House Oversight Committee Issues Testimony From Ex-Tennessee Deputy Governor Henry

WASHINGTON, July 11 -- The House Oversight and Reform Committee issued the following testimony by ex-Tennessee Deputy Governor James Henry at a hearing entitled "Identifying, Preventing, and Treating Childhood Trauma: A Pervasive Public Health Issue that Needs Greater Federal Attention":

"We appreciate the interest of the Committee in childhood trauma and approaches to prevent and mitigate adverse childhood experiences. It is an honor to be asked to talk briefly about activities in the State of Tennessee referred to collectively as Building Strong Brains Tennessee.

"The state of Tennessee believes there is a real need to address childhood trauma and strongly endorses educating leaders at all levels of government about this issue. I will address myself primarily to state government but want to note that leaders in local governments across the state are increasingly involved in and supportive of trauma-informed strategies at the local level.

"In Tennessee across departmental lines, the child serving departments are knowledgeable about the effects of trauma, taking a two generation approach--considering children and caregivers as a whole--in recognition that caregivers themselves may have experienced trauma. The question becomes "What might you do to make your children's experience growing up a good one, one better than your own?"

"For other areas of government--Labor and Workforce Development, Economic and Community Development, Transportation, Safety, for example--we know a competent workforce, so important to the future prosperity of Tennessee, depends on what is done today to support healthy social/emotional development of children, youth and young adults.

"There have been several notable activities that have contributed to the success of Building Strong Brains Tennessee, the state's initiative to address, prevent and mitigate adverse childhood experiences (ACEs).

"There were three key events that put Tennessee on the current path:

1. In January, 2015, business, government, community and philanthropic leaders who formed what is now the ACE Awareness Foundation released the results of a statistically sound survey of Memphis and Shelby County residents about the incidence of ACEs in the population. Vince Felitti, one of the two principle investigators of the original ACEs research had provided technical assistance. The two Mayors declared Memphis would not sacrifice another generation of young people to ACEs. They were clear that the benefits of prevention on quality of life far out-weighed the human and financial costs of intervening after the fact.

2. At about the same time, Robert Anda, the other principle investigator of the original ACEs study was invited to address the Three Branches Institute which had been convened by invitation of then Governor Bill Haslam to leaders of the Executive, Legislative and Judicial Branches of state government to form a common agenda to advance child welfare and realign the juvenile justice system. Following that, the Three Branches Institute proposed a Summit be organized about ACEs-related activities occurring statewide.

3. With invitations from the Governor, First Lady, and myself to state and local government officials, community leaders, academia, faith community, philanthropists, trade associations and business, the first "Tennessee ACEs Summit" occurred on November 12, 2015. It served as the kick-off to the robust set of activities referred to initially as "the ACEs Initiative". The kick-off created the impetus for goal-directed efforts to address, prevent and mitigate ACEs statewide.

"There are many factors that have contributed to the success of Tennessee's ACEs-related activities.

1. Prior to the first Summit, in my role as Deputy Governor, I directed the leadership of the child-serving departments and agencies, including TennCare and Department of Education, to identify two ranking staff who would be authorized to help guide the collective efforts of the state. This became the "Public Sector Steering Group."

2. The small Coordinating Team comprised of staff of Departments of Health, Education, Children's Services, Children's Cabinet and Commission on Children and Youth plus the ACE Awareness Foundation and Casey Family Programs determined that, notwithstanding tremendous support from the Administration, solutions and interventions to address ACEs had to be made in and by communities. So the "Private Sector Steering Group" was formed to balance the Public Sector Steering Group. It is comprised of community organizations, advocates, trade associations, providers, foundations, researchers and others.

