague Ingrid Cockhren advised us to take a step back and to do some staff-wide fundamental education about race and equity. Ingrid has a background in diversity, equity and inclusion training, and offered to lead this work for our team.

Post training, there was a gap in our race and equity work, a gap that was highlighted when George Floyd was murdered by police officer Derek Chauvin in Minneapolis, MN on May 25, 2020, after being held down with Chauvin’s knee on his neck for eight minutes, while handcuffed. The murder was caught on video, and sparked nationwide social and political protest against racially motivated, and systemically unaccountable, police brutality.

Staff at ACEs Connection wanted to make a statement denouncing this brutal display of systemic racial injustice, and we realized that the race and equity workgroup would have been the best space to draft this statement. We were regretful that we had not prioritized the workgroup since the first phase of our training concluded, and so we resolved to meet weekly, which we have done since June 18, 2020. Setting, and keeping, this meeting time has been a key component in our race and equity commitment at ACEs Connection. Please see this post to read the reflections from our race and equity workgroup members about our equity process thus far.

Below are a few of the ways race and equity is reflected in our content on ACEs Connection as a result of our internal training, and workgroup process, with more to come:

Anti-Racism Resources List

Ep.7 - Racial Health Inequities of COVID-19 [A Better Normal Series]

Ep.17 - Systems Transformation [A Better Normal]

Ep.25 - Racial Trauma & How to be Anti-Racist [A Better Normal Series]

Ep.28 - LGBTQ+ Identity and Race in the US: An Intersectional Discussion [A Better Normal Series]

Ep. 32 - Reinterpreting American Identity [A Better Normal Series]

Ep.52 - Can universal ACEs screening be equitable? Concerns and solutions. [A Better Normal]

Ep.54 Real Talk with Rafael [A Better Normal Series]

'A Better Normal:' Can universal ACEs screening be equitable? -- Concerns and solutions

Can universal ACEs screening be equitable? A conversation about concerns and solutions.

When: Tuesday, Oct. 13, 2-3:30 pm PDT/5-6:30 pm EDT

This webinar explores what it takes to ensure that equity is built into the process of screening and providing support for families who have experienced trauma and want help.

REGISTER HERE

Background

At the beginning of this year, California, through the ACEs Aware initiative began rolling out universal screening for adverse childhood experiences (ACEs), under the leadership of the Department of Health Care Services and the state’s surgeon general, Dr. Nadine Burke Harris. Burke Harris is a pediatrician and founder of the Center for Youth Wellness. In her book, “The Deepest Well,” she discusses how learning about ACEs changed the way she practiced medicine.

The approved tool for ACEs screening of pediatric patients in California is called the PEARLS tool. It was developed by a team of clinicians and researchers from the University of California at San Francisco Benioff Children’s Hospital in Oakland, the UCSF School of Medicine and the Center for Youth Wellness, with feedback from focus groups of patients. The tool includes questions about abuse and neglect, as well as whether a child has experienced such things as bullying at school or discrimination based on race or gender orientation, has witnessed violence in the community, and has been separated from a parent due to foster care or immigration. The screener also asks whether a family ever faced eviction or worried about having enough food, among other questions about basic needs. Answering the PEARLS questions is voluntary.

Training through a learning collaborative known as CALQIC is underway for health care providers from more than 50 safety net sites around California on how to implement systemwide practices that create safe environments for addressing trauma and reducing disparities. More than 100 additional recipients of grants from the state’s ACEs Aware Initiative are developing training and other learning opportunities to support clinics in healing trauma.

Here's who's on the panel:

IngridCockhrenIngrid Cockhren is ACEs Connection’s Midwest community facilitator. She will speak about the history of racism in medicine.  Cockhren graduated from Tennessee State University with a B.S. in psychology and Vanderbilt University’s Peabody College with a M.Ed. in child studies. Her research areas are African American parenting styles, ACEs science, historical trauma and its intergenerational transmission, brain development, developmental psychology and epigenetics.

Cockhren is an adjunct professor specializing in developmental psychology at Tennessee State University. She chairs the Parent & Community Education Committee for ACE Nashville. She also serves as an advisor on both the Vanderbilt Institute for Clinical and Translational Research’s Community Engaged Research Core Advisory Council and the Lloyd C. Elam Mental Health Center’s Advisory Board. She’s also worked with the Nashville Public Schools and the State Office of Child Safety among other institutions, agencies and organizations.

REGISTER HERE

RJGillespie1
Dr. R.J. Gillespie is a pediatrician with The Children’s Clinic in Portland, Oregon. Nationally, he was an early adopter of ACEs screening. He will discuss why his practice chose to identify parents' ACEs rather than children's, and how he has built trust with patients around ACEs screening.

Gillespie attended medical school at Oregon Health Sciences University, graduating in 1997, and completed his residency and chief residency at Rush Children’s Hospital in Chicago in 2001. He earned a master’s in health professions education from the University of Illinois-Chicago in 2007.

DrShandiFullerDr. Shandi Fuller, a pediatrician, is the deputy health officer/maternal child adolescent health consultant for Solano County, California. She has worked for the Solano County Family Health Services since 2012, and oversaw the training and implementation of a pilot on ACEs screening among parents and adults without children in a safety net clinic in Vacaville. Fuller will talk about the in-depth equity training she and a colleague developed for medical providers.

Fuller is the co-facilitator for Solano HEALS, whose mission is to decrease black infant mortality rates by promoting equity in healthy births. She is also the medical director for California Children Services. She is an active member of Solano County’s Community Action for Race Equity (CARE) team and the CARE collaborative, as well as the African America/Black Caucus for Solano County. Fuller has developed training on historical trauma and implicit bias and works with medical centers to build equity into their health systems. Previously, she served as chief of pediatrics at the Cherokee Indian Hospital in Cherokee, North Carolina. She earned her master’s in public health from the University of California at Berkeley and her medical degree from Howard University.

