GOOD AFTERNOON.
THIS WILL BEGIN TODAY'S JOINT
HEARING BETWEEN SUB ONE AND SUB
TO. ON POTENTIAL PATH FORWARD IN
ADDRESSING ADVERSE CHILDHOOD
EXPERIENCES.
AND I WANTED TO START TODAY IF I
COULD WITH A BIT OF EXCITEMENT
IT'S.
A RARITY TO BE ABLE TO SPEAK
ABOUT SOMETHING THAT IS
INSPIRING AND POTENTIALLY A REAL
OPPORTUNITY FOR US AS A STATE.
TO FIND ADVANTAGES WITHIN OUR
ABILITY TO LOOK AT TRAUMA
INFORMED CARE.
AND WHAT WE COULD DO TO BETTER
MEET OUR KIDS WHERE THEY'RE AT.
AND I'M EXCITED TO HEAR FROM
THIS UPCOMING PANEL ABOUT
POTENTIAL OPPORTUNITIES FOR US
AS A STATE.
TO LOOK AT AS.
WHAT WOULD WORK FOR US
SO WITH THAT I WANTED OFFER IT
TO A CO CHAIR HERE TODAY AND SEE
IF HE HAD ANY WORDS?
BEFORE WE BEGIN.
WELL THANK YOU IT'S I I THINK
IT'S A GREAT OPPORTUNITY TO TALK
ABOUT THIS ISSUE I'M CERTAINLY
NOT THAT AN EXPERT IN THE FIELD
I KNOW THAT. DOCTOR RAMBLE YOU
EXPERIENCE THIS AS A
PRACTITIONER IN MEDICINE. BUT
I'VE BEEN HEARING A LOT ABOUT
THE TOXIC STRESS OF ACES
CONVERSATION RECENTLY LAST
YEAR'S AND. START TALKING ABOUT
ACES PEOPLE SAY OH YOU MEET ACES
THE AFTER SCHOOL PROGRAM.-AND SO
THAT'S LITTLE LITTLE YOU
THE FIRST.
THE GOAL OF TODAY IS TO
DIFFERENTIATE ADVERSE TELL
EXPERIENCES WITH THE CALIFORNIA
SAFE AFTER SCHOOL OUR PROGRAM.
BUT SELL ALL SERIOUSNESS YOU
KNOW THAT DOESN'T TAKE ROCKET
SCIENCE TO FIGURE OUT THAT THESE
EXPERIENCES AND IN YOUNGSTERS'
LIVES HAS A LIFELONG IMPACT.
AND WE KIND OF.
I THINK I KNOW THAT ON THE
NATURALIST CALIFORNIANS AND
CITIZENS BUT AS POLICY MAKERS I
THINK IT'S.
AND TEAR UP WITH US TO TO TO
TALK TO PEOPLE WHO ARE
PRACTITIONERS RESEARCHERS.
AND A LOOK AT REMEDIES HOW WE
CAN LOOK AT THIS FROM THE
EDUCATIONAL. BACKGROUND AS WELL
AS THE HEALTH BACKGROUND TO
HELP.
FOCUS ON YOU KNOW MAKING SURE
THESE YOUNGSTERS HAVE
OPPORTUNITY TO SUCCEED BECAUSE
THEIR SUCCESS IS OUR SUCCESS AND
CONVERSELY.
THEIR FAILURES ARE FAILURES WE
HAVE TO DEAL WITH AS WELL SO YOU
KNOW HAVING A YOUNGSTER IN THE.
JUVENILE JUSTICE SYSTEM IS A
COUPLE HUNDRED THOUSAND DOLLARS
A YEAR.
I KID YOU NOT.
AN INVESTING IN EARLY EDUCATION
FOR EXAMPLE FOR ONE YOUNGSTER
PER YEAR DIPPING ON PART DAY A
FULL DAY'S. IT EITHER FIVE
THOUSAND OR EIGHT THOUSAND
DOLLARS PER YEAR AND SO. I THINK
THIS IS WHAT.
KINDA LANDS AND I'M LOOKING AT
FROM THE EDUCATION PERSPECTIVE
BUT ELSE ALSO KNOW THAT DEALS
WITH.
AB HEALTHCARE WORLD AS WELL SO
LOOK FORWARD TO THE OF THE PANEL
CONVERSATION TODAY.
WITHOUT IF WE CAN HAVE OUR FIRST
PANEL COME FORWARD DOCTOR
HARRIS.
DOCTOR THOMPSON AND DOCTOR
HELFAND
.
HOW LUCKY WE ARE TO HAVE SUCH A
DISTINGUISHED PANEL BUT IF YOU'D
LIKE TO?
INTRODUCE YOURSELVES WHEN YOU
SPEAK AND HAVE WE CAN GO IN
ORDER OF HOW WE WERE PRESENT.
WITHOUT FURTHER ADO DOCTOR
HARRIS.
THANK YOU HAVE MY NAME IS NADINE
BURKE HARRIS I'M A PEDIATRICIAN
AND I'M THE FOUNDER AND CEO OF
THE CENTER FOR YOUTH WELLNESS IN
SAN FRANCISCO. AND AT THE
MISSION OF OUR ORGANIZATION IS
TO AT IMPROVE THE HEALTH OF
CHILDREN AND ADOLESCENTS.
EXPOSED TO ADVERSE CHILDHOOD
EXPERIENCES AND OUR GOAL IS TO
DO THAT BY IMPROVING TRANSLATING
THE SCIENCE ABOUT ADVERSE
CHILDHOOD EXPERIENCES INTO
IMPROVEMENTS AND PRACTICE BY IN
WHAT WE DO AS WELL AS RAISING
AWARENESS FOR PREVENTION.
I'M.
GO AHEAD.
BUDGET SHOULD WE DO THE
ELECTIONS FIRST OR DO SHOULD BE
TO CHECK JUST CHAMPION I THINK
IF YOU CAN JUST JUMP IN AND THEN
WE'LL DO AN INTRODUCTION BEFORE
EACH PART I THAT'S ALRIGHT OKAY
GREAT.
SO I I'LL GO AHEAD AND GET
STARTED ABOUT.
IN TERMS OF LOOKING AT HOW
ADVERSE CHILDHOOD EXPERIENCES
AFFECT HEALTH AND WHAT WE CAN DO
ABOUT IT.
I'M THIS WORK STARTED FOR ME
MORE THAN A DECADE AGO NOW.
WHEN I OPENED A CLINIC AND ONE
OF SAN FRANCISCO'S MOST
UNDERSERVED NEIGHBORHOODS
BAYVIEW HUNTERS POINT. OUT WHICH
IS A NEIGHBORHOOD.
WITH.
HIGH NUMBERS OF.
AT COMMUNITIES OF COLOR IT'S
ALSO ABOUT ONE OF THE LOWEST
INCOME NEIGHBORHOODS IN SAN
FRANCISCO AND IS A PEDIATRICIAN
WHAT I WAS OBSERVING WHAT'S THAT
MANY CHILDREN WERE BEING
REFERRED TO ME. FOR ADHD OR
ATTENTION DEFICIT HYPERACTIVITY
DISORDER.
BUT WHEN I DID A THOROUGH
HISTORY AND PHYSICAL WHAT I
FOUND WAS THAT FOR MOST OF MY
PATIENTS I COULDN'T MAKE A
DIAGNOSIS OF STRAIGHTFORWARD
ADHD.
I AND THE REASON FOR THAT WAS
BECAUSE MANY OF MY PATIENTS WERE
BEING EXPOSED TWO VERY VERY HIGH
DOSES OF. ADVERSITY.
AND IF YOU LOOK AT THE
DIAGNOSTIC CRITERIA AT THE TIME
IT WITH THE DSM FOUR. THEY
SHOWED ALL OF THE SYMPTOMS THAT
MY PATIENTS WERE HAPPENING BUT
AT THE BOTTOM. IT SAID AND THESE
SYMPTOMS ARE NOT CAUSED BY ANY
OTHER MENTAL HEALTH DISORDER.
NOW I'M NOT A MENTAL HEALTH
CONDITION I'M A PEDIATRICIAN BUT
MY QUESTION WAS WHAT IF THIS IS
BEING CAUSED BY SOME OTHER
NEUROLOGIC PROCESS.
THAT WASN'T NECESSARILY A MENTAL
HEALTH DISORDER.
AND AS I.
MOVE FORWARD IN MY PRACTICE
WHAT I NOTICED THAT IT IT WASN'T
JUST CHILDREN'S BEHAVIOR.
IN ADDITION WHAT WE WERE SEEING
UP WAS FOR EXAMPLE AS I WAS
MANAGING A TEN YEAR OLD GIRL
WITH ASTHMA AND I WAS GOING
THROUGH HER ASTHMA TRIGGERS AND
TRYING TO MAKE SURE THAT WE WERE
DOING A GOOD JOB OF. NOT
PREVENTING HER ASTHMA.
I AS I ASKED HER MOM YOU KNOW
WHAT DO YOU NOTICE THAT TRIGGERS
YOUR DAUGHTER'S ASTHMA BECAUSE
WE HAD DONE KIND OF ALL OF THE
STANDARD PRECAUTION.
PRECAUTIONS
SHE SAID TO ME. YOU KNOW LOOK
TOWARD TOWN I NOTICED THAT MY
DAUGHTER'S ASTHMA TENDS TO ACT
UP EVERYTIME HER DAD PUNCHES A
HOLE IN THE WALL.
AND FOR ME THAT WAS REALLY WHAT
GOT ME INTO LOOKING AT THE
SCIENCE ABOUT HOW EARLY
ADVERSITY. GETS UNDER OUR SKIN
AND CHANGES OUR BIOLOGY AND THAT
IS WHAT HAS LED ME TO THE
ADVERSE CHILDHOOD EXPERIENCES
STUDY.
AND SO.
FOR FOLKS WHO MAY NOT BE
FAMILIAR OUTSIDE THE ADVERSE
CHILDHOOD EXPERIENCES STUDY WAS
CONDUCTED NOW TWO DECADES AGO IT
WAS PUBLISHED IN NINETEEN NINETY
EIGHT. AND IT WAS A CONDUCTED IN
PARTNERSHIP BETWEEN THAT CENTERS
FOR DISEASE CONTROL AND
PREVENTION THE CDC AND KAISER
PERMANENTE A.
AND IN IT THEY ASKED SEVENTEEN
AND A HALF THOUSAND ADULTS
ABOUT THEIR HISTORIES OF WHAT
THEY CALLED ADVERSE CHILDHOOD
EXPERIENCES.
AND THESE INCLUDE PHYSICAL
EMOTIONAL OR SEXUAL ABUSE
PHYSICAL EMOTIONAL NEGLECT
OR GROWING UP IN A HOUSEHOLD
WHERE PARENT WAS MENTALLY ILL
SUBSTANCE THE PENDANT
INCARCERATED WITH WITH PARENTAL
SEPARATION OR DIVORCE. OR
DOMESTIC VIOLENCE
AND FOR EVERY YES
AN INDIVIDUAL WOULD GET A POINT
ON THEIR A SCORE FOR EACH ONE OF
THESE CATEGORIES THAT THEY HAD
EXPERIENCED.
AND WHAT THEY FOUND IN THIS
STUDY WAS REALLY GROUNDBREAKING
AND THERE WERE TWO IMPORTANT
THINGS.
NUMBER ONE WAS THAT.
ACES ARE INCREDIBLY COMMON
AND THIS REALLY DEFY IT I THINK
NOT PREVIOUS COMMON WITH THEM
THAT. I CHILDHOOD ADVERSITY ONLY
HAPPENS TO CERTAIN PEOPLE IN
CERTAIN POPULATIONS.
THIS STUDY WAS DONE IN A
POPULATION THAT WAS SEVENTY
PERCENT CAUCASIAN SEVENTY
PERCENT COLLEGE EDUCATED TWO
THIRDS OF THE STUDY PARTICIPANT
HAD AT LEAST ONE ADVERSE
CHILDHOOD EXPERIENCE. AND TWELVE
POINT SIX PERCENT ONE IN EIGHT
FOLKS HAD FOUR OR MORE ADVERSE
CHILDHOOD EXPERIENCES.
IN CALIFORNIA OUR DATA SHOWS
THAT EIGHTY SAYS DO NOT
DISCRIMINATE BY RACE OR
ETHNICITY IS FOUND IN EVERY
COMMUNITY AND EVERY POPULATION.
AND HERE IN CALIFORNIA.
ALMOST SEVENTEEN PERCENT OF
INDIVIDUALS HAVE FOUR OR MORE
ADVERSE CHILDHOOD EXPERIENCES.
THE SECOND FINDING FROM THE
ADVERSE CHILDHOOD EXPERIENCES
pWAS THIS VERY STRONG
RELATIONSHIP WHAT THEY.
I'VE FOUND WITH A DOSE RESPONSE
RELATIONSHIP
BETWEEN ADVERSE CHILDHOOD
EXPERIENCES AND HEALTH OUTCOMES.
SO FOR A PERSON WHO HAS FOUR OR
MORE ADVERSE CHILDHOOD
EXPERIENCES.
THEIR RISK FOR ISCHEMIC HEART
DISEASE THE NUMBER ONE KILLER IN
THE UNITED STATES IS DOUBLE.
AS COMPARED TO SOMEONE WITH AN A
SCORE OF ZERO.
HERE WE HAVE A LISTS OF THE TEN
LEADING CAUSES OF DEATH IN THE
UNITED STATES OF AMERICA. AND
HAVING AND A SCORE OF FOUR OR
MORE IS ASSOCIATED WITH A
DRAMATIC INCREASE IN SEVEN OUT
OF TEN OF THE LEADING CAUSES OF
DEATH IN THE UNITED STATES OF
AMERICA.
SO WHEN WE UNDERSTAND.
THIS
NUMBER ONE THAT A SAYS ARE
INCREDIBLY COMMON A NUMBER TWO
THERE'S A VERY STRONG
RELATIONSHIP BETWEEN A SAYS. AN
ADVERSE HEALTH OUTCOMES
THE NEXT UP IS UNDERSTANDING HOW
THIS HAPPENS WHAT IS THE
MECHANISM BECAUSE WHEN WE
UNDERSTAND THE MECHANISM WE CAN
USE THAT SCIENCE FOR. TO TO
DISRUPT THAT PROCESS.
AND BIO WHEN THE ORIGINAL
RESEARCHERS FIRST PUBLISHED
THEIR DATA MANY FOLKS THOUGHT OF
COURSE THIS MAKES SENSE.
YOU HAVE A ROUGH CHILDHOOD
YOU'RE MORE LIKELY TO DRINK AND
SMOKE AND DO ALL THE THINGS THAT
ARE GOING TO RUIN YOUR HEALTH.
REALLY THIS IS NOT SO MUCH ABOUT
HEALTHCARE OR MEDICINE THIS IS
REALLY ABOUT BEHAVIOR.
BUT FORTUNATELY THERE SOME VERY
RIGOROUS SCIENTISTS WHO HAVE
DONE THE EVALUATION TO DEBUNK
THAT MYTH
WHAT WE UNDERSTAND IS THAT.
PORTION OF THE RISK IS DUE TO
HEALTH RISK BEHAVIOR.
AND I'M GONNA PUT A LITTLE
ASTERISK THERE BECAUSE I'M GONNA
COME BACK TO IT.
BUT EVEN IF YOU DON'T ENGAGE IN
ANY HIGH RISK BEHAVIOR EVEN IF
YOU DON'T DRINK OR SMOKE YOU'RE
NOT IN ACTIVE YOU DON'T EAT JUNK
FOOD. YOU'RE STILL AT GREATER
RISK FOR DEVELOPING HEART
DISEASE COPD CANCER DIABETES
THAT SARAH. AND THE REASON FOR
THAT IS BECAUSE.
OF A MECHANISM THAT WE NOW KNOW.
CALLED TOXIC.
AND ESSENTIALLY IT ALL BOILS
DOWN TO OUR BODY'S BIOLOGICAL
FIGHTER FLIGHT RESPONSE.
AND IT WORKS A LITTLE SOMETHING
LIKE THIS IMAGINE YOU'RE WALKING
IN A FOREST.
AND YOU SEE THIS GUY
RIGHT.
WHAT HAPPENS IN OUR BRAINS AND
BODIES ARE BRAIN SENDS A SIGNAL
TO OUR BODIES TO RELEASE STRESS
HORMONES?
AND THE STRESS HORMONES PERFORM
SOME VERY IMPORTANT FUNCTIONS
THE INCREASE OUR BLOOD PRESSURE
THEY INCREASE OUR BLOOD SUGAR.
THEY.
SPEED UP OUR HEART RATE THEY
DILATE ARE PUPIL THINK OPEN UP
OUR AIRWAYS SO THAT WE ARE READY
TO EITHER FIGHT THAT BEAR. OR
RUN FROM THE PAIR.
AND THAT'S GOOD.
BUT FOR MOST OF US IF WE WERE
THINK TO THINK ABOUT FIGHTING A
BEAR RIGHT IT WOULDN'T SEEM LIKE
A GOOD IDEA AND THAT IS WHY THE
AMYGDALA THE PART OF THE BRAIN
THAT ACTIVATES THAT FEAR
RESPONSE.
SENSE PROJECTIONS TO THE PART OF
OUR BRAIN THAT'S RESPONSIBLE FOR
EXECUTIVE FUNCTIONING IMPULSE
CONTROL. AND LEARNING THE
PREFRONTAL CORTEX AND IT TURNS
IT WAY DOWN
RAIN BECAUSE YOU DON'T WANT
IMPULSE CONTROL GETTING IN THE
WAY OF SURVIVAL.
AND THE FINAL THING THAT HAPPENS
IN THE BODY WHEN OUR WHEN WE
ACTIVATE OUR STRESS RESPONSE
IS THAT IT ALSO ACTIVATES OUR
IMMUNE RESPONSE.
BECAUSE IF WE ARE IN A FOREST
AND IF THERE IS A BEAR.
IF THAT BEAR GETS ITS CLAWS INTO
US WE WANT OUR IMMUNE SYSTEM TO
BE PRIMED TO BRING INFLAMMATION
TO STABILIZE THAT WOUND. SO THAT
WE CAN EITHER. I.
LIVE LONG ENOUGH TO TAG BEAT
THAT THEY ARE OR GET AWAY.
THIS SYSTEM WAS DESIGNED OVER.
MILLENNIUM TO SAVE OUR LIVES
FROM A MORTAL THREAT.
BUT THE PROBLEM IS WHAT HAPPENS
WHEN THAT BEAR COMES HOME EVERY
NIGHT.
AND THIS BIOLOGICAL PROCESS.
IS ACTIVATED OVER AND OVER AND
OVER AND OVER AGAIN.
AND IT GOES FROM BEING ADAPTIVE
OR LIFESAVING.
TO MALADAPTIVE OR HEALTH
DAMAGING.
AND WHEN CHILDREN ARE EXPOSED TO
HIGH DOSES OF ADVERSITY.
THE RESULT IS LONG TERM CHANGES
TO THE STRUCTURE AND FUNCTION OF
CHILDREN'S BRAINS.
OVER ACTIVITY OF THIS FIGHT OR
FLIGHT RESPONSE AND DIFFICULTY
TURNING THIS RESPONSE OFF.
CHANGES TO AND I'LL COME BACK TO
THE ASTROCYTE MENTIONED EARLIER.
CHANGES TO CERTAIN PARTS OF THE
BRAIN INCLUDING THE VENTRAL
TEGMENTAL AREA AND THE NUCLEUS
ACCUMBENS. LEAD TO INCREASED
RISK
OF.
DEPENDENCE OR.
INCREASED RISK OF ENGAGING IN
HIGH RISK BEHAVIOR BECAUSE THEY
ARE CHANGES TO THE STRUCTURE AND
FUNCTION OF THE PLEASURE AND
REWARD CENTER OF THE BRAIN.
WE ALSO SEE LONG TERM CHANGES TO
THE IMMUNE SYSTEM. TO OUR
HORMONAL SYSTEMS
AND EVEN TO WEIGH EVEN TO THE
WAY OUR DNA IS RED AND
TRANSCRIBED AND THIS IS WHAT
LEADS TO THE LIFELONG CHANGES
THAT ARE ASSOCIATED WITH TOXIC.
SO NOW THAT WE UNDERSTAND THAT
EARLY LIFE ADVERSITY FILTERED
THROUGH THE LENS OF BOTH
PROTECTIVE FACTORS AS WELL AS
PREDISPOSED VULNERABILITY. LEADS
TO CHANGES WITH OUR IT IT TO A
CHILD'S ENTIRE DEVELOPING BRAIN
AND BODY.
AND THIS IS WHAT LEADS TO THE
LONG TERM HEALTH OUTCOMES
WE CAN USE THE SCIENCE
TO.
CHANGE OUR PRACTICES FOR OUR
CHILD.
.
THE FIRST THING IS UNDERSTANDING
THAT SIGNS OF TOXIC STRESS ARE
DETECTABLE AS EARLY AS INFANCY.
WE DON'T HAVE TO WAIT UNTIL
SOMEONE.
UP MOVES INTO THEIR FORTIES AND
FIFTIES AND DEVELOP
CARDIOVASCULAR DISEASE OR CANCER
OR CHRONIC OBSTRUCTIVE PULMONARY
DISEASE BEFORE WE CAN BEGIN TO
IMPLEMENT.
REMEDIES FOR THIS ISSUE WE CAN
BEGIN TO RECOGNIZE SIGNS AND
SYMPTOMS OF TOXIC STRESSED AS
EARLY AS INFANCY BUT IN ORDER
FOR US TO DO THAT WE NEED TO BE
ABLE TO.
TRAIN EVERY PROVIDER ON
UNDERSTANDING WHAT DOES THAT
LOOK LIKE.
SO WHEN WE FIRST LEARNED ABOUT
THE SCIENCE OF MY CLINICAL
PRACTICE ONE OF THE FIRST THINGS
THAT WE DID WAS WE WENT AND DID
A CHART REVIEW OF ALL OF OUR
PATIENTS TO UNDERSTAND.
WHAT WERE THEIR A SCORES LIKE
THE WHAT WE FOUND WAS THAT VERY
SIMILAR TO THE KAISER STUDY TWO
THIRDS OF OUR PATIENTS HAVE
EXPERIENCED AT LEAST ONE ADVERSE
CHILDHOOD EXPERIENCE?
AND ONE IT AND TWELVE PERCENT
HAD EXPERIENCE FOR ARM OR MORE.
NOW THE DIFFERENCE IN OUR
POPULATION WITH THAT RATHER THAN
IT BEING AN ADULT POPULATION
WHICH WAS BEING ASKED WHICH OF
THESE THINGS HAPPEN TO YOU WHEN
YOU WERE A CHILD.
THE MEDIAN AGE OF OUR PATIENTS
WITH EIGHT YEARS OLD.
AND WHAT WE FOUND WAS THAT FOR
OUR PATIENTS WHO HAD FOUR OR
MORE ADVERSE CHILDHOOD
EXPERIENCES.
THEY WERE TWICE AS LIKELYTO BE
OVERWEIGHT OR OBESE.
AND THIRTY TWO POINT SIX TIMES
AS LIKELY.
TO HAVE LEARNING OR BEHAVIOR
PROBLEMS IN SCHOOL.
AND WHEN WE LOOK AT OUR DATA.
FOR OUR KIDS WITH ZERO A SAYS
ONLY THREE PERCENT OF THEM HAD
LEARNING AND BEHAVIOR PROBLEMS
AND KIDS A IN SCHOOL. AND FOR
OUR KIDS WITH FOUR OR MORE ACES
FIFTY ONE POINT TWO PERCENT MORE
THAN HALF OF THEM HAD LEARNING
AND BEHAVIOR PROBLEMS.
THIS HAS SIGNIFICANT
IMPLICATIONS FOR EVERY PROVIDER
ACROSS THE STATE OF CALIFORNIA
WHO IS CURRENTLY. UP
TREATING KIDS WHO ARE BEING
PRESENTED TO THAT WITH
BEHAVIORAL PROBLEMS.
RIGHT NOW MOST OF THESE CHILDREN
ARE BEING MISDIAGNOSED AS HAVING
ADHD WITHOUT THE ROOT CAUSE OF
EARLY ADVERSITY BEING
RECOGNIZED.
AND THE MOST COMMON TREATMENT
FOR FOR ATTENTION DEFICIT
HYPERACTIVITY DISORDER. IF
STIMULANTS.
RIGHT SO WE HAVE AN OPPORTUNITY
TO PROVIDE BETTER QUALITY OF
CARE MORE APPROPRIATE CARE TO
OUR KIDS.
AND RIGHT NOW TEACHERS ACROSS
OUR STATE ARE BEING ASKED TO
EDUCATE KIDS WHO ARE BEING
EXPOSED TO A NEUROTOXIN AND IT'S
SIMPLY UNFAIR WE WOULD NOT. WE
CANNOT ASK TEACHERS TO BE
DOCTORS TO CURE TOXIC STRESS
WHAT WE HAVE TO UNDERSTAND IS
THAT WE HAVE TO GIVE OUR
EDUCATORS AN OPPORTUNITY. TO TO
OUR.
WORK WITH KIDS WHO ARE GETTING
THE APPROPRIATE TREATMENT
FOR TOXIC STRESS WHICH IS TO
REDUCE THEIR DOSE OF ADVERSITY
AND ENHANCE THE BUFFERING
CAPACITY OF THE CAREGIVERS AND
THEIR ENVIRONMENT.
SO WHAT WE KNOW NOW.
IT'S NOT ABOUT WHAT WE LOOK AT
HOW DO WE ADDRESS THIS ISSUE.
WE CAN IMPROVE OUTCOMES WITH
ROUTINE SCREENING EARLY
DETECTION AND EARLY
INTERVENTION.
I AT THIS
OUR MY ORGANIZATION THE CENTER
FOR YOUTH WELL LET'S HAS WORKED
WITH PROVIDERS FROM ACROSS THE
COUNTRY TO UNDERSTAND WHAT ARE
THE BIGGEST BARRIERS TO BEING
ABLE TO SCREEN FOR ADVERSE
CHILDHOOD EXPERIENCES AS PART OF
PRIMARY CARE.
AND ARE ONE TWO AND THREE
BARRIERS ARE TIME.
FOLKS DON'T KNOW WHAT TO DO WHEN
THEY HAVE A POSITIVE SCREEN AND
THEY DON'T GET REIMBURSED FOR.
BUT WE HAVE A SCREENING TOOL TO
BE ABLE TO SCREEN QUICKLY AND
EFFECTIVELY. FOR RISK FACTORS OF
TOXIC STRESS IN PRIMARY CARE
THAT CAN BE DONE IN THREE
MINUTES OR LESS
WE TWENTY ENHANCE OUR PROTECTIVE
FACTORS AND THEN WE NEED TO DO
THIS INTERVENTION. BOTH IN THE
CLINICAL SETTING AND IN THE
COMMUNITY AND ALSO YOUR BRIEF
EXAMPLE OF WHAT THAT LOOKS LIKE
BEFORE WE WRAP UP.
SO IN OUR CLINICAL SETTING UP
FOR EXAMPLE THIS IS THE GROWTH
CHART OF A PATIENT THAT I CARED
FOR. WHO WITH EXPERIENCING
FAILURE TO THRIVE AND IF YOU
LOOK AT THOSE LITTLE DOTS AS
THEY FALL BELOW THAT THE LIGHT
PART OF THE GRAPH THIS IS A
CHILD WHO LITERALLY?
HAD GROWTH IMPAIRMENT SHE WAS
NOT GAINING WEIGHT OR HEIGHT.
AND.
ABOUT THIS IS A CHILD WHO HAD
ACTUALLY BEEN THIS THIS GROWTH
CHART IT'S FROM HER PREVIOUS
PEDIATRICIAN.
THIS YOUNG UP GIRL CAME TO SEE
ME AFTER HER PARA ACT HER FAMILY
MOVED TO OUR COMMUNITY.
AND AS PART OF HER REGULAR
TREATMENT WE ACTUALLY SCREEN HER
FOR ADVERSE CHILDHOOD
EXPERIENCES.
HER A SCORE FOR THIS.
ALMOST THREE YEAR OLD CHILD WITH
A SEVEN SHE HAD EXPERIENCED
SEVEN OUT OF TEN OF THE ACES
THAT I TALKED ABOUT.
BUT WHEN WE IMPLEMENTED TRAUMA
INFORMED CARE AND IN OUR CASE WE
HAD INTEGRATED PRIMARY CARE AND
BEHAVIORAL HEALTH.
THIS CHILD WHO HAD BEEN TREATED
WITH ONLY WITH NUTRITIONAL
SUPPLEMENTATION WHICH IS
SUPPOSED TO BE THE STANDARD OF
CARE FOR FAILURE TO THRIVE WHO
HADN'T BEEN GROWING. FOR OVER A
YEAR.
WHEN WE DID.
ACES INFORMS TREATMENT.
WITHIN SIX MONTHS SHE WAS BACK
ON THE GROWTH CHARTS.
IN ADDITION IN THE COMMUNITY
WHAT WE SEE IS THAT.
MORE AND MORE COMMUNITY BASED
ORGANIZATIONS ARE BEGINNING TO
IMPLEMENT INTERVENTION THAT IS
ARE DESIGNED TO REDUCE THE
STRESS RESPONSE ENHANCE
BUFFERING CAPACITIES AND AT WITH
INTERVENTIONS LIKE SLEEP.
EXERCISE NUTRITION MINDFULNESS
MENTAL HEALTH AND HEALTHY
RELATIONSHIP.
AND AS AN EXAMPLE SAN FRANCISCO
UNIFIED SCHOOL DISTRICT JOHN
O'CONNELL HIGH SCHOOL AND THEN
ALSO A JUNIOR HIGH SCHOOL
IMPLEMENTED A MINDFULNESS
INTERVENTION WITH THE GOAL OF
CALMING THIS OVER ACTIVE STRESS
RESPONSE.
AND WHAT THEY FOUND WAS A
REDUCTION IN SCHOOL VIOLENCE.
A SUBSTANTIAL DROP IN THE
SUSPENSION RATE.
AN INCREASE IN GPA.
AN INCREASE AND COMPOSITE STAR
TEST SCORES.
AND MY FAVORITE DECREASE
PSYCHOLOGICAL DISTRESS AMONG
ADMINISTRATORS AND TEACHERS OVER
THE COURSE OF THE INTERVENTION.
HAVING A TRAUMA INFORMED
FRAMEWORK KNOWING WHAT WE ARE
TREATING KNOWING THAT WE CAN.
WITH ROUTINE SCREENING EARLY
DETECTION AND EARLY INTERVENTION
CHANGE THE TRAJECTORY
FOR.
MILLIONS OF OUR CHILDREN.
IS AN INCREDIBLY POWERFUL
POWERFUL WAY FOR US TO USE THE
SCIENCE TO IMPROVE HEALTH.
AND LIFE OUTCOMES
CHILDREN ACROSS OUR STATE.
THANK YOU SO MUCH
THANK YOU DOCTOR HERS.
NEXT WE'LL HEAR FROM DOCTOR
THOMPSON AND.
I THINK HE'LL UNDERSTAND WHY SO
MANY OF US ARE EXCITED ABOUT
THIS BODY OF WORK AND THE
PASSION IN WHICH YOU BRING TO
THE SUBJECT MATTER.
IT'S IMPORTANT THE. I'M
REMEMBERING YOUR STORIES OF
BAYVIEW THAT COME THROUGH YOUR
BOOK AND REMIND MYSELF OF MANY
OF THE COMMUNITIES THAT MANY OF
US COME FROM AS WELL.
AND REALLY I'M HONORED THAT.
YOU'RE HERE TODAY TO BRING YOUR
TESTIMONY AND.
SO WITH THAT DOCTOR THOMPSON.
WELL AYE ROSS THOMPSON AND
DISTINGUISHED PROFESSOR OF
PSYCHOLOGY AT THE UNIVERSITY OF
CALIFORNIA DAVIS WHICH IS WHERE
I STUDY YOUNG CHILDREN AND THIS
EVENING I WILL BE MORE
DISTINGUISHED AMONG MY FAMILY
WHEN THEY LEARNED THAT I JUST
FOLLOWED NAY DEEMED BURKE
HARRIS.
I'M I ALSO SERVE ON THE
EXECUTIVE COMMITTEE OF OUR
UNIVERSITY CENTER FOR PULP FOR
POVERTY RESEARCH.
AND THEN THE OTHER HAT THAT I
WEAR IS I'M CURRENTLY PRESIDENT
OF OF THE BOARD OF DIRECTORS OF
ZERO TWO THREE. WHICH IS A
NATIONAL NONPROFIT DEVOTED TO
THE HEALTHY DEVELOPMENT OF OUR
YOUNGEST CHILDREN AND THEIR
FAMILIES AND I VERY MUCH
APPRECIATE THE OPPORTUNITY TO
SPEAK TO YOU TODAY. I I WILL NOT
HAVE POWER POINT SLIDES IN ORDER
TO AVERT THE WORST TENDENCIES OF
AN ACADEMIC.
BUT I WILL SAY THAT IN ORDER TO
MAKE UP FOR THAT I THINK YOU
HAVE A COUPLE OF ARTICLES THAT I
HAD SENT ON FRIDAY. RELATING TO
CHILDREN IN STRESS AND SOME OF
THE PUBLIC POLICY AVENUES THAT
CAN HELP TO ADDRESS THAT
CHALLENGE AND.
AND SO THAT IS THE SUBSTITUTE
FOR FOR POWER POINTS PERHAPS.
THE RESEARCH PRESENTED BY A BY
DOCTOR HARRIS CONCERNING ADVERSE
CHILDHOOD EXPERIENCES OF THEIR
LONG TERM CONSEQUENCES
PHYSICAL AND MENTAL HEALTH IS
REALLY REALLY IMPORTANT.
IT DRAWS OUR ATTENTION AGAIN TO
THE WAYS IN WHICH EARLY
EXPERIENCE COULD HAVE A PROFOUND
LEGACY FOR LIFELONG DEVELOPMENT.
AND IT COINCIDES WITH RESEARCH
SUBSTANTIAL RESEARCH THAT
FOLLOWS CHILDREN FROM VERY EARLY
IN LIFE.
I ANY EXPERIENCES THEY HAVE AND
LOOKS AT WHAT ARE THE LONG TERM
OUTCOMES FOLLOWING FROM THOSE
EXPERIENCES.
AS ONE OF STUDY SOCIAL AND
EMOTIONAL DEVELOPMENT OF VERY
YOUNG CHILDREN BEGINNING AS
EARLY A SIX MONTHS OF AGE AND
WORKS TO PROMOTE YOUNG
CHILDREN'S MENTAL HEALTH DURING
THE EARLY YEARS OF LIFE.
I THINK THERE ARE THREE MESSAGES
FROM CURRENT RESEARCH THAT I
WOULD LIKE TO ADD TO DOCTOR
HARRIS'S COMMENTS.
AND THE FIRST OF THEM IS ONE
THAT YOU ALLUDED TO BRIEFLY THAT
I THINK WE NEED TO DEEPEN A
LITTLE BIT ON. WHICH IS THAT
RESEARCH UP EARLY DEVELOPMENT IS
SHOWING THE EFFECTS OF CHRONIC
STRESS IT IF YOUNGER AND YOUNGER
AGES.
BOB I'VE LITERALLY BEEN IN THE
POSITION OF WATCHING HOW PSALM
THE THE THRESHOLD FOR THE ON. OF
OUR ABILITY TO DETECT
SIGNIFICANT ELEMENTS OF CHRONIC
STRESS IS MOVING IT EARLIER AND
EARLIER AGES.
THERE NOW NEW STUDIES USING
NEURO IMAGING METHODS AND
CORTISOL ATTACHES ALSACE
SHOWING HOW THE BIOLOGICALLY
DISRUPTIVE EFFECTS OF CHRONIC
STRESS CAN BE SEEN AS EARLY AS
THE FIRST YEAR OF LIFE. NOT JUST
INFANCY.
THE FIRST YEAR OF LIFE.
WITH AFFECTS BOTH ON BRAIN
FUNCTIONING.
BUT ALSO AND BRAIN STRUCTURE.
THAT WE CAN OBSERVE THROUGH
IMAGING STUDIES
SIMPLY PUT.
JUST AS WE HAVE LONG KNOWN THE
BRAIN DEVELOPMENT SHAPED BY
EARLY EXPERIENCE WE ARE NOW
SEEING THE PROFOUND EFFECTS OF
EARLY STRESS ON HOW THE BRAIN
DEVELOPS AND FUNCTIONS.
AS EARLY AS THE FIRST YEAR.
EQUALLY IMPORTANTLY I THINK.
OF CONCERN TO TO THOSE OF US WHO
STUDY YOUNG CHILDREN IS THAT
THESE BIOLOGICAL EFFECTS OF
CHRONIC STRESS.
HAVE BEEN LINKED TO HOW TO TO
DIFFERENCES IN HOW CHILDREN
LEARN AND HOW THEY DEVELOP.
ONE STUDY SHOWED FOR EXAMPLE THE
BIOLOGICAL DIFFERENCES IN BRAIN
STRUCTURE EMERGING DURING THE
EARLY YEARS.
HELP TO ACCOUNT FOR THE LOWER
ACHIEVEMENT TEST SCORES IN
PRESCHOOL CHILDREN EXPERIENCING
CHRONIC STRESS
COMPARED TO THEIR PEERS.
THERE'S ALSO GROWING EVIDENCE A
CHRONIC STRESS CAN HELP EVEN
EARLIER AFFECTS.
IN EFFECT.
BEFORE CHILDREN ARE BORN.
STUDIES OF INFANTS BORN TO
MOTHERS WHO EXPERIENCED PERSON
STRESS DURING THEIR PREGNANCIES
REVEAL THAT IS NEW PARTS THESE
CHILDREN ARE THEMSELVES MORE
EMOTIONALLY REACTIVE INSENSITIVE
TO STRESS.
WITH FOLLOW UP STUDIES SHOWING
THAT THERE ARE MORE VULNERABLE
TO EMOTIONAL PROBLEMS SUCH AS
DEPRESSION AND ANXIETY DISORDERS
IN CHILDHOOD AND ADOLESCENCE.
THE PRENATAL AFFECTS A MATERNAL
STRESS ON THE DEVELOPING FETUS.
WHAT HAS COME TO BE KNOWN IN THE
FIELD AS FETAL PROGRAMMING?
IT'S ANOTHER INDICATION OF HOW
MUCH THE CHILD'S RAPIDLY
DEVELOPING BIOLOGICAL AND
BEHAVIORAL SYSTEMS ARE
VULNERABLE.