3. A partnership with the FrameWorks Institute (FWI) was underwritten by the ACE Awareness Foundation. That partnership helped to set the pace to achieve an in-depth plan for people across the state to use research-based values and metaphors to communicate about trauma and its effects on brain development. The proposal by the FrameWorks Institute implemented over an 18 month period of time was comprised of

(a) Three scientific symposia:

- The Science of Biology/Physical Science

- The Science of Programmatic Innovations

- The Science of Policy Innovations 2

(b) Four "FrameLabs" in which individuals from all sectors and professional disciplines learned values and metaphors that help even people who have no familiarity with child development understand why it is important to invest in early childhood, youth and young adults.

4. Training has been among the most essential elements for extending learnings statewide and at the grassroots level. Two principle efforts have been:

(a) Using materials developed in conjunction with the Harvard Center for the Developing Child and with leadership from the Tennessee Commission on Children and Youth, over 900 individuals from a wide variety of professional disciplines and sectors have been trained to be able to speak knowledgeably for as few as 15 minutes or up to providing three-hour trainings about brain development, trauma-responsiveness, ACEs prevention, mitigation and skill building. The 900+ trained individuals have now reached over 42,000 people statewide.

(b) Building Strong Brains--Strategies for Educators was adapted from the TCCY T4T materials. The Department of Education trained over 5,000 Educators and Administrators during FY17 and FY18. Because interest was so high, the model has been restructured to develop in-school expertise with 71 schools in the first cohort selected from 150+ schools who applied to become "Trauma-Informed Schools". This permits sustainable in-school capacity to train all staff, including support staff, in how best to interact with and respond to students in wholesome ways.

"Building Strong Brains Tennessee has been the beneficiary of tremendous resources from foundations, In-kind resources of state government, and state appropriations.

1. Foundation support has been both financial and programmatic. The ACE Awareness Foundation underwrote FrameWorks scientists and faculty of the three symposia and FrameLabs. The Foundation also sponsored an evaluation of the initiative. The Healing Trust was an early financial supporter and it has subsequently funded its grantees for trauma-responsive practices. Casey Family Programs' contributions are innumerable including sponsorship of 3BI and participation in the BSB TN Coordinating Team.

2. In-kind resources of state government have been and are extensive comprised of staff time for participation in the Coordinating Team, Public Sector Steering Group, management of the procurement process for Community Innovations grants and grants management, extensive T4T and DOE training activities, materials, logistics and planning.

3. State Appropriations for Community Innovations: Tennessee is the envy of most states in the nation to have had $1.25M in state appropriations recommended by the Governor and appropriated by the Legislature annually in FY17 and FY18. The decision was made in first year to distribute the funds equally among the three Grand Regions so long as there were worthy proposals, and there were. This made the initiative statewide from the beginning. During the Haslam Administration 35 Community Innovations were funded across the state. 3

"Governor Haslam recommended and the Legislature appropriated $2.45M in the recurring budget beginning in FY19. Notably the total value of 102 proposals submitted in response to the FY20 Announcement of Funds was 5 times greater than the amount available for grants this year, a clear indicator that community interest is great in wanting to address, prevent and mitigate ACEs.

"With all that has been accomplished in Tennessee, challenges remain. The first is engaging businesses in recognizing the Return On Investment for support of early childhood services and supports. We are developing strategies to get the message out to the business community and we have gained support of a limited number of Chambers of Commerce but there is much more to do. The second is we need strong indicators of outcomes. Most of the outcome measures we have are process outcomes. We need solid indicators that we are making a difference and moving the dial on reducing trauma and ACEs. And third, we need to think bigger. What can we do to reduce the community conditions that contribute to ACEs? The Sycamore Institute, an independent, nonpartisan policy research center, recently published The Cost of ACEs in Tennessee. That cost? An astounding $5.2B per year attributable to health care costs and lost productivity. Clearly we need to focus broadly on prevention of adverse experiences that lead to serious health conditions in adults and the way to do that is to address childhood trauma now.

"So in conclusion I believe the work we have done and continue to do in Tennessee is among the most important endeavors in which I have ever been involved. We can change the trajectory for generations to come, all for the better, as children today become responsible adults in the future."

[TheHill]