CerellaCraigCerella Craig is a research assistant at the Health Justice Lab at the Yale School of Medicine and is currently pursuing a master's degree in public health at Southern Connecticut State University. She also serves on the Community Leadership Council for the JPB Research Network on Toxic Stress. She will be talking about what it takes to integrate the voices of the community into medical system practices and to ensure equity.

Craig is a graduate of the University of Connecticut and holds a bachelor of science degree in health and social inequalities, an individualized major that was crafted around her passion for health equity. Craig is dedicated to improving access to equitable and quality health care within marginalized communities. She has worked in community-based research for nine years, engaging families in research trials as a social justice advocate. Craig also supports families in challenging systems that threaten their health and wellness. 

Host:: Laurie Udesky is a staff reporter at ACEs Connection and the community manager of the ACEs in Pediatrics community. She has been a public-interest and investigative journalist for more than 25 years. Her work has earned a number of honors, including awards from Investigative Reporters & Editors, the Association of Health Care Journalists, and the Exceptional Merit Media Award from Radcliffe College.

REGISTER HERE

Delaware joins interstate collaboration on childhood trauma (Delaware Public Media)

By Nick Cliolino, August 28, 2020, DPM.

Delaware is collaborating with other states to study Adverse Childhood Experiences, or ACEs.

The First State, Pennsylvania, Virginia and Wyoming were chosen by the National Governors Association to be mentored by California, Tennessee and Alaska on how to be more trauma informed.

The collaboration seeks to share and analyze data on ACEs, offer training for state agencies and create collaborations with the public sector.

Fink says Delaware’s application for the collaboration relied heavily on spotlighting Gov. Carney’s 2018 executive order to make Delaware a trauma-informed state. 

[Please click here to read more.]

National Governors Association Chooses Delaware to Participate in Adverse Childhood Experiences Learning Collaborative [Delaware.gov]

Department of Services for Children, Youth and their Families | Featured Posts | Date Posted: Wednesday, August 26, 2020

WILMINGTON, Del. – Governor John Carney on Wednesday announced Delaware was one of four states chosen by the National Governors Association to participate in a learning collaborative focused on recognizing and responding to adverse childhood experiences.

The State of Delaware will join teams from Pennsylvania, Virginia and Wyoming in the Improving Well-being and Success of Children and Families – Addressing Adverse Childhood Experiences Learning Collaborative through the National Governors Association Center for Best Practices. This initiative will provide Delaware with access to 10 months of technical assistance, engagement with trauma-informed mentor states and information about innovative and evidence-based policies and practices for responding to adverse childhood experiences.

Referred to as “ACEs”, adverse childhood experiences describe experiences in one’s home or community, which occur before the age of 18. ACEs include a range of events such as abuse and neglect, violence between household members, community violence, food insecurity and racism. Exposure to ACEs can cause prolonged stress impacting a child’s brain and nervous system development and negatively impact a person’s health and well-being across their lifetime. This learning collaborative will connect Delaware state agency leaders with national experts and provide opportunities to learn strategies to prevent and mitigate exposure to ACEs for children, their families and communities.

“When children experience trauma, we know it has the potential to impact their lives in a range of ways. That’s why we have made it a commitment in Delaware to take a look at the root causes of trauma and how we as a state help families cope with traumatic experiences,” said Governor John Carney. “The work of the Family Services Cabinet Council has aided our efforts and created a strong foundation for us to tackle this work. I thank the National Governors Association for recognizing our work and plans, and look forward to the being part of this important collaborative on adverse childhood experiences.”

The Governor’s commitment to trauma-informed practices, with the leadership of the Family Services Cabinet Council, provided a strong foundation for Delaware’s application to participate in the collaborative. In 2018, Governor Carney signed Executive Order 24, which launched efforts to make Delaware a trauma-informed state. The Family Services Cabinet Council has led this movement, developing training tools, creating action plans and finding ways to enhance services for children and families exposed to trauma.

For the Improving Well-being and Success of Children and Families – Addressing Adverse Childhood Experiences Learning Collaborative, Delaware’s application identified the following goals and objectives:

To read the entire release, click here.

 

Greater Richmond Trauma Informed Community Network, first to join ACEs Cooperative of Communities, shows what it means to ROCK!

In the fall of 2012, Jeanine Harper, Melissa McGinn, and Lisa Wright were hearing more and more about adverse childhood experiences and trauma-informed practices. Feeling inspired, their organization, Greater Richmond SCAN (Stop Child Abuse Now) and five other community partners hatched a one-year plan to educate the Richmond, Virginia, community about ACEs science and to embed trauma-informed practices.

Eight years later, the original group has evolved into the Greater Richmond Trauma-Informed Community Network (GRTICN) with 495 people and 170 organizations. They have a solid foothold in infusing ACEs science throughout the Greater Richmond community. Inspired by their work and facilitated by their knowledge, there are now Trauma Informed Community Networks in 26 cities and towns across Virginia. The statewide coalition is called the Virginia Trauma Informed Community Networks. (McGinn is SCAN's community programs coordinator and coordinates the state's trauma informed community network; Wright is the GRTICN coordinator, in additional to her work as a therapist at SCAN; Harper is SCAN’s executive director.) And, despite the advent of COVID-19 into every community across the state, GRTICN and the other communities in the network hosted the state’s first Resilience Week May 3-9, 2020, with virtual events all across the state. 

Although it’s a foothold, that progress still significant because now a notable portion of the community says it will never stop integrating ACEs science. But the more they do, the more they realize there’s still a long way to go. 