T. INFLUENCES SUCH AS STRESSORS
EARLY IN DEVELOPMENT EVEN BEFORE
A CHILD IS BORN.
SO THE ASUS STUDY IS CONSISTENT
WITH OTHER RESEARCH SHOWING HOW
THE STRESSES OF ALL KINDS CAN
HAVE EARLY IN AND DURING THE
IMPACT ON DEVELOPMENT. WITH
GREATER AFFECTS THE YOUNGER THE
CHILD.
BUT I NEED TO SAY THAT THERE'S A
SILVER LINING TO THIS DARK CLOUD
OF EARLY VULNERABILITY.
BECAUSE THE SAME BIOLOGICAL AND
BEHAVIORAL SYSTEMS THAT ARE SO
VULNERABLE TO THE EFFECTS OF
EARLY STRESS.
ARE ALSO CAPABLE OF REMEDIATION
IF THE SOURCES OF STRESS ARE
IDENTIFIED INDUSTRY
THE EDITOR AND ADDRESS.
THROUGH EARLY IDENTIFICATION AND
TREATMENT THE BRAINS
MALLEABILITY OR PLASTICITY IS WE
CALL.
COMPARE ALLY IN HELPING TO SHIFT
THE ODDS TOWARD MORE HEALTHY
DEVELOPMENT.
I'LL BE TURNING TO THAT LITTLE
BIT LATER.
IDENTIFYING SOURCES OF EARLY
STRESS REALLY LEADS TO MY SECOND
CONCLUSION AND IT IS THIS.
THERE ARE MORE SOURCES OF TOXIC
STRESS FOR YOUNG CHILDREN THEN
FOR OLDER CHILDREN AND ADULTS.
AND WHEN WE THINK ABOUT THE TERM
TOXIC STRESSING AND WHERE CAN
COME FROM FOR CHILDREN WE
NATURALLY THINK OF THE
EXPERIENCES THAT HARM OR
THREATEN. OR TERRORIZE
I TRAUMATIZE THEM.
THESE ARE THE STRESSES THAT
ATTRACTED THE ASUS STUDIES SUCH
AS PHYSICAL EMOTIONAL OR SEXUAL
ABUSE
DOMESTIC VIOLENCE SUBSTANCE
ABUSE OR MENTAL ILLNESS IN THE
HOME. PARENTS SEPARATION OR
DIVORCE OR EMOTIONAL OR PHYSICAL
NEGLECT.
IT IS IMPORTANT FOR RECOGNIZE
THAT THE STRESS IS LIKE THESE
ARE MORE PREVALENT AMONG THE
YOUNGEST CHILDREN THAN FOR ANY
OLDER AGE GROUP.
TWENTY FIFTEEN FOR EXAMPLE
NEARLY ONE QUARTER OF CHILDREN
AGED THREE AND UNDER LIVED IN
POVERTY.
AND AN ADDITIONAL TWENTY THREE
PERCENT LIVED IN POOR FAMILY
HOUSEHOLDS.
THESE PROPORTIONS ARE HIGHER FOR
YOUNGER CHILDREN LIVING IN
CALIFORNIA.
WHICH MEANS HAD MORE THAN HALF
OF CHILDREN AGED THREE AND BELOW
LIVE IN FAMILIES AND ECONOMIC
DIFFICULTY IN OUR STATE NOW. THE
REASON I MENTION POVERTY.
IS THAT FOR THOSE OF US WHO
STUDY THE EFFECTS OF CHRONIC
STRESS ON YOUNG CHILDREN POVERTY
BECOMES THE EGO TO TEST CASE.
BECAUSE A COMBINED SO MANY
SOURCES OF STRESS ALL IN ONE FOR
YOUNG CHILDREN.
IT MEANS THAT YOU NOT ONLY ARE
IN A SITUATION OF ON FOOD
INSECURITY AND HOUSING
INSTABILITY YOUR PARENTS WERE
THEMSELVES STRESSED.
AND MAY HAVE OTHER DIFFICULTIES
ASSOCIATED WITH THAT.
SO POVERTY IS A SOURCE OF TOXIC
STRESS FOR YOUNG CHILDREN AND
THE YOUNGER THE CHILD THE MORE
LIKELY YOU ARE TO BE LIVING IN A
LOWER INCOME SETTING.
BUT IT'S NOT JUST POVERTY MORE
THAN ONE THIRD OF THE VICTIMS OF
SUBSTANTIATED CHILD MALTREATMENT
TWENTY FIFTEEN WERE CHILDREN
UNDER THE AGE OF THREE. AND
VICTIMIZATION RATE WAS HIGHER
FOR INFANTS UNDER ONE YEAR OF
AGE.
SO SAY IT AGAIN THE YOUNGER YOU
ARE THE MORE LIKELY YOU ARE TO
BE LIVING IN CONDITIONS
ASSOCIATED WITH TOXIC STRESS.
BUT THE IMPORTANT THING IS A
VIEWS EXPERIENCES ONLY CAPTURE
PART OF THE NATURE OF TOXIC
STRESS FOR YOUNG CHILDREN.
BECAUSE THEY DEPEND SO
SIGNIFICANTLY ON ADULTS TO
PROVIDE PROTECTION AND
SUPPORTIVE CARE.
EXPERIENCES CAN ALSO BE TOXIC TO
YOUNG CHILDREN WHEN THEY INVOLVE
A DEPRIVATION OR WITHDRAWAL OF
THAT.
CARE.
THIS IS WHY CHILD EMOTIONAL
NEGLECT IS INCLUDED AMONG THE
ACES AS WELL AS PARENT MENTAL
HEALTH PROBLEMS LIKE DEPRESSION.
AND HERE AGAIN THE YOUNGEST
CHILDREN ARE THE MOST
VULNERABLE.
MOTHERS HAVE MORE THAN ONE IN
SEVEN INFANTS WILL EXPERIENCE
MAJOR DEPRESSION IN THEIR
CHILD'S FIRST YEAR AND THIS
EXPERIENCE HAS BEEN DIRECTLY
TIED TO CHANGES IN THE BABY'S
DEVELOPING BRAIN.
THAT'S WHEN WE THINK OF TOXIC
STRESS FOR YOUNG CHILDREN WE
HAVE TO CONSIDER A BROADER RANGE
OF EXPERIENCES THAN WE
ORDINARILY CONSIDER FOR AN OLDER
CHILD OR AN ADULT.
CHILD UNDER THE AGE OF THREE OR
FOUR HAVING TO FACE STRESSFUL
SPIRIT EXPERIENCES ALONE WITHOUT
SUPPORT IS TOXIC.
BEEN DEPRIVED OF NURTURING
SUPPORTIVE CARE IT'S TOXIC.
MY LAST CONCLUSION FROM CURRENT
RESEARCH ADDRESSES INTERVENTION.
THE EFFECTS OF EARLY STRESSES
ARE BEST ADDRESSED.
THROUGH A COMBINATION OF
SERVICES THAT BEGIN WITH EARLY
IDENTIFICATION BUT WHICH
CONTINUE TO SUPPORT THE CHILDREN
AND THOSE WHO CARE FOR THEM AS
THE CHILD DEVELOPS.
BOB PERHAPS THE BEST WAY OF
EXPRESSING THIS IS TO STATE WHAT
I'M SAYING IN THE NEGATIVE.
EARLY IDENTIFICATION IS
IMPORTANT AND ESSENTIAL
BUT WE CANNOT STOP THEIR. WE
ALSO NEED TO INTERVENE
EFFECTIVELY TO ADDRESS THE
SOURCES OF STRESS.
AN INTERVENTION FOCUS OF THE
DEVELOPING CHILD IS IMPORTANT
AND ESSENTIAL BUT WE CANNOT STOP
THEIR.
WE ALSO NEED TO PROVIDE
ASSISTANCE TO THE CHILD'S
CAREGIVERS ON HOME THE CHILD
DEPENDS FOR NURTURANCE AND
PROTECTION TO HELP THEM BE
SOURCES OF RELIABLE SUPPORT IF
WE CAN'T.
FINALLY INTERVENING EARLY IS
IMPORTANT AND ESSENTIAL BUT WE
CAN'T STOP THERE. WE NEED A
SYSTEM OF CONTINUING SUPPORT TO
PROVIDE SEAMLESS AND ONGOING
ASSISTANCE AS THE CHILDREN ARE
HEALING.
NOW WHAT I JUST DESCRIBED YOUR
SOME OF THE BASIC PRINCIPLES OF
INFINITE EARLY CHILDHOOD MENTAL
HEALTH.
YES
THERE IS A FIELD INFANT MENTAL
HEALTH.
AND IT DOES NOT CONSIST OF
BABIES LYING ON A COUCH RELATING
THEIR PROBLEMS TO A PSYCHIATRIST
TO SCRIBBLING NOTES NEARBY.
INSTEAD IT IS BASED ON THE
REALIZATION THAT THERE ARE MANY
SOURCES OF TOXIC STRESS IN THE
LIVES OF CHILDREN AGED THREE AND
UNDER. AND THAT THE STRESSES
EXIST EXACT A COST ON THEIR
EMOTIONAL WELL BEING AS WELL AS
IN THEIR LEARNING AND THINKING
SKILLS.
TREATING THESE PROBLEMS REQUIRES
NOT PSYCHOLOGIST IN CULTURES BUT
RATHER SKILLED EARLY CHILDHOOD
MENTAL HEALTH PRACTITIONER.
WORKING CLOSELY WITH A CHILD AND
THEIR CAREGIVERS.
AND THE REASON FOR THIS
IS THAT TREATMENT FOR YOUNG
CHILDREN IS A TO GENERATIONAL
APPROACH.
BECAUSE YOUNG CHILDREN DEPEND SO
MUCH ON THE PROTECTION IN
SUPPORT OF THEIR CAREGIVERS THE
GOAL OF INTERVENTION IS TO
STRENGTHEN THE CHILD'S
CAPACITIES FOR LEARNING IN
RELATING TO OTHERS.
BY IMPROVING THE QUALITY OF
CARE.
THE CHILD CAN DEPEND ON.
IT A POLICY BRIEF COMMISSION BY
THE ROBERT WOOD JOHNSON
FOUNDATION IT WILL BE RELEASED
EARLY NEXT WEEK. I REVIEWED THE
VARIETY OF EVIDENCE BASED
PROGRAMS WILL BE THAT THAT THAT
EXISTS TO TRY TO ACCOMPLISH THIS
GOAL. INCLUDING THOSE FOCUSED ON
EVERYTHING FROM BUILDING
PARENTING SKILLS AND
RESPONSIVENESS TO THE CHILD.
TWO INITIATIVES A COMBINED HOME
VISITATION WITH PARENT EDUCATION
ASSISTANCE WITH HEALTHCARE AND
OTHER SERVICES BASED ON THE
FAMILY'S NEEDS.
THESE PROGRAMS HAVE BEEN SHOWN
TO BE EFFECTIVE IMPROVING YOUNG
CHILDREN'S EMOTIONAL WELL BEING
SELF REGULATION AND LATER SCHOOL
READINESS BEGINNING EARLY IN
LIFE.
NOT ALL EARLY CHILDHOOD MENTAL
HEALTH PROGRAMS ARE FOCUSED ON
THE CHILD OF THE PARENT HOWEVER.
THERE ARE ALSO EARLY CHILDHOOD
MENTAL HEALTH CONSULTATION
PROGRAMS DEVOTED TO HELPING
TEACHERS IN EARLY CARE AND
EDUCATION PROGRAMS TO UNDERSTAND
THE SIGNS OF EARLY STRESS AND
TRAUMA IN THE YOUNG CHILDREN
THEY CARE FOR. AND TO KNOW THE
STRATEGIES FOR RESPONDING THESE
CHILDREN IN WAYS THAT CAN REALLY
HELP THEM OF THE KIND OF DOCTOR
HARRIS SPOKE TO.
IN A MATTER PARALLELING THE
GROWTH OF TRAINING IN TRAUMA
INFORMED TEACH.
THAT IS OCCURRING IN THE K.
TWELVE SYSTEM THROUGHOUT
CALIFORNIA.
EARLY CHILDHOOD EDUCATORS ARE
BEING ASSISTED IN LEARNING
SKILLS OF TRAUMA INFORMED CARE
FOR YOUNG CHILDREN.
AND THEIR MOTIVATION IS BASED ON
WHAT I HEAR FROM THESE TEACHERS
IN MY WORK WITH THEM THROUGHOUT
THE STATE.
THEY ARE SAYING FAR MORE YOUNG
CHILDREN SHOWING SIGNS OF TOXIC
STRESSED NOW THAN IT EVER SEEN
IN THE PAST.
AND IT SEEMS RELATED TO THE
FAMILY STRESSES.
IN THE FAMILIES OF THESE
CHILDREN ARE LIVING IN
ASSOCIATED WITH POVERTY FOOD
INSECURITY AND HOUSING PROBLEMS
THAT THEY ALL HAVE TO COPE WITH.
AND THOSE WHO WORK WITH EVEN THE
YOUNGEST CHILDREN INFANTS AND
TODDLERS ARE REPORTED THAT THE
SIGNS OF STRESS.
OUR ALSO HIGHER THAN THEY'VE
EVER SEEN BEFORE.
NOW OWING TO THE STATE'S
INVESTMENT OF THE PAST IN THE
WORK OF FIRST FIVE AND OTHER
ORGANIZATIONS THERE EXISTS A
HOME VISITATION.
AND PARENTING SKILLS TRAININGS
PROGRAMS AN EARLY CHILDHOOD
MENTAL HEALTH INITIATIVES IN
SOME COUNTIES IN CALIFORNIA.
THERE DOES NOT EXIST HOWEVER
SYSTEM THAT INTEGRATE C.
SERVICES SEAMLESSLY.
TO ENSURE THAT YOUNG CHILDREN
WHO ARE BEGINNING TO COUNT UP
THE NUMBER OF ACES IN THEIR
YOUNG LIVES RECEIVE THE
CONTINUING SUPPORT THEY NEED TO
PUT THEIR FUTURE DEVELOPMENT.
OUGHT A POSITIVE TRAJECTORY.
PERSONALLY DOES NOT EXIST SUCH
AS SYSTEM THROUGHOUT THE ENTIRE
STATE AN IMPORTANT SERVICES
REMAIN LACKING IN THE COUNTIES
OF GREATEST NEED.
DEVELOPING SUCH A SYSTEM WOULD
REQUIRE SEVERAL THINGS
INCLUDING STRENGTHENING AVENUES
OF EARLY IDENTIFICATION SUCH AS
IN PEDIATRIC PRACTICE THROUGH
PROGRAMS SUCH AS HEALTHY STEPS.
AND ENSURING THAT REFERRAL
RESOURCES ARE AVAILABLE TO THE
CHILDREN IN CARE GIVERS WHO NEED
THEM.
IT WOULD INVOLVE USING OF HEALTH
CARE NETWORK.
PARTICULARLY WORKING ON THE
ELIGIBILITY REQUIREMENTS FOR
MEDICAID REIMBURSEMENT TO ENSURE
THAT FAMILIES CAN RECEIVE THE
SERVICES THAT THEY NEED FOR
THEIR YOUNG CHILDREN.
IT CAN ALSO INVOLVE PUBLIC
PRIVATE PARTNERSHIPS TO CREATE
AVENUES FOR THE INTEGRATION OF
COORDINATION OF SERVICES FOR
CHILDREN WHO HAVE BEEN
IDENTIFIED THE GREATEST NEED OF
LOCAL COMMUNITIES.
IT WOULD ALSO INVOLVE
STRENGTHENING THE STATE SYSTEM
OF EARLY CHILDCARE PROGRAMS TO
ENSURE THE TEACHERS ARE WELL
EQUIPPED TO ADDRESS THE
CHALLENGES.
TRAUB INFORMED CARE IT WOULD
INVOLVE MUCH MORE.
WHAT IS HISTORICALLY NOVEL ABOUT
THE CURRENT MOMENT?
IT'S NOT JUST THE WE HAVE MORE
INFORMATION.
ABOUT THE CHALLENGES TO CHILDREN
ARISING FROM EARLY STRESS.
BUT WE HAVE MORE EVIDENCE BASED
PROGRAMS THAT WE CAN TAKE TO
ADDRESS THESE CHALLENGES.
AND WE HAVE MORE EXAMPLES
THROUGHOUT THE COUNTRY OF STATE
BASED BAND LOCAL PROGRAMS THAT
ARE ALREADY PROVING EFFECTIVE IN
ADDRESSING THESE CHALLENGES WE
HAVE MORE TOOLS TO WORK WITH.
TO DEAL WITH THE PROBLEM THAT WE
UNDERSTAND BETTER.
SO CREATING THAT SYSTEM IS A
CHALLENGING BEFORE CHALLENGE
BEFORE US RECOGNIZING THAT BY
MAKING THESE KINDS OF
INVESTMENTS IN PREVENTIVE AND
REMEDIAL SERVICES FOR YOUNG
CHILDREN WHERE TO BETTER
POSITION TO ENSURE THAT THESE
CHILDREN GET A HEALTHY START IN
LIFE.
THANK YOU FOR THE OPPORTUNITY TO
SEE.
THANK YOU DOCTOR THOMPSON.
NEXT.
DOCTORAL.
HIGH I'M.
NEIL HEALTH AND I'M A
PEDIATRICIAN ALSO AND I'M A
PROFESSOR OF PEDIATRICS IN.
MEDICAL SCHOOL AT UCLA
PROFESSOR OF PUBLIC HEALTH AND
PROFESSOR OF. PUBLIC POLICY AND
I RUN SOMETHING CALLED THE
CENTER FOR HEALTHIER CHILDREN
FAMILIES AND COMMUNITIES.
AND I STARTED MY CAREER THIRTY
SOMETHING YEARS AGO OF. ON A
VERY SIMILAR PATH TO NADINE I
READ SOMETHING CALLED THE CENTER
FOR THE BOND WILL CHILD AT
CHILDREN'S HOSPITAL OAKLAND ALL
WE DID WAS TAKE CARE OF KIDS
THAT HAVE BEEN ABUSED AND
NEGLECTED.
AND SAW LOTS OF THOSE GROWTH
TRAJECTORIES WERE KIDS WERE IN
THE ROTH GOING IN THE WRONG
DIRECTION. AND WE GOT VERY GOOD
AT PUTTING TOGETHER SERVICES FOR
THEM BUT THAT AT SOME POINT I
REALIZED.
ARE THERE WEREN'T ENOUGH
PEDIATRICIANS AND ENOUGH
SERVICES THAT I HAD TO FIGURE
OUT HOW TO MOVE UPSTREAM AND
FIGURE OUT HOW DO WE STOP THOSE
YOU KNOW. AND THAT TOO IS
TREATED.
AND SO WHAT I THINK NEEDING TO
STAND AS MADE A PALLET FOR
ARGUMENT FOR WHY WE NEED TO DO
SOMETHING TO DO SOMETHING
DRAMATIC AND TRANSFORMATIVE. AND
ROSS LAID OUT A LOT OF WHAT WE
CAN BE DOING AS AS MADE THE AND
I'M I'M GONNA TALK A LITTLE BIT
ABOUT HOW WE CAN DO THAT. AND
WHAT THE POLICY IT SHOULD LOOK
LIKE OF WE'RE GOING TO MOVE
FORWARD.
WE WERE WE EVER REACH TREATING
CALIFORNIA DREAM I THINK IN THE
STATE OF CALIFORNIA WE HAVE
GROWING ADVERSITY BECAUSE OUR
HUMAN ACCO SYSTEM IS RADICALLY
CHANGING RIGHT NOW VERY QUICKLY.
AND IT'S NOT JUST FOR POOR KIDS
BUT IT'S FOR ALL CHILDREN WHICH
SEEMED DISTRICT AND DEEP CHANGES
ARE DISRUPTING FAMILIES AND
COMMUNITIES IN THE DEVELOPMENTAL
SCAFFOLDING THE KIDS NEED TO
FLOURISH AND THRIVE. IN KIDS ARE
KIND OF THE.
CANARIES IN THE CHANGING GLOBAL
COAL MINE THAT'S GOING ON.
WE HAVE SYMPTOMATIC PIECEMEAL
SOLUTIONS THAT ARE COSTLY
INEFFECTIVE DISHEARTENING AND
OFTEN SELF DEFEATING BECAUSE
WE'RE NOT PUTTING THE PIECES
TOGETHER. WE NEED A SYSTEMS
APPROACH WORKING AT SCALE
MEANING THAT WE DID NOT BE DOING
DEMOS BUT WORKING AT SCALE IS IN
A COMPREHENSIVE STRATEGY WITH
THE PURPOSE OF A SOCIAL
MOVEMENT.
AND WHAT YOU HEARD FROM NADINE
IS A PASS ON THAT SUCH A SOCIAL
MOVEMENT THAT WHAT WHAT PURPOSE
WOULD BRING.
A SOLUTION I BELIEVE AS WE NEED
A UNIVERSAL STRATEGY FOCUSING ON
ALL CHILDREN THRIVING AND ALL
FAMILIES FLOURISH.
WE NEED UNIVERSAL FAMILY
SUPPORTS BECAUSE THE FAMILIES OF
THE ONES THAT ARE STRUGGLING
RIGHT NOW. AS WELL AS HEALTH
MENTAL HEALTH EDUCATION THOSE
HAVE TO BE UNIVERSAL FOR ALL
KIDS WE NEED POPULATION LEVEL
DATA AN IMPROVEMENT MANY OTHER
COUNTRIES MANY OTHER PLACES HAVE
THAT DATA WE DON'T. IN
CALIFORNIA WE'VE BEEN RUNNING
FIRST FIVE MALE FOR ALL CLOSE TO
TWENTY YEARS AND WE DON'T EVEN
HAVE DATA TO KNOW WHETHER IT'S
WORKING AT ALL. SPENT BILLIONS
OF DOLLARS WE HAVE NO MEASURES
ON THE OUTCOMES FOR THE STATE.
WE HAVE BEEN OVER AND WE NEED
INNOVATIVE FINANCING THAT
INCENTIVIZE AS IMMIGRATION
ACROSS SECTORS IN SILOS AND
THERE'S A REAL OPPORTUNITY. TO
USE THIS CHANGE FROM VOLUME TO
VALUE FINANCING THEM THE HEALTH
CARE SYSTEM WHERE THERE'S FOUR
BILLION DOLLARS THAT IS A FOUR
TRILLION DOLLARS THAT'S GOING TO
BE SPENT ON TWENTY TWENTY. ON
HEALTH CARE IN AMERICA FOUR
HUNDRED BILLION IN THE STATE OF
CALIFORNIA MUCH OF WHICH IS
WASTE OF BUT THAT COULD BE
SHIFTED UPSTREAM TO KIDS.
UP IN IN TERMS OF THAT VALUE.
AND FOCUS ON CITIES AS UNITS OF
INNOVATION IN ACTION AND
TRANSFORMATION.
ARE THEY CREATING A LEARNING
PLATFORM FOR RAPID CYCLE
INNOVATION COMMUNICATION MANDATE
AT THIS IS MY SORT OF
PRESCRIPTION THAT I THINK FROM A
POLICY STANDPOINT WE NEED TO BE
THINKING ABOUT.
IF WE WERE SUCCESSFUL LICENSE
WOULD BE DROPPING DOWN PRESIDENT
ITALY LOW LEVELS WE'D HAVE LESS
NEED FOR MENTAL HEALTH JUNE
WOMAN JUST SO SPECIAL EDUCATION
SCHOOLS WOULD BE LESS BURDEN
WITH MORE WITH THE KIDS THAT
WERE TROUBLE. WE'D HAVE A
DECREASE PREVALENCE OF THESE
PREVENTABLE CHRONIC CONDITIONS
THAT NEED IN I THINK WE COULD
ACTUALLY DROP OUR HEALTHCARE
COSTS BY ABOUT A THIRD. IF WE
WERE ACTUALLY TO TAKE THIS HAT
ON A MOVE FORWARD TO MAKE THE
INVESTMENT.
WE HAVE MORE STABLE HAPPIER
FAMILIES AND COMMUNITIES MORE
FUNDS TO SPEND ON OTHER STATE
PRIORITIES AND WE WOULD ACHIEVE
THE HUMAN CAPITAL REVOLUTION
THAT OUR STATE NEEDS TO FLOURISH
IN THE FUTURE. AND I THINK
THAT'S THE GOAL HERE IS WERE HOW
DO WE MOVE TO THIS NEW KIND OF
FUTURE BY TAKING CARE OF THIS
REALLY. INSIDIOUS PROBLEM.
SO WE KNOW A LOT WOOD THAT'S
ALREADY BEEN TALKED ABOUT HOW
ADVERSITY TO. REALLY.
DAMAGES HUMAN POTENTIAL WE HAVE
MORE ADVERSITY THAT AN
INCREASING AND WHAT I WANT TO
MAKE A POINT OF IS THAT IT'S NOT
JUST TEMPORE KIDS OR IN LOW
INCOME KIDS IT'S RISING RIDE UP.
THE OF THE.
INCOME SPECTRUM.
IN IT WITH STUDY THAT WE
RECENTLY SHOWED THAT UP TO FOUR
HUNDRED PERCENT OF THE POVERTY%
LEVEL YOU HAVE VERY VERY HIGH
LEVELS OF BASIS IN THE. IN THE
POPULATION AND PART OF THAT HAS
TO DO WITH THOUGHT WHAT'S GOING
ON IN OUR SOCIETY RIGHT NOW.
THE TRADITIONAL CAUSES OF BASES
ARE POVERTY SOCIAL EXCLUSION
RACISM FAMILY DYSFUNCTION ON
TREATED ON CONTROL MENTAL
HEALTH.
DRUG.
AN ALCOHOL PROBLEMS ALL THESE
THINGS THAT WE KNOW THAT WOULD
SEEM AT FACE VALUE OF THESE
THINGS ARE BAD FOR YOU SAID.
ASSEMBLY MEMBER CARTHY RIGHT
OFF THE BAT YOU DON'T NEED A
ROCKET SCIENTIST
STONE NO THAT'S THESE THINGS ARE
GOOD FOR KIDS AND OTHER LIVING
THINGS RIGHT WE KNOW THAT.
BUT WE HAVE THESE NEWER DEEPER
DRIVERS OF WHAT'S CAUSING
ADVERSELY WE'RE MAKING A CHANGE
OF AGE TO FROM A. FROM AN
INDUSTRIAL AGE TO AN INFORMATION
TECHNOLOGY AGE THAT IS CHANGING
EVERYTHING ON OUR SOCIETY OF
PRISA.
WE'RE SEEING MAJOR DE OUT THE.
DISRUPTIONS AND ALL OUR BAR
SOCIAL WACKO SYSTEMS CULTURAL
CHANGES VALUES STREAMS
PRODUCTION MODELS WORK MODELS
ARE ALL CHANGING RIGHT NOW FOR
EVERYONE.
AND WE'RE SEEING THE
ACCELERATORS OF THAT CHANGE
BEING GLOBALIZATION TECHNOLOGY
CLIMATE CHANGE URBANIZATION
INEQUALITY MASS MIGRATION THIS
IS OFF THAT'S A PERFECT STORM OF
MAJOR TSUNAMIS THAT ARE HITTING
OUR SOCIETY AND OUR FUTURE AT
PRESENT.
AND THIS UNDER COURAGE THAT
WHAT'S GOING ON AND THE SPEED OF
CHANGE IS ACCELERATING FASTER
THAN WE CAN ADAPT TO AT PRESENT.
AND SO WE'RE SEEING THIS
MISMATCH BETWEEN WHAT WE WERE
PROGRAMMED OUR ANCESTRAL BIOLOGY
AND PSYCHOLOGY IN WHAT WE'RE
BEING ASKED TO ADAPT TO. AT
PRESENT.
AND THAT'S WHY YOU'RE SEEING THE
SUICIDE RATES IN KIDS IN PLACES
LIKE PALO ALTO WHERE THEY'RE
THROWING THEMSELVES IN FRONT OF
TRAINS IT'S NOT POOR KIDS THAT
ARE DOING THAT. THESE ARE KIDS
THAT ARE IN HIGHER INCOME
FAMILIES THAT ARE IN MENTAL
DISTRESS.
A PART OF THIS THIS COMES FROM
TOM FRIEDMAN'S BOOK WORRY SO
SHOWS ARE TECHNOLOGY ADVANCES IN
HUMAN ADAPTABILITY AND WE HAVE
TECHNOLOGY IN DIGITALIZATION
STUFF THAT FAR EXCEED WHERE
WE'RE AT AT PRESIDENT. AND LOTS
OF POOR PEOPLE NOT EDUCATED
AREN'T UP THERE ON THE
ADAPTABILITY SIDE OF THIS THING
AND THIS IS GONNA JUST GET MORE.
AND THE THE REASON I'M MAKING
THIS POINT AS THE TSUNAMIS HAVE
CHANGE THAT ARE COMING IN AT A.
AND OCT CHANGING OUR WORKPLACES
INCREASING THE WHAT MAN OF ALL
ARTIFICIAL INTELLIGENCE THAT IS
GOING TO CHANGE THE THE NATURE
OF WORK AND IN CALIFORNIA THE
STUFF IS GONNA JUST KEEP COMING.
AND IT'S GONNA MAKE PEOPLE THAT
ARE MARGINALIZED ALREADY AND
POOR AND ISOLATED EVEN MORE
MARGINALIZED POOR AND ISOLATED.
SO WE HAVE THIS GROWING
DEBILITATING COMPLEX PROBLEM WE
HAVE SIGNIFICANT CONSEQUENTIAL
LIFELONG A FAX THERE'S NO SINGLE
CAUSE AND NO MAGIC BULLET. WE
KNOW IT'S AFFECTING LOTSA KIDS
AND WHAT WERE SEEN RIGHT NOW WE
HAVE FORTY PERCENT OF CHILDREN
THAT HAVE CHRONIC HEALTH
PROBLEMS.
OKAY WHEN I STARTED AS A
PEDIATRICIAN TWENTY BOATS TWENTY
FOUR CLOSE TO THIRTY FIVE YEARS
AGO THAT WAS AROUND FIFTEEN
PERCENT.
OKAY.
WE HAVE A GROWING PREVALENCE OF
MENTAL HEALTH PROBLEMS TWENTY
POINT EIGHT PERCENT OF KIDS
ADOLESCENTS HAVE MENTAL HEALTH
PROBLEMS WITH IMPAIRMENTS OF
PRESS.
AND WE HAVE A GREATER
APPRECIATION OF THESE NARROW
DEVELOPMENTAL PROBLEMS AND LOTS
OF KIDS WITH MULTIPLE PROBLEMS
THESE ARE CALLED SIN DEL MIX.
THESE ARE WHEN IT EPIDEMIC
SOURCE ENERGIZING TOGETHER AND
THEY'RE REFINING THE ROOTS BACK
TO THE SUPER EARLY ADVERSITY
THAT THEY'RE ALL FINDING THEIR
WAY BACK TO.
AND SO WE'RE SEEING THE PRUSSIAN
RATES THAT ARE JUST SKYROCKETING
OVER THE LAST SEVERAL YEARS.
AND WHAT WE KNOW IS THAT THIS
THING'S JUST CASCADE THEM NADINE
WAS SHOWING THIS HOW THAT'S JUST
CASCADES THROUGH THE LIFESPAN.
AND ENDS UP HAVING AN ENORMOUS
BECAUSE OF FOR OUR SOCIETY.
WE HAVE THE SCIENCE AND THE
EVIDENCE IN THE PROGRAMS AS ROSS
WAS TALKING ABOUT NAY DEAN WAS
TALKING ABOUT BAR CURRENT
APPROACHES PIECEMEAL FRAGMENTED.
WE HAVE NO COMMON METRICS GOALS
AND STANDARDS AND PART OF THE
PROBLEM IS HERE. WE'VE MADE LOTS
OF POLICIES THAT ACTUALLY.
THINGS SEPARATE AND FUN THING
SEPARATELY BUT DON'T ALLOW US TO
PUT RATIONAL SYSTEMS TOGETHER.
AND WE NEED A LONG TERM IN THE
GREAT A POLICY IN LEARNING
STRATEGY THIS HAS TO BE THIS IS
LIKE FOR FOR THE LEGISLATURE
THIS IS LIKE PUTTING A WHOLE NEW
WATER SYSTEM A WHOLE NEW
TRANSPORTATION SYSTEM IN THE
STATE OF CALIFORNIA. WE NEED A
FIFTEEN YEAR PLAN FOR HUMAN
DEVELOPMENT SYSTEM FOR THE CAT
STATE A CALIFORNIA THAT'S GOING
TO SOLVE THIS PROBLEM.
IF WE KEEP THROWING MORE MODEL
PROGRAMS A LITTLE BIT HERE AND
THERE WERE GOING TO END UP WITH
FIVE PERCENT OF KIDS GET THIS IN
FIVE PERCENT WHO NEED TO GET
THAT. AND WE'VE STILL WON'T BE
MAKING THE KIND OF PROGRESS.
THE WAY THAT WE'VE TRIED TO MAKE
THIS VERY SIMPLE TO COMMUNITIES
ONE WE'RE WORKING WITH THEM AS
WE SHOW THESE DEVELOPMENTAL
TRAJECTORIES KITS CAN GO INTO A
DILLON LATER DISORDER TRAJECTORY
OR AT RISK TRAJECTORY. ME UP
PROBABLY TEN FIFTEEN PERCENT
BELOW US PROBABLY ANOTHER THIRTY
TO FORTY PERCENT. AND THE MORE
ADVERSITY YOU HAVE THEM WHAT
LORD YOU GO ON THE LOWER
TRAJECTORIES MORE PROTECTIVE
FACTORS YOU HAVE TO GO ON A
HIGHER TRAJECTORY.
KIDS A LITTLE BIT HIGHER INCOME
COMMUNITIES HAVE MORE THESE
PROTECTIVE FACTORS IN FEWER
THESE RISK FACTORS SO THE NAME
OF THE GAME FROM A PUBLIC POLICY
STANDPOINT IS HOW DO WE INCREASE
THE PROTECTIVE FACTORS. AND
REDUCE THE RISK FACTOR SO WE
HAVE MORE RESILIENCE IN THE
COMMUNITIES AND IN THE FAMILY.
AND THAT'S ABOUT HAROLD OLD RULE
SALIENT SOCIAL CONNECTIONS
KNOWLEDGE SKILLS AND THEIR
RELATIONSHIPS.
AND THERE ARE A WHOLE SET OF
INDIVIDUAL STRATEGIES THAT WE'VE
HEARD ABOUT THAT WE CAN DO THAT
WE CAN IDENTIFY AND INTERVENE
AND THERE'S A GREAT THERAPIES
INFANT MENTAL HEALTH AND OTHER
CLIENT. THE MINDFULNESS
THERAPIES I THINK OR SOMETHING
THAT ARE REALLY HAVE LOTS OF
PROBLEMS BUT WE NEED TO THINK
BECAUSE WE'RE NOT TALKING ABOUT
THREE PERCENT OR FIVE PERCENT
WE'RE TALKING ABOUT TWENTY
THIRTY FORTY PERCENT OF THE
POPULATION.
AT PRESENT WE HAVE TO FIGURE OUT
HOW DO WE START SHIFTING THE
CURVE FOR ALL THE CHILDREN HOW
DO WE BUILD. COMMUNITIES MORE
RESULTS ARE GONNA SHOW YOU THIS
IT'S A LITTLE WONKY BUT WHAT
YOU'RE SEEING HERE AS ANY KIND
OF DEVELOPMENTAL OUTCOME.
AND WHAT YOU SEE ON THE LEFT A
POOR KIDS THERE ARE IN THE RED
THEIR SORT OF.
SHIFT TO THE LEFT IN THE RICH
ONES YOURSELF TO THE RIGHT NEAR
YOUR TRAUMATIZED AND VULNERABLE
CHILDREN.
AND ONE PART ONE WAY WE DO IS WE
GOING ON SCREEN FOR THESE KIDS
AND THEN TRY TO MOVE THEM
THROUGH INDIVIDUAL THERAPY MOVE
THEM OVER.
ANOTHER WAY IS TO TARGET A WHOLE
POPULATION THROUGH TARGETED
APPROACHES TOWARDS WHOLE
POPULATION.
IF THE PREVALENCE OF GREY THERE
IN TEN FIFTEEN TWENTY PERCENT
YOU DON'T HAVE TO SCREEN ANYMORE
YOU NEED TO PUT SOMETHING MORE
UNIVERSAL IMPLIES.
AND ONE IDEA BEEN GETS GREATER
THE REAL PUT WAY TO MOVE IS TO
USE UNIVERSAL SCURRIED SHIFTING
YOU SHIFT THE ENTIRE CREW. IT'S
A VERY DIFFERENT STRATEGY TO
WORK AT THE MARGIN TO WORK AT
BRINGING IN THE TAIL OF THE
CURVE VERSUS TRYING TO SHIFT THE
WHOLE CURVE.
AND RIGHT NOW WE DON'T HAVE
LEVERAGE AT THE TAIL OF THE
CURVE WE CAN'T GET AHEAD OF THIS
WHAT'S GOING ON BY JUST MOVING
AT THE TAIL WE HAVE TO HAVE
MEDIAN RENTS STRATEGIES TO MOVE
FORWARD.
SO WE NEED TO BE THINKING ABOUT
THESE TRAJECTORIES WERE TRYING
TO ACHIEVE AND THAT ALL CHILDREN
NEED FAMILY FOUNDATIONAL KINDS
OF SUPPORT READING MINDFULNESS
TRAINING HEALTH SERVICES
PRESCHOOL ALL KIDS NEED THAT
NOW.
KIDS THAT HAVE A HIGHER RISK
NEED OTHER KINDS OF SERVICES AND
WE NEED TO KNOW WHERE THOSE KIDS
ARE AND GET THEM TO WOMAN THEY
SHOULDN'T HAVE TO BE SCREENFORM
WE SHOULD JUST KNOW HOW TO DO
THAT. OTHER COUNTRIES DO THIS
WITH GREAT EASE THE COMPARATIVE
WHAT WE'RE DOING NOW.
AND FOR THOSE THAT ARE HIGHER
RISK YOU'RE GONNA NEED
SPECIALIZED SERVICES SO WE NEED
TO FIGURE OUT WHO GETS WHAT AND
HOW.
AND I'M JUST GONNA TALK ABOUT
ONE PROGRAM THAT'S ONE OF MY
FAVORITE PROGRAMS BECAUSE I
REALLY THINK THAT THIS HAS TO DO
WITH FAMILIES AND REALLY
SUPPORTING ALL FAMILIES.
