Recommendations Roadmap for Proposition 64 Expenditures: Advancing Healing-Centered and Trauma-Informed Approaches to Foster Individual, Family, and Community Resilience

Christina Bethell 7/24/1912:21 PM

“There is a critical need to focus on effective strategies that address the underlying causes and structural conditions of substance use, including adverse childhood experiences, adverse community environments and experiences, toxic stress, and trauma.”- Recommendations Roadmap for California Proposition 64 Expenditures Report

By Christina Bethell, Stephanie Guinosso, and Kanwarpal Dhaliwal
California’s Proposition 64 (2016 marijuana legalization) presents a special opportunity to invest in community-based substance use education, prevention, and more for children, youth, families, and the communities they live in. There is a critical need to focus these efforts on effective strategies that address the underlying causes and structural conditions of substance use, including adverse childhood experiences (ACEs), adverse community environments, toxic stress, and trauma—and the absence of positive childhood experiences.

Building on prior work to advance trauma-informed approaches through Proposition 47 expenditures and with support from The California Endowment, the Child and Adolescent Health Measurement Initiative (CAHMI) has facilitated a partnership with a stakeholder and expert Advisory Committee and the Campaign to Counter Childhood Adversity (4CA). This partnership led to a Recommendations Roadmap for Proposition 64 Expenditures which aims to advance culturally responsive, racially just, healing-centered and trauma-informed approaches to promote individual, family and community healing and resilience in the spending of certain Prop 64 funds.

The multi-disciplinary advisory committee who created this roadmap comprised state and national advocates, California community-based organizations, providers and academics with a high level of commitment and expertise regarding healing-centered and trauma-informed approaches. The roadmap is based on a set of principles and a framework with four categories of recommendations:

Relationship and Engagement-Centered Assessment, Interventions, and Healing – Compassionate, dependable, and trustworthy relationships that foster interpersonal and community connections re-establish healing and well-being as well as a sense of agency in addressing trauma.
Training and Capacity Building – A culturally responsive, racially just, healing-centered and trauma-informed approach also requires ongoing training and capacity for staff at all levels.
Cross-Sector Collaboration – Cross-sector collaboration is necessary to facilitate a coordinated response dedicated to healing and ending harm and ensuring health and racial equity as well as continuity of care. Cross-sector collaboration must be guided by local community stakeholders.
Learning-Centered Innovation, Measurement, and Evaluation – An enduring and purposeful infrastructure is needed to continuously foster meaningful reflection and learning, innovation, and support for scaling of innovations as they emerge.

For the full report and other dissemination materials, please visit www.Prop64Roadmap.org.

There are many efforts throughout the state related to the authorization and allocation of Proposition 64 dollars. Many are working to ensure that the legislation supports communities most impacted by the “War on Drugs”, and many of the strategies reflected in the recommendations are carried out every day by individuals and organizations who have lived experience, lived expertise, and proximity. However, the recommendations are also new, unknown, and challenging to many who make policy and allocation decisions.

We recommend this roadmap serve as a resource for policy-makers, advocates, and community leaders as they consider and advocate for local, state, and national policies to address adverse childhood and community experiences and promote healing, resilience, and justice. Although developed in response to Proposition 64, the policy and practice applications extend far beyond this particular legislation. The recommendations call out opportunities and highlight urgent needs for new development, resources and training requiring state and local leadership, while centering the priorities of the communities most burdened by the “War on Drugs”. We hope these recommendations will support swift action for systems to be responsive, accountable, and empathetic and for communities to cultivate and fortify their resilience, healing, self-determination, and collective power.

“Adopting these recommendations would place California as the first in the nation to take a reparative, restorative, and responsive approach to investing in substance abuse prevention, early intervention, and treatment.”-Recommendations Roadmap for California Proposition 64 Expenditures Report

What’s next for us?

The CAHMI continues to partner with the RYSE Center, Youth Forward, California Alliance for Boys and Men of Color, Trauma Transformed, and ETR to lead advocacy efforts and develop guidance materials and forums for communities to collectively reflect on these recommendations and consider their local, regional and statewide application. We hope these recommendations and forums inspire current and new efforts around Proposition 64 and other policy efforts, and also collectivizes a shared frame, set of strategies, and deepened relationships in all our work.

