Running head: ANALYSIS OF S.

774

Analysis of S.774: Trauma-Informed Care For

Children and Families Act of 2017

Cynthia Herndon

Briar Cliff University

ANALYSIS OF S.774 2

I. Historical background of policy: Trauma-Informed Care for Children and Families Act of

2017.

a. Problems that led to creation of policy

i. Nearly 35 million children in the United States have had at least one

serious traumatic experience

ii. Findings on the effects of adverse childhood experiences

b. Original management of the problems

c. Congressional history of S.774

II. Description of the problems that necessitated the Trauma-Informed Care for Children and

Families Act of 2017

a. Nature, scope, parameters, causes, and magnitude of the problem

i. More than 60 percent of the children surveyed were exposed to violence

within the past year, directly or indirectly

ii. Little knowledge of trauma-informed care practices

b. Target population

i. Children, youth, and appropriate family members

III. Description of the policy

a. Purpose of Trauma-Informed Care for Children and Families Act of 2017 S.774

b. How the policy is expected to work and the resources it will provide

i. Implementing a task force

ii. Who is covered and what resources will they receive

iii. Goals of the policy

c. Funding for the policy

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i. Role of the Secretary of Health and Human Services

ii. Grants

d. Scientific grounding on which the policy rests

IV. Policy analysis

a. How policy will be effective and efficient

i. Roles of the task force

b. Indications that the goals of the policy are legal, just, democratic, and contribute

to greater social equality

i. National Association of Social Workers code of ethics

c. Effects of the policy

i. Increase in education of trauma-informed care services

ii. Long-term effects of implementing trauma-informed practices

ANALYSIS OF S.774 4

Analysis of S.774 - Trauma-Informed Care for Children and Families Act of 2017

Historical Background of Policy

Congress has been able to conduct a variety of studies through different agencies that

have contributed to the findings of long-term and short-term effects that traumatic experiences

have on children and their caregivers. "According to the National Survey of Children's Health,

nearly 35 million children in the United States have had at least one serious traumatic

experience" (Heitkamp.Senate.gov, 2017). The prevalence of violence experienced by children

caused researchers to conduct longitudinal studies to find the long-term effects that adverse

childhood experiences caused. According to a study conducted by the Centers for Disease and

Prevention, "adults who had been exposed to multiple adverse childhood experiences were

significantly more likely to be unemployed, to be living in poverty, and not to have graduated

high school than adults who had zero adverse childhood experiences" (Congress.gov, 2017). The

Trauma-Informed Care for Children and Families Act of 2017 S.774 was introduced to address

the need for preventative care and educational services to decrease the adverse effects of

childhood trauma.

One of the causes of this problem is that adverse childhood experiences predispose children

toward negative trajectories from infancy through adolescence (Congress.gov, 2017). Parents and

caregivers of children and youth who have been affected by traumatic situations often are not

aware of trauma-informed services within their communities. This policy will provide training for

teachers, administrators, school counselors, mental health professionals, and other appropriate

individuals in developing evidence-informed practices and informing the parents and guardians of

children who would benefit from receiving these trauma-informed services.

ANALYSIS OF S.774 5

The effects of trauma have traditionally been studied among adults and how their exposure

to adverse childhood experiences have shaped their lives (Prewitt, 2017). Providing services to

children that help prevent negative long-term effects caused by adverse childhood experiences,

has shown to be more beneficial than trying to intervene once they are adolescents. It is estimated

that the United States spends $124 billion each year on the total lifetime burden of child

maltreatment cases, which includes medical, welfare, and criminal justice costs (Congress.gov,

2017). In contrast, "according to a 2008 Washington State report on prevention program that

assessed both cost and effectiveness, evidence-based, two-generational child trauma treatments

such as Parent-Child Interaction Therapy return $3.64 per dollar of cost" (Congress.gov, 2017).

Prior to the Trauma-Informed Care for Children and Families Act S.774 was the Trauma-

Informed Care for Children and Families Act of 2016 S.3519. It was introduced by Senator Heidi

Keitkamp [D-ND] on December 7th, 2016. It was introduced into the Senate's Committee of

Health, Education, Labor, and Pensions but was not enacted into law.

The Trauma-Informed Care for Children and Families Act of 2017 S.774 was introduced

by Senator Heidi Keitkamp [D-ND] and read twice by the Senate on March 29th, 2017. It is

currently being reviewed by the Senate's Committee of Health, Education, Labor, and Pensions

(Congress.gov, 2017). It was co-sponsored by Sen. Richard J. Durbin [D-IL], Sen. Al Franken [D-

MN], and Sen. Cory A. Booker [D-NJ] on the same day it was introduced. In April, Sen. Kirsten

E. Gillibrand [D-NY] and Sen. Brian Schatz [D-HI] became co-sponsors and in June they were

joined by Sen. Christopher Murphy [D-CT]. The sponsor and co-sponsors are all members of the

Democratic party.
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There is currently an identical version of this bill under the Subcommittee on Crime,

Terrorism, Homeland Security, and Investigations known as H.R. 1757 (Congress.gov, 2017).