AND BY THINKING ABOUT FAMILIES
THAT ADVERSITY IN FAMILIES IS
MEASURABLE AND CON MEN ACROSS
THE INCOME SPECTRUM FAMILY
CONFLICT THIS CONFLICT THAT. IS
MEASURABLE IMPACTS ON CHILDREN
AND PART OF THIS IS THAT WE LIVE
IN A SOCIETY TODAY WHERE WE'RE
NOT MARRIED MARRYING SOMEBODY
FROM OUR OWN TRIBE ANYMORE WHERE
WE DON'T HAVE TO NEGOTIATE
THINGS WE ALL MARY STRANGERS
REALLY.
AND THEN WE HAVE TO NEGOTIATE
EVERYTHING THAT WE DO ONE PARENT
TEEN RE PARENTING BURKE SOME
FIGURE OUT THERE'S LOTS OF
CONFLICT IN FAMILIES.
AND WE HAVE FAMILY INCOME
INSECURITY THAT BRIAN'S IS RIGHT
UP TO HALF THE POPULATION IN
THAT CREATES MORE CONFLICT.
AND WHAT WE KNOW IS THAT BY
COLLABORATIVE PARENT TEAM WE CAN
ENJOY UNDER RESILIENCE AND
FAMILIES AND IT REALLY. HELP
THEM MOVE FORWARD.
AND THIS A SOMETHING WHEN YOU
HAVE TWO PARENTS WORKING IN THE
STRESS OF TIME AND MONEY THAT
FAN ALL FAMILIES NEED RIGHT NOW.
AND THERE'S A THING CALLED
FAMILY FOUNDATIONS A PROGRAM
THAT WAS DEVELOPED AT PENN STATE
UNIVERSITY I HAVE NO STOCK AND
IT IT'S JUST. THE ONE THAT'S
BEEN ADVOCATED BY THE NATIONAL
ACADEMY OF MEDICINE IN THEIR
REVIEW OF THINGS.
IT'S REALLY CHEAP AND CHEERFUL
IT'S DONE LIKE BIRTH CLASSES BUT
FOUR CLASSES BEFORE BABY IS BORN
FOR AFTER A BABY IS BORN AND
IT'S ABOUT CORPS PARENTING IT'S
NOT ABOUT TEACHING MOTHERS TO BE
BETTER MOTHERS ABOUT. THE DYADIC
RELATIONSHIP WHICH HAS BEEN A
LOT OF WHAT INCREMENTAL HEALTH
IT'S BEEN ABOUT ABOUT. TEACHING
PARENTS HOW TO CO PARENT
TOGETHER.
AND HOW TO WORK TOGETHER AND I
CAN ALSO WORK WHEN YOU DON'T
HAVE A CO PARENT YOU CAN DO WITH
YOUR GRANDMOTHER OR YOUR AND IF
THAT THAT'S THE SITUATION.
AND THESE ARE THE EFFECTS THAT
IT HAS.
IT DECREASES PRETERM BIRTH AND
LOW BIRTH WEIGHT.
CRISIS HOSPITAL STAYS PARENTAL
STRESS PARENTAL DEPRESSION.
IT CHANGES THE WAY THE PARENTS
PARENT.
IT CREATES CONFLICTS IMPROVES
CHILD MENTAL HEALTH AND
BEHAVIOR.
CREATES COOPERATION AND AGE
EIGHT THESE KIDS WORK MUCH
BETTER IN SCHOOL ON THIS A SOME.
I OF SOME APPROACH AGAIN THE
COULD BE UNIVERSAL.
SO THE OTHER THING THAT WE NEED
BE SIDE UNIVERSAL THINGS AS WE
NEED BETTER DATA AN IMPROVEMENT
AND WE NEED TO HELP POPULATION
LEVEL COMMUNITY DATA. THAT WE
CAN MEASURE THESE TRAJECTORIES
TO FOR INTERESTED IN
TRAJECTORIES WE HAVE TO BE ABLE
TO MEASURE OF THEM. THEY'RE
MEASURING THEM IN CANADA OTHER
MEASURING THEM IN AUSTRALIA
ACROSS THE COUNTRY WE'RE JUST
NOT DOING THAT.
HERE'S THE CITY OF PASADENA
WHERE THEY'VE MEASURE OF ALL OF
THE CHILDREN AT AGE FIVE USING
SOMETHING CALLED THE EARLY
DEVELOPMENT AND THAT.
AND THEY'RE MEASURING THEIR
PHYSICAL EMOTIONAL COGNITIVE
SOCIAL DEVELOPMENT AND MAPPING
AT A NEIGHBORHOOD BY
NEIGHBORHOOD LEVEL MEN LOOKING
AT WHO'S GETTING CHILD CARE AND
WHO ISN'T GETTING CHILDCARE.
SO THEY'RE MAKING POPULATION Y.
DECISIONS FOR THE ENTIRE CITY OF
PASADENA.
AND CHANGING WHAT THEY'RE DOING
THEY CREATED AN EARLY CHILDHOOD
POLICY FOR THE CITY OF PASADENA
THEY HAVE A BLUEPRINT NOW OF HOW
TO MOVE FORWARD THEY CREATED AN
OFFICE OF THE YOUNG CHILD IN
PASADENA. SIMILAR THINGS GOING
ON A LONG BEACH SIMILAR THINGS
GOING ON IN SANTA MONICA SIMILAR
THINGS HAPPEN IN OTHER CITIES
AROUND THE COUNTRY THIS IS A
CITY STRATEGY USING DATA. FOR
THE ENTIRE CITY TO MOVE FORWARD.
AND HAVE A MASTER PLAN FOR
PASADENA.
THIS IS THE MAGNOLIA COMMUNITY
IN THIS SHOULD OF THE LOS
ANGELES WHICH IS ABOUT FIVE
HUNDRED SQUARE BLOCKS IN THIRTY
FIVE THOUSAND CHILDREN THIS
ISN'T ABOUT BUILDING A LITTLE.
PROGRAM FOR TWO HUNDRED OR THREE
HUNDRED KIDS THIS IS ABOUT
TAKING ALL ALL THE CHILDREN
NEIGHBORHOOD. AGAIN THERE
MAPPING ALL OF THE CHILDREN
WHERE THEY LIVE THERE LOOKING AT
HOW WELL THEY SPEAK AND WHAT
THEIR LANGUAGE FUNCTION IS AND
WHETHER THEIR PARENTS ARE
READING TO THEM.
AND THEN THERE SURVEYING THE
PAPER THE PARENTS IN THE
COMMUNITY AND SEEN WHETHER THEY
HAVE RESILIENCE AND SUPPORTS AND
VARIOUS THINGS. SO THESE ARE
POPULATION STRATEGIES ABOUT
SHIFTING THE ENTIRE CREW. THIS
ISN'T ABOUT THROWING MORE MONEY
INTO TREATMENT IT'S ABOUT
THINKING ABOUT THIS IS A PUBLIC
HEALTH INTERVENTIONS.
LASTLY THINKING ABOUT FINANCES
WE NEED THE BAY HAVING SILO
BUSTING SOLUTIONS IN VARIOUS
STATE INVESTING IN HUMAN CAPITAL
LEVERAGING LOTS OF WASTE OF
MONEY IN THE HEALTH CARE SYSTEM
OF PROCESS.
WE'RE GOING TO SHIFT MONEY IN
THE HEALTHCARE SYSTEM FROM
VOLUME TO VALUE OVER THE NEXT.
TEN YEARS.
AND I PLOY BY IPHONE OUT FOR A
REASON.
TAKE YOUR IPHONE I'M SURE A LOT
OF YOU HAVE IPHONES.
AND YOU CLICK ON IT EVERYTHING
STARTS TO JUGGLE. THAT'S WHAT WE
ARE ARE IN THE HEALTH CARE
SYSTEM RIGHT NOW WE'RE IN JUNGLE
MODE. BECAUSE WHAT'S GOING ON
RIGHT NOW IS THE INVISIBLE HAND
OF VALUES GOING TO START MOVING
THE THINGS IN THE HEALTH CARE
SYSTEM AROUND SO THAT WE GET. A
HIGHER PERFORMING HEALTH SYSTEM
IF IT'S LEFT UP TO ORTHOPEDIC
SURGEONS IT'LL BE ABOUT BUNDLING
PAYMENTS FOR SHOULDERS HER HIPS
ARE NEEDS.
YOU KNOW AND THINKING ABOUT HOW
WE INCREASE VALUE IN THAT WAY.
WE COULD ALSO BE THINKING ABOUT
HOW WE INCREASE VALUE BY
THINKING ABOUT HOW WE INCREASE
VALUE BY INVESTING MORE CHILDREN
EARLY ON.
AND ONE OF THE WAYS TO THINK
ABOUT DOING THAT. IS BY THINKING
ABOUT BUNDLING PAYMENT SO THAT
WE TOOK PAYMENTS AND EXTENT OF.
HAVING A BOTTLE FOR A NEW YOUR
SHOULDER OPERATION WHAT IF WE
HAD A BUNDLE FOR MINUS NINE
MONTHS OF AGE TO FIVE YEARS OF
AGE. WE PUT ALL OF THE PRIMARY
HEALTH SERVICES INTO THAT BUNDLE
WE PUT PRESCHOOL INTO THAT
BUNDLE EARLY INTERVENTION AND WE
GAVE IT TO COMMUNITIES AND SAY.
YOU HAVE THIS MONEY IT'S
INTEGRATED NOW YOU COMPOSED
TOGETHER YOU CAN ACTUALLY PUT
INTEGRATED SERVICES AND MENTAL
HEALTH SERVICES WITH PRIMARY
CARE THE KIND OF THING THAT
NADINE IS A DOING THAT SHE'S
FIGURING OUT HOW TO DO. HOW DO
WE MAKE THAT UNIVERSAL TITLE WE
MAKE ALL THESE MENTAL HEALTH
SERVICES AVAILABLE TO EVERYONE
WE HAVE TO HAVE A FUNDING
STRATEGY TO DO THAT? CITY
WASHINGTON DC IS CONTEMPLATING
THIS RIGHT NOW WORKING WITH THE
URBAN INSTITUTE I'M THINKING
ABOUT WHAT A LIFE CORRESPOND TO
WOULD BE.
AND WE'RE GONNA MOVE TOWARDS
GEOGRAPHIC BOTTLE SO WHAT IF THE
CITY OF PASADENA GOT THAT BOB
DOLE AND SAID WE'RE GOING TO
PULL THIS ALL TOGETHER FOR ALL
OUR CHILDREN.
AND MAKE SURE THAT THEY ALL GET
THE SCHOOL READY TO LEARN
WITHOUT A SCHISM WITH MORE
PROTECTION.
AND LASTLY THINK ABOUT CITIES AS
THE PLACE WHERE PEOPLE LIVE AND
IDENTIFY WITH CITIES CONTROL THE
SOCIAL TRANSPORTATION VARIOUS
OTHER
THINGS AND CITIES WHERE WE
ACTUALLY GET STUFF DONE.
AND SO WE'RE THINKING ABOUT WHAT
WENT ON ALL CHILDREN THRIVE CITY
LOOK LIKE WHERE WE CREATED A WAY
OF PULLING THINGS TOGETHER FOR
CITIES WHAT IF WE HAD TWENTY
THIRTY FORTY OR TWO HUNDRED
CITIES IN CALIFORNIA THAT WE'RE
ALL MOVING IN THIS DIRECTION.
WE'RE DOING IT RIGHT NOW FOR
SOMETHING CALLED HE'LL CITIES
HEALTHY EATING ACT OF LIVING
CITIES THE KAISER PERMANENTE A
PUBLIC HEALTH ADVOCATES OF DOING
WE HAVE TWENTY TWO HUNDRED.
HE'LL CITIES IN CALIFORNIA ANY
OF MAYORS AND CITY COUNCILS
TALKING ABOUT HEALTHY EATING
ACTIVE LIVING BECAUSE OF THE
OBESITY EPIDEMIC. WHAT IF WE
WERE TO DO THIS FOR WHAT WE'RE
DOING NOW?
SO.
AS I SORT OF LOOK TOWARDS THE
FUTURE AND THINK ABOUT POLICY I
THINK WE NEED TO HAVE CITIES
THAT ARE THRIVING THAT WE NEED
A.
FIFTEEN YEAR.
YOU KNOW PROP UP PROGRAM FOR THE
STATE OF CALIFORNIA BUT IF YOU'D
STATE IS CITIES HAVE TENURE
BLUEPRINTS AND WE'RE MOVING
TOWARDS UNIVERSAL FAMILY
SUPPORTS PRESCHOOL AND
CHILDCARE.
HAD DATA FOR INNOVATION HAD
INNOVATIVE FINANCING THAT YOU
COULD ALLOW THEM TO DO HAD BUT
WERE ABLE TO NETWORK WITH OTHER
CITIES AND HAVE A COMMON
PLATFORM WE WOULD HAVE THE
THINGS IN PLACE TO ACTUALLY
BUILD THE MOVEMENT TO ACTUALLY
TAKE THIS PROBLEM ON.
THANK YOU DOCTOR.
HAVING HAD ALL THREE OF YOU
PROVIDE AN OVERVIEW I WANTED TO
OPEN IT UP NOW TO THE DIET TO
SEE IF WE HAD ANY QUESTIONS
THAT.
PEOPLE HAD OF THE EXPERTS AND SO
WITHOUT ASSEMBLY MEMBER REVIEW.
HI THERE I APPRECIATE ALL THE
INFORMATION I WAS OF.
I TAUGHT FOR SIXTEEN YEARS.
AND SO I CAN RELATE WITH UP
EVERYTHING THAT YOU WERE
DISCUSSING THE. WHAT CAUGHT MY
ATTENTION RIGHT NOW IS THIS?
?
SILOS THAT WE LIVE IN AND.
I EIGHT THIS IS MY SECOND YEAR
AS AN ASSEMBLY MEMBER. AND WHAT
HAS BEEN THE BIGGEST.
HURDLE I BELIEVE.
IS THAT ALL OF THAT THE
COMMITTEES ALL OF THE AYE
DEPARTMENTS ALL WORK IN SILENCE
AND SO. WHAT YOU SAID WAS GREAT
AND FANTASTIC?
BY.
THAT THIS CAN ACT
BETWEEN THE STATE.
AND THE FILES WITHIN THE STATE
RIGHT AND THEN WITHIN THE
COMMUNITIES IS WHERE. QUITE
FRANKLY I THINK THE PROBLEM IS.
THE PROGRAM SOUND GREAT A
FANTASTIC AND. I'M AFRAID THAT
WE'RE GONNA LEAVE OUT HERE AND
SAY OH THAT WAS GREAT THAT WAS
FANTASTIC AND THEN WE JUST GO ON
ABOUT OUR REGULAR BUSINESS.
SO I THINK WHERE WE NEED HELP
ARE AT LEAST PERSONALLY IS HOW
DO WE PUT IT TOGETHER UP HERE.
BECAUSE WE FUNCTION IN SILOS I'M
THE CHAIR OF HUMAN SERVICES IN
ALL OF THE FOSTER KIDS AND
ADULTS WITH DISABILITIES AND ALL
THAT BUT THERE'S NO CONNECTION.
SAY WITH THE EDUCATION COMMUNITY
AND FOSTER KIDS GO THROUGH THE
EDUCATION COMMUNITY BUT WE'VE
YET TO HAVE.
AYE AND I LOOK OVER THERE
BECAUSE OF MY COLLEAGUE ON
ASSEMBLY MEMBER MCCARTY IS AND.
CHARGE OF THE EDUCATION FOLKS I
I WOULD LIKE TO SAY BUT I
ANYWAY.
WITHIN THE DEPARTMENTS WE DON'T
HAVE. A CONNECTION.
WE DON'T HAVE A CONNECTION.
WHERE WERE IN CYCLES SO?
HOW AM I AM OBVIOUSLY WE YOU
CAN?
GIVE ME THE SOLUTION RIGHT NOW
BUT I WOULD LIKE TO.
.
AND THEN LIST YOU I GUESS FOR
SOME HELP ON HOW WE CAN MAKE
THOSE CONNECTIONS WERE NOT.
AGAIN UP.
FOSTER KIDS IS A NOT TO
CONNECTION WITH EDUCATION BUT
WE'RE NOT EVEN TALKING TO EACH
OTHER AND HOW DO WE DO THAT.
.
HERE.
DOWN THERE I CAN YOU KNOW DOWN
THERE I MEANT IN MY COMMUNITY
YOU KNOW WHAT I BY MY CITY
BOTTOM PARK BY WE'RE PART OF THE
HEALTHY EATING COMMUNITIES. WITH
WHICH WAS A CONNECTION BETWEEN
THE CITY AND THE SCHOOL DISTRICT
THAT WAS A GREAT PROGRAM AND SO
I CAN SEE HOW IT COULD WORK.
LOCALLY BUT AT THE STATE LEVEL
THE CYCLES THAT WE LIVE AND. ARE
VERY DIFFICULT TO MANEUVER SO I
PERSONALLY AM ASKING FOR SOME
HELP BECAUSE AGAIN THIS IS A
GREAT PRESENTATION BUT I'M
AFRAID THAT WE'RE GONNA WALK OUT
AND GO. THANK YOU SO MUCH THIS
IS GOING TO GO ON MY DESK AND
THEN WE.
PICK IT UP AGAIN NEXT YEAR SO IF
YOU CAN HELP WITH SOME.
REAL SOLUTIONS AS TO HOW I CAN
MAKE THAT CONNECTION AND HOW
WEAK WE CAN MAKE CONNECTIONS I
SAID AND HUMAN SERVICES.
DOCTOR ARAMBULA IS ON THE
COMMITTEE AND YOU KNOW AND SO WE
HAVE ALL THESE GREAT. AMAZING
FOLKS READY TO WORK BUT IF WE
DON'T HAVE
HOW THEN AGAIN THIS IS GOING TO
BE PART OF MY INBOX AND
SOMEBODY'S GONNA PUT IT IN THE
BOX AND.
WE'LL SEE IT AGAIN NEXT YEAR
WHEN WE HAVE ANOTHER
CONVERSATION ABOUT THAT'S SO
THAT'S MY COMMENT AND.
TERMS FOR YOU AND I ARE DR
APPRECIATE BOTH OF YOU ARE ALL
THREE OF YOU. BUT THE
INFORMATION IS GREAT AND IT'S
YOU KNOW I FEEL ENERGIZED AND
REALLY LIGHT YOU'RE LOOKING AT
REAL.
SOLUTIONS TO REAL PROBLEMS I WAS
A TEACHER FOR SIXTEEN YEARS AND
IT WAS ADHD AT ALL TIMES. I TIED
IN FONTANA WHICH IS A LOW INCOME
COMMUNITY.
A THIRD AFRICAN AMERICAN A THIRD
ARE HISPANIC AND THAT THIRD.
CAUCASIAN AND ALL HAD THE SAME
ISSUE LOW INCOME. AND THEY WERE
ALL PORT AND SO WHEN I LOOK AT A
COMMUNITY LIKE THAT I CAN'T SAY
AWAITS THE YOU KNOW THE
HISPANICS OR THE AFRICAN
AMERICANS ARE THE WHITE IT WAS
ALL THE SAME. SYMPTOMS AND HOW
DO WE.
GET THAT MESSAGE OUT BECAUSE THE
FIRST THING IS ALL THEIR A DHD
LET'S GIVE HIM MEDICATION.
AND IT'S VERY DIFFICULT FOR
EDUCATORS AND TEACHERS' TO
REALLY DEAL WITH SOME OF THOSE
ISSUES IF WE DON'T HAVE THAT
INFORMATION OR THAT SUPPORT
ESPECIALLY WHEN WE DON'T HAVE A
AIDES IN THE CLASSROOM ANYMORE.
YEAH AND AND SO HOW DO WE GET
YOUR INFORMATION TO THE.
YOU KNOW TOO AGAIN TO THE FOLKS
THAT.
ARE OUT OVER MEDICATING ORDER
NOT MEDICATING WHAT WHICHEVER.
A.
WHATEVER WE CHOOSE BECAUSE YOU
KNOW WE HAVE OVER MEDICATION AND
NO MEDICATION FOR THE ONES THAT
THAT DO NEED THE HELP BUT THE
TEACHERS ARE ARE ARE. QUITE
FRANKLY IN AN ISLAND AND OTHER
THEY ARE AND A SURVIVAL MODE AS
WELL BECAUSE. YOU KNOW THEY'RE
BEING ALL THESE REQUIREMENTS ARE
BEING PUT ON.
TO TO ALL THE TEACHERS BUT NO
RESOURCES AND NO REAL REAL
SOLUTIONS.
WE HAVE THE PROGRAM OF THE WEEK
EVER IT'S GONNA SOLVE
EVERYBODY'S PROBLEMS
I CALLED THE PROGRAM DID YOU ARE
IS LIKE OUR GONNA RESOLVE ALL
THAT.
ISSUES IN EDUCATION BUT IF WE
DON'T LOOK AT THE ROOT OF THE
CAUSES OF THESE ISSUES THEN
WHENEVER WE'RE SPINNING OUR
WHEELS WERE NEVER GOING TO HAVE.
THE ALL OF OUR KIDS DRIVING AND
BEING EDUCATED IF WE DON'T DEAL
WITH THESE THESE ISSUES.
I APPRECIATE THE DISCUSSION BY
HELP ME.
EMPLOYMENT OR AT LEAST WITH SOME
IDEAS ON HOW WE CAN BRING SOME
OF THESE RESOURCE IT'S OR SOME
OF THESE PROGRAMS TO OUR
COMMUNITY THAT ARE SO
DESPERATELY. IN NEED OF THIS SO
IT'S MORE OF A CO A COMMENT NOT
ANSWER THE QUESTION BUT I DO
IMPLORE. YOU TO HELP ME FIGURE
OUT HOW WE CAN ALL PARTICIPATE
IN REAL CHANGE AND NOT JUST HAVE
THIS WONDERFUL CONVERSATION AND
THEN.
THE DOCUMENTS GOING UP AND UP IN
THE FILE.
SO MAYBE THAT'S A WONDERFUL
PLACE FOR ME TO JUMP AND TO
EXPLAIN OUR THINKING OF WHY WE
SET UP THE HEARING IN THIS WAY.
SO IN.
MEDICINE WE ALWAYS DESCRIBED
HIM AS SOAP NOTES AND MAYBE YOU
CAN PREFERRED ON BUT SUBJECTIVE
OBJECTIVE ANALYSIS AND PLANNING
TO TODAY'SHEARING IS SET UP IN
THAT SAME WAY TO.
SO WE WILL. FURTHER HERE OF AN
ANALYSIS AND A PLANNED COMING
FORWARD AND SAT DOWN.
EXPECTED UP COME UP WITH ONE
RIGHT ON THE FRONT. BUT BUT
DIDN'T WANT TO COMMENT IF I
COULD BECAUSE THE IMPORTANCE FOR
US IS TO GET UPSTREAM.
AND THE REASON WHY WE HELD THIS
HEARING TOGETHER HIS BONES THAT
HEALTHCARE AND EDUCATION YOU
HAVE. THE CHAIR OF HIGHER
EDUCATION AND HUMAN SERVICES WHO
ARE HERE WHO SEE THESE PROBLEMS
DOWNSTREAM AND.
MAYBE IT'S BECAUSE I HAVE THREE
YOUNG KIDS MYSELF BUT NO THE
IMPORTANCE THAT THESE EARLY
YOUNG YEARS HAVE.
AND THAT APPROPRIATE INVESTMENTS
FROM US AS A STATE CAN SAVE US
MONEY. DOWNSTREAM. AND WAS DRAWN
IF I COULD TO DOCTOR THOMPSON
YOU HAD A COMMENT THAT. THE
EFFECT OF COMICS STRESS ON.
THOSE WHO HAVE YOUNGER RACES MAY
LEAD TO DECREASED EDUCATIONAL
OUTCOMES.
THAT.
IDEA IS A POWERFUL ONE IF WE
THINK ABOUT HOW WE ARE TO HELP
OUR GATE THROUGH TWELVE.
SYSTEM BECAUSE IT SEEMS THAT
KIDS WHO START BEHIND STAY
BEHIND.
AND IF WE HAVE AN OPPORTUNITY TO
HELP THEM TO DEAL WITH THE TOXIC
STRESS AT A YOUNGER AGE. I
BELIEVE WE HAVE AN OPPORTUNITY
TO REALLY SOLVE A. CRITICAL
PIECE OF THE PROBLEM OUR STATE
FACES IN EDUCATING OUR
COMMUNITIES
AND THESE ARE MAJOR SYSTEMATIC
SHIPS THAT ARE NOT GOING TO BE
EASY FOR US AS A STATE.
TWO ONE SILO WORDS TO FIGURE OUT
HERE TODAY BUT REALLY WANTED TO.
HAVE THIS DISCUSSION AMONGST OUR
COLLEAGUE SO THAT IT CAN.
COME TO OUR THINKING AS WERE
TRYING TO COME UP WITH SOLUTIONS
GOING FORWARD BUT WANTED IF I
COULD
DOCTOR HELFAND YOU ENDED BY
SAYING THAT THERE WERE OTHER
COUNTRIES THAT WERE IMPLORING
ARE EXPLORING MODELS THAT ARE
USED AND I'M REALLY FOCUSING IF
I CAN ON THE SCALABILITY.
HOW DO WE GO FROM ONE COMMUNITY
TO EITHER LOOKING AT REGIONAL
MODELS OR EXAMPLES BUT WHAT
COULD WE AS A STATE BE DOING AND
ARE THERE SPECIFIC COUNTRIES
THAT YOU'RE LOOKING AT AS YOUR
EXPLOITS?
YEAH.
I THINK THEM TO RESPOND TO BOTH
YOUR QUESTIONS THERE ARE.
STRATEGIES THAT CAN BE IS THAT
LED THE DATA ON THE MONEY YOU'RE
REALLY BOTH IMPORTANT DATA BY
HAVING MEASURES ON WHOLE
COMMUNITIES.
WE GET PEOPLE FROM DIFFERENT
SECTORS TO START TO SEE THE
PROBLEM IS THE SAME AND THEY
START USING THE SAME MEASURE. SO
YOU START USING THAT NEEDY AYE
THAT HOW HOW ALL OF OUR KIDS ARE
DOING WHETHER YOU'RE FROM HEALTH
OR EDUCATION OR SOCIAL SERVICE
CHILD WELFARE. ALL USING THE
SAME MEASURE WHAT WE'RE SEEING
IN COMMUNITIES AROUND THE
COUNTRY. IS THAT THE CITY STARTS
USING A.
THE PROVIDERS START USING THAT
THE PARENTS START USING IT SO
WHEN YOU HAVE EVERYBODY USING
THE SAME MEASURE YOU'RE TURNING
DATA NOT JUST AND INFORMATION.
IT BECOMES CURRENCY THAT BECOMES
LIKE MONEY IT BECOMES VALUABLE
TO EVERYBODY AND IT HAS EXCHANGE
VALUE PEOPLE START MAKING
DECISIONS. SO ONE WAY TO BREAK
DOWN SILOS TO GET EVERYBODY ON
THE SAME PAGE ABOUT THE PROBLEM
THE OTHER IS OVER IS AROUND THE
MONEY ISSUES. AND THERE ARE A
WHOLE SET OF STRATEGIES AND
WAIVERS THROUGH MEDICAID VARIOUS
OTHER THINGS THAT PEOPLE ARE
EXPLORING AND ARE DOING ALL OVER
THE COUNTRY AND. TRYING THAT WE
COULD BE DOING HERE THE
COUNTRIES THAT WE'VE BEEN
WORKING MOST CLOSELY WITH OR
CANADA AND AUSTRALIA. AND THAT
CAN'T AUSTRALIA RIGHT NOW
MEASURES EVERY SINGLE FIVE YEAR
OLD WHEN THEY START SCHOOL USING
THAT SAME MEASURE THAT I WAS
SHOWING. AND THEY MEASURE THEIR
PHYSICAL EMOTIONAL CAR GOING OF
SOCIAL BALLOTS THAT HEALTH OF
AND DEVELOPMENT OF EVERY FIVE
YEAR OLD. IT PREDICTS.
THEIR THIRD GRADE AND.
READING AND MATH SCORE SO AND
WE'VE JUST DONE A STUDY IN
ORANGE COUNTY WITH GREG DUNCAN.
WE WERE WE DID THE SAME
MEASUREMENT WENT PREDICTS
THE KIDS AND ORANGE COUNTY'S SO
YOU GET THE START TO SEE WHAT
YOUR KIDS ARE DOING SO THERE'S A
DATA YOU CAN SEE. AND IN CANADA
RIGHT NOW THEY NOT ONLY MEASURE
THE IN VANCOUVER IN BRITISH
COLUMBIA THEY MEASURE ALL KIDS
AT AGE FIVE. THEY HAVE ANOTHER
MEASURE THAT IT'S DOWN AT AGE
NINE AND ANOTHER ELEVEN IN THE.
GETTING WHAT FOR FIFTEEN SO THEY
CAN MEASURE TRAJECTORIES OF
CHILDREN AND THEY THEN INTEGRATE
THE DATA WITH ALL THEIR
ADMINISTRATIVE DATA AND PERSONAL
DATA.
AND THAT'S GOING ON HERE IN
CALIFORNIA ALSO I WAS AT A
MEETING JUST LAST WEEK WITH THE
INTER OPERATIVE KEPT
COLLABORATIVE. SILICON VALLEY.
HOUSE EIGHT SILICON VALLEY
REGIONAL DATA TRUST THAT'S TAKEN
ALL THE SCHOOL DATA CHILD
WELFARE DUE TO MENTAL HEALTH
DATA AND IT'S ALL BEING COMBINED
TOGETHER SO IT'S STARTING TO
BREAK DOWN THE SILOS TO DO THAT.
SO ALL OVER THE WORLD PEOPLE ARE
TRYING TO BREAK DOWN SILOS.
WHETHER IT'S IN ENGLAND OR
AUSTRALIA CANADA AND THERE'S
OTHER STRATEGIES SO YOU YOU
DON'T HAVE TO REINVENT THE WHEEL
SOME OF IT IS SORT OF HARVESTING
IN DOING THE ENVIRONMENTAL
SCREENING OUT. AND SORT OF SEEN
WHAT ARE THE BEST PRACTICES AND
A LITTLE BIT OF RESEARCHCOULD
GO A LONG WAY TOWARDS BRINGING
YOU THAT INFORMATION.
THANK YOU.
SOMEONE ANOTHER CARD. YES THANK
YOU AND I KNOW WE HAVE IT.
ANOTHER PANEL ON THAT
PRACTITIONERS POINT OF VIEW AND
SOLUTIONS AND SO YOU KNOW IT.
JUMPED THERE BUT WHAT I WILL ASK
I WILL ASK YOU THIS AND SO.
.
YOU KNOW CERTAINLY AS WE SEE
FROM THE SLIDES AND AND THANK
YOU FOR JUST BREAKING IT DOWN IN
PLAIN ENGLISH TO TO IT TO US AS
FAR AS HOW THE BRAIN WORKS.
BUT.
YOU KNOW THE HOT THE HIGHER THE
SCORED HIGHER THE IMPACTSTHE
MORE NEGATIVE THINGS CAN HAPPEN
LATER IN LIFE IT AND YOU SEE
THOSE THINGS LATER LIKE PROBABLY
STUFF A TEN YEAR OLD HAS A.
HAS A SEVENTIES SCORE MAYBE
THERE.
LIKE THE GARAGE ON FIRE
DOING YOU KNOW THAT STUFF AND IN
THERE YOU SEE WHAT'S GOING ON
AND SO YOU CALLED THE YOU KNOW
RED ALERT TO YOU KNOW FIRED
ENGINE COMES AND. PUTS OUT THE
FIRE WHAT WHAT HAVE YOU.
WHERE IS IF YOU'RE A THREE YEAR
OLD?
YOU COULD SELL THAT FEAR IN THE
FIGHTER FLIGHT IT'S HARDEST TO
SEE THAT.
SO JUSTIN IN YOUNG IN ME I I'VE
ALWAYS WONDERED THIS LIKE YOU
KNOW I I HAD LITTLE KIDS AND
THEIR TWINS IN THE COULDN'T.
THEY WEREN'T SPEAKING RIGHT AWAY
SO INTO THE PEDIATRICIANS LOCAL
MAYBE THEY CAN'T HEAR.
ANOTHER TO SPEAK IN THAT WHEN
TALKS OVER THAT THAT THREE OR
FOUR.
THEY WENT WE WENT TO GO SEE A
SPECIALIST TO SEE IF WE NEED TO
GET IN THE ALTAR REGIONAL YOU
KNOW THAT.
I'M NOT SURE IT'S CALLED.
AND SO I'M I JUST ALWAYS
WONDERED IT WILL IF YOU HAVE A
THREE YEAR OLD AND DID YOU HAVE
A FIVE ACES SCORE WIDE ISN'T
THAT WHY DO WE HAVE JUST LIKE. A
RED BUTTON GOING OFF AND THEN WE
CALL THE HOTLINE AND THEN WE
KNOW THAT WE CAN WELL FIRST YET
THAT SCREENING FOR THAT WHICH IS
I GUESS.
THE CONDITION. BUT THEN YOU KNOW
THE INTERVENTIONS THAT TREATMENT
AND SO FORTH SO HOW IS IT SO
COMPLICATED THAT WE THAT WE
CAN'T. FIND THESE LITTLE KIDS
AND PASS UNDER FIVE THAT WE NOW
HAVE. A REALLY HIGH SCORE AND.
AND HAVE SOME TYPE OF ALERT
SYSTEM GOING OFFER PROSTITUTE IN
ROLE THESE KIDS IN SOME TYPE OF.
TREATMENT IS GOING TO HELP THEIR
SIX.
WELL.
WE DO SEE HER. AND A SKILLED
EARLY CHILDHOOD TEACHER.
SEES THE RED LIGHTS GOING OFF
ALL THE TIME MIGHT MY WIFE IS
ONE OF THOSE EDUCATORS SHE IS
PART OF WHAT INFORMS.
PRACTICALLY THE RESEARCH THAT I
WAS TELLING YOU ABOUT.
IT'S A CHILD WHO IS ARE OUT OF
CONTROL WITH PHYSICAL
AGGRESSION.
OUR IT'S A THREE YEAR OLD WHOSE
WAY OF EXPRESSING FRUSTRATION IS
TO BY OTHER KIDS.
OR IT CAN BE A CHILD WHO IS
WITHDRAWN.
ARE MORE THAN JUST THE SHALL I
DISCOVERED CHILD WHO'S JUST
TEMPERAMENTALLY.
INHIBITED BUT THE CHILD WHO
WITHDRAWS FROM ACTIVITIES THAT
OTHER KIDS WOULD ENJOY DOING.
ARM IT'S A CHILD WHO HAS
DISTORTED ATTACHMENTS TO PARENTS
IF PART OF THEIR FACES ARE
COMING FROM WHAT'S HAPPENING AT
HOME.
AREN'T. YOU KNOW THE ADOLESCENTS
WHO ARE IN TROUBLE DRAW OUR
ATTENTION BECAUSE THAT SOMETIMES
NOT ALWAYS BUT SOMETIMES THEY
ENGAGE IN CONTACT THAT CONDUCT
THAT COMES TO THE ATTENTION OF
AUTHORITIES.
THE PART OF THE REASON THAT THE
TEACHERS THAT I WORK WITH ARE
SAYING THEY'RE REALLY CONCERNED
IS THEY'RE SEEING THE RED LIGHTS
GOING OFF. IN THE THREE YEAR OLD
SON THAT THEIR CARRY FOR BUT
WHAT ABOUT THE RED LIGHT FIRST
YOU KNOW EITHER MAYBE KID SAID
MEDI CAL PATIENTS OR WHAT. GONNA
GOES TO THE LOCAL. PEDIATRICIAN
AND THEY'RE DOING. AT THE BACK
YOU KNOW AISER MAKE TRACKS AND
WHEN SOMEONE ADDS UP TO FIVE OR
MORE IT GOES IN A SPECIAL FILE
NEW AND MAKE SURE THAT THAT.
YOUNGSTER IN THAT FAMILY
HAS
SOME TYPE IT EXTRA BENEFIT LIKE
WE DO IF YOU CAN HEAR YOU CAN'T
SEE WE SET OUR HEARTS GOOD
VERSUS GOOD FOR SOCIETY TO
INVEST EARLIER IN THE SAGA.
SO THAT THAT'S WHAT WE DO
EVERYDAY AT THE CENTER FOR YOUTH
WELL THAT'S BUT I WILL TELL YOU
WE ARE ENTIRELY PRIVATELY
PHILOSOPHICALLY FUND HEAD WE DO
IT BECAUSE WE RAY THAT OUT OF
MONEY TO DO IT AND.
AND WE DO IT TO BE ABLE TO PILOT
THE TH MODEL SO THAT WE CAN
EVALUATE THEM AND RECOMMEND THEM
AS BEST PRACTICES. BUT THAT IS
EXACTLY WHAT HAPPENS BECAUSE I
WILL TELL YOU THAT THAT THE.
THAT THREE YEAR OLD CHILD HIT
THAT I HAD THE EXAMPLE THAT I
GAVE UP WHO WASN'T GROWING. HER
DEVELOPMENT WAS NORMAL HER
BEHAVIOR WAS NORMAL SOME KIDS
HAVE.
AT BEANO WITHDRAWAL AT. THAT
MENTAL HEALTH IN TERMS
BEHAVIORAL SEVEN TIMES AT CETERA
AND SOME KIDS HAVE FREQUENT
INFECTION IN FACT THAT
PARTICULAR CHILD HER YOUNGER
BROTHER WHO IS NINE MONTHS AT
THE TIME. HOW THAT AND A SCORE
OF FIVE HE HAD HAD TO PNEUMONIAS
AND FOR AARON FACTIONS WITHIN
HIS FIRST YEAR OF LIFE AND AFTER
WE STARTED THIS TO GENERATION
ALL?
THAT INTERVENTION TRAUMA
INFORMED INTERVENTION HE DIDN'T
HAVE A SINGLE OTHER INVASIVE
INFECTION HE HAD NO EAR
INFECTIONS NO PNEUMONIAS.
FOLLOWING THAT AND SO WE NEED
TO BE ABLE TO OFTENTIMES THE
KIDS WHO HAVE BEHAVIORAL ISSUES
ARE THE ONES WHO ARE RECOGNIZED.