“We did think it was going to be a shorter process,” says Wright about the last eight years and not without some irony. “As I reflect back, I am amazed that our plan was to complete so much in just one year and astounded by how the initiative created a ripple effect across so many sectors and disciplines.”

However, with the COVID-19 pandemic and the extraordinary shifts in White America’s understanding of Black historical and present systemic racism, Wright, McGinn and others in the GRTICN see this time as an opportunity to make an even greater impact in changing harmful policies and practices in many of their communities’ systems. They don’t feel as if they have to convince people ACEs science is real any more. But now they need to measure their progress. That’s why the GRTICN is becoming an affiliate of ACEs Connection Cooperative of Communities. They’re the first ACEs initiative to do so.

The ACEs Connection Cooperative of Communities is a program of ACEs Connection that provides special tools and services for ACEs initiatives in towns, cities, and counties. It’s designed for initiatives that need efficient and sophisticated ways to measure their progress to becoming a trauma-informed community; that want diversity, equity and inclusion coaching; whose members need training in how to be a network leader…in other words, established initiatives that are ready to move to the next level.

Here’s the thing about this new knowledge of ACEs science. You pull one thread. That leads to pulling more threads. Pretty soon you realize that you’ve got a bunch of threads that you’re weaving into a whole new tapestry. A different picture starts to emerge about how to change human behavior. Instead of integrating policies and practices based on blame, shame and punishment, you’re integrating practices based on understanding, nurturing and healing. And pretty soon you’re on the way to solving your most intractable problems.

The work is essential, the stakes are huge, the promise game-changing.

First, let me say that I will not do justice in this blog post to all that GRTICN has accomplished over the last eight years. It’s mind-boggling. Consider this overview a greatly abbreviation version of their accomplishments, so, I encourage you to check out the links.

“Yep,” says Wright. “We could do a better job at letting people know what we do.”

Wright and McGinn point out that integrating ACEs-science informed practices takes much longer than a year. They say that the essential foundation for making changes driven by people from different walks of life includes taking the time to develop relationships, developing a common language, and tackling tiny challenges to demonstrate early achievements, which helps inspire commitment and propel people toward taking on big challenges. They’ve done all that to accomplish a long list of changes:

  • They led efforts for new language in the Virginia State Board of Education regulations to require trauma-informed courses for university K-12 teaching programs.
  • ­They led efforts for a resolution in the state legislature to recognize the 26 trauma-informed community networks as a best practice model.
  • They provided consultation and technical assistance to organizations about the process of becoming more trauma-informed. These organizations were in the sectors of child welfare, law enforcement, juvenile courts, schools, and health systems.
  • ­They lead the Richmond City Police Department’s Road 2 Resilience initiative, which has trained more than 500 sworn officers in an introduction to trauma and resilience.
  • They facilitated the education of more than 10,000 people about ACEs science.
  • ­They provide consultation and technical assistance to support the development of trauma-informed community networks across Virginia and convene meetings of the statewide TICN network.
  • ­They participate in the development of Voices’ Campaign for a Trauma Informed Virginia and worked with VAKids.org to support 12 pieces of legislation that include funding for local ACEs initiatives and continued training about ACEs science for community members.
  • They’ve screened the documentary Resilience more than 200 times to more than 6,000 people.

The people behind all these accomplishments work on one of nine committees. Here are a few highlights.

The Healthcare Committee was set up as a learning collaborative for organizations who are at different stages of implementing trauma-informed practices and policies into their settings. These organizations include community health clinics, hospital systems, managed care companies, public health departments, private pediatric clinics, yoga and other wellness studios. 

ARichmondMcG
Melissa McGinn

“Lots of people want to make policy and practice changes,” says McGinn, who leads the committee. “Some organizations are further along than others.” GRTICN also assisted the three major health systems (VCU Health, Bon Secours, and HCA Virginia in launching the local Trauma-Informed Health Systems Collaborative in 2017. McGinn serves as the project manager for this initiative. Each of the three health systems and the Virginia Premier Health Plan, established trauma-informed leadership teams and decided to start their work in pediatric departments. ACEsConnection will do a separate blog post about that effort.

Since the pandemic hit, participants have been focusing on sharing good ideas to foster staff wellness.

“VCU Health, the largest hospital in Richmond has put Zen spaces on many floors,” says McGinn, “where nurses and doctors can rese’ before they have to go to the next hard thing.” Each room has food, soothing lighting, motivational signs, scent diffuser, comfortable seating, and items such as stress balls and coloring books.They also created a peer mentor model and trained several people to be mentors for the staff. That person walks the corridors to check in with staff members informally to see how they’re doing and offer an ear, a shoulder to cry on, or other resources. “They don’t have a structure,” she says. “There’s no reflective supervision. The staff likes it.”

The Legal/Courts Committee members helped the Richmond Police Department set up the Road 2 Resilience project, which has trained more than 500 law enforcement officers in trauma-informed practices such as trauma exposure responses, impact of trauma exposure and trauma-informed supervision. They also do ongoing research about the effects of trauma on police.

ARichmondPD

Road to Resilience project members(Left to right) Cpt. Don Davenport, Elaine Minor, Lisa Wright, Sgt. Adrienne Gardner, Sgt. Frank Scarpa & Lt. Anthony Jackson

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The committee, led by Wright, has also worked with local courts to create trauma-informed environments, which include providing privacy for people applying for protective orders, distributing parent handouts about trauma in some public spaces, and providing a witness box was moved to increase the physical space between victims and their alleged perpetrators, so that people who are testifying against people they fear don’t have to walk past or testify near them.

The largest committee is the Schools Committee. Its more than 90 members include classroom teachers, after-school teachers, parents, school nurses, administrative staff, etc. It’s currently working on developing guidelines for returning to school and is participating in a state-level workgroup convened by the governor to do the same.

