Feb 08, 2018VT Digger
After hearing sometimes-emotional stories from more than 60 witnesses, a group of state legislators studying the effects of childhood trauma couldn’t come up with just one bill to address the problem.
Instead, they drew up four.
The package of bills – three in the House and one in the Senate – aims to improve trauma support and treatment within state government, health care and education via new positions, training and strategies.
The idea is that the long-lingering impacts of childhood trauma are the “root cause” of social problems including imprisonment, poverty, homelessness, addiction and chronic illness.
“So many people feel like this is the nexus of so much of the work that we need to do in Vermont,” said Sen. Becca Balint, D-Windham.
At issue are adverse childhood experiences, defined as traumatic events that “can have negative, lasting effects on health and well-being.”
The concept is not new. A landmark 1998 study from the Centers for Disease Control and Kaiser Permanente found that nearly two-thirds of more than 17,000 participants reported at least one adverse childhood experience such as abuse or neglect. More than 20 percent reported three or more such experiences.
The study found that, as the number of adverse childhood experiences increases, so does the risk of a wide variety of issues including addiction, disease, depression, suicide attempts, intimate partner violence, poor work performance and poor academic performance.
Act 43, approved by the state Legislature last year, created a working group of six lawmakers to take a closer look at the impact of adverse childhood experiences in Vermont. The group held six hearings.
In addition to taking testimony from educators, social workers, corrections staff and medical providers, “we heard from real people who have lived experiences with trauma,” said Rep. Mike Mrowicki, D-Putney and chairman of the working group. “We heard from foster parents who are trying to parent children with that trauma, and all the barriers that they run into.”
For Sen. David Soucy, R-Rutland, it was “the first real work that I had as a senator” after being appointed to the body last year by Gov. Phil Scott.
“I was moved by what we heard,” Soucy said. “Not just by the experts, but by the people who have lived with trauma all their life.”
Rep. Anne Donahue, R-Northfield, has much experience with mental health policy issues as the editor of Counterpoint, a publication put out by Vermont Psychiatric Survivors. But she said serving on the adverse childhood experiences group was still eye-opening.
“What surprised me the most was hearing testimony from our school systems, from teachers, about the really, really dramatic changes they’re seeing in the kids that are coming into the primary grades connected with the opiate crisis,” Donahue said.
Rep. Kate Webb, D-Shelburne, said the impact of adverse childhood experiences on Vermont’s schools is clear. About 17 to 18 percent of children receiving special education have an emotional disturbance, and “that’s three times the national average,” Webb said.
Lawmakers are hearing from educators about the challenges of teaching children “whose brains are probably so awash in cortisol that they do not pay attention to curriculum,” Webb said.
The working group’s report discusses the link between excessive cortisol – the “fight or flight” hormone released during “toxic stress” events – and brain damage. “For some children, the damage and developmental delays prevent normal functioning and can become barriers throughout their lives,” it says.
It is one reason why individuals and families “can get stuck in the cycles of generational poverty, homelessness, addiction/substance abuse and chronic health care needs,” the report says.
The document concludes that “there is no one easy answer to such a complex dilemma.” But that doesn’t mean there’s nothing to be done, Mrowicki said.
“Without addressing the trauma underlying many non-productive behaviors, we’re just spinning our wheels and putting Band-Aids on serious injury,” he said.
The bills introduced by working group members take varying approaches to the problem.
H.578 establishes a “coordinator of trauma-informed systems” within the state Agency of Human Services and also sets up a Childhood Trauma Tri-Branch Commission. The coordinator “is a position that used to be in the Agency of Human Services and was cut in the last recession,” Mrowicki said. “It’s time that it’s put back in there.”
H.579 addresses the health care system by mandating that Blueprint for Health providers “assess trauma and seek opportunities for resilience-building.” Also, accountable care organizations would have to “provide incentives for addressing adverse childhood experiences and other types of trauma.”
H.580 offers a variety of educational reforms including boosting trauma-informed initiatives in schools, expanding a youth risk behavior survey to include questions about adverse childhood experiences and developing a curriculum that addresses childhood brain development.
S.261 incorporates some ideas from the House bills while also adding new supports for opioid addiction, trauma training for school nurses, inmate screenings for adverse childhood experiences and programming referrals for children with incarcerated parents.
“The bill that we have in the Senate looks to (create) a systematic public health approach to prevention of trauma and toxic stress in families,” said Sen. Ginny Lyons, D-Chittenden.