03/21/2017 03:00 PM House HEALTH & SOCIAL SERVICES

         HCR 2-RESPOND TO ADVERSE CHILDHOOD EXPERIENCES                                                                     
                                                                                                                                
4:16:53 PM                                                                                                                    
                                                                                                                                
CHAIR SPOHNHOLZ announced  that the next order  of business would                                                               
be  HOUSE  CONCURRENT  RESOLUTION  NO. 2,  Urging  Governor  Bill                                                               
Walker to  join with the  Alaska State Legislature to  respond to                                                               
the public  and behavioral health  epidemic of  adverse childhood                                                               
experiences  by establishing  a  statewide  policy and  providing                                                               
programs to address this epidemic.                                                                                              
                                                                                                                                
4:17:56 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE GERAN TARR,  Alaska State Legislature, paraphrased                                                               
from the sponsor statement, which read:                                                                                         
                                                                                                                                
                                                                                                                                
     In 1998, more than 17,000 middle-class Americans were                                                                      
     administered a 10-question study to evaluate childhood                                                                     
     traumatic experiences concerning abuse, neglect, and                                                                       
     household dysfunction. The results of this study were                                                                      
     used to formulate an adverse childhood experiences or                                                                      
     "ACEs" score ranging from 0-10. The term "ACEs"                                                                            
     thereafter became synonymous with traumatic                                                                                
     experiences that occur during childhood and have a                                                                         
     lasting, negative effect on a child's developing brain                                                                     
     and body.                                                                                                                  
                                                                                                                                
     There have been two key findings as a result of ACEs                                                                       
     studies conducted in Alaska: childhood trauma is far                                                                       
     more common than previously realized; and the impact                                                                       
     of this trauma affects individuals over a lifetime,                                                                        
     and societies over multiple generations. Sixty-seven                                                                       
     percent of Alaskan children have an ACEs score, and                                                                        
     Alaska has some of the highest ACEs rates among the                                                                        
     five other states surveyed (Washington, Louisiana,                                                                         
     Tennessee, Arkansas, and New Mexico).                                                                                      
                                                                                                                                
     In Alaska, we are seeing that ACEs is synonymous with                                                                      
     asthma, depression, teen pregnancy, suicide, drug                                                                          
     abuse, employment difficulties, and intimate partner                                                                       
     violence. Health measures are linked to ACEs, and                                                                          
     these community challenges are also fiscal challenges                                                                      
     for our state. According to Dr. Hirschfield of the                                                                         
     University of Alaska and Alaska's Southcentral                                                                             
     Foundation, reducing Alaska's ACEs score by fifty                                                                          
     percent could save the state $90 million annually.                                                                         
     That means $90 million more dollars that could be                                                                          
     spent on preventative measures that add to our                                                                             
     children's wellbeing.                                                                                                      
                                                                                                                                
     Alaska's state slogan "North to the Future" was                                                                            
     adopted to signify that our state is the land of                                                                           
     promise and that Alaskans are always advancing for the                                                                     
     benefit of the people and land that sustains us.                                                                           
                                                                                                                                
     HCR 2 urges the Governor to establish policies and                                                                         
     programs that address the public and behavioral health                                                                     
     epidemics associated with ACEs so that we can uphold                                                                       
     the promise to our children that they may grow up in                                                                       
     safe households with the best opportunities before                                                                         
     them in order to become upstanding Alaskan citizens.                                                                       
                                                                                                                                
                                                                                                                                
REPRESENTATIVE  TARR lauded  the Advisory  Board on  Alcoholism &                                                               
Drug  Abuse  and  the  Alaska  Mental  Health  Board  for  public                                                               
outreach  with  research.    She stated  that  prevention  was  a                                                               
necessary tool to  mitigate the cost to  families and communities                                                               
of these bad outcomes in adulthood.                                                                                             
                                                                                                                                
4:24:58 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE SULLIVAN-LEONARD  asked how asthma  was determined                                                               
as part  of the ACEs  (adverse childhood experiences)  effect but                                                               
not diabetes or other medical conditions.                                                                                       
                                                                                                                                
REPRESENTATIVE  TARR acknowledged  that  other health  conditions                                                               
could be  included on  the list.   She reported  on the  cycle of                                                               
violence, with  an increased likelihood  of violence  and abusive                                                               
behavior by  someone who grew  up in a  home with violence.   She                                                               
declared that  the physiological impact on  these physical health                                                               
conditions brought attention and created  a paradigm shift from a                                                               
concern only  with the social  problems.  She explained  that the                                                               
bodily response to  prolonged stress could be  manifested in many                                                               
ways,  including   the  physiological  impact  on   the  internal                                                               
systems.   She offered  an example of  obesity and  diabetes from                                                               
this stress.                                                                                                                    
                                                                                                                                
CHAIR SPOHNHOLZ added that research  indicated that both diabetes                                                               
and heart disease rates go  up considerably for those people with                                                               
4 or more ACEs.                                                                                                                 
                                                                                                                                
REPRESENTATIVE  TARR  said  that  it was  difficult  to  separate                                                               
between   causation  and   correlation  in   public  health   and                                                               
environmental research  as there were often  multiple influences.                                                               
She  said  that  hundreds  of  millions  of  dollars  were  spent                                                               
annually, especially  in Medicaid.   She offered her  belief that                                                               
this was an  opportunity to review the need  for more investments                                                               
into prevention  for unwanted outcomes  in adulthood.   She spoke                                                               
about the costs associated with  ACEs, offering an example of the                                                               
costs of smoking.  She declared  that it was necessary to develop                                                               
the policies that  get us to savings from the  outcomes, and that                                                               
an  intent  of the  proposed  resolution  was to  realize  dollar                                                               
savings  and  have healthier  communities.    She explained  that                                                               
trauma informed  health care and  trauma informed  curriculum for                                                               
education  were   opportunities  for  prevention  and   to  raise                                                               
awareness.  She  offered her belief that  increased awareness and                                                               
understanding  for the  impact  of ACEs  would  allow for  better                                                               
engagement and cooperation within  the communities.  She directed                                                               
attention   to  the   critical   nature  for   early  stages   of                                                               
development.   She relayed that  a constant stressor at  an early                                                               
age created  connections in  the brain  familiar with  the stress                                                               
response, and this negatively affected development.                                                                             
                                                                                                                                
REPRESENTATIVE  TARR concluded  by pointing  to the  relationship                                                               
between  child abuse  prevention  and  sexual assault  awareness.                                                               
She pointed  out that the  rates of  sexual abuse in  Alaska were                                                               
six  times  the   national  average,  and  that   the  rates  for                                                               
incarcerated family members were also  higher.  She reminded that                                                               
many  of the  issues in  adults could  be traced  back to  sexual                                                               
assault as a child.                                                                                                             
                                                                                                                                
4:40:07 PM                                                                                                                    
                                                                                                                                
CHAIR  SPOHNHOLZ  shared a  personal  experience  of one  of  her                                                               
foster children,  reporting that  she had an  ACEs score  of nine                                                               
before the  age of nine.   She  directed attention to  the health                                                               
alert [Included  in members' packets]  which was  "startling then                                                               
as how  it relates to actual  health outcomes."  She  stated that                                                               
chronic,  costly,  challenging,  expensive health  problems  were                                                               
tied to these early childhood experiences.                                                                                      
                                                                                                                                
CHAIR SPOHNHOLZ said that HCR 2 would be held over.