We invite and encourage you to reflect on these recommendations in your own work and community. As you review these recommendations, consider:

Which recommendations are most critical for your work?
Which recommendations are most critical to leverage and advocate for in your community?
What supports are needed to advance these recommendations?
Who else needs to be involved?
What can you commit to?

Please let us know how you plan to use these recommendations and how our team can provide support. Leave a post here or contact us at info@cahmi.org.

This project is supported by The California Endowment.

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Heather ThomsenMember

Dr. Felitti, I can not agree more with your post regarding parenting skills across the nation. I work with parents as their parent educator and advocate and often share how in our country to drive a car you, take need to pass both a written and field test. But to become a parent, to create a 3-Dimensional environment for a human being there is no training, no manual, no test and no support to normalize such a critical and lifelong process.

8/29/191:54 PM

Daun KauffmanMember

Vincent J. Felitti, MD posted:
The biggest public health advance in our time that I can think of would be to figure out how to improve Parenting Skills across the nation. We are just beginning to understand how concealed but anguishing life experiences in childhood play out a half-century later in terms of one's ongoing emotional state and the coping mechanisms used for relief, like alcohol, food, nicotine, street drugs, promiscuity, etc. and the long-term problems these initially relieving approaches cause. They are very difficult to erase because what we see in Public Health as the long-term Problem often turns out to be an attempted short-term Solution by the individual for early life experiences that are concealed by shame and secrecy and the fact that we have all been taught as children that nice people don't talk about certain things.
Most people would like to be good parents, but how does one learn about that? Like our spoken language, we learn parenting from the people who raised us, but at least proper language is taught in schools whereas parenting is surely not.
Were one to take this task on seriously, initially on a small scale to test out the proposed technique, I suspect it would best be done by storytelling and visual illustration, not by books or pamphlets or classes. Thus, what if someone were to develop a serial TV program where illustrations of supportive parenting were woven into the story line, with illustrations of how this plays out decades later. This might be contrasted with illustrations of destructive parenting and how it plays out.
Perhaps amongst us someone has a Theatre or TV association where this might be developed. Foundation support would not be difficult to find.

Dr. Felitti - - I have seen powerful but implicit(only) implementation of your concept in dramatic theatre via a "separated- twin" case study. The Americanized version of the English play "Blood Brothers". I am sure there are many more. Adding some explicit (or more explicit) "teaching" elements, or (to avoid interupting the production and to help build audience-curiosity about "the diffeence" perhaps a "epilogue" to make the specific conections or perhaps a post-production "discussion with the cast". It seems there's something here.

7/24/196:03 PM

Vincent J. Felitti, MDMember

The biggest public health advance in our time that I can think of would be to figure out how to improve Parenting Skills across the nation. We are just beginning to understand how concealed but anguishing life experiences in childhood play out a half-century later in terms of one's ongoing emotional state and the coping mechanisms used for relief, like alcohol, food, nicotine, street drugs, promiscuity, etc. and the long-term problems these initially relieving approaches cause. They are very difficult to erase because what we see in Public Health as the long-term Problem often turns out to be an attempted short-term Solution by the individual for early life experiences that are concealed by shame and secrecy and the fact that we have all been taught as children that nice people don't talk about certain things.

Most people would like to be good parents, but how does one learn about that? Like our spoken language, we learn parenting from the people who raised us, but at least proper language is taught in schools whereas parenting is surely not.

Were one to take this task on seriously, initially on a small scale to test out the proposed technique, I suspect it would best be done by storytelling and visual illustration, not by books or pamphlets or classes. Thus, what if someone were to develop a serial TV program where illustrations of supportive parenting were woven into the story line, with illustrations of how this plays out decades later. This might be contrasted with illustrations of destructive parenting and how it plays out.

Perhaps amongst us someone has a Theatre or TV association where this might be developed. Foundation support would not be difficult to find.

7/24/194:21 PM