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.