The Training Committee was very active early on, because GRTICN members were doing most of the training about ACEs science when there wasn’t as much information available about it. Over the years, they’ve educated more than 10,000 people about ACEs science. Two years ago, the Department of Behavioral Health and Developmental Services received a state grant to fund the ACE Interface train-the-trainers training about ACEs science. 

The members of the training committee still hold 90-minute online trainings every two months for 75-100 people. “It fills up every time,” says McGinn. “A lot of agencies use it for onboarding new staff, volunteers, and board members.” 

They’re continuing to at look at the gaps and needs in the community, as they have for the last eight years, and will use the tools offered by the ACEs Connection Cooperative of Communities to help assess and measure those gaps and needs.

Although they will tell you that this process has been more or less made up by all concerned as they went along—in other words, they had no blueprints—McGinn and Wright point out two big lessons learned.

“Since our initial goal was on improving practices and policies within the child welfare system, we began by being professionally driven,” says McGinn. “We’ve had to work backwards, to be more community driven. We’re providing more guidance to new TICN communities so that from the beginning they’re community-driven.” The Southside Trauma-Informed Community Network (STICN) is a good example of a community-driven initiative. Its members held meetings at local libraries, sponsored community awareness events and invited anyone to join. In 2019, STICN held an ACEs summit in Petersburg where they held workshops examining the intersection of ACEs, trauma, racism poverty, and equity. 

“They included a lot of youth voices and community members testifying about their own stories,” says McGinn.

ARichmondMap

Although in-person meetings halted as a result of the pandemic, says McGinn, “the work of GRTICN has continued at an accelerated pace.” One example is the integration of the North Carolina Project Broadcast Screening tool, which was developed for child welfare workers in North Carolina. It’s meant to help social workers screen for additional assessment of trauma. The tool is brief and comprises questions for caregivers and other professionals regarding trauma history, symptoms and behaviors.

“There are only four questions asked of children ages seven and older,” says Wright. “The departments piloting the tool are using other measures to assess the caregiver/family and resilience in the family. They vary in which ones that they use, but all agencies have been very cognizant to assess the whole family and to have a strengths-based approach.”

The other example is the work of the community resilience committee.

“Since COVID hit,” says McGinn, “the committee has been hosting community conversations for neighborhoods in the City of Richmond. COVID is hitting minority neighborhoods disproportionately. We identified several different ways of hosting the conversations, including Zoom, phone, Facebook Live chats, Instagram conversations. We wanted to elevate the voice of the community. A lot of well-intended people wanted to supply food, but we asked communities what resources they needed.” The community responded with a list of additional items they needed, including wifi hotspots, personal care items, making food distribution more accessible to certain communities, and COVID-19 testing.

They’ve also expanded their work in supporting anti-racist activities.

“We had one of our members who works at the Virginia Center for Inclusive Communities facilitate a discussion about diversity, equity and inclusion for our network,” says Wright, who notes that GRTICN is bringing a DEI lens to all of its work, including the Legal and Courts committee. “We know that there’s a disproportionate representation of minorities in the juvenile justice system. We’re talking about what we can do about that.”

Statement by the Trauma Matters Delaware Steering Group says racism is an ACE

Trauma Matters Delaware (TMD) feels it is important to share our thoughts with our community regarding recent incidents of violence against and deaths of African-Americans. We believe it is important to acknowledge that these incidents are not new, but rather evidence of long standing systemic oppression and structural violence that has traumatized African-Americans and communities of color.  Expressions of pain, anger, and anguish shown over the past few weeks are symptomatic of this historical trauma and will require a unified commitment for listening, understanding, and action to effect sustainable change that is desperately needed. We recognize that racism is an Adverse Community Experience with generational health impacts not only on people of color, but society as a whole.

 
TMD joins in solidarity with those who are working to address this trauma and effect equitable changes in access to opportunities that enable individuals and communities to thrive. We strongly advocate for the importance of physical, moral and psychological safety, empowerment, collaboration, voice and choice, addressing cultural, gender, and historical issues and raising up the voices of those with lived experiences. These principles are central to recognizing and responding to trauma and to promoting resilience and healing.  The recent events have strengthened TMD’s resolve to address injustice and inequality. We look forward to continuing to collaborate with individuals, communities, and organizations to create a trauma informed Delaware where everyone has an equal opportunity to reach their full potential.

Respectfully,
TMD Steering Group

Link to statement:  https://mailchi.mp/ee63e49cb92...-events?e=8e40b85385

Northeast and Mid-Atlantic trauma leaders share successes and challenges at May 1 networking meeting

Leaders in ACEs/trauma/resilience movement from nine states in the Northeast and Mid-Atlantic and the District of Columbia gathered for a networking call on May 1 to learn about flexible funding opportunities for states under the CARES Act, ways to get involved in advocacy, and share their successes and challenges in building statewide coalitions.  

The meeting of leaders was organized by ACEs Connection and the Campaign for Trauma-Informed Policy and Practice (CTIPP) in response to COVID-19 and the growing interest in organizing statewide coalitions. Taking a page from the governors in various regions around the country who are meeting to coordinate efforts around COVID-19, state coalitions jumped at the opportunity to share and learn from neighboring states. 

Members of the CTIPP National Trauma Campaign Core Team, Marlo Nash, Dan Press, and Jesse Kohler, focused on federal legislation that affects the states and described ways for advocates to get involved.  Marlo Nash, National Director of Partnership and Policy, Saint Francis Ministries, presented on the flexible funding opportunities in CAREs ACT and future legislation to support trauma-informed programs and policies—this presentation is summarized in a recent post on ACEs Connection.  Dan Press, legal advisor to CTIPP and attorney with the firm Van Ness Feldman, and Jesse Kohler provided tips on how both individuals and organizations can have an impact on national policy.  Kohler serves on the CTIPP Board and is involved in launching Pennsylvania Trauma-Informed Care Network. Check the ACEs Connection calendar next week to register for a "Better Normal" conversation on this topic May 15 at 3:00 pm EDT.

