Adverse Childhood Experiences Legislation

May 11, 2017|1:24 p.m.| KT Kramer

Adverse childhood experiences (ACEs) broadly describes abuse, neglect, and other traumatic events that occur in an individual’s life before the age of 18. An ever-growing body of research finds that individuals with a history of ACEs suffer long-term, serious, and negative health outcomes, ranging from heart attacks to increased rates of diabetes. In fact, one study found that on average, an individual who experienced six or more ACEs will die 20 years before an individual who hasn’t.

State and territorial policymakers play a key role in preventing ACEs and mitigating the impact of ACEs when they do occur. In 2011, Washington became the first state to enact legislation that referred to ACEs. The law required a multi-sector stakeholder planning group to identify ways to reduce and prevent ACEs. In 2013, New Mexico defined “home visiting” as “a program strategy that…is designed to promote child well-being and prevent adverse childhood experiences,” and Oregon specified that the community health improvement plans developed by coordinated care organizations must be based on research that included ACEs. In 2014, Arizona began requiring the department of child safety to provide “impact and intervention practices related to adverse childhood experiences” to its child welfare investigators and child safety workers. Both Minnesota and Vermont included ACEs in 2015 legislation.

Minnesota expanded children’s mental health grants to include training for “parents, collaborative partners and mental health providers on the impact of adverse childhood experiences” and developed a website “to share information and strategies to promote resilience and prevent trauma.” As part of Vermont’s proposed all-payer redesign, the “extent to which the [accountable care organization] ACO provides incentives for preventing and addressing the impacts of adverse childhood experiences and other traumas” is one of the factors to consider when “reviewing, modifying, and approving the budgets of ACOs.” Most recently, Washington, D.C. tasked the Criminal Justice Coordinating Council with looking at the causes of youth crime by assessing the prevalence of ACEs.

ASTHO is tracking bills and resolutions from 10 states that include ACEs language. Legislatures in Alaska (HCR 2), Hawaii (HCR 2017 132/HR 2017 82/SCR 2017 136/SR 2017 57), Illinois (HR 304/SR 489), and Virginia (HJ 652/SJ 263) introduced resolutions urging a coordinated, state-wide response to address ACEs. California (AB 11) is proposing a grant program to support a systems-approach to provide support to children who experience ACEs. Missouri (HB 1175), New York (AB 3427), and Texas (HB 4083) seek to leverage ACEs screening processes to assess health risks. New York’s legislation (AB 3424) establishes a multi-sector task force to identify solutions to reduce exposure to ACEs, which includes members appointed by the legislative and executive branches. Vermont has several bills (H 281/H 508/S 90) that include policies such as dedicated staffing to support ACEs efforts, expanded home visiting programs, task forces and committees to assess current policies and recommend improvements, as well as incorporating ACEs screening into primary care. Finally, in Washington state, a bill (HB 1639) creates a pilot program to provide trauma-informed care at child care facilities and requires pilot sites to reserve “at least fifty percent of their slots for children who have experienced an adverse childhood experience.”

Supporting environments where children and families can thrive is vital to improving the health and well-being of communities across the states and territories. Advancing targeted policies to address ACEs is one way for policymakers to achieve this end, and ASTHO remains dedicated to tracking this legislation.