What should trauma-informed cities and counties ask their states for? 

And as I reported earlier in a blog, Dr. Felitti, Sealaska Heritage Institute President Dr. Rosita Worl and I had a meeting with Alaska Governor Bill Walker, Lt. Governor Byron Mallott, Corrections Commissioner Dean Williams and Chief Medical Officer Jay Butler on Wednesday, February 10. Governor Walker committed to looking at the ACE Resolution (HCR 21) and consider supporting it. However, I had an additional conversation with Commissioner Williams. He had experience utilizing ACE research when he worked in Alaska's Juvenile Justice system and is looking for solutions. He committed to further discussions. Based on that, I just posted a blog on the research based assessment of benefits in teaching Vipassanā Meditation in Prisons. After 8 years of advocating for consideration of ACE's in Alaska, I finally see some hope that we can develop policy to address both prevention and effective intervention.

Tamar -- I think it takes a lot of time to move our trauma-organized culture (to borrow the phrase from K-Rahn Vallatine, from Live Above The Hype in LA). I once asked Teri Barila in Walla Walla, WA, how many presentations they'd done in their community of about 30K people, and she said, five years into the process they stopped counting at 500. This is mind- and life-shifting information that people have to hear many times to absorb personally before they can integrate professionally and then organizationally and then culturally.

That's why we've organized the groups in ACEsConnection to represent geographical areas (neighborhoods, cities, counties, states, nations) and interest-based groups (ACEs in Education, ACEs in Pediatrics, etc.). That way when people in an ACEs initiative in a town hit a wall with physicians, even though they're doing well with educators, they can then connect physicians -- who might doubt how an educator or advocate can offer any use information that concerns medical care -- to a physician who's integrating ACEs knowledge and is getting outstanding results, and will never go back to traditional approaches.

Thanks for posting the details about the report that Pat put out. He is indeed brilliant!

And hot off the presses -- Alaska's report: The economic costs of ACEs in Alaska. 

Yep, I agree that these estimates are probably on the low end of the cost spectrum. With ACEs capturing more damage than the traditional definition of child abuse on which we base intervention by child welfare, I'm sure we'll see more realistic cost estimates as time goes on. I'm sure it's a lot scarier than we know.

These are great questions and I applaud Jane and Karen for asking them AND finding some answers for us.  The numbers certainly bolster our case.

While those costs are staggering, Jane, it still feels like a "low" ball park to me.  Maybe I am just responding to the un-quantifiable damage to a child...

Pat Sidmore, a planner with the Alaska Mental Health Board and brilliant number cruncher has recently put out a report called "The Economic Costs of ACEs in Alaska." the report uses information he gathered through a study of more than 4,000 Alaskan adults and attaches $$ amounts to the costs the state pays in the long run for adults who experienced ACEs. Looking at only six outcomes of ACEs (Medicaid costs, smoking, diabetes...) and comparing with data from other states, Sidmore found that Alaska would save $90 million annually if we were able to reduce the state's ACE score by .5 alone. (reduce half the population's ACEs score by 1). We have been presenting this information around the state to anyone who'll listen, and currently have Dr. Vincent Felitti here in state's Capital talking to legislators and community leaders. On Monday, we introduced in front of the House an ACEs resolution asking for support of ACEs and trauma-informed practices, programs and research. Even with this concrete data in hand, we're still hitting a wall when trying to get buy-in from the people who matter. I'm very interested to follow this conversation and learn about what others are doing in their states and communities. 

There is interest also in Oregon in bringing data together from different systems and disentangling it at the county/community level to get this important information.  And certainly the understanding about the costs of childhood adversity is  critical and may generate new energy in the legislature.  However, I don't think there are going to be big surprises about where the greatest needs are or the impact on these challenged communities - at least not in our state.  What we need is to figure out the 'ask' for what to do about it.  We need to organize our thinking about whether we are asking for training across the board for public employees (city, county, state) who interact with the community, whether we are asking for demonstration projects such as a health literacy campaigns about ACEs and resilience at the community level, or technical assistance and coaching to work with agencies, providers, and systems to become more trauma informed.  I'd be interested to know what action steps others around the country are asking their legislators to consider supporting in 2017-19.  We are starting to think hard about this here and I'd love to hear what others are thinking.  

Jane,

Thank you for this information. This is very valuable to consider as we move forward beyond just the data.

~ Cathy