TIC Legislation and Policy

Maryland  has Health Empowerment Zone (HEZ) areas in which extra resources go to bring health care to the front doors/ living rooms of people in the affected areas. We have included education on Trauma Informed Care in the HEZ workers job description which is currently going through the legislative process.

It is my hope that we will use the Health Care Competencies published by the Academy of Violence and Abuse to certify hospitals. (We are fortunate at this time in Baltimore the first RN leader of the ACA, who runs a nursing school in Hong Kong, is at JHH preforming some studies on the topic on sabbatical.)

Approx 10 years ago 'Patient Safety' was the buzz word in hospitals. Everyone wanted to be recognized for high scores in this. Those not familiar with hospitals ask 'You ever DIDN'T care about Patient Safety???'   Magnet status came along about the same time, Hospitals wanted to compete for Magnet which meant that you are constantly examining new research take care of patients using the most currently Evidence Based Practice, again, those not familiar with hospitals ask 'You ever DIDN'T take care of patients in an Evidence Based Manner?'   I would like to see a wave where Hospitals compete for TIC Status and in 5 years those who are not familiar with hospitals ask 'You ever DIDN'T think that the trauma people go through affects their health?' 

Hi, Diane: Do you include education about ACEs in the TIC education? And when you say it's going through the legislative process, can you provide a few more details?

Thanks!

Yes. The ACES are the foundation of the TIC education. I use the ACE pyramid, give out Donna Jackson Nakazawa's book Childhood Disrupted, Vander Kolks book, depending on the audience I give out the Academy of Violence and Abuse competencies for healthcare workers pamphlet. The question I get in the hospitals is  how we fit in with the many other causes such as Domestic violence, suicide prevention. I again refer back to the pyramid and say it is the umbrella term that encompasses concepts from the others. Remember we first had 'Don't Drink and Drive, then Don't Text and Drive, and now it is Don't Drive Distracted'. Same thing with TIC, it is the broader term. I talk to hospitals who currently don't get paid for readmissions within 30 days for some common diseases such as CHF and COPD as we should be managing them in the community. I tell them that as hospitals we are only focusing mainly on the top two layers of the pyramid, we need to focus on the bottom layer which addresses Population Health, a very popular term in the medical community right now. 

URGENT HELP NEEDED !!!!!   Hello, I have a bill coming before the Maryland State Legislature on March 8 that is going to require Trauma Informed Training for healthcare workers serving the Health Empowerment Zones. It is literally just one small clause. I am giving them the Academy of Violence and Abuse's Competencies for Healthcare workers as a guideline, others will decide exactly how to implement it.     I need someone to come testify with me.  I am one staff level RN working alone on this topic.  It is called House Bill 1282 Health Enterprize Zone practitioners Traiuma Informed Care training. It is going before the Health and Government operations committee.    There is a wonderful State Delegate Sheree Sample-Hughes who is sponsoring it.  Contact me at d.iverson1@gmail.com       Thanks, Diane

To focus better on prevention, there has to be better primary care reimbursement.  I have lots of time in a practice trying to get up and going in that there aren't many patients so can spend lots of time. 

 

It is indeed harder when you have a 10 minute appointment.  What does this promote? Here take this pill.  I am not being sarcastic or cynical but that becomes the busy physician's solution (even instead of explaining a cold is caused by a virus --- oh it is easier and quicker -- here is your antibiotic).  

I see this as a massive disservice to patients, doctors, everybody.  

But I think that there is massive financial incentive to keep the system as it currently is.  

 

There is no incentive by PC's who aren't trained to talk - and won't be paid if they do, by psychiatrists who at this point (at least in rural areas for medicaid patients at Community Mental Health Centers) only give a pill. 

Drug companies make lots of money miss diagnosing people with borderline or bipolar or schizoaffective --- all which need to be treated with a pill --- except borderline (which is a character flaw).  Again not being sarcastic, being experiential.  

Everyone.  I mean everyone who is concerned, please advocate for the diagnosis of developmental trauma (which for many people is the correct diagnosis) and advocate for proper means to treat the affect dysregulation, impulse control dysregulation, attachment dysregulation etc.  

 

Thanks ya'all.  

 

 

 

 

Hi Diane,


I'm in Oregon so can't help, but I wanted to suggest that if you can find a patient that is willing to testify with you that would be very powerful. Perhaps you can think of a patient that could talk about how they were helped by a provider trained in TIC or how they had problems because a provider was NOT trained in TIC.


We have legislation about trauma informed moving right now and after having a youth testify with us we had unanimous support from our House Education Committee.


Good luck!

Maureen

I wonder if "www.traumainformedcare.com" might provide some potential sources of answers to your question, Diane.