The bulk of the call was devoted to reports by participants on their accomplishments in forming state coalitions and the areas where help is needed.   Zoom chat comments reflected how valuable participants saw this exchange—“this is such an amazing opportunity to share and learn” and “ and it is “so helpful to hear what is happening in neighboring states!”

Here are some quick summaries of what the states reported (some of these comments were included in a short survey circulated prior to the meeting):

Connecticut
The Connecticut ACEs Task Force is in the early stages of development but is building on the deep experience and expertise of key leaders representing two major organizations in the state that incorporate ACEs science into their programming—the Connecticut Women’s Consortium and the United Way of Coastal Fairfield County.  Kathleen Callahan of the Consortium and Katerina Vlahos of the Fairfield Co. United Way participated in the call and connected with states they’ve already consulted with and made new connections. Efforts are just underway to increase the Task Force’s impact on the state legislature and executive branch.

Delaware
Trauma Matters Delaware (TMD) has been active for years and has gained the support of the Governor and Delaware’s First Lady.  Governor Carney signed an Executive Order that supports the work for Delaware to become a trauma-informed state.  Marilyn Siebold with Wilmington University and Deb Stevens with the Delaware State Education Association—both leaders in TMD—see the coalition as well positioned to grow its statewide, multi-sector work.

Washington, D.C.
Cynthia Greer with Trinity Washington University stated that the District’s “taxation without representation” is part of the legacy of historical trauma in the nation’s capital.  DC was considered a territory in the recent stimulus package, resulting in a lower level of funding than the states.  The Center for Community Resilience at George Washington University, led by Dr. Wendy Ellis, was represented by Caitlin Murphy.  DC-MD-VA is one of 8 of communities in the Building Community Resilience (BCR) collaborative.

Maryland
Claudia Remington with MD Essentials for Childhood highlighted these accomplishments:
—120 ACE Interface Trainers across the state
—ACEs Roundtable for Members of the Maryland General Assembly (read post on MD ACEs in Action Community page)
—for 2 years have held an ACE Education & Advocacy Day at the Maryland General Assembly, advocated for ACE & Resilience informed legislation (passed several)
—statewide coalition/alliance cross-sector with both public and private agencies and individuals involved...and linked to and encouraging formation of ACE local partnerships (in 6 MD jurisdictions to date) —ACEs Legislative Brief, SCCAN Annual Reports since 2010 have highlighted the work

Massachusetts
A roundtable was held in early March with organizations across the state to discuss becoming a trauma-informed state. Jennifer Cantwell reported in ACEs Connection that the “City of Worcester, The Drug Endangered Children’s Initiative of the Plymouth County Drug Abuse Task Force and Wayside Youth and Family Support Network – all recipients of Office for Victims of Crime federal grants – have teamed up with Mass Inc., UMass Medical Center, UMass Medical School, Worcester ACTs, Worcester Public Health Department, and State Senator Harriette Chandler to host an opportunity to learn about trauma informed policies and share best practices.” Audrey Smolkin with the University of Massachusetts Medical School raised issues related to racial inequities and state legislators’ interest in providing trauma responsive trainings for teachers and early childhood providers.

New Jersey
Kimberly Boller of The Nicholson Foundation and several colleagues as well as a representative from state government participated.  The Nicholson Foundation along with two other foundations released a report in July 2019, Adverse Childhood Experiences: Opportunities to Prevent, Protect Against, and Heal from the Effects of ACEs in New Jersey. The report “details the challenges New Jersey faces in addressing Adverse Childhood Experiences (ACEs) and calls for a coordinated statewide response to mitigate their lasting effects on children’s health and well-being.  Meryl Schulman with the Center for Health Care Strategies provided an update on efforts in the state to educate policymakers and communities about trauma-informed approaches.Image 5-6-20 at 10.06 PM

New York
Members of the the New York Trauma Informed Coalition have been meeting regularly to develop strategies and build partnerships.  The Coalition held a Trauma-Informed Virtual Rally on April 30 and invited all impacted by ACEs “to join forces and create a plan of action for a trauma-informed response.” Jenn O’Connor, Prevent Child Abuse NY, reported on a legislative initiative to amend the New York constitution to require the state to incorporate trauma-informed approaches.

Pennsylvania
Rob Reed of the Pennsylvania Office of Attorney General has traveled throughout the state in a grassroots effort to create local trauma-informed coalitions.  He also is involved in a Pennsylvania Think Tank to create a trauma-informed state.  Daniel Jurman who is involved in the Governor’s COVID-19 response reported that trauma-informed approaches will be part of the state’s recovery plan.

Rhode Island
Two representatives of the Ocean State Trauma Informed Community Coalition (OSTICC)— Christine Hathaway and Wil Beaudoin—participated.  Hathaway reported that “the founding members of OSTICC began working together on a trauma informed initiative in 2015. The group was comprised of state and private sector professionals working with adults who have intellectual/developmental disabilities with the goal of learning successful ways to implement organizational change dedicated to implementing trauma-informed practices to reduce the use of seclusion/restrain and trauma while supporting professionals providing direct support.” Prior to the COVID crisis, OSTICC leaders were planning a fall conference on trauma informed approaches in building a community that is trauma responsive. They are working to expand on current partnerships that include the Governor's Commission on Disabilities, the RI DD Council, the City of Providence and several smaller organizations within the community.