THE KIDS WHO DON'T HAVE
BEHAVIORAL ISSUES OR THE KIDS
WHO ARE OFTEN PREVERBAL.
WE DON'T RECOGNIZE THEM UNTIL
THE UNTIL THE PROCESS IS PRETTY
FAR GONE AND THAT IS WHY WE NEED
TO SCREEN EVERY CHILD AS PER A
ROUTINE PART OF PEDIATRIC CARE.
AND HOW WE DO THAT A HAS TO DO
IT YOU KNOW RIGHT NOW WE'RE
LOOKING AT.
CHANGES TO EP SPT THERE TO
THINK THAT I CAN RECOMMEND TO
THERE'S SO THERE'S ONE.
WHICH IS THAT AT A CERTAIN POINT
WE'RE JUST GONNA HAVE TO DRAW A
LINE IN THE SAND AND SAY EVERY
PRIMARY CARE PROVIDER IN
CALIFORNIA. YOU KNOW BY WHATEVER
THE YEAR IS TWENTY TWENTY YOU
NEED TO UNDERSTAND THE PROTOCOL
THAT HOW TO SCREEN AND RESPOND
TO IT AND.
TO ACES IN YOUR PRIMARY CARE
SETTING RIGHT SO YOU KNOW GIVE
FOLKS TIME TO BE ABLE TO BUY.
YOU KNOW LEARN THE BEST
PRACTICES AND TRAIN AND TRAIN
THEIR STAFF BUT THAT'S REALLY
CRITICALLY IMPORTANT. AND YOU
KNOW THE WAY WE CONNECT SOME OF
THESE LINKS TO OUR SYSTEMS AND
YOU KNOW I'M NOT A POP POLICY
SPECIALIST I'M A PEDIATRICIAN I
RUN MY ORGANIZATION BUT. YOU
KNOW THING THINGS LIKE FOR
EXAMPLE THERE'S A PIECE OF PAPER
THAT SAYS IN ORDER TO GET INTO
SCHOOL EVERY CHILD HAS TO HAVE A
IT OR TO GET INTO KINDERGARTEN
THEY HAVE TO HAVE A PHYSICAL.
THEY HAVE TO HAVE THEIR
IMMUNIZATIONS THEY HAVE TO HAVE
A TB TEST AND THAT FORM SHOULD
SAY THEY ALSO HAVE TO HAPPEN A
SCREEN.
WE DON'T WE DON'T HAVE TO PUT
THE SCORE JUST THAT A PRIMARY
CARE CLINICIAN WHETHER IT'S A
FAMILY PRACTITIONER PEDIATRICIAN
OR A NURSE PRACTITIONER WHOEVER.
HAS SCREEN THAT CHILD FOR A SAYS
BECAUSE WHAT THAT ALLOWS US TO
DO IS TO CREATE NUMBER ONE A
SYSTEM WHERE THE CHILD IS NOT
BEING SCREENS. FOR A SAYS THAT
AT THEIR AT EVERY VENUE RITE
AID'S WHERE WHEN THAT SCREENING
IS MEANINGFUL. THEY HAVE THE
LEGAL PROTECTION SO THAT WHEN
PARENTS ARE DISCLOSING THE THINK
IT'S IT'S PROTECTED BY HIPAA.
RIGHT AND.
WE ALSO HAVE A AND. A MECHANISM
FOR.
BOTH MORAL ETHICAL AND LEGAL
ACCOUNTABILITY RIGHT THAT THEY
WHEN WHEN A CLINICIAN WHETHER
IT'S A DOCTOR OR.
YOU KNOW PRIMARY CARE CLINICIAN
THAT WHEN THEY SCREEN.
WE ARE SUPPOSED TO BE TRAINED TO
AND UNDERSTAND I'M WHAT THE
IMPACT IS BOTH ON HEALTH.
AND ON MENTAL AND BEHAVIORAL
HEALTH AND ON DEVELOPMENT AND IT
IS OUR JOB TO SCREEN SURVEY THAT
AND FOLLOW IT UP AND THE GREAT
THING ABOUT SCREENING IN PRIMARY
CARE. IS THAT WE FOLLOW CHILDREN
FROM THE TIME THEY'RE ZERO UNTIL
THEY'RE YOU KNOW I THOUGHT SOME
TWENTY YEAR OLD THE MY PACKETS
RIGHT FIND ANOTHER DOCTOR. GREAT
BUT THIS IS WE HAVE BOTH A OUT A
PROFESSIONAL AND A LEGAL
MECHANISM.
TO ENSURE THAT EVERY CHILD THE
SCREEN AND THEN WE NEED TO HAVE
THESE REDUNDANT SYSTEM THESE
CONNECTION BETWEEN OUR
EDUCATIONAL SYSTEM.
AND OUR HEALTH CARE SYSTEM AND
THAT ONE LITTLE FORM IF IT SAID
THAT EVERY CHILD HAD TO BE
SCREEN BEFORE THEY STARTED.
KINDERGARTEN CAN YOU IMAGINE
HOW THAT WOULD MAKE THE LIVES
EASIER.
OF
EDUCATORS.
OF PARENTS A PROVIDERS BUT MOST
IMPORTANTLY OF CHILL.
THERE'S A PART OF.
AND DOCTOR HEALTH INS
PRESENTATION WHERE YOU
SAID YOU FOCUSED ON A CERTAIN
SEGMENT IT SEEMS THAT THE
SCREENING.
ABILITY GIVES US THAT ABILITY TO
FOCUS
OUR INTERVENTIONS ON A SEGMENT
OF THE POPULATION. THAT HAS A
HIGHER TO SCORE I'M INTRIGUED TO
HEAR ABOUT. THE OPPORTUNITIES
FOR US TO INCREASE THE SCREEN.
I'M AYE MATE.
THROW UP THROW THIS IN THEIR
OWN WILL HAVE TO FOLLOW UP IF WE
CAN BUT THERE'S A WORKING GROUP
WE HAVE ON.
WORKING WITH A SAYS INTO EPS
DETAIL AND WOULD LIKE TO WORK
WITH YOU IN YOUR OFFICE
AFTERWARDS TO. SEE IF YOU WOULD
WANT TO SIT ON THIS WORKING
GROUP TO HELP US AS WE. MOVE
THIS IDEA FORWARD WITH THE STATE
BUT I'D LIKE THAT VERY MUCH WE
WOULD BE VERY HAPPY TO HELP WITH
THAT AND THEN I.
DOCTOR HEALTH AND ALL YOU JUMP
IN BED ASSEMBLYMAN MATHIS HAD A
COMMENT.
THANK YOU FOR BEING HERE.
THOUGH. A LOT OF GREAT POINTS
IN A LOTTERY POINTS FROM THE
OTHER MEMBERS.
WE WE'VE DEFINITELY GOT HIT
THIS.
FROM A HOLISTIC APPROACH.
BRIDGING BOTH THE IN IN THE
MIDDLE HEALTH SIDE AND THE
EDUCATION SIDE BECAUSE THEY ARE
THE IT IT'S ONE OF THE SAME.
ARMED
SO IT'S EXCITING TO ACTUALLY
HAVE THOSE CONVERSATIONS.
.
YOU KNOW WHAT ONE OF THINGS I
LOOK AT THE ESPECIALLY ON THE
BUDGETARY SIDE IT IS.
AND AND AND I'M SPEAKING AS A.
FATHER WITH TWO CHILDREN WITH
DISABILITIES.
ARM.
NO NOT EVERYBODY KNOWS TO GO TO
THE REGIONAL CENTERS.
THEM IN A BEEN THROUGH THIS.
BOY.
IT.
ALWAYS SH BRINGS A QUESTION IN
MY MIND WHEN I'M SITTING IN LIKE
AN IEP MEETING OR SOMETHING AND
I HAVE.
SEVERAL.
SOCIAL WORKERS ONE ONE FROM
EDUCATION WHAT FOR MENTAL HEALTH
LAW AND I'M GOING.
YOU'RE ALL PAID BY TAX DOLLARS
AND I REALLY JUST NEED ONE A FEW
THAT UNDERSTANDS MY KID INSIDE
AND OUT.
IN A NOT NOT THAT THEY'RE NOT
ALL GREAT PEOPLE THERE FOR THEIR
AMAZING IN THEIR PHENOMENAL
PLATE.
WE'VE GOT TO FIGURE OUT A WAY TO
SPREAD THE FUNDING.
ALL THE WAY ACROSS IN A MAKES
YOU WONDER. NOT HIGH SCHOOL YOU
HAVE A HIGH SCHOOL YOU KNOW
GUIDED SCOUTS FOR THE GOES ALL
THE WAY THROUGH.
WHY ARE WE LOOKING AT IT AS
WE'RE DEVELOPING THIS YOU KNOW
AND OBVIOUSLY PEOPLE ARE GOING
TO CHANGE YOUR RELATIONSHIPS ALL
OF IDEA THREE BUILD THEM? BLOOD.
YOU KNOW FROM OKAY YOU HAVE YOUR
CHILD YOU GO WHEN.
A AND NOW YOU HAVE SOMEBODY THAT
YOU KNOW YOU HAVE YOUR
PEDIATRICIANS
THAT TRACK YOUR KIDS ALL THE WAY
THROUGH HOW COME WE DON'T HAVE
SOMEBODY ELSE OWNS THAT OF
HAVING A SOCIAL WORKER THROUGH
SCHOOL.
AND ANOTHER ONE THROUGH THE
COUNTY WE END UP WITH TWO OR
THREE.
WHY ARE WE JUST HAVING ONE
THAT'S TRACKING IN MAKING SURE
THIS CHILD'S GETTING EVERY
SINGLE THING THAT THEY CAN GET?
THEY ARE CHINA FIGURED OUT AS A
AS A BUDGETARY SIDE.
BECAUSE OF I OF ONE PERSON IS A
PARENT OR ALLEN GOT A CALL ONE
PERSON TO KNOW WHAT'S GOING ON.
YOU KNOW I THOUGHT OF THE FUTURE
SENATE TALK TO THIS GUY THOUGHT
OF THE TEACHERS.
THAT MAKES LIFE SO MUCH LESS
COMPLICATED FOR THE PARENTS.
OUR. MADE IT BE PHENOMENAL
INSTEAD OF.
TRY TO CRAM TWENTY PEOPLE IN A
ROOM TO HAVE AN IEP MEETING.
.
IN ANY RIGHT THE THE EARLIER YOU
CAN CATCH IT.
THE BETTER I HAVE A SON WHO'S
ASPERGERS AUTISM OF ANOTHER LOT
VALUES THREE WAS FUNDED BY FOR
THE I MEAN IT'S.
WE'VE BEEN THROUGH IT.
SO I LOVE HEARING THE
CONVERSATION YOU'RE ABSOLUTELY
RIGHT ON THE DATA THAT THE MORE
DATA WE CAN GET THE BETTER.
ON DISH CURIOUS TO SEE WHERE
THESE CONVERSATIONS ALL ACTUALLY
GAL. AS US APPEAR ON THE DIETS
PURSUE OUR TEN YEAR.
DISCUSSING ABOUT WHAT YOU KNOW
THE NEXT TEN YEARS IS FOR THE
CHILDREN THAT THAT WE HAVE IN
THAT WE REPRESENT.
IT'S OF THANK ALLAH FOR TO THE
DISCUSSION BROTHERHOOD.
THANK YOU.
SEEING NO FURTHER DOCTOR
HELFAND.
RAINY.
.
I WAS A BIG HUGE ADVOCATE IN
RESEARCH AROUND DEVELOPMENTAL
SCREENING FOR KIDS.
.
AND.
THOUGHT THAT WAS REALLY
IMPORTANT TO DO BECAUSE ALL
THESE KIDS WERE FLYING UNDER THE
RADAR IN GETTING TH SCHOOL
SCREEN KIDS WE DO NOT HAVE
SERVICE OF SOME PLACE ONCE WE
SCREEN THEM FOR THEM TO GET WHAT
THEY NEED. OFTENTIMES.
AND.
I. WOULD ONLY DIFFER WITH NADINE
AND THAT MEANS.
HAS A A PROGRAM AND A SERVICE
CENTER THAT'S IT IT'S AN
OUTLINE.
EVERYBODY ELSE IT DOESN'T
PROVIDE THE SERVICES AND WHEN
YOU SCREAM FOR A SYSTEM A COMMON
PEDIATRIC CLINIC THEY DON'T
HAVE.
THE RESOURCES
TO ACTUALLY DO ANYTHING.
AND SO YOU KNOW WE HAVE TO BACK
UP SCREENING ETHICALLY WITH A AN
ABILITY TO RESPOND BECAUSE TO
SCREEN AND NOT BE ABLE TO
RESPOND EFFECTIVELY WITH PROVEN
STUFF THAT ACTUALLY WORKS.
IS IS. YOU KNOW. CAN BE QUESTION
IF IF THAT'S AN ETHICAL THING TO
DO. YOU KNOW WHEN HER CLINIC YOU
CAN DO THAT.
BECAUSE SHE CAN RESPOND AND
RESPONDS APPROPRIATELY LEGACY
THAT THAT THE DIFFICULTY PART
THERE AS AS A PARENT.
AND AND I I'VE GOT TO SEVERAL
PARENT WORKGROUPS IS.
YOU MEET WITH THE PEDIATRICIAN
YOU KNOW THERE'S SOMETHING WRONG
WITH YOUR CHILD.
YOU'RE TRYING THEN THE NEW BEGAN
KIND OF THIS IN IN THIS IS
COMING FROM AYE NOTING THROUGH
AND.
PARA GROUPS FOR THE LAST DECADE.
E. YOU KIND OF START DOING THE
GUESSING GAME.
OF OF PARENTS TRYING TO FIGURE
OUT WITH THE DIAGNOSIS IS AND
THE PEDIATRICIANS TRY TO FIGURE
IT OUT. AND THAT I LOVE YOU ALL
OF PEDIATRICIANS.
BUT YOU'RE NOT PSYCHOLOGISTS.
IT WON'T WILL NOT OF ON A SENIOR
YOU'LL PUT IT WOULD IN GENERAL.
AND.
IT A A LITERALLY HAD TO HAVE A
CONVERSATION WITH THE
PEDIATRICIAN AT ONE POINT AND
REMIND THEM YOU'RE YOU'RE NOT A
CHILD PSYCHOLOGIST YOUR
PEDIATRICIAN.
AND WHEN MY KIDS SICK YOU'RE
GREAT BUT.
YOU'RE NOT A SHRINK.
AND
TRY TO GET THE REFERRAL AND
DELETE THE INSURANCES AND ALL OF
THAT.
BUT. BUT AT THE SAME TIME IT'S
WE CAN'T ALLOW A SYSTEM BECAUSE
WERE AFRAID.
ESPECIALLY MANY OF US REPRESENT
RURAL AREAS
SIXTY FIVE PERCENT OF THE
SCHOOLS IN CALIFORNIA OUR RURAL
AREAS. THE SERVICES ARE IF
YOU'RE NOT IN THE BIG CITY YOU
DON'T HAVE THE SERVICES.
AND THAT'S A HUGE PROBLEM THAT
WE HAVE TO WORK ON.
AND SO.
BUT WE HAVE TO STILL.
MAKE SURE WERE FINDING OUT
WHAT'S GOING ON OF THESE
CHILDREN APPS BECAUSE WITH WITH
THE AMOUNT OF SPLIT HOMES IN
THESE THINGS THAT ARE HAPPENING.
IN THE NUMBERS JUST KEEP
SKYROCKETING.
YOU KNOW THAT THEY THAT GOES
INTO AND OTHER FACTORS.
IN CELL.
THE PEOPLE FROM TO. TO THE
PARENTS HAVE TO KNOW.
IT HELPS THEM PARA HELPS THAT
ALL ALL THESE CONNECTIONS IN IN
YOU'RE SURE GONNA DEATH YOU KNOW
ALRIGHT. SO.
WE HAVE TO DO IT WE HAVE TO
FIGURE OUT A WAY TO DO IT POOL.
AWAIT ALSO YOUR YOUR ABSOLUTE
RIGHT TO YOU'VE GOT HOW THE
SERVICES MATCH.
AND WE'VE GOTTA GET THOSE OUT TO
THE RURAL AREAS BUT WE CAN IT
WAIT WHEN YOU SAY SIR THAT THEY
YOU YOU YOU ALSO HOLD BACK
ETHICALLY BECAUSE YOU CAN'T
PROVIDE THE SERVICES.
THE PARENTS NEED TO KNOW.
THE PARENTS ABSOLUTELY NEED TO
KNOW BECAUSE.
SOME OF THE CHILDREN DEPENDING
ON WHAT IT IS ARE WALKING ON
EGGSHELLS AT HOME.
BECAUSE THEY DON'T KNOW WHAT'S
WRONG WITH THEIR CHILD.
IN INTO THEM ONE MINUTE IT'S
THERE SWEET BABY IN THE NEXT
MINUTE.
IT'S SOMETHING DEVASTATING.
AND SO TO TO NOT.
LOOK AT THE CHILD AND NOT
DIAGNOSED BECAUSE THERE'S NOT
SERVICES AVAILABLE NOW LOCAL
AREA.
DAD'S
DO AN AND ON JUSTICE FOR THOSE
PARENTS AND FOR THAT CHILD'S
FUTURE.
SO WE'VE GOT TO GET THIS FIGURED
OUT.
ALONG THOSE LINES MAYBE IT'S A
GOOD WAY FOR US TO SEGUE TOWARDS
THE NEXT CONVERSATION. BUT.
MAYBE THAT WAY I CAN FRAME IT
IS TO ECHO OF.
RECURRING TALKING POINT I'VE
HAD APPEAR WHICH IS WE HAVE TO
HAVE PROVIDERS TAKING CARE OF
OUR PATIENTS.
AND WE MAY NOT HAVE THE
INFRASTRUCTURE AND PROVIDERS
NEEDED TO ALLOW US TO ASK THE
TOUGH QUESTIONS.
BUT AFTER WE COLLECT THE
INFORMATION WE THEN HAVE TO HAVE
THAT COURAGEOUS CONVERSATION
MOVING FORWARD. ABOUT WHAT WE DO
AS A COMMUNITY AND HOW DO WE
DEAL WITH THE TRUMP. BECAUSE THE
SALIENT POINTS TO ME IS THAT HE
SAYS ARE INCREDIBLY CALM.
THAT HAPPENED TO US ALL
AND IT'S IMPORTANT FOR US AS A
STATE TASK ASK THE TOUGH
QUESTIONS SO WE CAN HOPEFULLY
COME UP WITH SOME OF THE
ANSWERS.
THANK YOU PANEL FOR COMING HERE
TODAY AND LOOK FORWARD TO THE
NEXT PANEL AS WELL THANK YOU
.
I AND MICHAEL.
NICHOLAS I'M SORRY.
HI GOOD AFTERNOON.
.
SO FIRST I WANT TO SAY THAT IT
WAS GREAT TO BE INVOLVED WITH
SOME OF MY HEROES IN THE FIELD.
SO THANKS AND THANKS FOR
CONVENING THIS.
AND I'M GONNA GET RIGHT INTO OUR
UP SOME OF THE NITTY GRITTY
QUESTIONS I HEARD PARTICULARLY
AROUND THE NEXUS OF HEALTHCARE
AND EDUCATION.
AND I COME TO THIS FROM A UNIQUE
PERSPECTIVE.
FOR TWELVE YEARS I WAS THE
HEALTH DIRECTOR IN ALAMEDA
COUNTY.
I AND THAT WAS A LOT OF ONE OF
THE FIFTH OR SIXTH LARGEST
COUNTY IN THE STATE.
WE WORKED WITH FOURTEEN SCHOOL
DISTRICTS THIRTEEN NINE ONE
RECEIVING CENTERS.
TWENTY TWO HOSPITALS WE HAD
FIFTY SIX THOUSAND CHILDREN
LIVING IN POVERTY.
AND THAT TWO THOUSAND CHILDREN
LIVING IN OUT OF HOME CARE.
I'M GONNA GET TO A MINUTE FLIP
THROUGH SOME SLIDES QUICKLY
BECAUSE I'D LIKE TO GET TO HOW
WE ADDED TEN THOUSAND CHILDREN
TO REPEAT TO TO MENTAL HEALTH
AND SIX YEARS. AND MADE OAKLAND
UNIFIED SCHOOL DISTRICT THE
FIRST SCHOOL DISTRICT IN THE
NATION TO HAVE UNIVERSAL ACCESS
TO PRIMARY CARE AND BEHAVIOR
HEALTH.
IN OVER A HUNDRED AND FORTY NINE
SCHOOLS.
SOME MIGHT TAKE US THROUGH THE
VERY DETAILED SPECIFIC
MECHANISMS THRIFT ABOUT HOW WE
DID THAT AND HOW WE FUNDED IT.
I THAT AGENCY IRAN I'M ON THE
BOTTOM LEFT HANDCORNER IN THE
SMALL PRINT THERE YOU'LL SEE.
IT WE ARE AN EIGHT HUNDRED AND
SEVENTY MILLION DOLLAR AGENCY.
BUT OUR BEHAVIOR HEALTH SERVICE
WAS FOUR HUNDRED SEVEN MILLION
OVER HALF OF THE LOCAL HEALTH
AUTHORITIES BUDGET IS ROUTINELY
BEHAVIORAL HEALTH.
AND BEHAVIORAL HEALTH IS
ESSENTIAL TO UNDERSTAND WHAT WE
TALK ABOUT ACES BECAUSE AS YOU
HEARD THE VAST MAJORITY OF
INTERVENTIONS NECESSARY TO
ADDRESS TRAUMA.
ARE RELATED TO MENTAL HEALTH
ALCOHOL AND DRUG ABUSE.
AND MY PERSONAL HISTORY I
STARTED A CHARTER SCHOOL IN MY
IN THE NEIGHBORHOOD I GREW UP IN
PHILLY.
WITHOUT WORK FOR OPEN UNIFIED
SCHOOL DISTRICT AS A THERAPIST I
WAS A CRITICAL INCIDENT RESPONSE
THERAPIST RESPONDING TO SCHOOL
SHOOTINGS ACCESSIBLE VIOLENCE.
BUT I WAS EMERGE FROM SOCIAL
PRESSURES HOSPITAL OAKLAND. THAT
I WHICH THE COUNTY WAS A
CHILDREN'S HEALTH DIRECTOR
EVENTUALLY THE HEALTH DIRECTOR.
AND NOW I'M WORKING WITH
SLAPPING AND SYSTEMS CHANGE AND
I HEARD A LOT OF STUFF THAT
REALLY EXCITED ME SO I THANK YOU
FOR YOUR INTEREST AGAIN.
AND THE THREE TAKEAWAYS FROM MY
TWENTY FIVE YEARS OF. WORKING
DIRECTLY LIVES OF CHILDREN IS
THAT THERE'S BEAUTY IN
INTELLIGENCE AND EVERY CHILD
THAT'S THEIR BIRTHRIGHT. NOT SO
WHAT WE TALK ABOUT THE
CHALLENGES FACING ON PEOPLE
PEOPLE ARE NOT THE PROBLEMS.
OTHER ACTUALLY THEIR BEAUTY AND
THE TRANSCENDENCE.
AND WITH SMART FINANCING AND
RESPECT WE CAN ACTUALLY DO GREAT
THINGS.
SO I'LL TELL YOU HOW WE NEEDED
IN BRAIDED AND BUBBLE GUM AND
SHOESTRING SOME STUFF.
BUT I COULD NOT AGREE MORE WITH
SOME OF THE SPEAKERS EARLIER
ABOUT THE NEED FOR A BROAD
SYSTEMIC APPROACH TO THIS
PROBLEM.
AND AS ALL TALK ABOUT IN A
SECOND THERE'S A UNIQUE
OPPORTUNITY RIGHT NOW IN
CALIFORNIA.
THREE BILLION OF ON SPENT KNOW
HOW FUNNY RIGHT TWO POINT TWO
MILLION OF MENTAL HEALTH
SERVICES ACT. ANOTHER BILLION OF
UNSPENT REALIGNMENT MONEY.
AND FEDERAL WAIVERS THAT
ORGANIZE OUR CURRENT MENTAL
HEALTH SYSTEM BETTER TO FOR
RENEGOTIATION AND TWENTY TWENTY.
SO THE TIMING OF THIS HEARING IS
EXTRAORDINARY AND HAS A CHANCE
TO DO SOMETHING SPECIAL.
SO WISE BEHAVIOR HEALTH SO
IMPORTANT AND THE DATA TELLS US
SO AND HER FROM TEACHERS AND
PARENTS IN THE ROOM TODAY.
SUICIDE IS THE THIRD LEADING
CAUSE OF DEATH FOR YOUNG PEOPLE
TO THE TWENTY FOUR.
AND WHEN YOU LOOK THE THINGS
THAT KILL KIDS AND REMEMBER THIS
IS TAKEN FROM BIRTH AND DEATH
RECORDS IN ALAMEDA COUNTY ROSE
UP DIRECTORS AS IS OUR DATA. WE
LOOK AT THE THREE THINGS THAT
KILL YOUNG PEOPLE THEIR HOMICIDE
SUICIDE AN INJURY. AND WHILE I
LOVE MEDINA AND THE DOCTORS WHO
SPOKE BEFORE ME.
DOCTORS DON'T TREAT THESE THINGS
RIGHT THERAPIST. AND SOCIAL
NETWORKS TO SOME ORDER FOR US TO
ADDRESS CHILDHOOD TRAUMA WE
ACTUALLY. HAVE TO ACCESS THE
PRIMARY CARE HOME BUT NOT DEPEND
ON IT BECAUSE THERE IS NOWHERE
NEAR ENOUGH STOCKS.
YOU COULD TAKE ALL OF THE
PRIMARY CARE PHYSICIANS
CURRENTLY IN TRAINING.
AND THEY WOULD BE SWALLOWED BY
KAISER ALONE.
FORGET SUTTER FORGET MEDICAID
RIGHT.
SHE CAN'T DO IT WITH JUST A
PRIMARY CARE PHYSICIAN WE HAVE
TO LOOK AT NEW WAYS NOW GO
THROUGH A COUPLE.
AND PARTICULARLY ADOLESCENTS
HAVE THE LOWEST RATE OF
PRIMERICA UTILIZATION OF ANY
DEMOGRAPHIC GROUP.
SO ONCE YOU GET TO BE TEN OR
TWELVE HE STOPS IN THE DOCK.
SO IN ORDER FOR US TO TREAT
YOUNG PEOPLE WE HAVE TO LOOK
WHERE THEY ARE. AND THAT TENDS
TO BE IN SCHOOLS RIGHT THAT'S
THE BEST PLACE
BUT ALSO ANOTHER CHILD SERVING
SYSTEMS.
AND WE ALSO KNOW MORE THAN WE
DID AS YOU HEARD VERY
COMPELLINGLY EARLIER WE HAVE NEW
SCIENCE EMERGING PRACTICES IT'S
NOT JUST ASUS RIGHTS ALSO BRAIN
SCIENCE ITSELF.
AND IF WE HAVE THE COURAGE WILL
AND SKILL WE CAN APPLY THIS WORK
THE LIVES OF CHILDREN BROADLY.
AND I WITHOUT I THINK GOING TO
HEART IT DHS AND OTHER PLACES
OUR CHILDREN'S MONEY HOUSES TO
MISS DRAMATICALLY
UNDERPERFORMING AND IT'S NOT
JUST OTHER NATIONS THAT AND THAT
I NEED TO POINT OUT HERE. THERE
ARE THREE STATES LEFT IN THE
NATION THREE.
THAT THE MINISTER MENTAL HEALTH
THE WAY THAT WE DO IN
CALIFORNIA.
NORTH CAROLINA COLORADO AND
CALIFORNIA.
THREE OF ALL THE STATE'S
CARVE MENTAL HEALTH OUT. AND
MINISTRY AND ADMINISTERED
COMPLETELY SEPARATELY.
FROM THE REST OF HEALTHCARE
SYSTEM JUST THREE OKAY.
I GUESS PRIEST I IN FACT
COLORADO NORTH CAROLINA ALREADY
DOING INTEGRATION EFFORTS
NOW LOOK I WAS AND I WAS A
COUNTY HEALTH DIRECTOR SO THAT
CARVE OUT OF THE NINETEEN
FIFTEEN BE WAIVER.
ESTABLISHES A IT'S ACTUALLY
CALLED FREEDOM OF CHOICE WEBER
BUT IT ESTABLISHES THE AUTHORITY
FOR COUNTIES TO RUN THE MENTAL
HEALTH BENEFITS SEPARATE
DISTINCT FROM MANAGED CARE
PLANS.
SO THAT MECHANICS AND STRUCTURE
IS DO WHAT FOR NEGOTIATION AND
TWENTY TWENTY.
YOUR INTEREST COULDN'T BE MORE.
EFFECTIVELY TIMES.
AND OUR CURRENT SYSTEM MOST
CHILDREN GET NO SUPPORT AND MANY
GET THE WRONG KIND RIGHT THAT
GET IT IN TO THE HALL OR IN
CHILD WELFARE.
AND NINETY SIX PERCENT OF ALL
CHILDREN CALIFORNIA'S OF ANY TO
CONGRATULATE THE LEGISLATORS IN
THIS ROOM YOU HAVE DONE A UNIQUE
THING WE BASICALLY HAVE
UNIVERSAL ACCESS TO HEALTHCARE
FOR CHILDREN.
NOT WHAT USING UNIVERSAL
COVERAGE THAT POINT TRYING TO
MAKE IS COVERAGE IS NOT EQUAL
ACCESS.
AS WE HAVE TO LOOK AT THAT THE
MECHANICS OF HOW CHILDREN ENTER
CARE.
NOT TO ENSURE THAT THEY GET IT
NOT JUST THE HAVE A HEALTH
BENEFITS MEMBER NINETY SIX
PERCENT OF CHILDREN.
ARE NOW COVERED BY HEALTH
INSRANCE BENEFITS THAT INCLUDES
A MENTAL HEALTH. PAIR.
BUT LESS THAN TEN PERCENT OF I
GET A SERVICE ONE AND FOUR
RECEIVE ANY KIND BUT THAT
INCLUDE SPECIAL EDUCATION WHICH
IS UNNECESSARILY RESPONSE TO
TREATMENT. NEED.
SO BOB BY GIVE YOU SOME TOUGH
NUMBERS THERE IS HOPE.
THERE ARE PROMISING PRACTICES IN
CALIFORNIA AND INTEGRATION IS
POSSIBLE SO MINUTE FOR THE FOR
THE TEACHER AMONG THAT GLOVES
LISTENING YOUR QUESTION I
COULDN'T HELP BUT. FEEL
ANTICIPATION TO TELL THE STORY.
BUT WE NEED A NEW FRAMEWORK WE
CAN'T JUST DO WHAT WE'RE DOING.
YEAH I I SAY SOME I SOMETIMES
SAY WE DON'T NEED ANYMORE NICE
CHRISTMAS TREE ORNAMENTS ON A
DEAD TREE RIGHT LET'S LET'S TAKE
A LOOK AT THE TREE AND WATER IT
AND GOT RIGHT.
SO YOUR CURRENT FRAGMENTATION
THAT YOU ALL SPOKE TO IS THIS
FEDERAL STATE DEVOLUTION TO
COUNTIES.
COUNTIES ARE THE PLACE WHERE THE
STATE AND FEDERAL DOLLARS BECOME
A SERVICE OR A CONTRACT FOR
SERVICE.
SORT FOR A THINK LEGISLATORS
UNDERSTAND THIS IT REALLY
ESSENTIAL.
AND THE SYSTEMS LIKE A CHILD
WELFARE SYSTEM IS ADMINISTERED
AT THE COUNTY LEVEL.
WITH STATE AND FEDERAL DOLLARS
THAT BECOME A CONTRACTOR SERVICE
AT THE COUNTY LEVEL AND THE
SYSTEMS BE A CHILD WELFARE
JUVENILE JUSTICE OR EDUCATION
AND I SHOULD HAVE ADDED THE
REGIONAL CENTER SO I'LL DO THAT
NEXT TIME.
THESE ARE FOUR DISTINCT SYSTEMS
BUT ONE HOPE THAT WE HAVE IS
THAT ALL I DID ADDED THANK YOU.
THEY ALSO INCLUDE A MENTAL
HEALTH BENEFITS
IF INTERESTING IF YOU LOOK OF
HEALTH AND SAFETY CODE OVER THE
WELFARE INSTITUTIONS CHO FOR
JUVENILE JUSTICE THERE'SA
REQUIREMENT FOR BEHAVE A LEVEL
OF BEHAVIOR HOW SUPPORT. AND
EVERY CHILD SERVING SYSTEM.
EXCEPT NO ONE SAYS WHAT IT IS.
IT JUST IT'S BRIGHT.
SO IF WE HAD A NEW FRAMEWORK AND
WE TO FIND WHAT IT WAS USING THE
NEW SCIENCE OF BASIS AND BRAIN
SCIENCE.
WE ACTUALLY HAVE A CHANCE TO
TRANSFORM THE ENTIRE CHILD
SERVING SAFETY NET.
IF WE TAKE THE OPPORTUNITY LOOK
AT CHILDREN'S MENTAL HEALTH IN
ANY WAY.
SO WHILE THERE ARE THE TERRIBLE
NUMBERS AT A SHOW YOU ABOUT THE
CURRENT PERFORMANCE ARE ACCIONES
KNOW HOW SYSTEM.
IT LOOKED AT AS AN OPPORTUNITY
LIKE THE OBSTACLE IS THE WAY IT
COULD BE A MOMENT. USING FEDERAL
WAIVER OPPORTUNITY ON SPENT
STATE DOLLARS
TRANSFORM THE EXPENSE OF
CHILDREN ARE SAFETY NET AND GET
TO A BROAD SOCIAL MOVEMENT LIKE
THE ONE WE HEARD ABOUT EARLIER.
AND THAT HAS TO BE SAID WHO'S IN
THE SYSTEM I WON'T GO THROUGH
THESE YOU'VE HEARD THIS HORRIBLE
DATA BEFORE.
THESE ARE LARGELY POOR KIDS
LARGELY POOR KIDS OF COLOR WHO
ARE SUSPENDED REFERRED TO
PROBATION OR IN FOSTER CARE.
AND THESE HARSH REALITIES MEAN
THAT THIRTY FOUR PERCENT OF
YOUTH EXPERIENCE HOMELESSNESS
AFTER LEAVING FOSTER CARE.
FORTY FOUR PERCENT OF YOUTH
ARRESTED AFTER THE FOSTER CARE
SEVENTY FOUR PERCENT OF YOU THAT
YOU DON'T JUST SYSTEM ARE
REARRESTED. AND WE RANK THIRTY
NINTH AT SCHOOL SPENDING PER
PUPIL AND THIRTIETH AND SCHOOL
ACHIEVEMENT.
IN THE NATION.
AND I NEED ALSO FEEL RESPONSIBLE
AS A SOME IS DONE THIS WORK TO
NAME THE REALITY OF STRUCTURAL
RACISM IN THE STATE'S POSITION
POVERTY.
I'M SEVEN OUT OF TEN CHILDREN
BORN INTO POVERTY NEVER GET OUT.
SO THE EXAMPLES FROM ALAMEDA
COUNTY THAT I WON A HIGHLY ARE
HOW WE USE BEHAVIORAL HEALTH AS
A WAY TO TRANSFORM THESE THREE
SYSTEMS JUVENILE JUSTICE CHILD
WELFARE EDUCATION AND I'M GONNA
FOCUS ON EDUCATION.
BUT JUST A COMIC QUICKLY IN OUR
JOURNAL JUSTICE SYSTEM.
TWO THOUSAND EIGHT WE OPENED UP
A NEW JUVENILE HALL WE BUST FOUR
HUNDRED EIGHT KIDS UP TO IT.
SIX YEARS LATER AFTER DOUBLING
THE MENA HOUSE STAFF AND.
DURING A TWELVE MILLION DOLLAR
EXPANSION SERVICES THERE ARE
SIXTY SEVEN KIDS IN OUR CURRENT
JUVENILE JUSTICE CENTER SO FROM
FOREIGNER NAY TO SIXTY SEVEN
KIDS IN DETENTION.
AND CHILD WELFARE DURING THAT
SAME PERIOD OF TIME WE WENT FROM
FIFTY FIVE HUNDRED CHILDREN IN
OUT OF HOME PLACEMENT OVER
FOURTEEN HUNDRED TODAY.
NOW THAT'S NOT JUST PAPER HEALTH
BUT OF COURSE BEHAVIOR HEALTH
WAS AN ESSENTIAL COMPONENT OF
THAT EXPERMENT.
AND WE ACHIEVE THE HIGHEST
PENETRATION RATE IN CHILD
pEIGHTY PERCENT OF ALL CHILDREN
AND COUNTY COUNTY CHILD WELFARE
SYSTEM RECEIVED AMOUNT OF
SERVICE.
BUT IT'S EDUCATION WHERE WE HAD
THE MOST SUCCESS AND IN THIS
FIFTEEN YEAR PERIOD TWO THOUSAND
TO TWO THOUSAND FIFTEEN.
NOVEMBER TWO THOUSAND I WAS
WORKING ACCIONES OAKLAND US OF
RANSOM SOCIAL WORKER AND SO WAS
TREATING KIDS OF THAT FORTY
EIGHT TWENTY FOUR.
AND THEN IN TWENTY FIFTEEN OF
THE HEALTH DIRECTOR I HAD BEEN
FUNDING THE EXPANSION OF THE
SERVICES.
THE VAST MAJORITY OF THOSE TEN
THOUSAND CHILDREN WHO GOT
SERVICE GOT IT IN SCHOOL BECAUSE
THAT'S WHERE KIDS ARE RIGHT.
AND SO THAT CHALLENGE OF
INCREASING CONCENTRATION OF
POVERTY IN PUBLIC EDUCATION.
A LOT OF MORE MORE POOR KIDS IN
THE SAME PLACE THAT'S IT THAT'S
IN MANY WAYS A NEGATIVE BUT IT'S
ALSO A BENEFIT BECAUSE THAT
MEANS YOU CAN PAY FOR SERVICES
FOR THEM UNDER MEDICAID. IF YOU
KNOW HOW TO USE IT.
SO NINETEEN NINETY SIX THERE
WERE FOUR SCHOOL HAS SCHOOL
HEALTH CENTERS ALL STARTED BY
DOCTOR BARBARA STAGGERS BY THE
WAY OF A MENTOR OF MINE AND AND
FROM CHáVEZ OAKLAND.
