ACEs and Policy: Improving Family Outcomes
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Addressing ACEs through legislative solutions, Megan Branham, Jennifer Jones
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ACEs and Policy: Improving Family Outcomes
- 1. ACEs and Policy: Improving Family Outcomes Megan Branham, LMSW Children’s Trust of South Carolina Jennifer Jones, MSW Alliance for Strong Families and Communities
- 3. What are we doing about ACEs? 3
- 4. % of South Carolinians with any ACE 44% 56% 0% 10% 20% 30% 40% 50% 60% No Yes
- 5. 45% 23% 11% 15% 5% 0% 5% 10% 15% 20% 25% 30% 35% 40% 45% 50% 0 1 2 3-5 6+ Percent of South Carolinians’ Cumulative ACE Exposure
- 6. Adverse Childhood Experiences Emotional abuse 26% Alcohol abuse 23% Divorce or separation 23% Domestic violence 17% Mental illness 13% Physical abuse 12% Sexual abuse 4-10% Substance use 8%
- 7. Why State Interest in Early Childhood and ACEs? • Brain research and the impact of young children’s early environments; • Concerns about “school readiness”; • Impact of poverty; • Economic interest in the future workforce; • Compelling economic (cost benefit) and return on investment data from National Conference on State Legislatures Children's Trust of South Carolina 7
- 8. States Responding to ACEs • The state of Washington passed a bill (H.R. 1965) in 2011 to identify and promote innovative strategies to prevent or reduce adverse childhood experiences (ACEs) and to develop a public-private partnership to support effective strategies. Children's Trust of South Carolina 8
- 9. Children's Trust of South Carolina 9
- 10. Washington Takeaways • Broad public and private, local and state support – Faith leaders and medical community • Advantage to “working behind the scenes” • Consistent messaging • More at www.appi-wa.org Children's Trust of South Carolina 10
- 11. States Responding to ACEs Children's Trust of South Carolina 11
- 12. Vermont Takeaways • Child Trauma Collaborative, community mental health focus • Local health district looking at ACE data to determine where to focus work: prevention of abuse and neglect through evidence-based interventions or identifying the scope of adverse childhood experiences in the community Children's Trust of South Carolina 12
- 13. States Responding to ACEs Children's Trust of South Carolina 13
- 14. California Takeaways • Committee on the Shelterless (COTS); focus on homeless population • Multiple sources of funding • Therapeutic focus, message of healing Children's Trust of South Carolina 14
- 15. Children's Trust of South Carolina 15
- 16. Key Takeaways and Considerations • States can create policies specific to their state data • More knowledge about brain science and trauma – Still a need to education policy makers, community leaders, professionals about ACEs (ACEs trainings in SC) – “ACE reduction is a winnable issue” • Joint resolutions, demonstrations projects are good starting place Children's Trust of South Carolina 16
- 17. 17
- 19. Wisconsin’s Four Key Priority Areas: 1) Increase public awareness; 2) Address co-occurrence of ACEs among children of incarcerated parents; 3) Expand the knowledge and use of ACE data within Medicaid/BadgerCare; and 4) Enhance ACE related data in Wisconsin. 19
- 20. • Greater Investment in Prevention Strategies – Project GAIN – Wisconsin’s Community Response Program – Positive Community Norms Statewide Initiative • Medicaid Policy Changes – Benefits package specific for individuals with ACEs and trauma – Reimbursement for evidence-based prevention initiatives • Design and Pilot Prevention and Intervention Strategies with Children and Parents involved in Corrections • Invest in Research on Resilience 20
- 21. Our Vision 21 With and through the power of our national network, the Alliance strives to realize its vision of a healthy society and strong communities for all children, adults, and families through a focus on impact. Together, we will reduce the number of people living in poverty; increase the number of people living healthy and safe lives; and provide more people with opportunities for educational and employment success.