Description of the Problem that Necessitated the Policy

"The rate of substantiated reports of child maltreatment in fiscal year 2015 was 9.2 per

1,000 children ages 0 through 17, with children under age 1 having the highest rate of 24.2 per

1,000 children" (Congress.gov, 2017). Many studies have shown that trauma experienced at a

young age alters the brain's natural progression. In a 2009 Office of Juvenile Justice Delinquency

Prevention study, it was found that 60% of the children they interviewed, between the ages of 0

through 17, had been exposed to violence within the last year, either directly or indirectly

(Congress.gov, 2017).

The Trauma-Informed Care for Children and Families Act of 2017 S.774 is intended to

assist children, youth, and any appropriate family members in receiving relevant information on

trauma-informed care practices within their communities. In order to ensure that many under-

served populations are reached, this policy will provide referrals to adequate services that are

"culturally sensitive, linguistically appropriate, age- and gender-relevant, and appropriate for

lesbian, gay, bisexual, transgender, and queer populations (Congress.gov, 2017).

"New neuroscience research shows exposure to traumatic events in childhood harms

children's developing brains so profoundly that the effects show up decades later in the form of

poor health and mental health and the perpetuation of violence and poverty" (Stillwell-

Parvensky, 2015). Stress decreases a child's ability to adapt to stressful situations and can cause

internal and external behavioral issues (Stillwell-Parvensky, 2015). If childhood trauma is not

intervened and correctly treated, those same children grow to have difficulties with developing
ANALYSIS OF S.774 7

and maintaining a healthy work ethic, a decent sleeping pattern, and a healthy social life

(Substance Abuse and Mental Health Services Administration, 2014).

Description of the Policy

The purpose of the Trauma-Informed Care for Children and Families Act of 2017 S.774

is to address the psychological, developmental, social, and emotional needs of children, youth,

and families who have experienced trauma (Congress.gov, 2017).

In order for this policy to work properly the Secretary of Health and Human Services has

to create a task force that will consist of one representative from each of the thirty-appointed

state, tribal, and local government and educational agencies (Farmer, 2017). These thirty

representatives will ensure that the set of best practices recommended will be maintained and

updated accurately (Congress.gov, 2017). The task force will "identify and evaluate a set of

evidence-based, evidence-informed, and promising best practices in regards to early detection of

children, youth, and any appropriate family members, who have experienced or are at risk of

experiencing trauma" (Congress.gov, 2017). This will allow for expedited services and referrals

for individuals or families who require specialized trauma-informed support.

One of the many goals that the Trauma-Informed Care for Children and Families Act of

2017 S.774 has is to teach others about the signs, effects, and symptoms of trauma. Many

adults do not understand the severity that adverse childhood trauma can have on children.

Children and youth who are placed in foster homes or in the juvenile system may not be

receiving adequate care for their psychological, social, and emotional needs. The task force that

will be developed as a result of the Trauma-Informed Care for Children and Families Act of

2017 S.774 will ensure that parents and guardians are well informed of the services that are
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available to them and if their affected child qualifies for Medicaid, which will help pay for the

services (Congress.gov, 2017).

The Trauma-Informed Care for Children and Families Act of 2017 S.774 will be

funded through appropriated funds to the Secretary of Health and Human Services, as well as

through grants that will be tailored toward specific program needs (Congress.gov, 2017). For the

fiscal years of 2018 through 2022, the Secretary of Health and Human Services will have a sum

of $2,000,000 to fund a Native American Resource Center to help provide trauma-informed

services to Native American populations (Congress.gov, 2017). An increase of $20 million to the

National Child Traumatic Stress Initiative will be contributed to their operating budget and $7.5

million of that total must be utilized specifically for gathering and reporting data, evaluating

models, and providing technical assistance for the fiscal years of 2018 through 2022 (Farmer,

2017). $15 million will be allocated to the grant program and $2 million will be allocated to

other activities for fiscal years of 2018 through 2022 (Farmer, 2017).

Political Analysis

To ensure that this policy is effective, each task force member is in charge of developing,

implementing, and evaluating evidence-informed practices within their government or

educational agency. Task force members will partner with "local social services organizations or

clinical mental health or health care service providers with expertise in furnishing support

services to prevent or mitigate the effects of trauma" (Congress.gov, 2017). The Trauma-

Informed Care for Children and Families Act of 2017 S.774 will also provide special attention

to under-served communities, like Native American communities and children who reside in

urban neighborhoods, where access to trauma-informed care is dismal (Prewitt, 2017).

ANALYSIS OF S.774 9

In order for the Trauma-Informed Care for Children and Families Act of 2017 S.774 to

be efficient, each member of the task force will be in charge of "assisting parents, foster parents,

and adult caregivers in learning to access resources related to such prevention and mitigation

services" (Congress.gov, 2017). Each state, tribal, and local government and educational agency

will have access to evidence-informed practices that they will be able to pass along to the parents

and guardians of children who have been exposed to or are at risk of experiencing trauma

(Congress.gov, 2017).

