As early as this week, the National Governors Association (NGA)—the premier organization representing the nation’s governors—is expected to release a new report providing guidance to the states on preventing and mitigating the effects of adverse childhood experiences and promoting resilience in children and families. The report marks the culmination of a learning collaborative launched early in the pandemic involving five states—Delaware, Maryland, Pennsylvania, Virginia, and Wyoming.
The initiative—“Improving Well‐being and Success of Children and Families – Addressing Adverse Childhood Experiences Learning Collaborative”—provided technical assistance to the five states, the development of two case studies of Tennessee and California, and the soon-to-be-released report "State Actions to Prevent and Mitigate Adverse Childhood Experiences." It will highlight lessons learned from the NGA-sponsored ACEs Learning Collaborative from states that served as models (Alaska, California, New Jersey, and Tennessee) for statewide approaches that prevent and address ACEs and the development of trauma-informed policies. The paper also addresses the goals, policy, and programs developed and launched by five states that were selected for the Learning Collaborative.
Other states including New York, New Jersey, and North Carolina participated in a Mid-Atlantic meeting in October that was convened to sustain the work in the region to address trauma and ACEs issues. There is interest in continuing this multi-state, regional work. NGA recognizes that the pandemic only increases the need to address ACEs: “The COVID-19 pandemic may be increasing adverse childhood experiences and trauma and demonstrates the importance of responding to them at the state level.”
The case studies of Tennessee and California provide overviews of initiatives in every state, taking diverse approaches to preventing and mitigating ACEs. Click here for “A Case Study of Building Strong Brains Tennessee (BSBTN): An Initiative to Address Adverse Childhood Experiences and Become a Trauma-Informed State” and here for the “Case Study of California’s ACEs Aware Initiative.”
The Tennessee case study describes BSBTN as public/private partnership to address community issues with leadership from the executive, legislative, and judicial branches of state government. It also “mobilizes knowledge derived from the science of brain development and communication science.” The decentralized, community-focused approach in Tennessee reflects the state’s politically conservative environment. In contrast, California’s ACEs Aware Initiative focuses on changes to the healthcare system, which provides incentives for Medicaid providers to screen for ACEs.
The Tennessee case study summarizes the factors critical to the success of BSBTN:
- Champions across the three branches of government, among foundations and within the community. Strong leaders at every level embedded the mission of BSBTN in public remarks, policy discussions and in the community.
- Public/Private Collaboration. The public/private relationships that serve as the foundation for BSBTN’s structure has assured local solutions are being developed to address community issues.
- Empowering Communities to Act. Communities—fundamental to the success of BSBTN—were prepared and supported by the three branches to act and innovate.
- Focus on Creating Culture Change. Transforming thinking and actions across all functions of society led to culture change, emphasizing making changes in an individual or groups’ own sphere of influence.
- Evidence-Informed Messaging. Extensive use of research-tested terminology and methods of communication permitted common understandings of the mission and expectations for culture change. BSBTN also periodically assessed what works and refined their approach knowing culture change is not a sprint but a marathon.
- Sustainable Resources. Financial, in kind, and programmatic supports across government and from key partners helped get the initiative off the ground and maintain ongoing work. Approaches to assure sustainability both with and without dedicated fiscal resources were critical to facilitating future work.
The California ACEs Aware initiative, according to NGA, “takes an innovative, evidence-based approach to addressing adverse childhood experiences and toxic stress by educating and training health care providers who are directly interacting with the public.” The case study lists the key elements that have contributed to the success of the ACEs Aware initiative:
- Strong leadership from the Governor and executive branch, as well as legislative support and funding for early detection and evidence-based interventions for ACEs and toxic stress;
- The appointment of the state’s first Surgeon General to serve as a champion for the initiative;
- The development of a financial incentive to align health systems and motivate health care providers to learn about ACEs, begin screening patients and respond to risk of toxic stress;
- Continuous improvement processes that ensure best practices are used and community networks of resources are available; and
- Maintenance of innovation through sustainable funding by means of grants, collaborations and shared experiences.
For more information about the NGA ACEs Learning Collaborative, the soon-to-be released paper, and the work of Virginia and the states in the Mid-Atlantic, join the Campaign for Trauma Informed Policy and Practice Community Advocacy Network (CTIPP CAN) meeting on December 15, 2:00-3:30 pm ET. Featured speakers include Chidimma Jenkins, advisor on Childhood Trauma & Resiliency, Health and Human Resources, Commonwealth of Virginia; and Shelby Hockenberry, PhD, of the NGA. The call-in information is attached.
The NGA ACEs Collaborative report will be posted here on PACEs Connection as soon as it is available.
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