AND BY CREATIVELY FINANCING THE
BRICKS AND MORTAR WAS SCHOOL
BONDS SOAP SCHOOL BONDS OF THE
MOST POPULAR TAX IMAGE OF
AMERICA THAT WAS PASSED.
WE WENT FROM AND WE HOPE TO FIND
THE NEXUS
OF
WHAT HEALTH A PUBLIC EDUCATION
AGAIN WOULD YOU SCHOOL BONDS TO
PAY FOR THE BRICKS AND MORTAR.
FOR THE CLINICS
WE USE MEDICAID TO PAY FOR
EIGHTY PERCENT OF THE SERVICES
THAT AN OPERATIONAL SUPPORTS AT
THE SCHOOL CLINICS NEEDED.
NEVER HAVE THAT AGAIN I DROP IT.
BECAUSE SOME.
FROM MEDICAID.
ALL YOUR SERVICES ARE TIED TO
DIAGNOSTIC
CRITERIA RIGHT AND A LOT OF
THESE KIDS AS YOU HEARD EARLIER
HAVE HAD BAD THINGS HAPPEN TO
THEM THEY'RE NOT PATHOLOGICAL.
SO IT'S A REALLY IMPORTANT THING
THE NAME THAT A LOT OF KIDS ARE
JUST POOR OR IT HAD BAD THINGS
HAPPEN TO THEM. THEY'RE NOT
PATHOLOGICAL ARE NOT SICK.
SO THE CHALLENGES OF THIS
EXPANSION HAVE BEEN HOW TO
BALANCE THE NEED TO GET SERVICES
TO KIDS.
WITH THE DIAGNOSTIC CRITERIA
REQUIRED TO GENERATE THE REVENUE
TO PAY FOR IT AYE WITH ME.
IT'S LIKE A CRITICAL ATTENTION
IN THE FIELD.
I AM SO WE LEARNED A LOT ABOUT
CLARA COMPETENCE TO WORK WITH
SCHOOLS THE LOCAL HEALTH
AUTHORITY HAS TO GET HUMBLE
RIGHT IF YOU WALK INTO SCHOOL
AND SAY HEY YOU'RE DOING A BAD
JOB OF YOU KNOW THAT IS THAT.
YOU KNOW. DOESN'T WORK.
YOU HAVE TO USE MARK CROSS
SECTORAL FINANCING STRATEGIES
MEDICAID MEDICAID MEDICAID.
HOW ABOUT MEDICAID RIGHT?
AND THEN YOU HAVE TO LEARN A
DOCUMENT AS WE HEARD EARLIER I'M
AN ESSENTIAL FUNCTION OF THIS
WORK IS TO UNDERSTAND WHO GETS
WHAT WHEN AND WHERE.
SO WHAT IF WE REIMAGINE CHáVEZ
PAPER HEALTH AND I'LL CLOSE WITH
THE
SLIDING ONE MORE THAT WHAT IF WE
LOOKED AT IT DIFFERENTLY. USING
THIS UNIQUE OPPORTUNITY OF RIGHT
NOW WHICH IS
TONS OF ON SPENT STATE MONEY
MENTAL HEALTH SERVICES ACTED
TWENTY LETTER REALIGNMENT IT'S
OVER THREE BILLION DOLLARS
THAT'S A FAVOR OF INTERVENTION.
WE ALSO KNOW THE TOOL FOR
HEALTHY DEVELOPMENT THAT ALL
CHILDREN THE VAST MAJORITY HAVE
EXPERIENCE IN THIS IS RIGHT SO
ALL CHILDREN COULD BENEFIT FROM
SUPPORT IN THEIR DEVELOPMENT
FROM SOMEONE TO TALK TO WHO
UNDERSTANDS THEIR NEEDS.
WE DO KNOW THAT SOME NUMBR OF
CHILDREN MEET CLINICAL
DIAGNOSTIC CRITERIA THERE ARE
SERIOUSLY MENTALLY ILL KIDS THEY
NEED SERVICES WE NEED TO LOOK AT
HOW TO INTEGRATE THEM WITH
TRADITIONAL HEALTHCARE PRACTICE.
AND FINALLY IF YOU IF YOU GO
WITH ME DESPITE THE POOR
PERFORMANCE OF A HEALTH WE CAN
CHANGE OUR SYSTEMS.
SO MY FINAL SLIDE IS TO REPEAT
THE WHY NOW WHY IS THERE SUCH AN
IMPORTANT OPPORTUNITY RIGHT NOW
IT'S NOT JUST INTERESTED IN AND
THAT YOU GUYS ARE BRIAN THERE'S
ACTUALLY SOME. BRICKS AND
MORTAR.
NUTS AND BOLTS CHANCE CHECK
COUNT OUR OPPORTUNITIES IN FRONT
OF US.
THESE FEDERAL WAIVERS IN TWENTY
TWENTY ARE UNIQUE OPPORTUNITY WE
CAN ENGAGE TEACH YES TO LOOK AT
THE CARVE OUT THAT'S CALLED THE
NINETEEN FIFTEEN BEWARE.
BUT WE ALSO HAVE ANOTHER WAVE
COMING CALLED ELEVEN FIFTEEN
HOSPITAL WHERE.
THAT'S THE WAIVER THAT CURRENTLY
FUNDS WHOLE PERSON CARE.
PREVIOUSLY FUNDED THE LOCK OF
HEALTH PROGRAM.
THE CHANCE TO BRING IN
SIGNIFICANT NEW FEDERAL REVENUE
TO EXPERIMENT IN ARE A HEALTH
SYSTEM.
I THINK THAT WE COULD LOOK AT
THE NINETEEN FIFTEEN BE WAVERING
ELEVEN FIFTEEN VIEW ELEVEN
FIFTEEN WAIVER TOGETHER.
AS A WAY TO REINVENT CHILDREN'S
NOT HEALTH ACROSS THE STATE.
WE HAVE ON SPENT AND STILL
GROWING STATE REVENUE REMEMBER
THOSE REAL. THE MENTAL SERVICES
ACT AS A ONE PERCENT TAX ON
MILLIONAIRES THERE'S NO SHORTAGE
OF MILLIONAIRES THEY'RE GROWING
RIGHT IRAN MENTAL HEALTH
RECEIPTS AND I RECEIVE THOSE
DOLLARS AN ARMY COUNTY. AND ARGH
RECEIPTS GREW TO FIFTY FOUR
MILLION DOLLARS A YEAR BECOMING
ONE OF THE LARGEST US SOURCES OF
OF FUNDING FOR A BIT MOUTH
APARTMENT.
WE HAVE LEARNED LESSONS WE HAVE
NEW SCIENCE
WE SET UP THE COURAGE TO APPLY
THEM.
THERE ARE PROMISING PRACTICES IN
CALIFORNIA WHILE WE DON'T NEED
ANYMORE GOOD CHRISTMAS TREE
ORNAMENTS ON A DEAD TREE WE HAVE
ENOUGH ORNAMENTS TO HANG ON
HEALTHY TREE WHEN WE GET ONE.
AND AS A NATIONAL MOVEMENT
TOWARDS INTEGRATION AS I
MENTIONED ONE OF THE FEW STATES
LEFT THAT DOESN'T THIS OLD
FASHIONED WAY.
AND THERE'S NEW SCIENCE AND
LEARNING FROM THAT'S STANDING.
CATEGORY COLLEAGUES KEEP GOING.
THANK YOU VERY MUCH NEXT WE HAVE
DOCTOR MICHAELS.
I APOLOGIZE I DON'T HAVE SLICE.
PUMP I'M DUTCH REALLY CYNICAL
ASIDE A PEDIATRICIAN AND THE CEO
OF THE CHILDREN'S CLINIC SERVING
CHILDREN AND THEIR FAMILIES. AND
I'M ALSO A CLINICAL PROFESSOR OF
PEDIATRICS AT UC IRVINE I WORK
IN LONG BEACH CALIFORNIA.
WE ARE A SYSTEM OF ABOUT FORTY
THOUSAND PATIENTS HALF OF WHOM
ARE CHILDREN SO WE PRIDE TAKE
CARE OF ONE OUT OF EVERY THREE
LOW INCOME CHILD IN LONG BEACH
AREA. TO TAKE CARE OF HALF OF
THE HOMELESS CHILDREN AND
FAMILIES EVEN THERE CALLED THE
CHILDREN'S CLINIC WE DO ALL
AGES.
AND IN THE LAST FIVE YEARS YOU
START TO DO PRENATAL CARE TO
DELIVER SIX HUNDRED.
BABIES A YEAR SO WE REALLY HAVE
ACCESS TO IT ENTIRE SPECTRUM.
ABOUT SIX YEARS AGO.
ALL THE NEWS ABOUT A SAYS
FINALLY HIT THE PEDIATRIC
LITERATURE THINKS AND EIGHTEEN
INJECTION COP AND OTHERS WE HAD
OUR TOXIC STRATHCONA SEE
STATEMENT. AND WE STARTED
READING AND I'VE SPENT MY ENTIRE
CAREER CARING FOR THE
UNDERSERVED BOTH IN THE UNITED
STATES IN AFRICA. I DID CHILD
ABUSE FOR TWO YEARS WHEN I
FIRST.
FINISH DATA COUNTY HOSPITAL.
AND SO THIS IS BEEN MY PASSION
FOR FOR MANY MANY YEARS. AND WE
HAD THE OPPORTUNITY TO APPLY FOR
A GRANT THAT WAS VERY SIZEABLE
IT'S A LOCAL LA COUNTY GRANT
FROM THE EVERY CHILD FOUNDATION.
WE DECIDE TO FOCUS ON CHILDHOOD
TRAUMA IN ADVERSITY AND FOCUS ON
THE VERY YOUNGEST CHILDREN AND
THE PRENATAL SO WE WENT AS
UPSTREAM AS WE COULD AT THE
TIME.
AND.
PUT IN A GRANT TO SCREEN AND.
ADDRESSED THE ADVERSITY WITHIN
OUR CLINIC WE HAVE A MEDICAL
LEGAL PARTNERSHIP SO EMPLOYERS
THAT WORK WITH US WE HAVE
INTEGRATED BEHAVIORAL HEALTH.
AND WE HAVE WORKED WITH THE
MENTAL HEALTH PROVIDERS THROUGH
A NATIONAL GRANT FOR OVER TEN
YEARS LOOKING AT INTEGRATING
THEIR BEHAVIORAL HEALTH SERVICES
WITH OUR CLINICAL SERVICES.
SO WE REALLY HAVE THE
OPPORTUNITY WE ALSO FOR SCHOOL
BASED CLINICS AND IT HAD
MULTIPLE RELATIONSHIPS WITH OUR
CITY HEALTH DEPARTMENT BECAUSE
OF LONG BEACH OF THE CITY.
HEALTH DEPARTMENT AND OUR OWN
UNIVERSITY AND OUR.
PHONE SCHOOL SYSTEM SO WE HAVE
BEEN WERE REALLY POISED TO DO
THIS
I THINK THE MOST IMPORTANT THING
THAT WE DID FIRST WAS. EDUCATE
OURSELVES FIRST WE EDUCATE
OURSELVES FOR THE WHOLE YEAR
NADINE TALKS ABOUT A PILE OF
STUFF NEXT TO HER BED WHEN SHE
WAS DOING THIS I HAVE EQUALLY.
HIGH PILE IN BOXES ALL OVER MY
OFFICE BECAUSE THERE WAS SO MUCH
LITERATURE COMING OUT SO
QUICKLY.
BUT WE.
MATT AND GOT TO KNOW NATIONAL
COUNCIL FOR BEHAVIORAL HEALTH
THEY WERE RUNNING
COLLABORATIVE'S TO DO.
TRUMP INFORMED CARE TRAINING
FOR ORGANIZATIONS WE'RE THE
FIRST TRUMPCARE CARE CERTIFIED
ORGANIZATION IN SOUTHERN
CALIFORNIA. AND WE TRAIN ALL TO
AND FIFTY NOW WE HAVE THREE
HUNDRED AND FIFTY STAFF WE
TRAINED EVERYONE INTRO INFORMED
CARE FIRST WHICH I THINK IS
REALLY REALLY IMPORTANT. AND I
NOW GET TO THE SCREENING YOU
CANNOT DO THE SCREENING UNTIL
YOU TRAIN PEOPLE IN WHAT THIS IS
HOW TO APPROACH YOUR FAMILIES
WITH DIGNITY AND KINDNESS AND
CARING. AND NOT TO DEMONIZED
THEM AND MAKE THEM FEEL LIKE
THEY'RE DAMAGED GOODS IT'S
REALLY REALLY IMPORTANT. AND WE
LEARNED A LOT DURING THAT
TRAINING I THINK ONE OF THE MOST
IMPORTANT THINGS IS THAT WHEN
YOU DO THAT TRAINING AND WHEN
YOU ROLL OUT THESE PRACTICES
WITH IN YOUR ORGANIZATION. YOU
WILL HAVE MANY PEOPLE IN YOUR
ORGANIZATION WHO THEY THEMSELVES
HAVE GONE THROUGH DOMESTIC
VIOLENCE BOTH NOW AND PERSON WE
HAD MANY PEOPLE COME UP TO ME
AFTERWARD AND SAID. I DIDN'T
REALIZE DOMESTIC VIOLENCE WAS
DANGEROUS FOR MY CHILD AND THEY
LEFT THEIR MARRIAGES THEY GOT
INTO SAFE WE GAVE THEM
REFERRALS.
YOU HAD PEOPLE THAT STOOD IN
WHEN WE HAD THE TRAINING I STILL
SEE THEM THEY'RE STANDING IN THE
BACK AND THERE ARE ONE OF MY
LEADERS AND I THOUGHT THE REDUCE
INTERESTED I WAS VERY UPSET.
ONE THING IS YOU HAVE TO LEARN
TO BE NON JUDGMENTAL SO THERE I
WAS JUDGING THEM WHY ISN'T SHE
INVOLVED.
JUST YOU KNOW WE'D WE NOW KNOW
THAT THOSE WERE PEOPLE WHO
COULDN'T REALLY HEAR ABOUT THAT
TO HEAR ABOUT THOSE THOSE ACES
AND AND THAT ADVERSITY AND THE
CHILD ABUSE AND THE DOMESTIC
VIOLENCE AND THE INCARCERATION.
AND THE MENTAL HEALTH ISSUES
WITH THEIR FAMILIES SO REALLY
ASHER DOING THAT TRAINING YOU
NEED TO BUILD A SUPPORT SYSTEM
FOR YOUR OWN STAFF. IT'S LIKE
PUTTING ON YOUR MAP OXYGEN MASK
FIRST BEFORE YOU GIVE IT TO YOUR
CHILD YOU HAVE TO DO THAT AND
MAKE SURE YOU BILL THAT END AND
THAT WAS ADVICE I GOT FROM
SOMEBODY WHO WAS TRAINING PRISON
GUARDS AND TRUMP INFORMED CARE.
IN HAWAII WHO I'D MET WITH
BEFORE WE STARTED OUR PROGRAM
SHE SAID PEOPLE DON'T TALK ABOUT
THIS AND OF SO I REALLY WANT TO
BRING THAT TO YOUR ATTENTION
THAT THIS TRAINING. OF THE STAFF
AND THE PEOPLE IN THE
ORGANIZATION.
SO THAT WAS VERY VERY IMPORTANT
THE OTHER WAS CREATING.
AN ADVISORY GROUP IT WAS EVERY
CHILD MENTAL HEALTH PROVIDER IN
LONG BEACH THE CHIEF OF POLICE
WHO IS IN OUR COUNTY SHERIFF
CAME TO OUR MEETINGS.
BODY LOWENTHAL IS STATE
ASSEMBLY WOMAN WAS THERE HER
STAFF WAS THERE THE LIBRARIAN
WIECK CHD P. THAT.
HEALTH DEPARTMENT OF THE SCHOOL
DISTRICT.
FAITH BASED ORGANIZATIONS WERE
ALL SITTING AROUND THE TABLE AND
THAT GROUP AFTER THE GRANT AND
IT EVOLVED INTO THE TRUMP INFORM
LONG BEACH.
COMMITTEE WHERE WE'RE TRYING TO
TRANSFORM THE ENTIRE COMMUNITY
OF LONG BEACH INTO BEING A
TROHMAN INFORMED AND RESILIENCY
PROMOTING.
PROCESS AND THEN WE GOT TO TO
LOOKING WHAT'S WE HAD EVERYBODY
TRAINED WE STARTED TO ROLL OUT.
ROLLOUT THE.
SCREENING TOOL WE'VE DEVELOPED
A SCREEN TO THAT INTEGRATED MANY
OTHER.
VALIDATED TOOLS BECAUSE WE
DIDN'T WANT TO JUST LOOK AT
ADVERSITY WE WANT TO LOOK AT
STRENGTHS I'VE. YOU KNOW I'VE
COME THROUGH THE STRENGTHS BASED
APPROACH IN MY CAREER AND I
REALLY BELIEVE IN THE STRENGTH
AND RESPECT THE STRENGTH AND
RESILIENCY OF OUR OUR PEOPLE
THAT WE SERVE AND OUR STAFF. AND
I THINK IT'S VERY IMPORTANT TO
REALIZE PEOPLETHAT GO THROUGH
EXTREME ADVERSITY ARE VERY
STRONG AND VERY RESILIENT THEY
NEED HELP BUT THEY HAVE THEY
HAVE BLURRED THEY HAVE SURVIVED
AND THEY'RE GETTING INTO YOUR
OFFICE TO BRING THEIR CHILD IN.
SO WE HAVE TO REALLY RESPECT
THAT AND BUILD THAT INTO OUR
PRACTICE.
SO WE STARTED SCREENING I HAD
AND MEDICAL ASSISTANCE THAT WERE
UNABLE TO ACTUALLY GIVE OUT THE
SCREENING BECAUSE OF TOO CLOSE
TO HOME FOR THEM WE HAVE TO
RESPECT THAT AND FIGURE OUT HOW
TO DO IT. WE HAD DOCTORS THAT
WERE UNCOMFORTABLE REVIEWING IT.
BECAUSE YOU KNOW THEY WERE FROM
A CULTURE WHERE YOU JUST SUCK IT
UP AND MOVE ON. AND THAT WAS
VERY HARD FOR THEM BUT THEY
STARTED GOING TO NATIONAL
COLLABORATIVE'S WE WERE IN AND.
THE STATE KIND OF TALKED ABOUT
IT WITH US AND THEY'VE REALLY
INTEGRATED IT INTO THE TO THE
CARE.
WE'RE VERY FORTUNATE TO HAVE
PLACES TO REFER TO I THINK ONE
OF THE BIGGEST ISSUES THAT IS A
POLICY ISSUE IS THESE ARE YOUNG
CHILDREN THEY'RE ALL UNDER THE
AGE OF FOUR.
IS THAT IN LONG BEACH WE HAVE AS
WE HAVE SIX THOUSAND PATIENTS
UNDER THE AGE OF FOUR IN OUR
PRACTICE ALONG ONE OF THE LIGHT
WE ARE THE LARGEST PRACTICE IN
IN LONG BEACH.
THEY'RE TWO HUNDRED EARLY HEAD
START PROGRAMS IN OUR COMMUNITY
TWO HUNDRED.
WE HAVE PROBABLY FOUR THOUSAND
JUST IN OUR PRACTICE SO WE WOULD
FIND FAMILIES THAT EARLY HEARTS
HEADSTART IF YOU DON'T KNOW
ABOUT IS A WONDERFUL PROGRAM
THEY WORK. WITH THE MOTHER AND
THE CHILD AND FOR ME THE MOST
IMPORTANT THING IS SUPPORTING
THAT PARENT ITS
INTERGENERATIONAL. I MEAN IT'S
THIS TRAUMA IS INTER
GENERATIONAL WHEN I WAS KIND OF
TALKING TO MY WITH MY PATIENTS
BEFORE WE ACTUALLY STARTED THE
GRANT. I ALSO ABOUT THEIR
CHILDHOOD VERY QUICKLY YOU KNOW
WAS A NEAR WHAT WAS YOUR
CHILDHOOD LIKE WAS THERE ANY
ABUSE NEGLECT SEXUAL ABUSE ANY
ALCOHOL ANYBODY PUT IN JAIL AND
IN DEPRESSION IN YOUR FAMILY.
WAS IT A LOVING FAMILY AND
PEOPLE'S THEY'D FILL UP WITH
TEARS IN THE SAID. YOU'RE THE
FIRST DOCTOR THAT EVER ASKED ME
THAT NOBODY EVER AFTER THAT
BEFORE FOR GENERATIONS OF SEXUAL
ABUSE.
THE MOTHER THE OLDER HER OLDEST
DAUGHTER FOR MOTHER AND HER
GRANDMOTHER ALL SEXUALLY ABUSE
I'VE THE FIRST PERSON I ASKED
FOR THEM SHOULD A NEW BABY GIRL
AND I SAID TO HER DO YOU WANT TO
BREAK THE CYCLE.
AND SHE SAID YES BUT SHE WASN'T
SURE HOW SHE DO THAT WE REFERRED
HER TO PLACES SHE CAME BACK
LATER SHE ACTUALLY CAME TO OUR
ADVISORY GROUP AND SPOKE UP. AND
SHE'S NOW ACTUALLY UNEMPLOYED
WITH THE CLINIC AND IS WORKING
FOR US AND SHE'S DOING VERY WELL
HER DAUGHTER IS STRUGGLING THE
OLDER ONE. BUT I LINKED HER INTO
THE TRAUMA RECOVERY CENTER ALSO
STATE FUNDED I DON'T IF YOU KNOW
THE TRAUMA RECOVERY CENTERS BUT
I THINK THAT'S AN IMPORTANT
GROUP TO LOOK AT. I BELIEVE
THERE ARE TWELVE AND I THINK IT
COMES FROM RESTITUTION FUNDS OR
CRIMINAL.
.
ANYWAY WHAT VICTIMS OF CRIME AND
WE ARE VERY FORTUNATE TO HAVE
HIM WITH A WONDERFUL.
PSYCHOLOGISTS A DOCTOR BE TO GO
FOR WHO WORKS VERY CLOSELY WITH
US AND SO WE PREFER CAN REFER
THEM IN THERE ALL OF OUR MENTAL
HEALTH PROVIDERS IN TOWN BE.
BECAUSE OF SOME OF THE EXPANSION
GRANTS THE MENTAL HEALTH
SERVICES ACT DO HAVE FUNDING FOR
THE DYADIC CARE SO THAT'S VERY
IMPORTANT BUT IT'S GETTING THEM
THERE AND IT'S NOT RELATIONSHIP
OF TRUST.
THAT'S IMPORTANT WITH THE WITH
THE PEDIATRICIANS MANY TIMES THE
OTHER THING WE TRAINED EVERYONE
IS IT WASN'T PERRY PART OF
DEPRESSION. UMP POSTPARTUM OR
PERRY PART OF DEPRESSION IS
EXTREMELY COMMON SPOTTED TWENTY
THIRTY PERCENT OF WOMEN HAVE
THAT. WE HAVE A MATERNAL.
ETERNAL HEALTH THERE'S A A GROUP
IN LA COUNTY THAT JUST FOCUSES
ON THAT AND THEY'VE TRAINED ALL
OF OUR PHYSICIANS IN THAT.
SO IN ADDITION TO THAT IN LONG
BEACH THEY RECEIVE DOJ FUNDING
FROM THE FEDERAL GOVERNMENT TO
CREATE A SAFE LONG BEACH WE WERE
INVITED IN TO BE THE TRAINERS
AND WE'VE TRAINED ALMOST A
THOUSAND PEOPLE IN THE CITY OF
LONG BEACH AND TRAUMA INFORMED
CARE. I HAVE TRAINED.
THE.
.
HOME THE BALLPARKS IN RACKS THE
HEALTH DEPARTMENT OTHER MENTAL
HEALTH PROVIDERS.
SCHOOLS OF MY STAFF DID A. THE
OVERSIGHT FOR.
DCS SOUTH AND THE RESPONSE IS
QUITE AMAZING IT'S REALLY JUST
CHANGING THE LANDS TEACHING
PEOPLE NOT TO BE JUDGMENTAL AND
ASKING. WHAT'S HAPPENED TO YOU
OR WHAT IS HAPPENING TO YOU
INSTEAD OF WHY YOU'RE NOT DOING
YOUR HOMEWORK Y. YOU CAN RELATE
TO YOUR APPOINTMENT.
WORLD WE ALL DO THAT AND IT'S
THROUGH OUT EVERY SPECIALTIES I
THINK ONE OF THE KEY POLICY
ISSUES IS THE TRAINING.
BUT ALSO THE TRAINING THE PEOPLE
IN THEIR PROFESSIONAL CAREERS
YOU CONTROLLED THIS STATE
UNIVERSITY SYSTEM AND THE UC
SYSTEMS I WANT YOU SEE A MEDICAL
SCHOOL. NOBODY EVER TALKED ABOUT
TRAUMA AND ADVERSELY PERSON WITH
A LONG TIME AGO BUT I TRAIN
RESIDENTS NOW FROM UC IRVINE
MEDICAL.
RESIDENCY PROGRAM AND WHEN I
GIVE MY TALK TO THEM IN THE
MORNING ABOUT.
TRAUMA INFORMED CARE IN
CHILDHOOD ADVERSITY ALMOST
UNIVERSALLY NOBODY HAS HEARD OF
IT. THERE IN THE UC SYSTEM MY
FRIEND I THINK.
WAS DEAN OF THE SCHOOL OF
EDUCATION OF CAL STATE LONG
BEACH THE T. FOR TEACHERS AND
SHE'S NOW HEAD OF THE STATE.
UNIVERSITY.
EDUCATION.
.
DEPARTMENT.
THEY GET NO TRAINING IN
CHILDHOOD ADVERSITY OR TRAUMA
IT'S A FAIR
CHILDREN SO I REALLY THINK
THAT'S A. VERY VERY.
RIGHT OPPORTUNITY TO MAKE SURE
WERE INTEGRATING THAT WOULD
THERE'S YEARS AGO WE TALKED
ABOUT HEALTH AND ALL POLICIES.
AND NOW WE NEED TO HAVE A TRUMP
INFORMED LANDS IT IN ALL
POLICIES AND SEE IF WE CAN
INTEGRATE THAT.
THE SCREENING TOOLS.
YOU KNOW I'M KIND OF BETWEEN
EIGHTEEN AND THEN AND NEIL AYE
SCREENING TO ME IS A WAY TO OPEN
UP A RELATIONSHIP IN A
CONVERSATION SO YOU REALLY HAVE
TO TRAIN PEOPLE TO PRESENTED AND
TO RESPOND. IN A NON JUDGMENTAL
WAY WE HAVE A WHOLE SCRIPT NO
THANK YOU FOR SHARING THAT WITH
ME FOR SOME PEOPLE IT HAS TO BE
TRUE A SCRIPT FOR OTHERS YOU CAN
JUST.
LEARN IT AND DO IT SINCERELY HAD
SINCERELY BUT YOU KNOW THANK YOU
FOR SHARING THAT WITH ME YOU'RE
NOT ALONE.
WE'RE HERE TO HELP YOU IF YOU
WOULD LIKE HELP.
AND AND THEN.
YOU IF THEY SAY THEY DON'T WANT
HELP NOW YOU A TO THEY COME IN
THE NEXT TIME YOU ASK AGAIN AND
YOU ESOS OPEN ENDED QUESTIONS WE
SCREEN FOR.
PSE SEVENTEEN FOR ANXIETY
DEPRESSION THE HYPERACTIVITY FOR
ALL OUR PATIENTS.
WHEN ASKING FOR MATERNAL
DEPRESSION EVERY DELTA COMES IN
GOT GET SCREEN FOR DOMESTIC
VIOLENCE BUT WE'RE UNIQUE LIKE
NADINE WE GET A LOT OF GRANTS TO
DO THIS.
AND.
WHERE FQHC SYSTEM?
SO WE REALLY DO MUCH MORE THAN
PEOPLE IN PRIVATE PRACTICE CAN
DO. AND REALLY WHAT I DON'T WANT
IT TO BE IS A CHECK OFF BOX YOU
KNOW WE HAVE THE.
SMOKING QUESTIONS ON THE SIEGE
DP FORM AND IT'S NO NO YES EVERY
JUST MARKS NO NO YES.
AND NO NO YES MEANS THERE'S NO
SMOKING NOBODY SMOKES IN THE
HOUSE AND YES I COUNCIL BUT
PEOPLE DON'T REALLY DO THAT.
THEY CHECK OFF A BOX WE DO WE
HAVE OUR FORMS FOR THE SCHOOL
PHYSICALS IT SAYS DEVELOPMENTAL
ASSESSMENT. BUT WE KNOW IN LA
COUNTY THAT MOST OF THE
PEDIATRICIANS AND FAMILY
MEDICINE PEOPLE ARE NOT DOING
DEVELOPMENTAL ASSESSMENTS WE ARE
WE GOT TRAIN BY NEIL STAFF YEARS
AGO THROUGH.
THROUGH EACH ITEM A FIRST FIVE
GRANT AND WE DO IT AND WE'VE
INTEGRATE ALL THOSE THINGS YOU
HAVE TO REALLY INTEGRATED INTO
YOUR.
.
TO YOUR PROCESS
THERE'S A VERY GOOD GROUP OF
FORMS I BROUGHT THIS IS MY
NOTEBOOK OF ALL THE FORMS AND
SCREENING TOOLS THAT WE HAVE IN
OUR CLINIC CAME.
I BROUGHT IT WITH ME
I COULD SHOW YOU.
WHAT I WOULD LIKE TO SEE
PERSONALLY IS?
THE STAYING HEALTHY FORUMS
STAYING HEALTHY COMES OUT OF THE
STATE DEPARTMENT OF HEALTH
SERVICES IT IS REQUIRED BY
EVERYONE WHO HAS MEDI CAL
MANAGED CARE AND MEDI CAL SO WE
GIVE IT OUT TO EVERYONE.
AND IT HAS QUESTIONS BY AGE IN
THE EARLY YEARS IT DOES NOT HAVE
MATERNAL DEPRESSION IT DOES NOT
HAVE VIOLENCE IN THE HOME IT
DOES NOT HAVE HOUSING IN THE
SECURITY OR FOOD INSECURITY.
WE WE COULD ACT IN THE OLDER AGE
AS THEY DO HAVE A LOT OF THAT
AND IN THE ADULTS SO I THINK WE
COULD ADD TO THAT AND YOURS YOUR
COMMITTEE ON THAT I'M I WOULD
LOVE TO HELP YOU WITH THAT ALSO
BECAUSE I FEEL SO STRONGLY OF
BEEN. TRYING TO GET THEM TO
CHANGE IT THERE'S A NEW VERSION
COMING OUT WE CENTER OUR
COMMENTS WE COULD ADD TO IT BUT
I THINK TO SYSTEMATIZE THAT. BUT
THE MOST IMPORTANT TO TRAIN
PEOPLE IF YOU'RE GOING TO DO
THAT SO THE STATE HEALTHY IT'S
AN EXISTING TOOL OUT OF THE
DEPARTMENT OF HEALTH SERVICES.
THAT HAS SOME OF THAT I THINK WE
NEED TO ASK ABOUT HOUSING AND
FOOD INSECURITY IN ADDITION
WE'VE STARTED TO DO THAT. WHEN
WE DID OUR SCREENING WE HAD
TWENTY TO THIRTY PERCENT OF OUR
FAMILIES AND HOUSING AND FOOD
INSECURITY.
IT'S VERY HARD TO BE A LEVINE
GENTLE PARENT IF YOU DON'T KNOW
WHERE GOING TO BE LIVING AND YOU
DON'T KNOW HOW YOU GONNA FEATURE
FAMILY. SO WE TRAIN TWENTY CAL
FRESHEN ROLLERS IT WITHIN MY
STAFF TO ENROLL PEOPLE IN THAT
WE'RE STARTING FOOD PANTRIES AND
WOOD LOOK WE'VE TALKED ABOUT
DOING AN APT TO DIRECT PEOPLE TO
THE DIFFERENT SOURCES OF FOOD.
I BEG YOU LOOK AT HOUSING WE
HAVE US
PROBABLY FIFTY PERCENT. FIFTY
SEVEN PERCENT OF EVERYONE IN
LONG BEACH IS RENT BIRD AND IT'S
GETTING WORSE AND WORSE AND
WORSE EVEN MY OWN STAFF IT'S
RENT SEVERELY RENT PRUDENT AND
WE INCREASED OUR MINIMUM WAGE IN
MY ORGANIZATION TWO YEARS AGO TO
FIFTEEN DOLLARS AN HOUR. BEFORE
ANYBODY ELSE IN THE CITY DID. SO
WE REALLY TRY TO MOVE THINGS UP
AS WE CAN.
BUT HOUSING AND FOOD INSECURITY
ARE HUGE AND THOSE ARE THINGS
THAT AFFECT YOUR ABILITY TO BE
KIND AND LOVING.
I THINK THE MORE WE CAN BILL
PROTECTIVE FACTORS AMONG
EVERYONE HAD THE MORE WE CAN ALL
BE KIND AND NONJUDGMENTAL. THERE
IS A LOT OF HEALING THAT CAN GO
ON THROUGH THAT AND EVEN DOCTOR
BEFORE WHO RUNS A TRAUMA
RECOVERY CENTER SHE SAYS MEANT
MOST PEOPLE THAT HAVE HAD SOME
TRAUMA IN THEIR LIVES. THEY
REALLY HEAL THROUGH THEIR
RELATIONSHIPS AND PEOPLE THAT
CARE ABOUT THEM IN THEIR
COMMUNITY.
SO THANK YOU.
THANK YOU FOR THAT PRESENTATION
DR.
WITH THAT I WILL BRING IT UP TO
THE DYESS TO SEE IF WE HAVE ANY
QUESTIONS.
NOT I'D LIKE TO OFFER A COMMENT
I WAS.
PARTICULARLY INTERESTED IN HOME
MISTER BRISCOE'S.
INVOLVING KIDS WHERE THEY'RE AT
IN A SCHOOL BASED SYSTEM.
AND WANTED TO KNOW IF THAT WAS A
LOCAL APPROACH ARE HOW. WE WOULD
BE ABLE TO SCALE THAT TO SIZE.
I HAD WANTED TO THINK ABOUT LAST
YEAR LOOKING AT SCHOOL NURSES.
THEN.
SCHOOLS AND WONDER IF THERE'S A
AN OPPORTUNITY THAT WE ARE NOT
CAPITALIZING ON THAT BY NOT.
LOOKING AT SYSTEMS LIKE YOU
PRESENT.
SO YES AND AND I DON'T IT DROP
DEEP INTO THAT POLICY READS AND
DECISIONS A PASSED ELECTED
BODIES BUT IT'S KINDA CRITICAL
TO. PARSE OUT SOME OF THE DETAIL
OF HOW GETS PAID FOR.
AND TO START AS A PERSONAL STORY
WHEN I STARTED WORKING ON THE
CLIMBS HAS SCHOOL IN WEST
OAKLAND AND TRUTH IN NINETEEN
NINETY NINE.
THERE WERE TWO FULL TIME POLICE
OFFICERS I HAVE TIME SCHOOL
COUNSELOR AND NO SWIMMERS.
AND I RIDE IS A SCHOOL
THERAPISTS PAID FOR BY THE STATE
AT THAT TIME.
AND OUT RIGHT AFTER THAT IN THE
EARLY TWO THOUSANDS OF THE EP
STT MENTAL HEALTH SETTLEMENT.
WAS ANNOUNCED.
BASICALLY THAT WAS A LAWSUIT
ENGENDERED BY LEGAL AID THAT
SAID PORTRAITS OF COLOR ARE NOT
GETTING MENTAL HEALTH SUPPORT.
AND IT CHANGED THE FEDERAL AND
STATE MATCHING RATIO AND WHAT IT
DID AT THAT TIME EARLY TWO
THOUSANDS WAS IT SAID ANY COUNTY
THAT PUT UP TEN CENTS.
GOT NINETY CENTS OF STATE
FEDERAL MATCH.
FORTY CENTS FOR THE STATE FIFTY
CENTS FOR THE FATS.
IT'S REAL IMPORTANT NINETY TEN
THAT.
IN MY COUNTY A PREDECESSOR
DAYCARES THE HEALTH DIRECTOR THE
TIME.
USE TOBACCO MONEY TO PUT UP TO
TEN PERCENT.
AND PULL DOWN NINETY CENTS ON
THE DOLLAR.
FOR EVERY UNIT OF SERVICE TO
START THE EXPANSION.
THE STATE LEGISLATOR TWENTY IT'S
LEGISLATURE DID SOMETHING IN
TWENTY ELEVEN.
DID HAPPEN TO TWENTY FOURTEEN
CALL TWENTY ELEVEN REALIGNMENT.
IT WAS A BLOCK GRANT TO
COUNTIES.
OF THE STATE SHARE.
MEANING THAT COUNTIES NOW HAVE
TO PROVIDE FIFTY CENTS INSTEAD
OF TEN TO EXPAND OFF.
SO TO ANSWER QUESTIONS RACKLEY
IF YOU WANTED TO PUT UP A MENTAL
HEALTH COUNSELOR IN EVERY
SCHOOL.
YOU ARE NOW ASKING COUNTIES TO
PUT UP FIFTY CENTS ON THE DOLLAR
SET OF TEN CENTS ON THE DOLLAR.
YOU THE FEDERAL FIFTY CENTS ON
THE DOLLAR IS A FEDERAL
ENTITLEMENT MEANING THE FEDS
CAN'T SAY NO.
RIGHT SUFFER EVERY TIME YOU PUT
A FIFTY CENT YOU GET A FEDERAL
MATCH AFFECT MP A FIFTY CENTS ON
THE DOLLAR. EVERYTIME
SO TO DO WHAT YOU SUGGEST.
YOU HAVE TO DEPEND TO SOME OF
THAT THREE BILLION OF UNSPENT
MONEY.
SEND IT DOWN TO COUNTIES.
WITH SPECIFIC REQUIREMENT BUT
SUCH WORK IN EVERY SCHOOL.
HOW THAT MATCH WITH STATE
FEDERAL DOLLARS TO W. MONEY?
SO THE LONG AND SHORT OF YOUR
QUESTION YES THERE IS A
MECHANISM BUT IT WOULD TAKE
STATE LEADERSHIP.
STATE RESOURCES
AND TECHNICAL ASSISTANCE TO
COUNTIES TO PULL DOWN THE
FEDERAL MATCH YOU WITH ME.
IT'S A CINCH UNDERSTAND THAT THE
COUNTIES MAKE THE FEDERAL MONEY
COME NOT THE STATE.