- 22. Policy Examples – Change in Mind Sites Children and Families First, Wilmington, DE • Develop a comprehensive system to collect and analyze ACE data statewide and use that data to inform policy and practice. • Engage legislators and policy-makers to ensure that concepts in trauma and brain science are included in appropriate policy decisions. Children’s Hospital of Wisconsin, Milwaukee, WI • Advocate for policies that support greater availability of innovative evidence-based or informed interventions that support child development and family resilience. The Family Partnership, Minneapolis, MN • Convene a statewide Minnesota Brain Science Coalition and publish a working document outlining policy implications and policy opportunities. Develop a long-term policy advocacy plan. 22
- 23. Purpose and Objectives Infuse AccelerateAlign 23 • Agencies have deep understanding of convergence science. • Use of science is embedded in policy and practice of the organization. • Agencies serve as leaders in the community & sector to accelerate wide spread adoption. • Leadership leads to greater alignment around systems that support children and families
- 24. Change in Mind Sites U.S. Sites • Children and Families First, Wilmington, DE • Children’s Hospital of Wisconsin, Milwaukee, WI • Wellspring Family Services, Seattle, WA • LaSalle School, Albany, NY • KVC Health Systems, Olathe, KS • The Family Partnership, Minneapolis, MN • Martha O’Bryan Center, Nashville, TN • East End House, Cambridge, MA • Family Service Association, San Antonio, TX • Children’s Home Society of Washington, Seattle, WA 24
- 25. Change in Mind Sites Alberta Sites • Sheldon Kennedy Child Advocacy Centre, Calgary, Alberta • Big Brothers, Big Sisters, Calgary, Alberta • Boyle McCauley Health Centre, Edmonton, Alberta • CASA Child, Adolescent, & Family Mental Health, Edmonton, Alberta • CUPS Health, Education, Housing, Calgary, Alberta 25
- 26. Policy Examples – Change in Mind Sites Children and Families First, Wilmington, DE • Develop a comprehensive system to collect and analyze ACE data statewide and use that data to inform policy and practice. • Engage legislators and policy-makers to ensure that concepts in trauma and brain science are included in appropriate policy decisions. Children’s Hospital of Wisconsin, Milwaukee, WI • Advocate for policies that support greater availability of innovative evidence-based or informed interventions that support child development and family resilience. To accomplish this goal there needs to be more flexibility in funding at both the federal and state levels. The lack of funding or incentives for providers to go through extensive trainings for these evidence-based approaches is a barrier for not only child welfare systems, but also the number of children in Medicaid who are disproportionally affected by adversity and toxic stress. 26
- 27. How can you be involved? Host an ACE Training Attend 2016 ACEs Summit Host a Community Conversation Sign-up for Newsletter Attend Prevention Conference
- 28. As professionals/experts in the prevention field…. • What would you like SC policy makers to know about ACEs as it relates to your work? • What would be your preferred method to communicate that message? • As SC looks to advance an ACEs prevention framework (policy and programs), what do you think should be included or considered?
- 30. scChildren.org Megan Branham, LMSW Policy and Government Liaison Children’s Trust of South Carolina mbranham@scchildren.org 803-744-4047 Jennifer A. Jones, MSW Director of Child and Family System Innovation Alliance for Strong Families and Communities jjones@alliance1.org 414-335-0621
Editor's Notes
- The ACE Study brings cohesion and synergy to policy with its finding that the cumulative stress of ACEs are the most powerful determinate of the public's health and the strongest common driver of mental, physical and behavioral health costs.
- Rita end
- In 2009 Washington became one of the first states to add ACE questions to the Behavioral Risk Factor Surveillance System survey - a random telephone survey of adults. Following the implementation of House Bill 1965 in 2012, state support of Family Policy Council operations discontinued, resulting in the closure of multiple Networks throughout Washington State. However, the legacy of the Family Policy Council lives on through the remaining Networks it helped create and efforts of the Washington State ACEs Public-Private Partnership Initiative (APPI). The APPI is a coalition of public, private, and community organizations in Washington State united in a common goal to reduce ACEs and their negative consequences through multilevel community change. To achieve this goal, the APPI has provided three-year grants to five communities located in rural Seattle: North Central Washington (Wenatchee), Okanogan, Skagit, Walla Walla, and Whatcom. Like its state level predecessor, the Family Policy Council, the APPI brings these sites and the broader community together to facilitate collaboration, learning and dialogue. To advance existing knowledge on ACE response strategies, the APPI has been conducting a cross-site retrospective evaluation of APPI sites. Results of this evaluation will be available at the end of 2015. An interim evaluation report on APPI sites' community contexts and methods used to mitigate ACEs and initiate multilevel community change can be viewed here.
- http://aceresponse.org/give_your_support/Washington_State_Family_Policy_Council_19_52_sb.htm
- Our results showed that certain Adverse Childhood Experiences were highly correlated with an ACE score of 4 or more. In this graph, for example, of those individuals who reported that they grew up with a household member who was incarcerated, 63% reported having experienced at least 4 ACEs. Similar for those who reported growing up witnessing violence in the home.
- There were also noticeable differences in ACE scores and types of health insurance. Individuals on BadgerCare or without any health insurance are more than twice as likely to have experienced four or more ACEs.
