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Standing on the shoulders of giants:  Trauma-Informed Pennsylvania builds on a foundation of early leadership and many community initiatives

 

Governor Tom Wolf, Pennsylvania

When Governor Tom Wolf’s office announced the release of “Trauma-Informed PA:  A Plan to Make Pennsylvania a Trauma-Informed, Healing-Centered State” on July 27, it was a significant milestone in the state becoming trauma-informed but only one of many over the long and storied history of addressing childhood adversity in the state.

In 2005, Dr. Sandra Bloom and her Philadelphia colleagues began their pioneering work on the Sanctuary model (see Sanctuary Institute) to transform thinking about human behavior, starting a movement animated by asking not “What’s wrong with you?” but “What happened to you?”

In 2013, the first national ACEs Summit was held in the city and organized by the Philadelphia-based Institute for Safe Families. The Philadelphia ACEs Project was one of the earliest local community initiatives focused on ACEs, and the first community site on ACEs Connection. Philadelphia was one of 14 states and communities chosen by the Mobilizing Action for Community Resilience (MARC) project organized by The Health Federation of Philadelphia. The Robert Wood Johnson Foundation provided funding for ACEs Connection, the MARC project, and most recently, an “Addressing ACEs Learning Collaborative” of the National Governors Association (NGA), which includes Pennsylvania and three other states.

There are ACEs/trauma/resilience initiatives throughout the state. The new Pennsylvania Trauma-Informed Network site on ACEs Connection links to 10 community initiatives throughout Pennsylvania. Starting a state site on ACEs Connection was one of the deliverables listed in the “Trauma-Informed PA” plan.

Strong community-based projects at the local level laid the foundation for the newly formed Trauma-Informed Pennsylvania initiative and are integral to the work ahead.  A network of local initiatives provides a structure to support implementation of the state level plan. The combination of support from the state executive branch, legislature, and the communities helps to ensure the initiative will continue even when the governor who provided the initial leadership leaves office. Governor Wolf is in the remaining two years of his final term of office, but the initiative should survive in part because of the deep grassroots support.

The buildup to today’s achievement—the development of a plan to achieve a trauma-informed state that will guide the work ahead—is a culmination of a long history of trauma work and a few key leaders creating and seizing opportunities in recent years.  The accounts of some of those leaders provide a context for how Pennsylvania got to this moment.

Dan Jurman
Dan Jurman

Similar to other stories about how trauma-informed communities got started, Dan Jurman, executive director of the Office of Advocacy & Reform, Office of the Governor, and leader of the development of the Pennsylvania plan; and Robert Reed, executive deputy attorney general for special initiatives, Office of the PA Attorney General, had their own “Ah Ha” moments around ACEs and trauma, acted on their new knowledge and insights, and found their paths crossing along the way. 

When he was appointed by Attorney General Josh Shapiro in March of 2017 to head the new office of public engagement, Rob Reed began to speak to groups and individuals in many sectors around the state about ACEs and trauma. It was then that he began to realize how valuable it would be for all of the emerging and established efforts to connect. When he was a federal prosecutor, Reed had often seen the tragic consequences of criminal justice involvement (“the what”) but didn’t understand “the why” until he learned about ACEs. That happened in 2010 when Dr. John Rich, Chair of Drexel University’s Healing Hurt People initiative, told him about a hospital-based violence prevention program. He learned about Sandy Bloom’s work and eventually did trainings for Philadelphia city employees, police officers, probation officers, judges, returning citizens, and community members. He and Bloom also partnered with Gerry Vassar, the CEO of Lakeside to present at a number of trauma-informed conferences across the state.

D3BCF67E-FA7F-419A-B484-DD0085E822A5_4_5005_c
Robert Reed

Reed discovered that great work was being done in the counties but not in a coordinated way.  He imagined how great the impact would be if all systems worked together from education to health care to human and family services, to criminal justice, veterans, first responders, victim services and others. Serving on the Think Tank under the direction of Dan Jurman gave Reed an opportunity to move that aspiration to reality.

Dan Jurman’s career in the private and non-profit sectors led him to ACEs as a way of understanding the root causes of the many social problems he was addressing in his non-profit work related to health care, domestic violence, early childhood, and poverty. Reed and Jurman met along the way at one of Reed’s many presentations and in January of this year, they had coffee and shared their dreams of amplifying the work being done locally by connecting entities across the state. 

After a horrific child-related tragedy, the Governor issued an Executive Order that created the Office of Advocacy and Reform with a directive to create a Trauma-Informed Pennsylvania. Dan Jurman was selected to be the executive director in December 2019.  He created a Think Tank of 25 members, expecting to have 10-member group but increased it to 25 when 68 people applied. He envisioned the group would meet by Zoom so the pandemic did not change the original plan. Jurman has asked the 43 people who applied for membership in the original task force to work with the Think Tank on implementation of the plan. 

The plan contains specific recommendations to create a trauma-informed state government (pages 32-43), starting with the importance of embedding “trauma-informed and healing-centered practices and principles into the culture of every state office and agency, as well as in the culture of every county office and nonprofit social service agency and faith-based program…” This would be accomplished by requiring all state employees and others to receive training in trauma-informed care. A separate recommendation calls for all state legislators to be trained as well as local elected officials. The job descriptions for state employees would include adherence to trauma-informed and healing-centered principles.  For years prior to the executive order, people around Governor Wolf advised him about the power of trauma-informed approaches, according to Jurman. In his 2019 Budget address, Wolf highlighted support for home visiting and other programs to support parents and their children framed to prevent ACEs. He said:

“Home visiting programs promote healthy relationships and safe and stable home environments. They’re proven to work in preventing adverse childhood experiences, giving children and their parents the skills they need to reach their full potential and lift families out of poverty and into good jobs.”

Below is a recent timeline that shows the progression from the executive order until now:

—July 31, 2019
By Executive Order, Wolf announced “an overhaul of state services and systems to protect most vulnerable Pennsylvanians…”  The order established the Office of Advocacy and Reform (with a charge to make Pennsylvania a Trauma-Informed State), the position of Child Advocate, and the Council on Reform to study best practices and make recommendations to improve support and protection of vulnerable populations. Prior to the executive order, Wolf mentioned adverse childhood experiences in his Feb. 5, 2019 Budget Address.

—December 2019
Dan Jurman, Executive Director of OAR hired

— February 2020
Nicole Yancy filled the new Child Advocate position in the OAR

—May 7, 2020
Governor announced the launch of the 25-member think tank in the Office of Advocacy and Reform.

—July 27, 2020
Governor released the “Trauma-Informed PA” plan to guide the commonwealth and service providers statewide on what it means to be trauma-informed and healing-centered in PA.

Both Jurman and Reed spoke of taking action now but also recognizing the importance of taking the long view. This work was needed before the pandemic but both COVID-19 and the racial reckoning bring urgency to taking decisive action now.  We’ve “pulled back the curtain on this country’s racism,” says Reed. At the same time that the pandemic has heightened stress levels at a minimum, if not caused widespread trauma.  

"But there is no vaccine for racism or for trauma,” he says. The problems of racism, health disparities, and inequality are exposed by the pandemic, and Pennsylvania and other states expect to find many of the solutions in integrating policies and practices based on ACEs science and taking a trauma-informed approach. 

 

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