Virginia
Virginia has had a statewide coalition of Trauma Informed Community Networks (TICN) since 2012.  Now there are 26 TICNs in the state.  Melissa McGinn, the state’s TICN coordinator/Greater Richmond SCAN, reported that several years ago they worked to get a resolution passed with the General Assembly to recognize the importance of Trauma Informed Community Networks across the state as a mechanism to build community resilience. In addition, she said they have held a Trauma Informed Virginia Advocacy Day in Richmond, the state capital, where they “pulled together teams from across the state to advocate for selected bills that promote trauma informed practice and address the impact of ACEs.”

As the survey responses are received and additional connections are made among the participants, we will provide updates on the State ACEs Action site on ACEs Connection.  Among the challenges the states reported were the need for sustainable funding to support coalitions and recruiting and developing diverse partnerships.  A major issue that was raised by a number of participants is the need to address the inequities and health disparities that are in shocking display with the COVID crisis. Others wanted to learn more about what states and localities are doing to address grief and other losses from the COVID crisis.

Participants were encouraged to communicate with state policymakers about the need to address ACEs and trauma now and in the aftermath of the COVID crisis to mitigate its traumatic impact. For the meeting, Jane Stevens, founder and publisher of ACEs Connection, curated a short list of examples of successful programs around the country using trauma-informed approaches (attached), providing examples of the types of programs that state coalitions should share with policymakers. State coalitions were encouraged to share successful programs with the Governor and urge that they be taken to scale.

ACEs Connection and CTIPP have scheduled a similar meeting with the Mid-west region on May 11 at 10:00 Central Time. Additional networking meetings will be scheduled for other regions.  Please respond in the comment section below if you have questions or comments. 

 

Join Feb. 18th webinar on addressing ACEs in public policy

Please join this ACEs Connection co-sponsored webinar "Making Meaningful Change:   Addressing ACEs through Public Policy" on Feb. 18 (11:30 am-1:00 pm ET) presented by the Health Federation of Philadelphia and MARC (Mobilizing Action for Resilient Communities).

In this webinar, three nationally recognized experts will discuss policy and advocacy strategies on a local, state, and national level using evidence from studies they have conducted with legislators and the general public. Speakers will share advocacy and messaging "how to’s" including communicating the effects of structural racism as an ACE and fostering equity as an essential component of resilience, and leveraging the power of community based ACE, trauma and resilience networks to influence policy. 

Chick here to register. 
Presenters: 

Aditi Srivastav, PhD, MPH
Director of Research 
Children's Trust of South Carolina

Wendy Ellis, DrPH, MPH
Director, Center for Community Resilience
George Washington University

Jonathan Purtle, DrPH, MPH
Assistant Professor
Dornsife School of Public Health
Drexel University

Moderated by:
Leslie Lieberman, MSW
Senior Director, Training and Organizational Development
Health Federation of Philadelphia

Co-sponsors:
ACEs Connection
Campaign for Trauma Informed Policy and Practice (CTIPP)
Children’s Trust of South Carolina
Center for Community Resilience, George Washington University

Background:  Mounting evidence demonstrates that adverse childhood experiences (ACEs) are a root cause of chronic disease and illness. This has spurred public health action, ranging from increasing public awareness to developing cross-sector community networks. However, to see sustainable and meaningful change, researchers, practitioners and advocates need to partner with legislators to develop and implement public policies that support and sustain efforts to prevent ACEs and mitigate their effects. 

 

Two studies shed light on state legislators’ views on ACEs science and trauma policy

New and returning lawmakers take the oath of office on day one of Washington state's 2017 legislative session. — Jeanie Lindsay/Northwest News Network

As advocates prepare to see how ACEs (adverse childhood experiences) science, trauma, and resilience play out in the 2020 state legislative sessions — many beginning in January — they are undoubtedly asking: “What does a legislator want?"

It may be a stretch to play on Freud’s question: “What does a women want?", but the query captures how communication among humans is often perplexing and fraught. Two studies released in 2019 shed some light on this question as it addresses state legislators’ perspectives and opinions on the science of adverse childhood experiences. 

The lead authors of both studies — Jonathan Purtle of Drexel University and Aditi Srivastav of the Children’s Trust of South Carolina and the University of South Carolina — examine state legislators’ knowledge and views on ACEs science using different approaches. Purtle’s study is quantitative and surveys a national sample of legislators, while Srivastav’s is qualitative and queries South Carolina legislators. Both studies recognize the importance of state legislators’ views on the impact of ACEs because the policy decisions they make have a significant impact on preventing ACEs and building resilience. 

The ultimate goal of the study by Purtle and his co-authors “was to provide an empirical foundation to inform how evidence about ACEs as risk factors for behavioral health conditions can be more effectively disseminated to state legislators.” While some research has been done about how to communicate evidence about early childhood (e.g., research by FrameWorks Institute focuses on a public audience and other studies examine views of primary care providers), Purtle's study aims to address the lack of research on attitudes of policymakers with “the ultimate goal of maximizing the persuasive power of the messages…” This suggests ”the need to tailor evidence summaries for legislators” on the basis of characteristics such as political party, ideology, and gender. The authors conclude that there is a "need for research that examines the effects of various ways of framing evidence on opinions about ACEs and how ideology moderates message effects.”

The Purtle study asks about how four ACEs (childhood sexual abuse, physical abuse, witnessing domestic violence, and childhood neglect) “increase a person’s risk of developing a mental illness or substance use disorder as an adult.” The focus on mental health and substance use rather than overall physical and mental health in adulthood is because the research was part of a larger study that focused on behavioral health. Asking about all 10 ACEs wasn't possible the survey would have been too long.

Participants were asked specifically if they knew about the ACE Study. The majority (67%) said "no" or "not sure". Liberals and moderates were found to have considerably higher levels of knowledge about the ACE Study than conservatives. Since the survey was conducted in 2017, knowledge of the ACE Study has undoubtedly increased in the interim, but the need for basic education is still high, especially among conservatives.