THE STATE PROVIDES THE NON
FEDERAL SHARE.
BUT THE ACT THE ACT OF EXECUTION
THE MECHANICS OF MATCHING IT.
HAPPENS AT THE COUNTY LEVEL.
AND THE CAPACITY OF COUNTIES.
ARE DRAMATICALLY DIFFERENT.
SOME COUNTIES A REALLY GOOD
POINT ON THAT FEDERAL MATCH WE
HAPPEN TO BE GOOD AT IT NOW ME
COUNTY. AT GREAT.
PREDECESSORS
MANY COUNTIES ARE VERY POOR AT
IT.
SO THE CHALLENGES AND JUST THE
STATE SAYING SO IT'S NOT JUST
STATE SAYING SO IN GIVING THE
MONEY IT'S A STATE SAYING SO
GIVEN THE MONEY AND PROVIDING
SUPPORT FOR LOCAL JURISDICTIONS
TO EXECUTE.
AS LONG WINDED BUT I HOPE.
THAT WAS AN ANSWER NO I.
I THINK YOUR ANSWER.
.
A HIGHLIGHT SOME OF THE
DIFFICULTIES WE HAVE AS A STATE.
THAT OFTENTIMES. A ONE SIZE FITS
ALL APPROACH DOESN'T WORK FOR.
AND EACH INDIVIDUAL COUNTY WHICH
IS ATTEMPTING TO PULL DOWN
FEDERAL FUNDS AND THE WAY THAT
YOU BRING FOR. BUT I ALSO
RECOGNIZE THAT WE SERVE IN THE
LEGISLATIVE BRANCH. WHICH MEANS
WE SPEND PART OF OUR TIME.
CONVINCING IN EDUCATING OUR
COLLEAGUES ON WHAT ARE THE BEST
WAYS TO MOVE POLICIES FORWARD
AND. I'M IS WHY I'M SO EXCITED
FOR TODAY'S TOPIC AND. THIS
OPPORTUNITY TO DISCUSS THE
SUBJECT IS.
UP.
HIGHLIGHTING WHAT HAS WORKED IN
CERTAIN AREAS AND COMMUNITIES
AND LOOKING AT IT AS AN EXAMPLE
THAT WE AS A STATE COULD LOOK TO
REPLICATE OR SCALE YEAH
EXERCISE.
IF IT IS NOT GOING COVER THE
DOCTOR HOW OFTEN MADE THAT PUTS.
THAT SO SENSUAL.
JUST BECAUSE WE WERE ABLE TO DO
SOME STUFF AND ALAMEDA COUNTY I
DON'T AT ALL SUGGEST THAT THE
STORY I TOLD YOU IS THE ANSWER.
WHAT UCLA'S DOINGS ANSWER?
BUNDLED VALUE BASED PAYMENT WITH
A NEW MECHANISM BUT LITERALLY YA
WE NEED TO BREAK IT DOWN START
HOPE FOR RIGHT THERE'S IT A
REINVENTION OF HOW WE DO BEHAVE
OUR HOUSE IS ESSENTIAL IN THE
STATE.
AND THE COUNTIES ON OPTICAL WAY
THERE'S A ROLE FOR THEM TO.
BUT WE HAVE TO LOOK AT
REINVENTING RESTRUCTURING IT
FUNDAMENTALLY IN IN THE CONTEXT
OF A BROAD SOCIAL MOVEMENT.
SO THE DOCTORS WHO SPOKE BEFORE
ME THEY HAD IT RIGHT.
AND JUST AS I TOLD YOUR STORY
ABOUT HOW WE DID IT IN ONE PLACE
WITH SOME SOPHISTICATED
RESOURCES AND DOLLARS I DON'T
WANT THAT TO COME OFF AS THE
SOLUTION.
THAT WAS A WAY OF MITIGATING
HARM.
THE SOLUTION IS A MUCH BROADER
ONE.
AND HAVE TO INCLUDE GHS AND IT
HAS TO INCLUDE COUNTIES.
WITH THAT.
WANT TO THANK THIS PANEL FOR
COMING FORWARD AND WE WILL MOVE
ON TO OUR SECOND PANEL. TO
DISCUSS SOLUTIONS MIA I IT JUST
TWENTY I PUT IN.
FUTURES WITHOUT VIOLENCE THE
CHANGING MINDS PREVENT TEEN AND
HEALING CHILDHOOD TRAUMA STATE
POLICY GUY. ITS STAPLE TO
SOMETHING ELSE IN YOUR PACKET
SO.
GOT IT AGAIN THANK YOU FOR.
FIRST WE WILL HAVE DOCTOR
COFFER.
BY PRONOUNCE THAT CORRECTLY
FOLLOWED BY JOHN POWDERS FRANK
MECCA AND DONNA SNEERING
.
REALLY THRILLED TO BE HERE TODAY
TO TALK ABOUT WHAT WE CAN DO
ABOUT TRAUMA AND BE PART OF THE
SOLUTIONS WE'VE HEARD SOME
PRELIMINARY SOLUTIONS ALREADY.
ON BUT I THINK THERE'S A LOT
MORE TO STILL ADD TO THE
CONVERSATION AND IN PARTICULAR I
THINK IT'S GREAT THAT WE'VE HAD
SO MANY PANELISTS WHO COME UP
AND TALKED ABOUT SOME OF THE
SCIENCE. ARMIN TALKED ABOUT
INDIVIDUAL TRAUMA BEAT BUT
THERE'S ONE THING THAT I THINK
THAT WE STILL NEED TO ADD TO THE
CONVERSATION.
AND SO. THAT IS THE CHARM HAS TO
BE A PRIORITY.
AND WE HAVE TO REMEMBER THAT
THE WORD I HAVEN'T HEARD.
UTTERED AT LEAST ENOUGH TODAY TO
TALK ABOUT TOXIC STRESS WE
TALKED ABOUT TRAUMA BUT WE HAVE
NOT TALKED ABOUT SAFETY.
AND HAVE A TALK ABOUT SAFETY AS
BEING ONE OF THE QUARRY NEEDS
THAT WE HAVE A WE THINK OF
MASSLIVE HIERARCHY OF NEEDS
SAFETY IS RIGHT UP THERE WITH
WHAT WE NEED.
AND SO WE HAVE TO CONSIDER
EMOTIONAL SAFETY IN OUR POLICY
PRIORITIES.
AND AND AS HAS BEEN ALREADY
ARTICULATED YOU KNOW THIS IS A
RISK FACTOR FOR BEHAVIORAL FOR
PHYSICAL AND FOR MENTAL HEALTH
OUTCOMES.
WE REALLY NEED TO THINK ABOUT
THIS AND FRAME IT FROM A SAFETY
PERSPECTIVE AND HOW DO WE
RESTORE SAFETY BECAUSE A LOT OF
WHAT THE BRAIN AND WITH THE BODY
IS DOING IS IT'S WAY OF TRYING
TO RE ESTABLISH SAFETY. IT'S
JUST I JUST HAPPENS TO BE
MALADAPTIVE.
SO. OPPORTUNITY NUMBER ONE IS
IMPROVE DATA COLLECTION AND THIS
IS BEEN TALKED ABOUT.
INCOME TO DANCE AROUND A LITTLE
BIT DOWN IN TERMS OF WHAT WE MAY
NEED
BUT ONE OF THE THINGS WE HAVE
RIGHT NOW IS A RETROSPECTIVE
SELF REPORT DATA ON ADULTS.
SO THE ASUS STUDY THAT WAS
INITIALLY DONE WAS THAT WAS IN
ADULTS AND WE HAVE A LOT OF DATA
ON THAT AND THAT WE HAVE A LOT
OF CLINICAL DATA AND A LOT OF
RESEARCH ON CHILDREN. BUT WHAT
WE NEED IN A MORE SYSTEMATIC WAY
IS POPULATION BASED DATA ON
CHILDREN SO NODDED POCKETS NOT
PER CORRECT PROGRESSIVE CITIES
THAT DECIDE THAT THEY'RE GOING%
TO SCREEN AT CERTAIN AGES WE
ACTUALLY TO DO THIS ON AN
ONGOING BASIS. AND HAVE
INFRASTRUCTURE FOR IT AND THE
EXAMPLE THAT I WOULD USE FOR WHY
THIS IS SO IMPORTANT IS THAT WE
THINK ABOUT INFANT MORTALITY AND
ONE OF THE THINGS THAT'S REALLY
CONTRIBUTED TO THAT IS THAT
EVERY STATE HAS PREMIUMS OR IN
CALIFORNIA'S CASE THE MATERNAL
AND INFANT HEALTH ASSESSMENT.
AND THAT ALLOWED US TO BE ABLE
LEARN MORE ABOUT THE ISSUE AND
GET TO THE HEART OF WHAT'S GOING
ON WITHIN FOR MORTALITY WE'VE
ACTUALLY SEEN MARKED DECREASES
IN INFANT MORTALITY BECAUSE WE
HAD. THAT ROBUST POPULATION
BASED DATA SET AS WELL AS ONE OF
THE THINGS WE REALLY NEED TO
FOCUS ON IN TERMS OF A PAY
CONCRETE NEXT STEP.
THE NEXT IS WE NEED TO THINK
ABOUT EXPANDED ACES AND SO WE
TALK ABOUT THESE MEASURES OF
YOUR HOUSEHOLD THE COLLECTIVE
ABUSE AND DYSFUNCTION BUT WE
HAVEN'T TALKED ABOUT ARE SOME OF
THE OTHER THINGS THAT ARE
CAUSING TRY.
LIKE FOSTER CARE SO WE KNOW THAT
POVERTY IS ARGUMENT WE TALKED LA
FOSTER CARE
BEING IN FOSTER CARE IS THE
TRAUMA. I'M HAVING A PARENTAL
DEATH IS A TRAUMA IT'S NOT
INCLUDED IN THE EIGHTH THE STUDY
ON DISCIPLINE AND INCARCERATION
OF YOURSELF NOT YOUR PARENT ALSO
IS NOT INCLUDED IN ACES AND SO
WE NEED ALSO BE THINKING ABOUT.
WHAT ARE THE OTHER TRAUMAS THAT
ARE NOT INCLUDED IN THOSE COURT
TEN THAT ARE PREVALENT IN OUR
COMMUNITIES AND THAT ARE
IMPACTING HEALTH OUTCOMES?
AND THEN THE LAST ONE IN THIS IS
SOMETHING THAT WE HAVE TO GIVE A
LOT OF CREDIT TO HOWARD PINTER
HUGHES AT UCSF AND MY SHOULD
JACKSON FOR FOR TALKING ABOUT
ADVANCING ITS ADVERSE COMMUNITY
EXPERIENCE AS. SO ALSO EXISTS
AND THESE ARE THINGS LIKE RACISM
AND VIOLENCE AND OTHER THINGS
THAT ARE NOT OF NOT NOT ONLY
HAPPENING AT THE INDIVIDUAL
LEVEL BUT ARE ALSO HAPPENING AT
A COMMUNITY LEVEL BUT EVERYONE
IS EXPERIENCING. AND MUCH LIKE.
LIKE YOU TO USE VIOLENT EXAMPLES
MUCH LIKE A BOMB THAT HAS SORT
OF AT THE CENTER AND THEN IT
RICOCHETS OUT THE SAME THING IS
TRUE FOR ADVERSE COMMUNITY
EXPERIENCES BUT THERE IS A HEAT
POINT WHERE. IT DIDN'T IMPACT
THE FAMILY IF THERE'S A SHOOTING
OR IF THEY'RE IF I'M SOME SORT
OF VIOLENCE THAT HAPPENED THERE
BUT IT ALSO ECHOES OUT INTO THE
REST OF THE COMMUNITY AND WE
NEED TO THINK ABOUT THAT AS WEL.
THE SECOND AND I THINK THIS IS
REALLY IMPORTANT IS TRAINING IN
SCHOOLS AND SO I HAVE BEEN I'VE
HAD THE PLEASURE OF BEING ABLE
TO WORK WITH SEVERAL SCHOOL
DISTRICTS AS WELL AS THE
CALIFORNIA DEPARTMENT OF
EDUCATION. ON THE CALIFORNIA
ASSOCIATION OF AFRICAN AMERICAN
SCHOOL SUPERINTENDENTS AND
SCHOOL ADMINISTRATORS.
AND TALK TO THEM ABOUT ABOUT
TRAUMA AND MUCH LIKE MANY OF THE
OTHER PANELISTS HAVE SUGGESTED
THIS IS SOMETHING THAT IS NEW.
BUT ONE OF THE THINGS THAT THEY
THEY. FREQUENTLY WALK AWAY WITH
IF THIS IDEA OF WHAT AM I
SUPPOSED TO DO NEXT AND I'M SO
GLAD THAT YOU GAVE ME SOME
CONCRETE EXAMPLES IN CONCRETE
NEXT STEPS.
SO ONE OF THE BIG THINGS THOUGH
IS THAT WHEN WE NEED TO CHANGE
THE FRAME AWAY FROM BAD KIDS.
BECAUSE WE THINK OF OF CHILDREN
AS BEING BAD WE THINK OF THEM AS
BEING INHERENTLY PROBLEMATIC WE
WE COME UP WITH SOLUTIONS THAT
ARE RESPONSIVE TO THE FRAME THAT
WE COME UP WHAT WE THINK ABOUT
CHILDREN BEING TRAUMATIZED.
WE THINK ABOUT THEIR BEHAVIOR AS
A WAY TO RESTORE SAFETY WE SEE
IT DIFFERENTLY AND WE RESPOND
DIFFERENTLY
IF WE REALLY NEED TO THINK ABOUT
HOW WE CAN INSTITUTIONALIZE
TRAINING FOR ADMINISTRATORS FOR
TEACHERS AND FOR STAFF ON
ADVERSE CHILDHOOD EXPERIENCES AN
ADVERSE COMMUNITY EXPERIENCES.
AND SO THERE ARE ORGANIZATIONS
THAT ARE ALREADY DOING A LOT OF
THIS WORK FEATURES WITH PILOT
WITH WITHOUT VIOLENCE HAVE BEEN
MENTIONED.
ACES CONNECTION OF THE NUMBER
ONE THEIR LOCAL CHAPTERS
THROUGHOUT THE STATE THEY'RE
DOING SOME OF THIS WORK AND THE
TRAINING NEEDS TO BE FOCUSED ON
INDIVIDUAL AND COMMUNITY TRAUMA
INCLUDING RACISM VIEWS ARE ALL
WORKING TOGETHER. AS A CSUS.
AND SO ONE OF THE THINGS I JUST
WANTED TO TALK ABOUT BRIEFLY OR
SOME OF WHAT THOSE CONCRETE NEXT
ABSOLUTE BOOK LIKE FOR SCHOOLS.
I'M A BIG ONE IS RESTORATIVE
DISCIPLINE HAVE ONE OF THE WAYS
IN WHICH WE OFTEN RE TRAUMATIZED
STUDENTS IS IN THE WAY IN WHICH
WE DISCIPLINE THEM FOR THE
BEHAVIORS THAT ARE ACTUALLY
SYMPTOMS OF TRAUMA.
AND SO WE NEED TO BEGIN TO
REALLY TO RETHINK RESTORE WRIST
RETHINK OUR DISCIPLINE AND MAKE
IT RESTORATIVE AND THIS IS MODEL
THE DESIRED BEHAVIOR REPAIRING
HARM. TEACHING LESSONS HAVING
PROPORTIONAL AND RESPONSIVE.
DISCIPLINE FOR FOR BEHAVIOR
THINK BEHAVIORS BETTER
INAPPROPRIATE HAVE TO BE
ADDRESSED BUT THEY DON'T HAVE TO
BE ADDRESSED IN A WAY THAT'S
DRAMATIC.
IN THE CAN BE MUTUALLY AGREED
UPON SO THERE'S SORT OF THIS
CONTINUUM OF PUNITIVE TO
PERMISSIVE AND IT OFTEN.
CIRCUMVENTS THE RESTORATIVE BUT
WE REALLY NEED TO FOCUS ON THE
UPPER RIGHT QUADRANT EVERYTHING
ABOUT BEING RESTORATIVE. THE
NEXT IN THIS IS BEEN IMPORTANT
IS MENTORSHIPS TO RESTORE SAFETY
AHMED SO. AT MAKING SURE THAT WE
HAVE THOSE WITHIN SCHOOLS THIS
IS ESPECIALLY IMPORTANT FOR
STUDENTS WHO MAY BE IN FOSTER
CARE OR ME.
HAVE TRANSIENT LIVING
SITUATIONS WHERE A LOT OF THEIR
COMMUNITY
CONSTANTLY SHIFTING
AND SO HAVING AN ESTABLISHMENT
OR HAVING SOMEONE YOU CAN CALL
WHEN THAT CHILD IS HAVING A BAD
DAY. AND BE ABLE TO HAVE BEEN
RESTORED SAFETY OF INCREDIBLY
IMPORTANT.
AND THEN THE OTHER ONE THAT'S
BEEN MENTIONED I REALLY THINK
THE PANELISTS FOR FOR BRINGING
THAT UP IS HAVING RESOURCES TO
MEET BASIC NEEDS WE KNOW THERE'S
FOOD INSECURITY WHEN WE KNOW WE
HAVE A HIGH.
HOMELESSNESS AND ISSUE IN THE
STATE WE NEED TO MAKE SURE THAT
WE'RE RESPONSIVE TO THAT IN OUR
SCHOOLS AND OUR SCHOOLS ARE
RESOURCE TO BE ABLE TO HANDLE
BACK BECAUSE THAT'S WHERE IT'S
GOING TO SHOW UP. AND OFTEN IN
OUR YOUNGEST KID THAT HAS
BEEN-MENTIONED THAT'S WHERE SOME
OF
THE SYMPTOMS ARE GOING ON TO BE
DISPLAYED IN WAYS THAT WE MAY
NOT UNDERSTAND OR MAY NOT
IMMEDIATELY RECOGNIZE AS BEING
LINKED TO TRAUMA BECAUSE OF THE
THINGS THAT WE THINK ABOUT. AS
BEING TRAUMA SYMPTOMS.
AND THEN MEMBER THREE AND THIS
IS REALLY IMPORTANT IS HOW WE
RESPOND TO OUR PREVENT COMMUNITY
TRAUMA.
AND SO. AS PUBLIC OF ADVOCATES
WE HAVE BEEN A.
A PROGRAM CALLED THE HEALTHY
EATING ACTIVE LIVING CITIES
CAMPAIGN AND IT'S IN A HUNDRED
NINETY CITIES IN CALIFORNIA.
AND IT FOCUSES ON HEALTHY
EATING AND ACTIVE LIVING BUT WE
THINK THAT THERE IS AN
OPPORTUNITY TO EXPAND THIS
MODEL.
AND AND TO BE ABLE TO ALSO
FOCUS ON TRAUMA AND ONE OF THE
THINGS THAT WE SEE WHEN THERE
ARE TRAUMAS THAT HAPPEN AT THE
COMMUNITY LEVEL IS THAT THE CITY
LEADERSHIP NEEDS TRAINING ON HOW
TO HOW TO APPROPRIATELY RESPOND.
BUT YOU ALSO NEED TO MERGE THE
MENTAL HEALTH RESPONSE WE HAVE
ALL THESE EMERGENCY RESPONSE
TEAMS THAT ARE DIVIDE TO RESPOND
TO YOU KNOW HURRICANES AND
EARTHQUAKES AND ALL THAT THAT
THE THINGS BUT WHEN THERE'S A
TRAUMA IN THE COMMUNITY WE
NEEDED EMERGENCY RESPONSE TEAM
THAT'S GOING TO RESPOND. TO THAT
AS WELL AND BE ABLE TO REACH OUT
TO PEOPLE WHO ARE HURTING AGAIN
ADDRESS THAT AT THE CENTER AND
WHAT RICOCHETS OUTWARD FROM.
WE NEED COMMUNITY HEALING
EVENTS RIGHT HERE IN SACRAMENTO
ACTION ON FRIDAY THERE WITH THE
COMMUNITY HEALING OF BAD THAT
WAS SPONSORED IN THE WITH IN
RESPONSE TO THE STEFAN CLARK
CLARK SHOOTING AND THAT WAS DONE
BY SOUTH SACRAMENTO CHRISTIAN
CENTER AND. THAT IS SACRAMENTO
KINGS ORGANIZATION AND SEVERAL
OTHERS BUT THAT SHOULD BE LEFT
UP TO GOOD AND YOU KNOW WELL
MEANING CITIZENS THAT SHOULD BE
SOMETHING THAT'S
INSTITUTIONALIZED AS PART OF
THAT WAS.
AND SO THAT THAT GOES ALONG TO
THE RESPONSE PROTOCOLS OF HOW DO
WE
FRAME THE ISSUES HOW DO WE MAKE
SURE WE ADDRESS THEM IN AN
APPROPRIATE WAY THAT DOESN'T
TRAUMATIZE.
COMMUNITIES IN THE AFTERMATH OF.
SOME OF THE THINGS THAT ARE
HAPPENING IN OUR COMMUNITY
AND THEN WE ALSO NEED TO FOCUS
ON RESILIENCE AND SO MANY OF THE
PANELISTS WHO COME BEFORE ME
HAVE TALKED ABOUT. THE ASUS
SERVIAN HOW IT HAS THESE TEN
QUESTIONS ON IT THAT MEASURE
ABUSE NEGLECT AND HOUSEHOLD
DYSFUNCTION BUT WHAT WE HAVEN'T
TALKED ABOUT IS THERE'S ALSO A A
RESILIENT SURVEY THAT TALKS
ABOUT SOME OF THE THINGS SOME OF
THE REASONS WHY WE DO THESE
TRAINING. THERE'S ALWAYS
SOMEBODY WHO INEVITABLY COMES UP
TO YOU AFTER THAT THAT I WAS
REALLY WORRIED WHEN YOU TALKED
ABOUT ALL YOU KNOW THAT PEOPLE
WHO HAVE.
ACES ARE A THOUSAND TIMES MORE
LIKELY TO PASS THEM ON TO THEIR
CHILDREN AND THAT YOU KNOW THEY
THAT THERE'S THIS INCREASE IN
HEART DISEASE AND DIABETES AND
SMOKING AND ALL THESE THINGS.
AND THEN I REALIZED THAT MY
RESILIENT SCORE WAS FOURTEEN AT
FOURTEEN AND THAT'S WHY I'M HERE
TODAY AND HAVEN'T EXPERIENCED
SOME OF THE THINGS THAT'S WHY I
MADE MY BRAIN HAD SOME
PLASTICITY AND WAS ABLE TO DO SO
MADERA PRUNING IN THE RIGHT WAY
FOR THE GRAIN RIGHT MATTER. TO
BE ABLE TO ALLOW ME TO COPE WITH
TO ADAPT I HAD PEOPLE IN MY LIFE
WHO BELIEVED IN ME MY COMMUNITY
HAD GOAL THERE ALL OF THE THINGS
THAT WERE HAPPENING THAT WERE
RESILIENT. IF WE NEED TO THINK
ABOUT HOW DO WE THEN EXPAND
THOSE FROM INDIVIDUAL RESILIENCE
FACTORS TO BEING COMMUNITY
RESILIENCE FACTORS AND SO WE ARE
PROGRAMS LIKE THE ADVANCE PEACE
PROGRAM WHICH OF THE DRESSING
COMMUNITY VIOLENCE.
WE NEED TO THINK ABOUT HOW DO WE
EXPAND THOSE WE HAVE ECONOMIC
DEVELOPMENT PROJECTS SO IF WE'RE
THINKING ABOUT YOU KNOW
COMMUNITIES THAT ARE
EXPERIENCING HOMELESSNESS
COMMUNITIES THAT THAT ARE
EXPERIENCING HIGH LEVELS. OF
UNEMPLOYMENT WE NEED TO GO HOW
DO THEY DO WE ADDRESS THOSE AND
NOT THINK ABOUT IT JUST FROM THE
PERSPECTIVE OF YOU KNOW THE
TYPICAL OUTCOMES BUT HOW THEN
DOES THAT ALSO AFFECT THE
RESILIENCE WHEN THERE IS A
COMMUNITY TRAUMA. WE NEED TO
THINK BY INFRASTRUCTURE PROJECTS
IN THE SAME WAY AND HOW THAT
ALLOWS COMMUNITIES TO CONNECT IT
TO BE MOBILE AND THEN HOW THAT
ALSO ALLOWS US TO BE ABLE TO
HAVE THAT CONNECTION WITHIN THE
COMMUNITY. AND MAKING SURE THE
COMMUNITIES ARE ENGAGED IN
PRIORITY SETTING ONE OF THE
THINGS ABOUT INTO RESTORING
SAFETY IS THAT MANY TIMES THE
PEOPLE HAVE BEEN TRAUMATIZED
THEY FEEL LIKE THE TROUBLE WITH
OUT OF THEIR CONTROL. AND SO
WHEN EVERYTHING ELSE WHEN THE
COMPANIES COMMUNITY TRAUMA THEM
THAT'S ALSO OUT OF THEIR CONTROL
THERE'S THE SENSE OF
HOPELESSNESS THAT BACK NAM TAKES
HOLD AND SO REALLY MAKING SURE
THAT EVEN IN THE WAY IN WHICH WE
ENGAGE IN SETTING POLICY
PRIORITIES. IS COMMUNITY BASED
IN IS INCLUDING PEOPLE SO THAT
WERE NOT TRAUMATIZING THEM IN
THAT WAY AND THEN OF COURSE
MAKING SURE THAT OUR SAFETY
POLICY THERE AGAIN NOT
DRAMATIZING.
AND SO IF YOU THINK ABOUT THAT
WHEN.
YOU KNOW I'D SHOW THEM EXAMPLES
HERE OF SOME OF THE COMMUNITY
TRAUMAS OF HAVING INTERIOR
ENFORCEMENT FOR AYE EASE OF A
YOU KNOW SCHOOL SHOOTINGS ONE OF
THE GOOD ONE EXAMPLE THE BAT IS.
A SAFETY PROTOCOL FOR THE SCHOOL
SHOOTINGS IS TO DO THESE DRILLS
THAT WE HAVEN'T THOUGHT ABOUT
HOW DOING SAFETY DRILLS FOR
SCHOOL SHOOTINGS DRAMATIZES MANY
CHILDREN.
AND SO WE REALLY NEED TO THINK
ABOUT WHAT WE'RE DOING IN TERMS
OF HOW DO WE BALANCE THE NEED
FOR PREPARATION WITH ALSO THE
NEED FOR SAFETY.
THANK YOU SO.
ALLOW MY OTHER PANEL.
RIGHT.
YOU VERY MUCH
WELL SHE KINDA GIVE MY SPEECH.
BUT THAT'S OKAY THOUGH THAT
THAT'S A GOOD DREAM THERE'S A
LOT OF AGREEMENT AS A LOT OF
HEADS NODDING I KIND OF FELT
LIKE I COULD CHECK OUT MY BOXES
OF.
MY NAME'S JOHN VOTERS AND THE
DIRECTOR OF GOVERNMENT RELATIONS
AT CALIFORNIANS PERCEIVED
INJUSTICE AND AYE AYE ONE
ACTUALLY JUST TAKE A HALF STEP
I APPRECIATE THE NARRATIVE ON
SAFETY BECAUSE.
THAT'S THAT'S THE PERSPECTIVE
I'M HOPING TO SHARE A LITTLE BIT
ABOUT AS WELL.
.
AND ACTUALLY YOU KNOW TEN YEARS
AGO I WAS A DEFENSE ATTORNEY.
AND.
I HAD A CLIENT COME TO ME AND
SHE I WAS REPRESENTING HER IN A
MATTER. ARE RELATED TO HER
BROTHER ACTUALLY SHE WAS BEING
EVICTED BECAUSE OF HER BROTHERS
A CRIMINAL BEHAVIOR. INCHES THAT
ACTUALLY HAVE A HAVE ASK OF YOU
AND I SAID YES YES I NEED TO
TALK TO SOMEBODY ABOUT MY SON.
AND SHOULD A SIX YEAR OLD SON
AND.
HER SIX YEAR OLD SON GOT UP ON
SATURDAY MORNING HAD HIS PAJAMAS
I GOT A BOWL OF CEREAL AND SEAN
WENT DOWN TO WATCH CARTOONS LIKE
ANY OTHER KID SHOULD DO ON A
SATURDAY MORNING.
AND HER MIND HIS MOM HAD INVITED
HER BROTHER WHO WAS RECENTLY AT
A PRISON INTO THE HOME TO STAY
BECAUSE HE HAD NO PLACE TO GO.
AND UP THE LAST THREE WEEKS
AFTER I GOT OUT OF PRISON HE HAD
BEEN GAUGING HIS OLD WAYS AND
OUR A SWAT TEAM FROM CHICAGO PD.
CAME IN AT SEVEN THIRTY IN THE
MORNING.
TO ARREST. JON'S UNCLE AND HE
WATCHED TWELVE OFFICERS TAKE HIS
OWN CLOUT HAIRCUTS HE CAN
UNDERSTAND SINGLE THING OF IT.
AND MONDAY MORNING HE WENT TO
SCHOOL. ANNA SCHOOL RESOURCE
OFFICER PSALM IN THE HALLWAY AND
SAID. DO YOU HAVE YOUR LUNCH
MONEY.
PROBABLY BECAUSE HE WAS GOING TO
OFFER HIM MONEY IF YOU DON'T
HAVE IT.
THE WEB ITSELF
IN THE HALLWAY.
AND SO THE IMPACT THAT THE
CRIMINAL JUSTICE SYSTEM.
HAS ON ACES IS ACTUALLY
SOMETHING THAT I'M GONNA TRY TO
NARROW MY CONVERSATION DOWN TO
BECAUSE I'M GONNA BE EXTREMELY
REPETITIVE OTHERWISE OF ALL THE
GOOD PEOPLE BEFORE ME.
BUT CALIFORNIANS RECEIVED
INJUSTICE IS A CRIMINAL JUSTICE
REFORM ORGANIZATION THAT'S
FOCUSED ON LIFTING UP THE VOICES
OF CRIME SURVIVORS THAT INCLUDES
CHILDREN WHO EXPERIENCE TRAUMA.
AND WE HAVE BEEN.
LEADERS HERE IN CALIFORNIA ON
THE ISSUE OF ACES IN THE PUBLIC
SAFETY SPACE FOR AWHILE NOW.
WE WORKED ON PROP FORTY SEVEN
IN ORDER TO HELP MAKE TEN
PERCENT OF THE STATE SAVINGS
FROM PROP FORTY SEVEN AVAILABLE
TO TRAUMA SURVIVORS IN TRAUMA
RECOVERY CENTERS.
I'M WE HELP PASS A DOCTOR WEBER
IS BILL TO CREATE THE STATEWIDE
STANDARDS FOR TRAUMA RECOVERY
CENTERS.
WE WORKED WITH THE CHAIR HERE
LAST YEAR ON AB THREE FORTY
WHICH I'M WILL INCREASE
SCREENINGS FOR KIDS WHO
EXPERIENCED TRAUMA AND MEDICAL
PROGRAMS. TO MAKE SURE THAT ALL
KIDS HAVE ACCESS TO EARLY.
IDENTIFICATION OF TRAUMA.
AND WE HAVE BEEN FOLLOWING THAT
PIPELINE BACK FROM THE PRISON TO
FIGURE OUT WHY DO WE HAVE SO
MANY FOSTER INVOLVED YOUTH WIDE
WE HAVE SO MANY CHILDREN FROM
MINORITY LOW INCOME.
YOU NO DISADVANTAGED COMMUNITIES
IN PRISON WHY ARE SO MANY WOMEN
WHO ARE IN PRISON IN CALIFORNIA
THESE DAYS VICTIMS OF SEXUAL AND
VIOLENT ABUSE IN THEIR CHILDHOOD
AND ADOLESCENCE.
AND THE REALITIES THAT.
A LOT OF THE THINGS WE FOUND
CAN BE DEALT WITH IN A PLACE
THAT WOULDN'T THINK WE'D FIND IT
PROBABLY THE SCHOOL.
AND SO OUR INTEREST IN THIS
HEARING WE'RE GRATEFUL TO THE
CHAIRS FOR CONVENING IT IS THAT
WE ACTUALLY THINK THE SCHOOL
PROVIDES ONE OF THE NEXT STEPS
BEYOND FROM RECOVERY CENTERS FOR
ADULTS AND. HEALTH SCREENINGS
FOR KIDS THAT THE SCHOOLS
ACTUALLY A TOTALLY ADEQUATE
PLACE AN APPROPRIATE PLACE.
A PLACE WHERE CHILDREN SPEND
MOST OF THEIR DAY WHEN THEY'RE
NOT AT HOME.
TO ACTUALLY SCREEN IDENTIFYING
TREAT CHILDREN FOR TRAUMAS.
A LARGE NUMBER OF TRAUMA
SURVIVORS AS I MENTIONED ARE ALL
JUSTICE INVOLVED IN AS WE LIKE
TO SAY I'M HURT PEOPLE.
HURT PEOPLE.
AND SO IF WE ARE GOING TO LOOK
SERIOUSLY AT HOW WE TREAT TRAUMA
IN KIDS.
IT WITH WE ARE REALLY SERIOUS
ABOUT PUBLIC SAFETY
AND I APPRECIATE THE SAFETY
NARRATIVE BEING KICKED OFF AHEAD
OF ME. OUT IF WE IF WE REALLY
ARE SERIOUS ABOUT SAFETY WE HAVE
TO LOOK AT THE CYCLE OF VIOLENCE
AND REALIZE IT'S.
IT'S ACTUALLY BUILT OFF OF THOSE
NEUROLOGICAL MECHANISMS DOCTOR.
NADINE SPOKE ABOUT EARLIER
RELATED TO THAT FIGHT OR FLIGHT
INSTINCT.
ITS OF IMPLICATIONS TODAY ARE
SERIOUS A CHILD WHO IS A VICTIM
OF TRAUMA.
THE GOES UNDETECTED IN UNTREATED
IS LABELED TRUANT TODAY THEIR
LABEL ANTISOCIAL MAXED.
THEN THERE ARE DELINQUENT
THEN THE SCHOOL DECIDES THAT
THEY SHOULD BE.
DISCIPLINED AND WITHHELD FROM
RECESS
THAT BECOMES A SUSPENSION.
THEN THAT'S AN EXPULSION WHEN
THEY TURN EIGHTEEN WE SEE
DIFFERENT THINGS WE CALL THEM A
CRIMINAL WE CALL THEM A FELON.
WE CALL THEM A RECIDIVIST.
IN CALIFORNIA THERE FORTY EIGHT
THOUSAND.
CIVIL STATUTE PENALTIES THAT
PROHIBIT A PERSON WITH A
CRIMINAL RECORD FROM ENGAGING IN
NORMAL DAILY ACTIVITY.
YOU CAN'T BECOME A BARBER IN
CALIFORNIA IF YOU HAVE A
CRIMINAL RECORD YOU CAN'T BECOME
A COSMETOLOGIST.
YOU CAN'T BE A NURSE YOU CAN'T
CARE FOR IT AS A BEEN ADOPTED
PARENT FOR ONE OF YOUR. YOUR
YOUR NIECES OR NEPHEWS IF THE
PARENTAL.
HEAD OF HOUSEHOLD DIES OR IS
OTHERWISE INCARCERATED WE HAVE
CREATED A SYSTEM WHERE HURT
PEOPLE WILL HURT PEOPLE.
AND SO WE BELIEVE THAT THERE
ARE A NUMBER OF VERY GOOD
OPPORTUNITIES FOR INTERVENTION
AND WE'D BE VERY HAPPY TO SPEAK
WITH MEMBERS OF THIS COMMITTEE
FURTHER ABOUT THOSE
OPPORTUNITIES. A LOT OF THEM
HAVE BEEN SAID ALREADY.
BUT ONE OF THE ONES THAT WE
WANT TO SEE HAPPEN IS WE WANT TO
BREAK THE INTERGENERATIONAL
NATURE OF.
TRAUMA AMONG CHILDREN IN THE
BEST WAY TO DO THAT IS EARLY I
MEAN DOCTOR ETIENNE'S FIRST
SLIDE WAS THE BEST SLIDE OF THE
DAY. YOU KNOW A THREE YEAR OLD
CHILD WHOSE GROWTH TRAJECTORY IS
ALTERED.
BY HAVING ACES AT THE AGE OF
THREE. AND SO HOW DO WE DO THAT
IN THE SCHOOLS WILL BE FOR A LOT
OF GOOD INFORMATION ABOUT.
THAT YOU KNOW THE STATE IS SILO
DIDN'T STRUCTURE THAT'S VERY
TRUE AND NOT YOU KNOW MEMBER
MATHIS WAS SPEAKING EARLIER
ABOUT HAVING TO.
IDENTIFYING WORK WITH A WHOLE
TON OF DIFFERENT PEOPLE AND I
THINK.
ONE OF THOSE THINGS THAT YOU
KNOW THE TRUMP RECOVERY CENTER
MODELED DOES.
THERE'S A POINT PERSON EVERY
TIME YOU COMMAND IF YOU'RE CRIME
SURVIVOR EVERYTIME YOU COME IN
THE SAME PERSON.
WHO WHO MET YOU THE FIRST DAYS
THE PERSON WHO MEETS YOU
EVERYTIME YOU COMMAND YOU TO
COMPLEMENT OF STAFF TO ASSIST
YOU WITH YOUR NEEDS AS YOU GO
THROUGH? COUNSELING OR THERAPY
ON BUT YOU HAVE A SINGLE SOURCE.
FOR CONTACT TO YOUR WHOLE PERSON
CARE.
AND IN THE SCHOOL SETTING THE
SCHOOL REALLY ACTUALLY SERVES
ALMOST AS ITS OWN LITTLE.
.
IT'S ALMOST LIKE THE WHITE BLOOD
CELL OPPORTUNITIES LIKE THE
SCHOOL ITSELF THE CHILDREN ARE
THE WHITE BLOOD CELLS.
AND IF YOU ACTUALLY CREATE A
SYSTEM SIMILAR TO WHAT THE SAN
FRANCISCO. ARMED UCSF HEARTS
SYSTEM DOES RIGHT SO THEY HAVE
THEY HAVE A MODEL. ON IN SAN
FRANCISCO RIGHT NOW WHERE
THEY'RE UP THERE. SEVEN TO TEN
SCHOOLS THAT THEY'RE SERVING ON
WHERE THEY ACTUALLY GO IN AND
THEY CREATE ENTIRE RESILIENCY IN
THE SCHOOL SO THEY'VE.