- We are utilizing our ACE data in Wisconsin to inform policies, practices and prevention efforts statewide. Specifically, our state ACE & Trauma Workgroup convened by CTF has prioritized the following areas of work…. Increasing public awareness of adverse childhood experiences, including working closely with the First Lady of Wisconsin and her Fostering Futures Initiative to broadly disseminate the ACE findings. In March, CTF and SaintA, a direct service agency working with families in the child welfare system, co-hosted the ACE Interface Master Training program with Dr. Rob Anda and Laura Porter. We trained 29 individuals who will conduct trainings across the state on ACEs, brain development, and prevention. We have been working closely with my Department to identify strategies that will improve outcomes for children growing up with an incarcerated parent/household member. Specifically, we are identifying ways to gather ACE data among our Corrections population so we can develop services to support those individuals with trauma histories, and work with their children to mitigate exposure to additional childhood adversity. We are also working closely with Kevin and the Department of Health Services to integrate ACE related questions into our Medicaid process with the intent of developing a benefits package for those children and families who identify high ACE scores. We are focused on enhancing Wisconsin’s ACE data to better inform policies and prevention efforts in our state. In 2013, we oversampled the Native American population and translated the entire BRFS into Spanish. In 2014, we added questions on poverty and child neglect to the BRFS. We will also continue to do deeper analysis on the association of ACEs to health outcomes as they vary by race and income.
- The cumulative effect of ACEs reflect a powerful opportunity for prevention. In fact, if we intentionally invested resources in the prevention of adverse childhood experiences, we have the potential to shift the trajectory of the health and well-being of Wisconsin residents for generations to come. The Children’s Trust Fund has created and invested in prevention programs that we believe have great promise in preventing the accumulation of ACEs and moderating their effects. Project GAIN in Milwaukee is the first of its kind, randomized control evaluation to test whether the impact of an economic intervention will prevent child abuse and neglect. The results of the evaluation will provide critical knowledge for the field of child maltreatment prevention nationally. Wisconsin’s Community Response Program is a promising practice working voluntarily with children and families who are reported to our child protective services system but are screened out. These families are provided with services and supports to help alleviate the issues that are putting their children at risk for maltreatment. The CTF Positive Community Norms Initiative in partnership with the Child Abuse Prevention Fund of Children’s Hospital has recently completed a random sample survey of Wisconsin residents on their beliefs and support for safe, stable, nurturing relationships and environments. Based on the survey findings, CTF and the CAP Fund, in partnership with Hiebing have created a statewide marketing campaign aimed at growing positive community norms and bridging the gap between actual and perceived social norms. The Campaign will launch later this summer. As I mentioned earlier, there are systems changes that could be implemented in BadgerCare to incorporate our knowledge about ACEs. We can create specific benefits for individuals and families that have experienced childhood adversity and trauma. We could also consider allowing for Medicaid reimbursement for providers who are using evidence-based prevention initiatives in the medical setting. We could design and pilot prevention strategies to help mitigate exposure to additional ACEs for children currently growing up with an incarcerated household member. At the same time, we should provide trauma-informed care services and supports for all parents involved in the correctional system as they begin to reintegrate back with their families and into their communities. And lastly, there is much we still need to learn about resilience. It’s critical that we invest in research and data to help us better understand why some individuals and communities thrive in the face of adversity and trauma. This research can help us continue to make significant strides in mitigating the negative outcomes associated with childhood adversity.
- Latricia A special thanks to Greg Kurth for sharing his wisdom and expertise with us on health care. It’s such a critical and important area of work and will continue to be in the future. Good morning. It is truly a pleasure to be with you this morning. My name is Latricia Boone and I am Manager of Public Relations with the Alliance. In my role, I manage communications primarily focused on our policy and mobilization/advocacy efforts. One of my major initiatives right now is our Keeping Kids in Families campaign which I’ll share more about later in the presentation. The Alliance is a national organization dedicated to achieving a vision of a healthy society and strong communities for all children, adults and families. With a membership network of nearly 450 nonprofit human serving organizations located in North America, the Alliance works for transformational change by representing and supporting this system to translate knowledge into best practices that improve their communities. The Alliance strives to achieve genuine impact by working with and through its member network to decrease the number of people living in poverty, increase the number of people living safe and healthy lives, and put more people onto pathways for educational and employment success.
- Here are three examples of sites and they effort to influence policy… Children and Families First in Wilmington, DE Children’s Hospital of Wisconsin The Family Partnership, Minneapolis, MN
- Jennifer Our objective is to infuse, align and accelerate the brain science research throughout the sector so that organizations have a deep understanding of the science and it is embedded in the policies and practices of the organization. These organizations will serve as leaders in their communities and across the sector to accelerate the knowledge and inform wide spread adoption within their organizations, their communities, and the public sector systems in which they work to advance policy, regulatory and fiscal changes.
- These are the U.S. Sites….
- These are the Alberta Sites….
- These are the Alberta Sites….