Other highlights as summarized in the study include:
—A survey of U.S. state legislators found that 77% identified childhood sexual abuse as a major risk factor for adult behavioral health conditions, 59% identified childhood physical abuse, 39% identified witnessing domestic violence as a child, and 38% identified childhood neglect.
—The proportion of legislators who identified each adverse childhood experience (ACE) as a major risk factor for adult behavioral health conditions was significantly higher among Democrats than among Republicans, among liberals than among conservatives, and among women than among men.
—Many state legislators were unaware of or unpersuaded by evidence about the extent to which ACEs influence risk of adult behavioral health conditions, especially the experiences of witnessing domestic violence and childhood neglect. (The authors found this finding “troubling” since witnessing domestic violence accounts for a considerably higher burden of mood, anxiety, and substance use disorders than physical abuse, and childhood neglect is strongly associated with risk of adult behavioral health conditions.)

The study found the largest differences were between liberal and conservative legislators: “The proportions of liberal legislators who identified witnessing domestic violence and childhood neglect as major risk factors for adult behavioral health conditions were nearly twice those of conservative legislators…” The authors concluded: “Our study highlights the importance of increasing legislators’ knowledge about the potential severity of these ACEs as well as interventions that can prevent exposure and mitigate their consequences.”

The authors concluded that “researchers and advocates might consider developing multiple versions of ACE evidence summaries that are tailored on the basis of these characteristics” [e.g., liberal vs. conservative]. Summaries for Republicans/conservatives, for example, might be more persuasive if they emphasis the economic costs of ACEs and how policies can “enhance resilience to ACEs instead of emphasizing the possible neurobiological effects of ACEs.”

South Carolina Study

The South Carolina study — Addressing health and well-being through state policy: understanding barriers and opportunities for policymaking to prevent adverse childhood experiences (ACEs) in South Carolina — comprised interviews with 24 state legislators conducted in 2018. Participants were diverse, reflecting the make-up of the legislature in terms of party, region, gender, race, and House and Senate. 

In a November meeting of the American Public Health Association (APHA), Srivastav summarized the purpose of the study:

  • This study sought to understand barriers and opportunities for policies and program creation and implementation 
  • Used the perspectives of state legislators to build insight on state advocacy strategies for ACEs
  • Focused on understanding how to best communicate research and data surrounding complex topics in public health while pushing forward ACE policies

She reported that legislators have a general understanding of ACEs science and recognize the intergenerational component of ACEs, but they do not see the link between ACEs and long term health outcomes. To get legislators to care about ACEs science as a policy issue, she suggests using terms childhood trauma and ACEs strategically. The term “childhood trauma” was found to be more serious and urgent than adverse childhood experiences but “ACEs frames the issue as something that affects many children instead of a certain population or group, possibly increasing its significance.”

C8B2A0E3-89C9-48FD-9171-72AAFF3925DDThe study findings suggest the importance of making ACEs a solvable policy problem with legislators recommending several options that advocates should consider: 1) talking about ACEs and a health outcome that has a pressing need to be addressed, 2) focusing on the link between ACEs and cost, or 3) highlighting how ACEs relate to a core function of government (e.g., child protective services). It is also important to embed the issue in a hot topic such as mental health, the opioid epidemic, and education reform. The findings suggest that prevention cannot be the main argument.

The study found that stories, in addition to data and research, were important to legislators in the presentation of policy options. Several legislators said they “were more likely to listen to stories that came from within their district about the effects of ACEs” than traditional policy advocacy strategies such as policy briefs or one-pagers. Others suggested presenting data and research in the form of policy briefs was important. The source of the data analysis (e.g., their own staff, experts, legislative committee staff, fellow legislators) affected the trust placed in the information by legislators. 

In the context of framing ACEs as a measurable and solvable issue in public health, the authors discussed how there is the focus on interpersonal causes of ACEs and lack of awareness of the social, environmental, and political factors that can influence early childhood experiences. They suggested that as ACEs increasingly include community conditions, these definitions can be used to better describe “the role of policy and other macro-level influences in addressing ACEs.”

Both studies, which are attached to this post, conclude that more research is needed on advocacy messages to translate ACEs science into policy action. 

ARealms

ACEs Connection launches Cooperative of Communities

Like most of you, when I learned about the science of adverse childhood experiences, I was blown away! A huge missing answer in my professional life clicked into place, and the disconnected puzzle pieces that comprised my personal life merged into a clear picture. It was a double AHA! moment.

Another AHA! that hit me not too long after I launched ACEs Connection was that the transition to healing-centered cultures based on ACEs science was not a three- or four-year endeavor. Depending on the community, it’s at least a 20-year transition, and more likely, a 30- to 40-year transition.

This is one of the reasons we’re launching the ACEs Connection Cooperative of Communities today. We want to continue to contribute to the ACEs movement to grow and support people, families, organizations, systems and communities for as long as it takes to create a worldwide healing-centered culture based on ACEs science. We want that to take hold in this world in the same way electricity has — we only notice it if it isn’t there.

First, a clarification: Nothing on ACEsConnection.com changes! Membership is and remains free! Everything — the guidelines for starting and growing ACEs initiatives, the presentations tracker, interaction with community facilitators…everything — that our current 300+ communities use is free. And it will remain free for initiatives that want to start communities on ACEsConnection.com.