ADMINISTRATORS TEACHERS STAFF
AND THE STUDENTS ARE ALL TRAINED
IN TRAUMA INFORMED PRACTICES AND
SO THEY ALL ACT IN THE THAT BEN
BODIES RESTORATIVE JUSTICE
THINGS THAT WE WANT TO SEE
HAPPEN IN THE COMMUNITIES.
BECAUSE WHEN ONE CHILD HURTS
ANOTHER CHILD RIGHT THAT THE
CHART THE CHILDREN OUR POSITION
TO LEARN HOW TO FORGIVE ONE
ANOTHER LEARN HOW TO REPAIR
RELATIONSHIPS HOW TO MAKE THAT
COMMUNITY HOLE AGAIN. BUT WHEN
CHILDREN EXPERIENCE ACES
ELSEWHERE IN THE COMMUNITY AND
BRING THEM TO SCHOOL WE CAN
ACTUALLY HAVE TEACHERS WHO
UNDERSTAND. AND TRACK ARE AND
ARE TRAINED IN PROFESSIONALS WHO
ARE TRAINED TO BE PART OF A
SUPPORT SYSTEM THAT KEEPS THAT
CHILD IN SCHOOL EVERY MINUTE AND
EVERY DAY THAT A CHILD REMAINS
IN SCHOOL. IS A GREAT CREATES A
GREATER LIKELIHOOD THAT THEY
WILL SUCCEED EDUCATIONALLY AND
EMPLOYMENT OPPORTUNITIES IT
SIGNIFICANTLY DECREASES THE
LIKELIHOOD THAT THEY WILL BE. A
FUTURE VICTIM OF THE CRIMINAL
JUSTICE SYSTEMS PROCESS
AND SO.
I'M GONNA CUT LEAVE IT AT THAT
AT A HIGH LEVEL I COULD GO INTO
ALL THE DETAILS OF HOW THE MODEL
WORKS IN AND WHERE THE SUPPORTS
ARE AT A BASE A LARGE MAJORITY
OF THE TIME SPENT ON BUILDING.
UNDERSTANDING OF TROM INFORMED
PRACTICES AND RESILIENCY AMONG
STUDENTS AT A HIGHER LEVEL YOU
ACTUALLY GET DOWN TO THE HANDFUL
OF STUDENTS WHO REALLY NEED
INTENSIVE. TRAUMA INFORMED
THERAPIES ON THINGS THAT ARE
AKIN TO IEP KIND OF KIND OF
STUFF ON AND AND THAT THE MODEL
REALLY ACCOMMODATES ALL THOSE
THINGS BUT YOU CAN'T REALLY
SERVE KIDS INDIVIDUALLY. WITH
COUNSELING ONE ON ONE AND SEND
THEM TO SCHOOL WHERE THE
TEACHERS THESE AND SHOWING UP
LATE AND JUST THINGS BELIEVES
ABSENT A BILL IS TRUANT. OR
BELIEVES IS ACTING OUT IN CLASS
WHEN THE TRUTH IS BILLY DIDN'T
WANT TO COME TO SCHOOL TODAY
BECAUSE HIS MOM HAD A NEGATIVE
INTERACTION WITH A NEIGHBOR WHO
THREATENED TO CALL THE POLICE
AND HAVE REMOVED BY ICE. AND
HE'S AFRAID TO GO TO SCHOOL
BECAUSE HE'S AFRAID HE'LL COME
HOME HIS MOM WON'T BE THERE.
AND SO THOSE ARE THE KINDS OF
THINGS THAT TEACHERS.
TEACHERS AND STAFF
ADMINISTRATORS IN SCHOOLS ARM
CAN'T CAN'T DEAL WITH ALL THOSE
THINGS AND TEACHERS HAVE THEIR
OWN DRAMAS THAT THEY EXPERIENCE
SECOND HAND RIGHT TEACHERS.
TEACHERS EXPRESS THAT ALL THE
TIME AND AND WE REALLY CAN
CREATE GREATER COMMUNITY
RESILIENCY COST EFFECTIVELY ARE
SMART JUSTICE STRATEGY EMPLOYEES
A PROCESS WHERE WE REALLY
BELIEVE THAT WE CAN LEVERAGE THE
EXISTING. SCHOOL SYSTEM AND THE
EXISTING SCHOOL PARTNERS TO MAKE
OUR COMMUNITIES SAFER FOR KIDS
WE JUST HAVE TO CHOOSE TO GO IN
THAT DIRECTION.
THANK YOU VERY MUCH
NOT THE APPOINTMENT.
THANK YOU MISTER CHAIRMAN MISTER
CHAIR PRE SHEET THE OPPORTUNITY
TO TESTIFY AT WHAT I WOULD ARGUE
IS ONE OF THE MOST IMPORTANT
TOPICS. THE LEGISLATURE SHOULD
CONSIDER.
I'M THE EXECUTIVE DIRECTOR THE
COUNTY WELFARE DIRECTORS
ASSOCIATION AND I'M GONNA SPEAK.
SORT OF FROM THE STANDPOINT OF
THE CHILD WELFARE SERVICES
SYSTEM.
NAM MOSTLY.
RON.
MY MEMBERS ADMINISTER THE CHILD
WELFARE SERVICES IMPOSTER CARE
SYSTEMS.
AND THE SYSTEM IN WHICH.
CHILDREN ARE FAR MORE LIKELY TO
HAVE SUFFERED MULTIPLE ACES AND
THEIR LIVES.
IF YOU THINK ABOUT IT EVERY
CHILD IN THE CHILD WELFARE
SYSTEM HAS AT LEAST TWO ADVERSE
CHILDHOOD EXPERIENCES. THE ABUSE
AND NEGLECT.
THAT LEAD TO THE REMOVAL AND
THE REMOVAL ITSELF WHICH
RESEARCH SHOWS IS. AS DRAMATIC
AS THE UNDERLYING ABUSE THAT'S
NOT TO SAY THEY SHOULDN'T BE
REMOVED BUT IT IS TO SAY THAT WE
HAVE TO.
ACKNOWLEDGE THAT IT IS IN AND
OF ITSELF DRAMATIC
SO EVERY KID IN OUR SYSTEM. HAS
AT LEAST TWO ACES THE REALITY IS
THOUGH THAT MANY OF THE CHILDREN
OUR SYSTEMS HAVE MORE THAN TWO
BECAUSE THE CONSTELLATION. OF.
OF ADVERSE CHILDHOOD
EXPERIENCES.
FAMILY VIOLENCE MENTAL HEALTH
ISSUES SUBSTANCE ABUSE ISSUES
EXTREME POVERTY THAT
CONSTELLATION OF ISSUES IN
REALITY MEANS THAT MOST KIDS IN
THE CHILD WELFARE SYSTEM HAVE
MANY ACES. AND ARE AT THE POINT
WHERE THE RESEARCH INDICATES
ARM.
ARE ARE ARE LIKELY TO SUFFER A
MOON SIGNIFICANTLY DIMINISHED
LIFE OPPORTUNITIES AND WORSE. ON
HEALTH AND WELL BEING OUTCOMES.
COM.
FROM OUR VANTAGE POINT WE SEE
EVERY DAY THE RESULTS OF ALL THE
RESEARCHERS HAVE TALKED ABOUT.
TOM.
CHILDREN IN OUR SYSTEM ARE MUCH
MORE LIKELY TO HAVE PTSD AND
MENTAL HEALTH ISSUES
BOB THERE ARE FAR MORE LIKELY TO
HAVE A LOT SENSE OF SAFETY
SECURITY AND TRUST.
BIG DEAL TERRIBLE SHAME OFTEN
WONDERING WHY WHAT DID I DO TO
DESERVE ALL THIS.
DIFFICULTY BONDING AND.
WE SEE EVERY DAY THAT THE REAL
MANIFESTATION OF THE TOXIC
STRESS AFFECTS ON THE FIGHTER
FLIGHT A MECHANISM IN THE BRAIN.
WE SEE KIDS THAT ARE EXTREMELY
DISASSOCIATED.
BOMB THE FLIGHT.
OR.
AGGRESSIVE
THE FIGHT
BOB THAT OFTEN RESULTS IN
SERVING ON AN OVERWHELMING
SITUATION FOR CAREGIVERS ARM WHO
OFTEN ON HAD DIFFICULTY.
SORT OF MANAGING.
KIDS WHO HAD SO MUCH UNTREATED
PRIOR TRAUMA.
MOST OF THE KIDS THAT WE SEE IN
OUR SYSTEMS HAVE CONTACT WITH
OTHER SYSTEMS BEFORE CHILD
WELFARE. UMP WHETHER IT'S HEALTH
SCHOOLS BEHAVIORAL HEALTH OTHER
SOCIAL SERVICES AGENCIES
SOME DON'T SOME WHEAT SOME OF
THE FIRST SYSTEM THAT THEY'VE
BEEN. IN CONTACT WITH BUT ONCE
THEY COME INTO OUR SYSTEM WE
BROKER SERVICES THE CHILD
WELFARE SERVICES SYSTEM DOESN'T
DELIVER HEALTH OR BEHAVIORAL
HEALTH SERVICES WE WORK WITH
PARTNER AGENCIES PUBLIC AND
NONPROFIT TO DELIVER THE
SERVICES.
SO FROM WE HAVE IT WE HAVE IT AT
A GOOD VANTAGE POINT I THINK
ARM TO COME TO THE FOLLOWING
CONCLUSION AND THAT'S DESPITE
TWO DECADES OF RESEARCH.
THAT INDICATES.
REALLY WHAT PUBLIC AND AND OTHER
SYSTEMS OUGHT TO BE DOING
THERE'S A HUGE GAP BETWEEN WHAT
THE RESEARCH ON ASUS SUGGEST
THAT OUR SYSTEM SHOULD BE DOING
AND WHAT THEY'RE ACTUALLY DOING.
AND TO BE ABLE TO FOCUS ON THAT
TO HAPPEN.
OFFER SOME SOLUTIONS IS IS A
PRIVILEGE THAT I'M THAT I'M
QUITE THANKFUL FOR.
AT.
BOTTOM LINE I THINK WE NEED AND
INTENTIONALLY COORDINATED
STRATEGY.
TO CREATE A TROM INFORM SYSTEM
WHERE EVERY TOUCH POINT IN A
CHILD'S LIFE
LOOKS AT AT A CHILD THE A LENS
THAT'S TRAUMA INFORMED.
BREAKING DOWN SILOS SHARING
INFORMATION IT'S ALL REALLY
IMPORTANT.
BUT.
BEAT BETWEEN NOW AND THEN WE
NEED TO MAKE SURE THAT EVERY
SINGLE SYSTEM IS INFORMED ABOUT
ASUS INFORMED ABOUT TRAUMA. AND
LOOKS AT CHILDREN AND IN THE
FAMILY ENVIRONMENT FROM THAT
CONTEXT.
IN THE CHILD WELFARE SERVICES
SYSTEM BY VIRTUE OF THE FACT
THAT WE SERVE ABUSED AND
NEGLECTED KIDS WE HAVE.
BEEN THINKING ABOUT IT WE HAVE
BEEN IMPLEMENTING TROM INFORMED
PRACTICES FOR FOR MANY YEARS.
ARM AND YET THERE ARE STILL
SIGNIFICANT GAPS IN OUR SYSTEM
AND I WANNA I WANNA TALK ABOUT
SOME OF THE MAJOR GAPS THAT
WE'VE WITNESSED.
IN THE CHILD WELFARE SERVICES
SYSTEM WE KNOW THAT NINETY
PERCENT OF THE PARENTS IN OUR
SYSTEM THEMSELVES EXPERIENCED
TRAUMA MANY ABUSED AND NEGLECTED
THEMSELVES MANY OTHER TRAUMATIC
EXPERIENCES IN THEIR LIVES.
BOB WE KNOW THAT PRINT OR TRAUMA
MAKES IT DIFFICULT FOR THEM TO
TO PROTECT THEIR CHILDREN AND
FOR THOSE CHILDREN TO HEAL.
BUT THE FEDERAL AND STATE CHILD
WELFARE SYSTEM IS REALLY
STRUCTURED IN A WAY. THAT WE
HAVE VERY LITTLE FLEXIBILITY TO
USE FUNDS ON PREVENTION.
SO THE VAST MAJORITY OF FUNDING
IN OUR SYSTEM BECOMES AVAILABLE
ONCE A CHILD IS REMOVED ONCE
THEY'VE ALREADY SUFFERED
MULTIPLE A SAYS. AND THAT'S AN
ISSUE THAT THAT WE HAVE TO WORK
ON.
IN THE PHYSICAL HEALTH BROWN WE
WERE HAPPY TO SUPPORT A BILL
THAT CSJ SPONSORED AB THREE
FORTY DOCTOR REGULARS BILL. THAT
REQUIRED THAT EP STT IT'S THE
MEDI CAL ENTITLEMENT FOR
CHILDREN.
WHO ARE WHO ARE ON THAT ACCOUNT?
THERE'S A REQUIRED SCREENING
BASED ON A PERIODICITY SCHEDULE.
AND EVERY TIME OPPOSITION SEES
A CHILD AN EP STT PROGRAM
THEY'RE REQUIRED TO LOOK FOR
CYCLE SOCIAL AND BEHAVIORAL
ISSUES. ARM THERE'S NO MANDATE A
REQUIREMENT THAT THAT SCREEN
THAT ALREADY REQUIRED IN IT'S AN
ENTITLEMENT FOR KIDS HAVE A
TRAUMA FOCUS IN AB THREE FORTY.
WILL TAKE CARE OF THAT I LOOK
FORWARD TO PARTICIPATING ON THE
WORKING GROUP AND I HOPE DOCTOR
HARRIS. JOINS THAT AS WELL.
AND THE BEHAVIORAL HEALTH BROWN.
EIGHTY PERCENT OF KIDS IN THE
CHILD WELFARE SYSTEM ACCORDING
TO NATIONAL STUDIES HAVE SOME
SORT AB HAD MENTAL HEALTH ISSUES
BUT ACCORDING TO NATIONAL
STUDIES ONLY ONE THIRD. ARE
GETTING MENTAL HEALTH SERVICES.
I'M IN CALIFORNIA THAT THE.
PROGRAM OF.
BEHAVIORAL HEALTH SERVICES AN
INDEPTH BEHAVIOR HEALTH SERVICES
FOR PEOPLE WITH SIGNIFICANT.
IMPAIRMENTS IS THE BOMB
SPECIALTY MENTAL HEALTH SYSTEM
WE CALL IT AND THERE'S A
PENETRATION RATE THAT WE
CALCULATE. IN CALIFORNIA THE
PENETRATION RATE THE NUMBER OF
CHILDREN IN THE FOSTER CARE
SYSTEM WHO HAVE ANY CONTACT WITH
THAT SPECIALITY MENTAL HEALTH
SYSTEM IS FORTY TWO POINT ONE
PERCENT ITS MOST RECENT DATA.
THAT INFORMATION THAT NUMBER
INCLUDES KIDS WERE ASSESSED BUT
THEN NOT.
SORT OF NOT REFER TO ANY OTHER
SERVICE.
THE STATE CALCULATE SOMETHING
CALLED THE ENGAGEMENT RATE THE
ENGAGEMENT RATE IS THE NUMBER OF
CHILDREN HAVE HAD FIVE CONTACTS
IN A YEAR AND THAT'S THIRTY ONE
POINT SEVEN PERCENT.
SO WHY THIS WHY THIS DISCONNECT
BETWEEN WHAT WE KNOW ABOUT
ADVERSE CHILDHOOD EXPERIENCES.
BOB AND THE DAMAGE IT DOES TO
KIDS AND THAT PRECEDED
BEHAVIORAL HEALTH SERVICES AND I
AT. I THINK IT'S A REALLY
IMPORTANT QUESTION.
BUT BECAUSE EP STT AS A FEDERAL
ENTITLEMENT AND IF YOU LOOK AT
THE FEDERAL LAW IT'S QUITE
BROAD.
IT'S EARLY PERIODIC DIE NOW
DIAGNOSTIC SCREENING AND
TREATMENT.
PROGRAM.
.
AND IF YOU JUST READ THE FEDERAL
LAW YOU WOULD SAY WELL THIS IS
THE ANSWER TO ISIS.
BECAUSE.
THE ELIGIBILITY IS BROUGHT TO
SERVICES THAT CAN BE PROVIDED TO
A PRETTY BROAD.
BUT IN IN ACTUALITY THE WAY THE
FEDERAL GOVERNMENT ADMINISTERS
THE PROGRAM IN THE WAY BE
ADMINISTERED IN THE STATE AND
FUND THAT IN THE STATE. ARM.
THE NOTIONS OF MEDICAL NECESSITY
AND A DIAGNOSIS FOR AN ACTUAL
MENTAL HEALTH I'M ACTUAL MENTAL
HEALTH DIAGNOSIS
SOMETHING IN THE DSM FIVE.
REALLY. IN A SIGNIFICANT WAY
CREATES THE GATE INTO.
US SPECIALTY MENTAL HEALTH
SERVICES
AND SO.
THERE THERE IS IN MY OPINION A
DISCONNECT
BETWEEN.
THIS IS THE BIG.
THIS IS NOT TO CRITICIZE
COUNTIES THIS IS THE NATIONAL
WAY THE BEHAVIORAL HEALTH
SYSTEM.
IS BEHIND
IN TERMS OF INCORPORATING THE
LEARNING FROM ASUS RESEARCH INTO
MODERNIZING ITS DIAGNOSTIC RULES
AND ITS TREATMENT RULES.
.
MANDA.
THE EAT AN EP FTT STANDS FOR
EARLY ARM.
AND YET.
MUCH OF WHAT'S PROVIDED UNDER
THAT ENTITLEMENT PROGRAM
PRACTICALLY IT DOESN'T HAPPEN
E..
THAT HAPPENS AFTER.
THE ACES WAS THE TRAUMA THAT THE
CHILD.
SUFFERS RESULTS AT SOME POINT
OR LEADS TO OUR CONTRIBUTES TO
FINALLY THE DIAGNOSIS ON AND
WE'VE LOST THAT TIME.
TO INTERVENE CELL ON TO
SOLUTIONS.
.
IDENTIFICATION IS THE KEY AND I
THINK THE NOTION OF AB THREE
FORTY SHOULD BE EXPANDED TO
OTHER SYSTEM.
WE SHOULD TAKE THE IDEA OF A
MANDATORY TRAUMA SCREEN AND TAKE
THE KEY SYSTEMS THAT INTERACT
WITH CHILDREN.
SCHOOLS.
PHYSICAL OUR HELP BEHAVIORAL
HEALTH DEE DEE. CRIMINAL JUSTICE
SYSTEMS AND REQUIRE IT.
TRAUMA INFORMED SCREEN.
.
I'D LIKE TO TAKE ISSUE WITH ONLY
ONE THING THAT ANYONE SAID TODAY
AND IT WAS DOCTOR HOW OFTEN
EXPRESSED.
HIS AMBIVALENCE OVER SCREENING
WHEN IT'S POSSIBLE THAT WE DON'T
ACTUALLY.
HAVE SOMETHING FOR THE CHILD IF
WE DO SCREEN. ARM THAT THERE IS
A SAYS.
BRADLEY'S FOR CHILDREN IN MEDI
CAL IF WE SCREEN AND IDENTIFY
THAT THERE IS A NEED.
IT IS NOT JUST.
IT IS AN ENTITLEMENT.
UNDER FEDERAL LAW THAT THEY
RECEIVE OF APPROPRIATE SERVICES
TO REMEDIATE THATNEED. IF
THEY'RE IDENTIFIED AS MEDICALLY
NECESSARY SO AT LEAST FOR THAT
AT LEAST FOR CHILDREN AND MEDI
CAL WHICH IS YOU KNOW QUITE A
FEW CHILDREN IN THE STATE. ARM
WE DO HAVE.
OPPORTUNITIES TO BE ABLE TO
TREAT.
TRAUMA THAT WE IDENTIFY.
WE HAVE TO MODERNIZE OUR
BEHAVIORAL HEALTH SYSTEM WE HAVE
TO MODERNIZE THE WAY WE.
FUNDS CHILD WELFARE SO THAT WE
CAN DO MORE PREVENTION AND WE
HAVE TO DO A SIGNIFICANTLY.
UP SIGNIFICANTLY MORE TRAINING
FOR CARE GIVERS.
THE FOR KIDS WHO'VE EXPERIENCED
THE TRAUMA OF KIDS IN THE CHILD
WELFARE SYSTEM THE WORST THING
THAT CAN HAPPEN TO THEM IS TO BE
PLACED INTO FOSTER CARE AND THEN
BE PLACED INTO ANOTHER.
HOME WHICH IS ANOTHER ACE AND
INTO ANOTHER HOME.
AND WE NEED TO STABILIZE THAT
RELATIONSHIP BETWEEN THE
CAREGIVER AND THE CHILD BECAUSE
FOR MANY CHILDREN HAVE SUFFERED
MULTIPLE A SAYS.
POSITIVE.
STRONG RELATIONSHIP WITH SOMEONE
IS IS THE MOST IMPORTANT. ASPECT
TO HEALING AND SO WE'RE WE'RE
PROUD TO AND HERE COMES THAT THE
PITCH WE'RE PROUD TO BE ONE OF
THE CO SPONSORS OF AB TWENTY
FORTY THREE. DOCTOR ARAMBULA IS
BILL THAT WOULD CREATE A TWENTY
FOUR SEVEN. URGENT RESPONSE
SYSTEM SO IF YOU'RE A FOSTER
PARENT.
OR FOSTER CHILD AND THERE'S AN
EMOTIONAL ISSUE THERE'S A
BEHAVIORAL ISSUE THERE SOME
CRISIS THAT HAPPENS.
LARGELY TRIGGERED BY TRAUMA
THAT.
THAT PERSON CAN CALL A HOTLINE
BAKER HAD SOMEONE TRY TO ADDRESS
THE ISSUE THERE CAN BE IT IN
PERSON URGENT RESPONSE.
STABILIZE THAT SITUATION SO THE
CHILD ISN'T MOVED TO A DIFFERENT
PLACEMENT. THE FOSTER PARENT
ISN'T CALLING LAW ENFORCEMENT
AND YOU AND YOUR STRENGTHENING
THAT THAT BOND BECAUSE AT THE
LEAST WE CAN DO IS NOT RE
TRAUMATIZE KIDS ARE IN OUR
SYSTEM. AND I THINK THAT THAT
IT'S INCREDIBLY PARTNER.
AND THEN FINALLY WE CAN'T
FORGET POVERTY MIGHT MIGHT
MEMBERS ALSO ADMINISTER THE CAL
WORKS PROGRAM AND IN THE CALPERS
PROGRAM. AND WE KNOW KIDS IN
VERY DEEP POVERTY SUFFER THE
WORST TOXIC STRESS THEIR LIFE
PROSPECTS ARE THE MOST
DIMINISHED CLOSELY BY THE
RESEARCH. AND THERE'S
LEGISLATION BY SENATOR MITCHELL
TO ENHANCE CAL WORKS GRANT SO
THAT NO CHILD IN THE STATE LIVES
IN VERY DEEP POVERTY ME NEXT WE
HAVE DONNA STEERING HER.
THANK YOU I APPRECIATE THE
OPPORTUNITY TO BE HERE AND WITH
MY COLLEAGUES TALKING ABOUT
SOMETHING THAT I AGREE. IS
INCREDIBLY IMPORTANT TO THE
FUTURE OF OUR STATE I'M MY
NAME'S DONNA SNARE DRUM THE
DIRECTOR OF GOVERNMENT RELATIONS
FOR THE CHILD CARE RESOURCE
CENTER AND I'VE WORKED IN EARLY
CHILDHOOD DEVELOPMENT CHILD CARE
AND. CHILD POVERTY ISSUES IN
CALIFORNIA FOR MY WHOLE
PROFESSIONAL CAREER SO. I'M I'M
NOT GONNA GIVE YOU ALL MY STORY
HIS. OF THE CHILDCARE RESOURCE
CENTER ACTUALLY IS A COMMUNITY
BASED NONPROFIT ORGANIZATION AND
WE SERVE NORTH LOS ANGELES AND
SAN BERNARDINO COUNTY. AND WE
REALLY STARTED OFF IN NINETEEN
SEVENTY SIX AS A CHILD CARE
AGENCY.
I WORKING WITH FAMILIES TO HELP
THEM FIND CHILDCARE SO THEY
COULD GO TO WORK WHILE THEIR
PARENTS WHILE THEIR CHILDREN
WERE LEARNING. AND OVER THE
YEARS WE HAVE EXPANDED AND
CHANGED OUR SERVICES BECAUSE OF
THE NEEDS THAT WE'VE BEEN SEEING
IN OUR COMMUNITY. AND I WILL SAY
WATCHING THE STATISTICAL CHANGES
THAT I SAW ON THE PRESENTATIONS
EARLIER TODAY I'M NOT ALL
SURPRISED THAT WE'VE HAD TO MAKE
SOME OF THE SHIPS THAT WE HAVE.
ON EACH YEAR WE SERVE ABOUT
TWENTY ONE THOUSAND FAMILIES WHO
HAVE THIRTY TWO THOUSAND
CHILDREN AND THEY'RE ALL LOW
INCOME.
AND.
BECAUSE OF OUR RELATIONSHIPS
WITH THEM WE HAVE REALLY HAD THE
OPPORTUNITY TO SEE THE IMPACTS
OF TOXIC STRESS AND POVERTY UP
CLOSE.
I WE WE DID SOME WORK WITH THE
UNIVERSITY OF SOUTHERN
CALIFORNIA AND THEIR CHILDREN'S
DATA NETWORK. I'M TO ACTUALLY
TRY TO DO SOME DATA MATCHING AND
SHARING. AND I HAVE WHAT WE
FOUND WAS.
THIRTY PERCENT OF THE CHILDREN
IN OUR CHILDCARE SUBSIDY AND
HEAD START SYSTEM WERE KNOWN TO
CHILD WELFARE.
SO WHAT THAT MEANT TO US WAS
THERE IS THIS OVERLAP THERE IS
NO IMAGINARY WALL AND ALL OF THE
ISSUES THAT CHILDREN ARE FACE
SAYING ARE ISSUES THAT ARE IN
ARE SUBSIDIZED CHILDCARE
PROGRAMS AND BECAUSE OF THAT.
WE REALLY HAVE TRIED TO EXPAND
OUR REACH AND LOOK AT HOW WE CAN
BE BETTER PARTNERS WITH THE
FOSTER CARE SYSTEM WITH MENTAL
HEALTH. AND HOW WE CAN BROADEN
THE SERVICES THAT WE PROVIDE TO
BE A BETTER SUPPORT TO FAMILIES.
I'M AS WAS STATED IN THE
PRESENTATIONS THIS MORNING VERY
YOUNG CHILDREN GETTING BACK TO
BACK TO BASICS BACK TO THE
BABIES.
BIRTH THROUGH THREE THE MOST
RAPID PERIOD OF BRAIN
DEVELOPMENT.
THEY CAN BENEFIT FROM TYPES OF
POSITIVE SUPPORTS THAT COME FROM
SEPARATE STABILIZING FAMILY
INCOME AND OVERALL COMMUNITY
SUPPORTS. AND ACCESS TO HIGH
QUALITY CHILDCARE OPTIONS NEEDS
TO BE CONSIDERED AS PART OF
THIS.
I'M DOCTOR THOMPSON WHO SPOKE
EARLIER TODAY INCLUDES THE
ACCESS TO QUALITY CHILDCARE AS
ONE OF HIS PILLARS AND LOOKING
AT COMMUNITY BASED SOLUTIONS.
AND I THINK WE DO HAVE TO
CONSIDER THE CHANGING DYNAMICS
THAT WERE ALSO DISCUSSED EARLIER
TODAY FOR FAMILIES.
I MOST FAMILIES HAVE ALL THE
ADULTS WORKING.
YOU HAVE EITHER A SINGLE PARENT
WORKING PARENT OR YOU HAVE TWO
PARENTS WORKING WHICH MEANS MOST
KIDS ARE IN SOME SORT OF CARE
OUTSIDE OF THE HOME EVERYDAY.
AND WHAT WE ALSO KNOW IS LOW
INCOME FAMILIES ARE OFTEN IN
MULTIPLE JOBS WITH VERY
COMPLICATED SCHEDULES SCHEDULES
NONE OF US WOULD WANT.
AT MULTIPLE LOCATIONS AT STRANGE
HOURS THAT CHANGE WEEK TO WEEK
THAT IN ITSELF CAUSES A GOOD
DEAL OF STRESS.
I'M AT OUR AGENCY ALONE OVER
SIXTY FIVE PERCENT OF THE
FAMILIES WE SERVE WORK THESE
NONTRADITIONAL HOURS AND THEIR
IN SERVICE INDUSTRIES. AND THIS
CREATES ADDITIONAL STRESSES
CONSTANT CHANGE IN PRESSURE TO
FIND ARRANGEMENTS FOR CARE ON
TOP OF THE EXISTING FINANCIAL
STRESSES THAT THEY'RE FACING.
WE DO BELIEVE THAT ACCESS TO
QUALITY CHILDCARE MITIGATE SOME
OF THE STRESSES AND IT CAN BE A
PREVENTION AS WELL AS AN EARLY
INTERVENTION. AND IF YOU HAVE
QUALIFIED CAREGIVERS WHO ARE
USING THAT TROMBONE FORMED
LANDS.
AND THEY CAN HELP IDENTIFY AND
MITIGATE SOME OF THESE CONCERNS.
SO I DID GO AND LOOK AT SOME OF
THE WORK THAT HAS BEEN DONE
NATIONALLY AND CHILD TRENDS WHO
IS A LEADING NONPROFIT RESEARCH
ORGANIZATION.
FOCUSED ON IMPROVING THE LIVES
AND PROSPECTS OF CHILDREN. I'M
IDENTIFIED SOME KEY
RECOMMENDATIONS FOR POLICY
MAKERS TO SUPPORT THE WORK OF
EARLY CHILDHOOD. AND THE COMPLEX
NEEDS OF CHILDREN HAVE BEEN
EXPOSED TO TRAUMA THEIR
RECOMMENDATIONS INCLUDE
PROVIDING CHILDREN WITH AMPLE
ACCESS TO HIGH QUALITY STABLE
CARE AND STRONG EARLY LEARNING
SUPPORTS.
INCREASING EASY PROFESSIONALS
ABILITY TO RECOGNIZE AND RESPOND
TO TRAUMA. AND EXPANDED
INITIATIVES THAT HELP EARLY
CHILDHOOD PROGRAMS CONNECT
FAMILIES TO COMMUNITY SERVICES A
FAMILY RESOURCE CENTER TYPE
MODEL.
AND WE'VE MADE SOME HEADWAY IN
CALIFORNIA IN THE NUMBER OF
CHILDREN WE SERVE LARGELY IN OUR
EXPANSION OF SERVICES TO FOUR
YEAR OLDS.
FOR THE BIRTH THROUGH THREE
GROUP WE REALLY ARE VERY BARELY
SCRATCHING THE SURFACE OF NEED
IN THE COMMUNITY. AND THE
AMERICANS AND STE IN THE
AMERICAN INSTITUTE FOR RESEARCH
IS DONE A RECENT STUDY THAT
SHOWED THAT LESS THAN TEN
PERCENT OF THE VERY YOUNGEST
CHILDREN BIRTH TO THREE ARE
BEING SERVED. AND THOSE ARE KIDS
WHO ARE INCOME ELIGIBLE AND IN
THESE COMMUNITIES THAT WE'VE ALL
EXPRESS CONCERN FOR AND THIS
LEADS WOULD REALLY CRITICAL GAPS
FOR FAMILIES.
SO TO SOLUTIONS.
I CALIFORNIA HAS EXISTING HOUSE
ASSETS WHICH ARE AVAILABLE IN
COULD BE LEVERAGED AND EXPANDED
UPON. I CALIFORNIA HAS A VERY
LARGE HEAD START CONTRACT WITH
THE FEDERAL OF FEDERAL FUNDS
THAT ARE COMING TO LOCAL
JURISDICTIONS THROUGHOUT THE
STATE.
I HAVE THERE'S ABOUT A BILLION
DOLLARS IN HEAD START FUNDING
THAT COMES TO CALIFORNIA. AND
THE UNIQUE THING ABOUT HEAD
START AND EARLY HEAD START IS IT
REALLY IS DESIGNED AS A POVERTY
ALLEVIATION PROGRAM AND ITS A
COMPREHENSIVE SERVICE THAT LOOKS
AT MENTAL HEALTH AND FAMILY
SUPPORTS BEYOND JUST THE
CLASSROOM LEARNING ENVIRONMENT.
I THINK IT WOULD BE WORTHWHILE
FOR US TO ALL CONSIDER WHAT
WOULD THAT LOOK LIKE IF WE
OFFERED THAT TO MORE OF OUR
CHILDREN IN POVERTY. SO HOW DO
WE TAKE THAT BASED ON THE
KNOWLEDGE OF WHAT HAD START IS
DOING AND EXPAND THAT EFFORT
OUT.
I WE OFFICE WE ALSO OFFER A
VARIETY OF SUBSIDIZED CHILDCARE
PROGRAMS IN A VARIETY OF
DIFFERENT MODALITIES. I'M FRANK
MENTIONED THE CAL WORKS PROGRAM
WHERE FAMILIES HAVE AN
ENTITLEMENT TO CHILDCARE WE ALSO
HAVE A ALTERNATIVE PAYMENT
GENERAL CHILDCARE PROGRAM FOR
LOW INCOME WORKING FAMILIES. BUT
MORE ACCESS IS NEEDED AND THIS
IS WHERE MY.
MY TWO CENTS FOR THIS YEAR'S
ASKS COMES AND I'M WE REALLY
BELIEVE THERE'S AN OPPORTUNITY
TO EXPAND ACCESS FOR FAMILIES
THE SHARE. OF THE FEDERAL BUDGET
WHICH WAS RECENTLY SIGNED DOES
INCLUDE AN EXPANSION IN THE
FEDERAL CHILD CARE AND
DEVELOPMENT BLOCK GRANT.
SO THERE SHOULD BE ADDITIONAL
ACCESS COMING TO CALIFORNIA AND
WE'RE HOPING THAT THE STATE IS
ABLE TO MATCH AND GO ABOVE AND
BEYOND THOSE EFFORTS.
WE ALSO KNOW THAT IT'S IMPORTANT
THAT YOU SEE PROFESSIONALS.
HAVE ACCESS TO TROMBONE FORM
TRAINING AND I ONE OF THE THINGS
THAT WE HAVE DONE KIND OF
CROSSING SECTORS IN THIS PAST
YEAR IS CREATED A. FOSTER CARE
BRIDGE PROGRAM FOR CHILDCARE.
AND THE UNIQUE THING ABOUT THAT
IS IT INCLUDED TRAUMA INFORMED
CARE TRAINING FOR THE PROVIDERS
WHO ARE WORKING WITH THE
CHILDREN IN FOSTER CARE.
I THINK IT'S A GOOD
DEMONSTRATION IT'S AN
OPPORTUNITY FOR US TO SEE HOW
THIS WORKS AND WE'RE DOING A LOT
OF WORK TO TRY TO BUILD. THE
BRIDGE BETWEEN THOSE TWO SYSTEMS
BUT IT IS ANOTHER EXAMPLE OF A
PLACE YOU COULD CONTINUE TO LOOK
TO BUILD.
AND I'M AYE OF ALSO WANTED TO
MENTION HOME VISITING I KNOW IT
CAME UP EARLIER THAT CALIFORNIA
DOES HAVE A VARIETY OF DIFFERENT
HOME VISITING MODELS.
AND THEY ARE FUNDED BY A VARIETY
OF SOURCES INCLUDING FEDERAL. OF
FUNDS EARLY HEAD START LOCAL TO
A FIRST FIVE COMMISSIONS.
BUT THEY'RE NOT CONSISTENTLY
AVAILABLE FROM COUNTY TO COUNTY
THROUGHOUT THE STATE I'M AND
THESE WOULD BE OTHER POWER
PLATFORMS WHICH YOU COULD CHOOSE
TO BUILD UPON.
I APPRECIATE ALL YOUR TIME AND
I'M GLAD TO GET AND WITH BABIES.
AND I'M HAPPY TO BE LAST.
THANK YOU VERY MUCH.
WILL START WITH QUESTIONS FROM
THE DIETS AND THEN I WANTED TO
MAKE SURE THE PUBLIC.
HAD AN OPPORTUNITY TO COMMENT AS
WELL ON ANY OF THE PANEL WERE.
S. COUSINS WHO CAME UP BUT FIRST
ASSEMBLY MEMBER MCCARTY HERE
THANK YOU THANK YOU FOR THE.
.
THE LAST PANEL AND SOME OF THE
SOLUTIONS I'M FAMILIAR WITH SOME
AT THE THE REQUEST YEAR AND WILL
SEEM AN ARE RESPECTED
SUBCOMMITTEES AND THEIR.
THERE WERE THE.
YOU KNOW IT'S IT'S SAID NO
BRAINER TO INVESTING IN AND THAT
FAMILIES AND KIDS AND POVERTY
ARE GONNA GET.
AT THE BIGGEST BANG FOR YOUR
BUCK AS FAR AS THAT SOLUTIONS UP
BY DOING A KIND OF GO BACK TO
TWO PANELS AGO WE TALKED ABOUT.
THAT THIS SCREENING AND WHETHER
OR NOT IT'S THAT.
IT'S WHERE THE TO DO IT'S IT
WHEN BECAUSE YOU CAN HAVE LET'S
LAY IN A HUNDRED OF THOUSANDS OF
FAMILIES ALL OF A SUDDEN YOU
HAVE.
REPORT CARD AND THAT NOTHING TO
DO.
NO REMEDY TO GIFTED TO GET THE
FAMILY SO WHAT I WANTED TO ASK
IS I I THINK I'D RATHER HAVE
THAT SCREENING IT'S LIKE YOU AND
YOU YOU YOU WANTED TO HAVE THE
DOCTOR NOT SO YOU HAVE SOME
HORRIBLE ILLNESS NOT OTHER NO.
AND THEN DEAL WITH NO TO DO WIT
WITH THAT SO I THINK WE SHOULD
ERR ON MAKE SURE THAT WE HAVE.
THE SCREENINGS.
OTHER WET PEDIATRICIAN'S OFFICE
IS OUR KINDERGARTENERS SCHOOL
SYSTEM SO. WHERE WHERE CHYNA IN
ACCORD THERE?
BUT IF WE DID HAVE.
YOU KNOW.