This policy is democratic and legal because it has been introduced into the judicial

system so that other members of the House and Senate can vote on whether or not this policy

should be enacted as a law. The Trauma-Informed Care for Children and Families Act of 2017

S.774 is providing essential services to children, youth, and appropriate family members that

might not otherwise have access to productive trauma-informed care agencies.

Implementing trauma-informed care services promote the greater good. Alex Johnson,

the Executive Director of the Children's Defense Fund-California found that, "by intervening

early to heal childhood trauma, we can help raise resilient children who can grow up to live

healthy productive lives" (Stillwell-Parvensky, 2015). He has also witnessed local community

programs work toward "building resiliency in children and youth by giving children love,

positive role models, and opportunities for artistic expression and physical activity (Stillwell-

Parvensky, 2015). This has helped change the way local schools in Richmond, CA address

suspension and expulsions in children who display negative behavioral issues (Stillwell-

Parvensky, 2015).
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It is important to support policies that are consistent with the code of ethics provided by

the National Association of Social Workers. The Trauma-Informed Care for Children and

Families Act of 2017 S.774 aligns with the National Association Social Workers' ethical

standard of competence (2008) in that all the members of the task force will function within the

boundaries of their education, training, license, certification, consultation received, supervised

experience, and other relevant professional experience. This policy is also culturally competent

and provides culturally sensitive, linguistically appropriate, age- and gender-relevant, and

appropriate for lesbian, gay, bisexual, transgender, and queer populations (Congress.gov, 2017).

Clients are encouraged to exercise self-determination when deciding what services will

work best for them however, if there is any evidence of possible harm to the client or those

around them, the professional they are working with will have to report those findings to the

appropriate law enforcement or state agency, which aligns with the ethical standards related to

self-determination and confidentiality (National Association of Social Workers, 2008). Keeping

a client's information private and confidential is an important aspect of the Trauma-Informed

Care for Children and Families Act of 2017 S.774. A client's information will not be submitted

to data collectors unless the client authorizes such a disclosure.

The Trauma-Informed Care for Children and Families Act of 2017 S.774 will increase

awareness to the benefits of trauma-informed care. Trauma-informed care is different than

current methods of treatment in how it recognizes that there are multiple forces that impact a

child's behavior (National Network of Hospital-Based Violence Intervention Programs, n.d).

Trauma-informed care seeks to address the continuous effects that trauma has and how to

prevent chronic diseases such as post-traumatic stress disorder (National Network of Hospital-
ANALYSIS OF S.774 11

Based Violence Intervention Programs, n.d). Members of the task force will provide educational

information regarding trauma-informed care within schools, hospitals, and other community-

based locations as a result of this policy.

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Resources

Congress.gov. (2017). Trauma informed care for children and families act of 2017. Retrieved on

October 4, 2017 from https://www.congress.gov/bill/115th-congress/senate-

bill/774?q=%7B%22search%22%3A%5B%22s.774%22%5D%7D&r=1

Farmer, K. (2017). Summary of S.774. Retrieved from

http://www.acesconnection.com/fileSendAction/fcType/0/fcOid/468137553018992175/fi

lePointer/468137553018992196/fodoid/468137553018992191/Summary%20of%20S.77

4_by_Kate_Farmer_Alaska_Resiliance_Initiative.pdf.

Heitkamp.Senate.gov. (2017). Trauma-informed care for children and families act. Retrieved

from https://www.heitkamp.senate.gov/public/cache/files/11a898a0-ba2b-4775-a2f3-

a923a53b879/one-pager-trauma-informed-care-for-children-and-families-act.pdf.

National Association of Social Workers. (approved 1996, revised 2008). Code of ethics of the

National Association of Social Workers. Washington, DC: NASW. Retrieved from

http://www.socialworkers.org/pubs/code/default.asp.

National Network of Hospital-Based Violence Intervention Programs. (n.d). Trauma informed

care. Retrieved from http://nnhvip.org/trauma-informed-care/.

Prewitt, E. (2017). Comprehensive legislation introduced in U.S. Senate and House to address

trauma. Retrieved from https://acestoohigh.com/2017/04/02/comprehensive-legislation-

introduced-in-us-senate-and-house-to-address-trauma/.
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Substance Abuse and Mental Health Services Administration. (2014). Trauma-informed care.

SAMHSA News, 22(2). Retrieved from

https://www.samhsa.gov/samhsaNewsLetter/Volume_22_Number_2/trauma_tip/

Stillwell-Parvensky, M. (2015, September 21). New report highlights need to address child

trauma. Children's Defense Fund-California. Retrieved from

http://www.cdfca.org/newsroom/press-releases/2015/New-Report-Highlights-Need-To-

Address-Child-Trauma.html?referrer=https://www.google.com/.