So, what’s the Cooperative of Communities, then? It’s an addition to ACEsConnection.com. It’s for ACEs initiatives that have progressed to the point where they’re ready for more tools and services. Specifically, the ACEs Connection Cooperative of Communities is a program of ACEs Connection that provides special tools and services for ACEs initiatives in neighborhoods, towns, cities, counties, regions, states and countries. It’s affiliate-driven, which means that ACEs initiatives steer the course of the cooperative. Affiliates pay $5,000 a year to participate, an amount that is low enough so that the cost can be shared among organizations and individuals; organizations can take turns paying; initiatives can even crowd-source the funding; and it may not even require a line-item in a budget. They receive access to tools and services that cost them a fraction of what it would cost for them to develop those tools and services themselves. 

An affiliate’s benefits include:

  • data-gathering tools and guidelines, including a Community Resilience Tracker (here’s a prototype of a tracker)
  • access to virtual think-tanks
  • eligibility for participation in cooperative committees and advisory committees
  • jobs bank
  • (coming later in 2020) fiscal pass-through for qualifying funds/activities


Who is eligible to become an affiliate in the cooperative? ACEs initiatives with:

  • demonstrated six-month history as an ACEs initiative (you don’t need to have had a community on ACEsConnection)
  • cross-sector representation of at least four sectors (e.g., education, law enforcement, healthcare, faith-based)
  • a committee responsible for interaction with ACEs Connection, to handle the affiliate agreement, payment, fiscal pass-through, etc.
  • an MOU or other similar agreement with participating organizations and individual members of their ACEs initiative
  • at least one community manager, paid or volunteer


Affiliates of the cooperative will guide the development of the cooperative; that’s another reason we’re starting it. Most foundations and agencies have a limited funding horizon, including the good people who support ACEs Connection. That horizon is usually two or three years, occasionally five or 10, but very rarely longer. (We’ve been very fortunate to have two of our funders support us for six years.) The question from funders that most nonprofits have to answer is: At the end of this grant, how will you sustain your work?

But, as I noted earlier, the transition for ACEs science to become integrated in most communities, and for communities to integrate practices based on ACEs science into most of their organizations and systems will take decades. Most of the world doesn’t know ACEs science from aardvarks; most people and organizations haven’t caught up to what ACEs science is or means. That’s just the nature of this change. It’s BIG — transformational on the scale of the Internet, electricity, the iPhone, social media and the concept of love. We’re moving from a world that by and large uses blame, shame and punishment to change human behavior — which has resulted in our burden of seemingly intractable health, economic and social problems — to one that uses understanding, nurturing and healing, which has been shown to solve our most intractable problems. 

Some examples: By integrating healing-centered, trauma-informed practices based on ACEs science, an elementary school in San Diego stops suspending and expelling students. A health clinic in Pueblo, Colorado, sees a 30 percent drop in visits to the emergency room. A juvenile diversion program in Philadelphia reduces arrests from 1600 to 500 in three years. In San Diego, during the first year of a juvenile detention facility built to be trauma-informed from the ground up, there are no violent incidents whatsoever. Pediatricians say they have a better relationship with parents and their kids. They can address developmental problems and identify family violence earlier to prevent lasting damage. After one year, family courts that integrate the Safe Babies Courts approach see 99 percent of the kids suffer no further abuse. A family physician in Tennessee who treats people addicted to opioids sees that 99 percent of his patients are able to hold down a job, which is the best indicator of healing. Within 24 to 48 hours after a person recovers from an opioid overdose in Plymouth County, MA, a police officer visits and offers to take them to a rehab facility right then and there. And then says, “How about I treat you to dinner on the way?” Opioid deaths in the county drop 26 percent, while in the surrounding counties, death rates increase 84%. A batterer intervention program in Bakersfield, CA, sees recidivism rates fall from 60 percent to six percent. The Wisconsin Economic Development Corporation sees staff turnover decline from 21 percent to just 10 percent. In Cowlitz County, WA, youth suicide and suicide attempts drop 98 percent.

Big change — change that affects everything — takes time. But we have a plan to accelerate this change. By growing the cooperative, we hope and plan for ACEs Connection itself to become self-sustaining in about three years. That, in turn, will enable us to start funding new ACEs initiatives with the small amounts of money they need to get started. Those small amounts of funding are usually hard to come by while an initiative is getting organized; the cooperative will be in a prime position to identify and support nascent ACEs initiatives and give them the boost they need for a healthy launch, faster than most funders can. We also want to create a process and perhaps a fund that will support — and encourage local and regional funders to support — pivotal points in the growth of ACEs initiatives as their work becomes ever more integrated into all organizations in their communities. Both of these approaches will continue to accelerate the ACEs movement. We need to accelerate it. We’re facing some extremely challenging times as climate crises increase. It would make a lot of sense to have people better-equipped to handle these crises and to reduce our current problems so that we have adequate resources to address the new ones.

Because the cooperative will be affiliate-driven, ACEs Connection will be more closely guided by people who are working day-to-day in the movement, who have the experience to respond quickly to changes that occur in the movement, and the foresight to understand how circumstances outside the movement may affect it.

Even if ACEs Connection is fortunate enough to become self-sustaining, we still want to work with national and regional funders on a long-term basis on research and development. R&D projects include developing ever more complex data tools to measure progress; formulas to calculate economic savings in other sectors when one sector sees progress after integrating practices based on ACEs science, to encourage support of continued investment in change; and research to identify tipping points in sectors and communities, to accelerate the process of change.

We and others calculate that under 1,000 ACEs initiatives have been launched in cities and counties across the U.S. There are 34,000 cities and counties across the U.S.; each one will need to integrate practices based on ACEs science if they want to solve their most intractable problems.

We’ll be posting more information about the Cooperative of Communities soon. A couple of communities will debut their Community Resilience Trackers in a few weeks, so that you who are interested can see a tracker in action. If you have questions now, either leave them in the comments section, below, or if you’d like to talk with an ACEs Connection Community Facilitator, use this link to identify the person who can help you and contact them.

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