THE MAGIC.
THE BOX
THE CASE HERE OR SHOE BOX WITH
YOU KNOW LET'S SAY A HUNDRED
MILLION DOLLARS YOU WANT TO DO
SOMETHING TODAY BESIDES THE FACT
THAT WE KNOW.
ESPECIALLY FROM THAT WELFARE
DIRECTORS AND THAT.
CHILD CARE AND
DEC WORLD KIND OF WHAT THE ASK
OUR WHAT WHAT ARE SOME OF THE
THAT THEIR REMEDIES WOULD HAVE
OUT THERE LET'S SAY ALL OF A
SUDDEN EVERY. YOU KNOW
KINDERGARTNERS HOW TO SCORE AND
AND SOME PEOPLE OFF THE CHARTS
WE WANT TO GIVE. GRANTS TO
NONPROFITS A SCHOOL DISTRICTS TO
DO STUFF YOU KNOW WHAT WOULD WE.
DO IF ALL OF A SUDDEN WE HAD
ONE.
BUT BASICALLY A DIAGNOSIS FOR
ALL THESE KIDS ACROSS CALIFORNIA
INTO A POTENTIAL.
THE OPPORTUNITY TO MAKE A SOUND
BEST.
DURING A FOR SHOWING HER HOW AM
I I MEAN THE FIRST THING WE
WOULD DO REALLY WOULD BE
RESTRUCTURING SCHOOLS AND THE
WAYS IN WHICH THEY INTERACT WITH
THE STUDENTS.
SO THAT MEANS THAT YOU KNOW
DOCTOR BURKE HARRIS TALKED ABOUT
HAVING MINDFULNESS HAVING THINGS
THAT ARE PART OF THE SCHOOL DAY
THAT WOULD HELP TO BUFFER THAT
TRAUMA THAT STUDENTS ARE
EXPERIENCING. HELP THEM LEARN
HOW TO REGULATE THEIR EMOTIONS.
IT IN WAYS THAT WE KNOW ARE
PREVENTIVE SO THAT WOULD BE ONE
OF THE HARDEST TO HEALTH
PROFESSIONALS ON FUNDING YES FOR
OF AND CERTAINLY THAT WOULD BE
NECESSARY BUT THERE ALSO ARE
THINGS WE CAN DO AS FROM A
POPULATION BASED PERSPECTIVE FOR
EVERYONE. ESPECIALLY WHEN YOU
HAVE SCORED THE YOU KNOW THAT
YOU HAVE A HIGH LEVEL LEVEL OF
CONCENTRATED TRAUMA AND IN MANY
INSTANCES WHEN WE DO THE A SCORE
AS A REMINDER WE DON'T HAVE THE
COMMUNITY TRAUMA AS WELL. SO YOU
COULD HAVE AN INDIVIDUAL A SCORE
OF ZERO BUT STILL BE TRAUMATIZED
BY SOME OF THE COMMUNITY TRAUMAS
THAT ARE HAPPENING BECAUSE YOU
LIVE WITHIN THAT COMMUNITY AS
WELL AND SO THAT THAT WOULD BE
REALLY IMPORTANT AND THAT WOULD
HAVE A WAY OF BEING ABLE TO
PROVIDE. A BUFFER FOR WHAT'S
HAPPENING IN ADDITION TO THE
PROGRAMMATIC INVESTMENTS.
FOR INDIVIDUALS THAT ARE
CLINICAL.
YEAH THAT'S A SOME OF THESE ARE
CISPA SUCKS SOCIETAL ON PARTS
THE COMMUNITY IN.
IN OUR J. GENERATIONAL POVERTY
AND JUST LIKE YOU KNOW MILLIONS
AND BILLIONS TO TO IMPACT THAT.
BUT BUT LET'S SAY ALL OF A
SUDDEN.
BECAUSE IF YOU DID THIS
SCREENING WOULD BE PRIMARILY FOR
YOUNGER KIDS WRITINGS OF THE
KINDERGARTENERS OR LET'S SAY THE
PEDIATRICIAN LEVEL BEFORE BEFORE
IT'S A LET'S SAY ALL OF A SUDDEN
WE HAD. FIFTY THOUSAND
CALIFORNIA.
KIDS ALL OF SOLICITOR WERE UNDER
SIX YEARS OFF. AND ALL OF A
SUDDEN THEIR FAMILY OR LOVED ONE
ALL OF A SUDDEN HAD.
YEAH A LETTER FOR.
AND THE NOTE SAYS HATE.
AND YOUR NOT IN LET'S SAY HEAD
START PROGRAM YOU NOT
NECESSARILY.
PART OF IT OF THE OF THE SUPPORT
SYSTEM THAT THAT COULD BE THERE
AND SO WHAT SHOULD CALIFORNIA
DUE TO MAKE SURE THAT THESE.
KIDS.
HAVE SOMETHING
YOU'RE TALKING.
I I'M SURE I'M GONNA STICK AWAY
SOME OF MISTER MAC AS THUNDER
BUT I'VE A COUPLE THINGS ONE IS.
I MEAN IF IF THERE MEDI CAL
INVOLVED THEY'RE SUPPOSED TO BE
GETTING ASSISTANCE NOW YEAH BUT
THEY'RE NOT THE I UNDERSTAND I
THINK THAT THAT IS A NON
MONETARY ALL OF SOME MIGHT SAY
THERE'S A MONETARY ISSUE. THAT
IS A THAT IS A IMPLEMENTATION
ISSUE THAT IS LONG OVERDUE TO BE
FIXED AND THAT.
PERHAPS
MILLER DOT DOCTOR ARAMBULA IS
COMMITTEES A LITTLE MORE VESTED
IN IT BUT I BUT I REALLY
APPRECIATE THAT ANGRY BECAUSE
OUR OUR POSITION ESPECIALLY FOR.
CHILDREN UNDER THE AGE OF FIVE
IS THAT MANY OF THESE CHILDREN
ON WHO DO EVEN THOUGH WE WERE
WORKING ON MAKING EPS DTM MORE
SCREEN. IN FRIENDLY PLACE WHERE
YOU CAN IDENTIFY CHILDREN
EARLIER. THEY'RE NOT GETTING THE
ACCESS YOU HEARD ABOUT THE
PENETRATION RATES AND THE
ENGAGEMENT RATES THOSE ARE VERY
LOW RATES AND THEY ACTUALLY
HAVING WORKED ON AB THREE FORTY
SO INTIMATELY THEY VARY SO
GREATLY BY COUNTY. YOU CAN BE IN
COUNTY A AND HAVE AN EIGHTY FIVE
PERCENT NINETY PERCENT
PENETRATION RATE YOU CAN BE
COUNTY BE NEXT DOOR HAVE A
FIFTEEN PERCENT RATE. AND
COUNTIES ARE NOT SPENDING THE
MONEY THAT IS DESIGNED TO BE
USED FOR JUVENILE MENTAL HEALTH.
ACROSS THE BOARD EVENLY THERE'S
NOT CONSISTENCY IN THE
IMPLEMENTATION OF THAT PROGRAM
SO ON THE ONE LEVEL IF YOU WANT
TALK ABOUT SYSTEMIC CHANGES
USING THE SYSTEM THAT'S ALREADY
IN PLACE THE SYSTEM THAT'S
ALREADY IN PLACE IN MY. PERSONAL
OPINION I THINK MY COLLEAGUES
MIGHT BE AGREEING WITH ME.
DOESN'T WORK THE WAY IT'S
DESIGNED WORK RIGHT NOW AND SO
IF YOU WANT TO ACTUALLY MAKE AND
MAJOR IMPACT YOU WANT TO SCREEN
THOSE KIDS BECAUSE I AGREE YOU
SHOULD BE SCREENING THOSE KIDS.
AND YOU WANT THE PARENT AND THE
IN THE FAMILY TO KNOW WHAT'S
GOING ON THE TRUTH IS THAT
THEY'RE THEY'RE FINDING OUT
WHAT'S GOING ON THERE BEING TOLD
THERE'S YOU JUST NEED CASE
MANAGEMENT. YOU JUST NEED SOME
OTHER LOW LEVEL INTERVENTION
THEY'RE NOT BEING GIVEN THE
THERAPY AND COUNSELING AND
MENTAL HEALTH CARE THE SPECIALTY
METAL HORSE HEALTH SERVICES THE
CHILDREN WHO EXPERIENCE TRAUMA
NEED.
ESPECIALLY IN FOSTER YOU
SITUATIONS A LOT OF FOSTER KIDS
WHO DON'T GET THE TYPE OF
INTERVENTIONS THEY NEED NOW TO
THE QUESTION ABOUT WE HAVE THE
SCALE OF COST AND HOW DO YOU HOW
DO YOU SKILLED OUT ONE OF THE
PROPOSALS WE HAVE THIS YEAR. IS
TO MAKE AN INVESTMENT IN SCHOOLS
TO PILOT TRYING TO CHANGE THE
WAY SCHOOLS OPERATE WITH A
TRAUMA INFORM SCHOOL MENTALITY
IT DROMUND FROM SCHOOL PROGRAM
WHERE YOU BASICALLY COME IN AND
YOU CAN MAKE AN INVESTMENT. IN A
SCHOOL DISTRICT WHERE YOU'RE
GOING TO DO THAT YOU COULD
SCREEN ALL THOSE KIDS IN THAT
SCHOOL DISTRICT AT SCHOOL. RIGHT
AND THERE'S GONNA THEY'RE GONNA
CRAWL ALL OVER THE MAP PROBABLY
RIGHT IN SOME COMMUNITIES ARE
GONNA BE VERY HAPPY ON THE DRAMA
SIDE. AND THE REALITIES YOU CAN
ACTUALLY PUT.
AT A MUCH LOWER COST THAN YOU
WOULD IF YOU WERE TRYING TO
INDIVIDUALLY TREAT KIDS OUT IN
THE COMMUNITY IF YOU TRY TO
BUILD THE RESILIENCY THAT IMMUNE
SYSTEM. ID I KIND OF TRY TO
PROMOTE EARLIER YOU ACTUALLY PUT
INSIDE THE SCHOOL THE TRAUMA
INFORMED PROVIDER THE PERSON WHO
WAS THERE AT THE RESOURCE TO THE
TEACHERS AS THE RESOURCE TO THE
STUDENTS NOT JUST INDIVIDUALLY
BUT COLLECTIVELY AND THAT IDEA
THAT YOU'RE GOING TO CREATE
COMMUNITY RESILIENCY. OUT OF
HAVING ALL THOSE CHILDREN BE IN
THE SAME PLACE AND BE AT A PLACE
OF EDUCATED ARE OF ELEVATED ON
COLLABORATION WITH ONE ANOTHER
JUST MAKE ME PRACTICAL LEVEL TO
SAY THERE'S AN ELEMENTARY SCHOOL
THAT HAS. FOR KINDERGARTEN CLASS
YOU
AND THERE'S.
TWENTY FIVE KIDS.
ROGER RIGHT LET'S SAY.
ARE A QUARTER OF THE KITS
HAVEN'T ACES SCORE FIVE
BY RACH.
AND SO YOU HAD THOSE TWELVE
TWENTY FIVE.
GET SO WHAT WOULD YOU GIVE LIKE
IT'S KID LIKE.
IT'S THE WRONG TERM LIKE A
VOUCHER FOR THEY CAN GO LIKE A
COUPON TO GO. GET A SERVICE OR
WOULD YOU TRY TO BRING SOMEONE
IN THE SERVICE WILL IN HOUSE ALL
TWENTY FIVE WOULD BE IN THE
SCHOOL WOULD BE A SCHOOL BASED
HEALTH SERVICE. THAT THE SAID
THE SCHOOL ESSENTIALLY IS
GETTING THE SOCIAL WORKER THE
CARE PROVIDER WHO HAS THE
ABILITY TO BRING IN OTHER
RESOURCES IF NECESSARY BUT THAT
PERSON IS THE LOCUS FOR THE
CARE.
IN THE SCHOOL BECAUSE YOU WANT
SOMEONE WHO HAS DAY TO DAY
RELATIONSHIPS WITH TEACHERS
STAFF AND THE STUDENTS BECAUSE
PART OF TRAUMA INFORMED CARE IS
ABOUT RELATIONSHIP BUILDING AND
TRUST AND RIGHT SO YOU'RE
ALREADY IN THAT THE SYSTEMS ARE
SUPPORTER THERE IN THE SCHOOL.
AND VOUCHERS REQUIRES THE FAMILY
TO GO FIND CARE PROVIDER AND
THAT'S WHAT THE SYSTEM IS
FAILING TO DO RIGHT NOW.
BUT ALSO TO GIVE TWENTY FIVE I
MEAN JUST TO USE YOUR EXAMPLE IF
YOU'VE TWENTY FIVE KIDS OF A
SCORE FIVE OR HIGHER YOU ALSO OF
SOMEWHERE ONE THAT'S FOR THAT'S
THREE THAT'S TO THAT SEVEN THAT
RIGHT LIKE SO. YOU YOU I MEAN IF
YOU IF YOU DON'T WANT TWENTY
FIVE PERCENT ARE ALREADY HAD A
SCORE FIVE OR HIGHER YOU REALLY
NEED TO ALSO BE THINKING ABOUT
THE THE SCHOOL ENVIRONMENT IN
GENERAL AS WELL. NOT JUST
LITERALLY A CLASSROOM FULL OF
STUDENTS WHO ARE TRAUMATIZED.
I WOULD ADD IT SCREENING IS DONE
ROUTINELY IN SCHOOLS ARM OR DONE
BY PEDIATRICIANS.
.
THAT REGARDLESS OF WHERE THE
SCREENING OCCURS THAT THERE
SHOULD BE STRONG CONNECTIONS
BETWEEN. THE SCHOOL THE SCHOOL
THAN THE PHYSICAL HEALTH
PROVIDERS AND SOCIAL SERVICES
AGENCY
IT SHOULD BE EASY FOR THEM.
TO HELP.
YOU KNOW TO CONNECT WITH US TO
GET SERVICES TO FAMILIES THAT
ARE ALREADY.
YOU NO AVAILABLE THEIR THEIR
THEIR PEOPLE FOR GOOD BECAUSE
THEY LIVE ISOLATED DRAMATIC WAYS
WHO ARE DISCONNECTED SO I THINK.
I THINK
A CONNECTIVE TISSUE BETWEEN THAT
FRONTLINE.
SCREENER AND THE AND THE THE
BACK AND SOCIAL SERVICES I THINK
IS THAT IS A COST EFFECTIVE AND
PROBABLY.
RELATIVELY SMALL AND SORT OF THE
GRAND SCHEME OF THINGS TYPE OF
INVESTMENT.
.
I THINK WE WE ALSO WOULD DO IF I
COULD.
JUST SORT OF.
REPEAT
THERE'S THIS THERE'S THIS
DISCONNECT NATIONALLY I THINK
BETWEEN WHAT BEHAVIORAL HEALTH
MEANS AND WHAT THE H. HAS
RESOURCE SAYS.
AND AS LONG AS THE BIG GATE
TO.
SORT OF.
INTENSIVE THERAPEUTIC OPTIONS
AND FLEXIBLE TYPES OF OPTIONS
IS A DIAGNOSIS.
SOMETHING THAT'S IN THE DSM IT'S
WE'RE GONNA WAIT TILL IT TILL
IT'S TOO LATE. AND YOU DON'T
CURE A SAYS WITH A FIFTY MINUTE
HOUR ON MONDAY THROUGH FRIDAY.
THE IN THERAPY WE NEED FLEXIBLE.
CREATIVE
SERVICE SAYS THAT ARE BROUGHT TO
KIDS WHERE THEY WHERE THEY ARE.
AND.
AGAIN NO DISRESPECT OR
CRITICISM OF EXISTING
PRACTITIONERS WHO ARE WORKING
THEIR* OFF EVERY DAY. BUT
BUT THIS.
THAT THE SYSTEMS MANY SYSTEMS
INCLUDING THE CHILD WELFARE
SYSTEM
HAVE BEEN TOO SLOW TO
ACKNOWLEDGE THAT THIS ACES IS
SERIOUS.
ARM AND IT IS THE BUSINESS OF
CHILD WELFARE IT IS THE BUSINESS
OF EDUCATION IT IS THE BUSINESS
THAT BEHAVIORAL HEALTH NOT JUST
SOMETHING ON THE OUTSIDE THAT WE
LOOK AT AND WAIT FOR THINGS TO
GET REALLY BAD. BEFORE WE DECIDE
TO INTERVENE.
AND AND I WOULD SAY THERE'S
EXAMPLES IN THE EARLY CHILDHOOD
SYSTEM. WHERE YOU COULD TAKE
THAT MODEL FROM HEAD START WHERE
THERE IS A MENTAL HEALTH
PRACTITIONER ASSIGNED TO EVERY
CLASSROOM IN EVERY EARLY HEAD
START EXPERIENCE WHAT WOULD THAT
LOOK LIKE WHEN YOU TOOK IT TO
KINDERGARTEN?
I I THINK WE NEED TO LEARN FROM
THINGS THAT HAVE WORKED AND I
WOULD ALSO SAY THAT THE
REFERENCE EARLIER TO INFANT
MENTAL HEALTH IS CRITICALLY
IMPORTANT. AND THE SOONER YOU
INTERVENE THE SOONER THERE'S A
PLAN THE SOONER WE START
MITIGATION AND THE LESS PROBLEMS
THERE ARE DOWN THE ROAD. AND
WHAT'S MISSING IS THAT THE
CRITICAL SUPPORT TO THE
PRACTITIONERS.
ASSESSMENT IS PART OF EARLY
CHILDHOOD EDUCATION CHILD
ASSESSMENTS ARE DONE ALL THE
TIME.
ADDING THIS END TO WHAT IS
ALREADY DONE WITH THE
APPROPRIATE CONNECTION.
TO THOSE SERVICES THAT KIDS
NEED.
WOULD BE A GOOD PATH TO PURSUE.
JUST WANT TO ADD ONE THING IN
LIGHT OF ALL THE REALLY GOOD
COMMENTS
SO DOCTOR NADINE BURKE OPEN AND
TALKED ABOUT YOU KNOW THREE
THINGS EARLY SCREENING EARLY
DETECTION AND INTERVENTION RIGHT
THAT'S WE ALL WE ALL AGREE ON
THAT.
AND SO IF YOU'RE THINKING ABOUT.
IF YOU PLACE
PEOPLE WHO ENGAGE IN TRAUMA
INFORMED PRACTICES IF YOU DO
SCHOOL BASS TROMBONE FORM
PROGRAM.
GAVE YOU ARE PREPARED.
SCREEN CHILDREN.
WHEN ASUS HAPPEN SO YOU'RE GONNA
HAVE SOME KIDS WHO HAVE ZEROS
AND ONES TODAY.
WHO WILL HAVE A LIFE EVENT OR
SERIES OF LIFE EVENTS IN THEIR
HOME FOR THEIR COMMUNITY AND YOU
ARE ALREADY NOW PREPARED?
TO INTERVENE
BECAUSE YOU WERE ENGAGED IN A
SCREENING PRACTICE IN THE
ENVIRONMENT THAT IS SENSITIVE TO
DETECTION AND YOU HAVEN'T BEEN
INVENTIONS TOOLS AVAILABLE TO
YOU.
THAT IS WHY OUR OPINION IS YOU
NEED TO YOU NEED TO INVEST IN TO
THE SCHOOL SYSTEM INTO CREATING
A WHOLE COMMUNITY WITH.
SCHOOL AND THE OTHER THING IS
YOU KNOW WE TALK ABOUT THE THE
WALLS OF THE SCHOOL BUT. YOU
KNOW A AND AND THE ENVIRONMENT
INVERSES OUT. ONE OF THE THINGS
WE DON'T TALK A LOT ABOUT WHAT
IS REALLY IMPORTANT I KNOW TO.
SOME EVER MCCARTY'S COMMITTEES
TEACHERS.
RIGHT TEACHERS.
TEACHERS ABSORB TRAUMA EVERYDAY
THEY GO HOME AYE AYE JUST TELL
YOU AS A LAWYER I CLIENTS WHO I
WAS DID DOMESTIC VIOLENCE
LITIGATION I HAD TO LEAVE THE
PRACTICE OF DOMESTIC VIOLENCE
ALLEGATION. BECAUSE IT WAS SO
EMOTIONAL DRAMATIC TO ME TAP
CLIENTS THAT.
PHOTOS OF THINGS THAT HAD
HAPPENED A CLIENTS IT WAS
EXTREMELY DRAMATIC I HAD I HAD
THAT THE SECOND. EFFECTS OF
TRAUMA MY LIFE AND EVEN KNOWS
GOING ON IF I WAS A TEACHER AND
EVERY DAY I HAD TO COME IN TO%
SCHOOL AND I HAD CHILD WHOSE
WERE AND HE WAS WEARING THE SAME
CLOTHES FOR TWO WEEKS IN A ROW.
WHO DIDN'T HAVE FOOD TO EAT?
WASN'T SLEEPING WHO WAS UP AT
THREE IN THE MORNING BECAUSE
THERE IS A FAMILY TRANSFER AT
NIGHT THOSE TYPES OF THINGS I
KNEW THAT I WOULD HAVE A VERY.
HARD TIME BEING RESILIENT IN MY
JOB AND THEN GIVING A HUNDRED
PERCENT OF MY CARE.
TO ALL THE KIDS I HAVE TO DEAL
WITH EVERYDAY AND BY HAVING THAT
LOCUSTS IN THE SCHOOL THAT
TROMBONE FROM PRACTICE IN THE
SCHOOL YOU'RE ALSO BUILDING
RESILIENCY WITH YOUR TEACHING
FORCE. AND THAT MEANS YOU'RE
GONNA HAVE BETTER TEACHER
PRODUCT AS THEY'RE GOING TO GET
THE HEALTH CARE TO IT'S NOT JUST
ABOUT KIDS IT'S ABOUT THE
COMMUNITIES THAT COMMUNITY
ASPECT. THEY NEED THAT TOO AND
THAT'S THAT'S WHY I THINK IT
SHOULD BE IN THE SCHOOL.
SO I WANTED TO END WITH ONE
COMMENT AND THEN WE WILL TAKE
PUBLIC COMMENT IF I COULD.
YOU KNOW I. WAS INTERESTED WHEN
YOU TALKED ABOUT HOW INFANT
MORTALITY IS A METRIC THAT WE DO
FOLLOW. AND EARLIER WE HEARD
FROM DOCTOR THOMPSON WHO TALKED
ABOUT THE CANARY IN THE COAL
MINE.
AND OFTENTIMES I LOOK AT OUR
INFANT MORTALITY AND. LOOK AT
THE TRAUMA THAT HAPPENS TO TOO
MANY OF OUR COMMUNITIES AND
COMMUNITIES OF COLOR.
WE MUST BE HONEST ABOUT IT.
AND I WANTED TO. TALK ABOUT A
FEW SOLUTIONS THAT ACTUALLY
ENCOURAGE ME BECAUSE OFTENTIMES
YOU CAN HEAR PRESENTATIONS LIKE
THIS.
AND.
THEY CAN GET YOU DOWN ABOUT THE
PROBLEMS THAT FACE OUR
COMMUNITIES BUT THERE ARE REAL
OPPORTUNITIES HERE. AND ONE OF
THEM I'M MOST EXCITED ABOUT
COMING INTO THIS YEAR WAS THE
HOME VISITING PROGRAMS THE
GOVERNOR IS PUSHING.
HOW WE HAVE AN OPPORTUNITY AT A
YOUNG AGE FROM ZERO TO AGE TO?
IN OUR FAMILIES THAT HAVE THE
GREATEST NEEDS
TO BE IMPACTING THEM AND MEETING
THEM WHERE THEY'RE AT. TO HAVE
AN OPPORTUNITY TO.
HAVE AYE AYES HAVE A TRUSTED
PRACTITIONER WHO'S IN FRONT OF
US IS AN EXCELLENT OPPORTUNITY
FOR US TO RECOGNIZE SOME OF THE
TRAUMA THAT IS AFFECTING OUR
COMMUNITIES AND. SOME POTENTIAL
SOLUTIONS BUT I WANTED TO
HIGHLIGHT IF I COULD WHAT I DO
THINK IS A POTENTIAL OPPORTUNITY
AN OVERLAP BETWEEN EDUCATION.
WHICH IS SOCIAL EMOTIONAL
LEARNING.
THIS IDEA THAT YOU HAVE A.
ADULT
CARING REPRESENTATIVE AT A
SCHOOL IF THEY DON'T HAVE A
PARENT AT HOME IS NOT PROVIDING
THAT. AMOUNT OF NURTURING AND
SAFETY.
AND.
YEAH I'M REMINDED OF WHAT OPRAH
SAID AND SINCE SHE'S NOW GOING
ON SIXTY MINUTES TALKING ABOUT A
SAYS A.
PROBABLY TRUE BUT SHE SAID THAT.
AT A SCHOOL IS WHERE SHE FOUND
AND FELT SAFE.
THAT THERE WAS AN ADULT WHO
CARED ABOUT HER AND.
IS THAT A MODEL THAT WE SHOULD
LOOK AT FOR OUR SCHOOLS AND HOW
WE CAN HELP TO EMPOWER OUR
EDUCATORS.
AND OUR SCHOOLS TO BE SAFE
PLACES FOR OUR COMMUNITIES.
SO WITH THOSE EXAMPLES AND
POTENTIAL SOLUTIONS I THINK WE
HAVE OUR WORK WORK CUT OUT FOR
US AS A STATE.
BUT IDENTIFYING THIS EARLY
DETECTING IT AND PROVIDING THEM
AND INTERVENTION IS OUR ROLE. IF
FOR SERIOUS ABOUT WANTING TO GET
AHEAD OF THIS COST CURVE OF
GOING UPSTREAM ON THESE PROBLEMS
WE HAVE TO IDENTIFY AND
RECOGNIZE. AND TREAT TRAUMA MUCH
EARLIER THAN WE ARE NOW. SO WITH
THAT I'D LIKE TO THANK THIS
PANEL FOR COMING HERE TODAY.
WOULD LIKE TO OPEN UP FOR ANY
PUBLIC COMMENT YOU MAY HAVE ON
THIS INFORMATION.
GOOD AFTERNOON ADRIN SULTAN WITH
THE STEINBERG INSTITUTE I WOULD
FIRST LIKE TO COMMEND THE
LEADERSHIP OF THESE COMMITTEES.
FOR ORGANIZING THIS HEARING ON
SUCH A CRITICAL TOPIC.
WE ALSO BELIEVE THAT ADDRESSING
CHILDHOOD TRAUMA IS ONE OF THE
MOST URGENT PUBLIC HEALTH ISSUES
OF OUR TIME.
AND THE STEINBERG INSTITUTE IS
REALLY COMMITTED TO BRINGING THE
RESEARCH AND WORK ON A SISTER
THE FOREFRONT.
OF THE MENTAL HEALTH SERVICES
ACT PREVENTION AND EARLY
INTERVENTION COMPONENT
WE HAVE A REAL OPPORTUNITY WITH
THE PREVENTION EARLY
INTERVENTION COMPONENT WHICH IS
A. FOUR HUNDRED MILLION DOLLAR
ANNUAL INVESTMENT OF DOLLARS TO
BE MUCH MORE STRATEGIC AND
FOCUSED IN TERMS OF THE
CRITICAL.
MODELS OF CARE THAT SHOULD BE
FUNDED WITH THESE DOLLARS AND WE
BELIEVE CHILDHOOD TRAUMA
PREVENTION. AND EARLY
INTERVENTION SHOULD BE ONE OF
THOSE WERE SPONSORING
LEGISLATION THIS SESSION ARE
SENATE BILL TEN OH FOUR AUTHORED
BY BOTH SENATOR WIENER. AND
SENATOR MORLOCK WHICH WOULD
ENSURE.
THAT CHILDREN WHO WERE EXPOSED
TO TRAUMA AND VIOLENCE HAVE
ACCESS TO THE MOST EFFECTIVE
MENTAL HEALTH SERVICES ACROSS
THE STATE.
SO S. B. TUNNEL FOUR SETS UP A
STRATEGIC FRAMEWORK AND PROVIDES
A MANDATE FOR THE COUNTIES I'M
IN ONE OF THOSE PRIORITY AREAS
THAT SHOULD BE A FOCUS IS.
CHILDHOOD TRAUMA PREVENTION
EARLY INTERVENTION WITH ACTUALLY
LOOK TO THAT RESEARCHERS.
THAT HAVE PRESENTED TODAY TO
FRAME OUT THIS PRIORITY IN THE
LEGISLATION. AND REALLY WANT TO
JUST BE ENGAGE WITH YOU ON THIS
TOPIC AND REALLY WANT TO SUPPORT
THE WORK THAT YOU'RE DOING AND
THANK YOU AGAIN FOR YOUR
LEADERSHIP ON THIS.
THANK YOU MA'AM.
GOOD AFTERNOON MICHELLE GIVENS
OF THE COUNTY HEALTH EXECUTIVES
ASSOCIATION OF CALIFORNIA WE
REPRESENT LOCAL HEALTH
DEPARTMENTS THROUGHOUT OUR STATE
AND AT THE CORE OF OUR PUBLIC
HEALTH MISSION IS PREVENTION.
AND SO WE AND FROM OUR
STANDPOINT IN ADDITION TO JUST
PREVENTING CHRONIC CONDITIONS
AND DISEASES WE REALLY THINK
THAT YOU HAVE TO ALSO DO
PREVENTION ON THE FACTORS THAT
CONTRIBUTE TO THAT. AND ACES IS
ONE OF THEM AS YOU'VE HEARD ON
THROUGH A LOT OF THE TESTIMONY
THAT WAS BEFORE YOU TODAY. AND
WE ALSO FROM THE LOCAL HEALTH
STANDPOINT AND DEPARTMENT SIMPLY
HAVE PARTICIPATED IN A LOT OF
STRATEGIES AND INITIATIVES TO
REALLY PREVENT. AND KNOWINGLY OR
EVEN UNKNOWINGLY AT PREVENT
ADDITIONAL ACES IN THE FUTURE
AND THINGS AROUND VIOLENCE
PREVENTION INITIATIVES ARE
OPIOID AS COALITION.
WORK THAT WE'VE DONE TO. REDUCE
HARM AND TO PREVENT OVERDOSES ON
THAT ALSO PREVENT AT NEW
ADDICTIONS AND SO FORTH AND THEN
ALSO WE SPEARHEAD THE.
NURSE HOME VISITING PROGRAMS
OUT OF OUR LOCAL HEALTH
DEPARTMENTS AND.
IN ADDITION TO WHAT THE GOVERNOR
IS DOING IN HIS PROPOSAL TO
BRING A NEW* VISITING AB
PROGRAM TO LIGHT WE STILL DON'T
THINK THAT IT'S ENOUGH THEY'RE
STILL GONNA BE A NEED OMINOUS
SEVERAL JURISDICTIONS THAT WILL
NOT HAVE A HOME VISITING
PROGRAMS. AND SO WE URGE AND
ADDITIONAL ATTENTION TO THAT
MATTER AND WE WANT TO WORK AND
BE A PART OF THIS CONVERSATION
WITH YOU ONLY THINK YOU FOR
HAVING IT TODAY. THANK YOU.
HELLO MY NAME IS GAIL YOUNG
CHILDREN NOW.
WE'RE STATEWIDE AFTER SEE
ORGANIZATION DEDICATED TO
PROMOTING CHILDREN'S HEALTH AND
EDUCATION AND OVERALL WELL
BEING.
I'M ONE OF THE THINGS YOU HAVE
BOTH ASSEMBLYMEMBERS I'M
ARAMBULA AND MCCARTY FOR PLAYING
ON THIS IMPORTANT INFORMATION OR
HEARING.
WE ARE ACTUALLY VERY EXCITED TO
BE A PART OF THE AB THREE FORTY
ADVISORY GROUP AND WE LOOK FOR
TO WORKING WITH YOU.
IF YOU.
AND DOCTOR MARTHA MERCHANT AND
I'M WITH YOU CASF PARTS HEALTHY
ENVIRONMENTS RESPONSE TROHMAN
SCHOOLS.
AND WE'VE BEEN DOING THIS WORK
IN THE SAN FRANCISCO SINCE TWO
THOUSAND EIGHT NINE WE'VE BEEN
WORKING ON CREATING FROM INFORM
SCHOOLS IN.
IN THE DISTRICT AND.
I JUST WANNA SAY THAT WE HAD
REALLY GREAT IDEAS AND LOTS OF
WONDERFUL COMMENTARY AND I KEEP
HEARING PEOPLE TALKING ABOUT
MORE SERVICES RESOURCES LIKE
THERAPY. AND I THINK THAT
THEY'RE JUST WE DON'T HAVE
ENOUGH PEOPLE TO ACTUALLY DO
THAT I THINK IS A GREAT IDEA
AND.
AND I ALSO THINK YOU KNOW IN
YOUR EXAMPLE ABOUT FIVE KIDS IN
EVERY CLASSROOM THAT HAVE HAD
FIVE OR MORE ACES THAT DOESN'T
NECESSARILY MEAN THAT THOSE
CHILDREN ONLY NEED THERAPY. ARE
JUST BECAUSE YOU HAD THEM IF
YOU'VE HAD RESILIENT FACTORS IN
YOUR LIFE YOU MAY NOT JUST LIKE
MAYA ANGELOU WHO HAD ALL THOSE.
THINGS HAPPEN TO HER RIGHT BUT
SHE WAS RESILIENT SHE HAD
SOMEONE WHO CARED ABOUT HER.
SO WHEN WE'RE TALKING ABOUT A
WHOLE SCHOOL CHANGE WE'RE NOT
ACTUALLY TALKING ABOUT.
PROVIDING THERAPY AT TO EVERYONE
IN THE SCHOOL WE'RE TALKING
ABOUT CHANGING THE COMMUNITY SO
THAT COMMUNITY ENHANCES
RESILIENCE FACTORS FOR EVERYBODY
TEACHERS AS HE WAS AS A JOHN WAS
SAYING. AND ALSO FOR STUDENTS SO
THAT. IF YOU HAD SOME FIVE KIDS
IN IN THE FOR CLASSROOMS THAT IT
HAD TRAUMA THEY BE EXPERIENCING.
BENEFICIAL EFFECTS ALL DAY LONG
FROM THEIR TEACHER WHO ISN'T A
FAIR BILLS BUT WHO CAN PROVIDE A
SAFE AND COMPASSIONATE PERSON.
WHO CAN PROVIDE PREDICTABILITY
AND SAFETY IN THE CLASSROOM
RIGHT SO THAT YOU WOULD BE?
BY HAVING EVERYONE A SCHOOL
TRAINED.
EVERYBODY IN THE SCHOOL IS
BENEFITING.
ALL DAY
SO THAT'S WHAT I WANNA SAY THANK
YOU VERY MUCH THANK YOU DOCTOR.
HELLO MY NAME IS ANA HOW
SUPPLIED WITH UNITED WAYS OF
CALIFORNIA. WHOSE MEMBER WHOSE
MISSION IS TO IMPROVE THE HEALTH
EDUCATION AND FINANCIAL
STABILITY OF LOW INCOME CHILDREN
AND FAMILIES. WANT TO START WITH
A THANK YOU TO THE CHAIRS AND
STAFF.
FOR ADDRESSING THE INTERSECTION
OF HEALTH AND EDUCATION TO
SUPPORT THE SOCIAL AND EMOTIONAL
HEALTH OF OUR CHILDREN.
BRING TO BEAR THE PROFOUND
RESEARCH ON A SCHISM TRAUMA
PRESENTS CALIFORNIA WITH KEY
OPPORTUNITIES OUT TO IMPLEMENT
POLICY CHANGE WE MUST APPROACH
THIS CHANGE WITH A COMMITMENT TO
EQUITY AND INTEGRATED CARE
ACROSS SERVICE DELIVERY SYSTEMS.
IN ADDITION TO THE RESEARCH
PRISON UP PRESENTED TODAY WE
ALSO HAVE EVIDENCE OF SCHOOL
BASED SYSTEMS OF SUPPORTS AN
INTER AGENCY COORDINATION THAT
MEETS CHILDREN WHERE THEY ARE
AT.
A PROPOSAL THE UNITED WAYS IS
WORKING ON A TO GET THIS NEXUS
OF EDUCATION AND HEALTH IS A
REINVESTMENT.
IN THE HEALTHY START INITIATIVE.
AND DOING SO WITH THE LANDS OF
EQUITY TRAUMA INFORMED CARE AND
UPSTREAM INTERVENTIONS WHEN.
COORDINATING THEIR RANGE OF
SUPPORTS AND SERVICES CHILDREN
NEED. EXPLORING STRATEGIES TO
SCALE THE SYSTEM CHANGE WE ALL
ARE COMMITTED TO MEANS DURING
THE HARD WORK OF BREAKING DOWN
THE SILOS SO THAT WE CAN BUILD
UP OUR CHILDREN AND FAMILIES
UNITED WAY STANDS AS A PARTNER.
AT THE STATE AND LOCAL LEVEL TO
DO THIS WORK THANK YOU FOR THE
SPEAKERS TODAY.
AND LEADERSHIP OF THE
SUBCOMMITTEES AT TODAY AND
MOVING FORWARD.
YOU KNOW.
JANICE CAO MY CHILDREN'S DEFENSE
FUND A CALIFORNIA AND I TOO WANT
TO THANK YOU AND TO AND. I WE
BEEN LOOKING AT THIS ISSUE IT
PARTICULAR OF ACES AND
COMMUNITIES OF COLOR FOR THE
LAST THREE YEARS AND I FEEL LIKE
THIS PAYROLL THIS HEARING TODAY.
PRETTY MUCH LAID OUT EVERYTHING
THAT WE HAVE.
HAVE DISCOVERED IN OUR RESEARCH
SO THANK YOU FOR THAT AND THANK
YOU FOR LISTENING TO ALL OF
THAT.
I AM I ALSO WANT TO ECHO THE
COMMENTS OF MY COLLEAGUE ABOUT
HEALTHY START WE BELIEVE THIS IS
A REALLY GOOD STRONG INITIATIVE
OF INTEGRATED COORDINATED CARE.
AND THE LAST THING I'M GONNA
TALK ABOUT IS JUST I'M NOT TO
FORGET THE IMPORTANCE OF
COMMUNITY BASED ORGANIZATIONS
HAVE BEEN DOING THIS WORK FOR A
LONG TIME. AND.
I HAD ONE I HAD ONE.
DIRECTOR TOLD ME AND THIS IS
NOTHING NEW WE'VE KNOWN HOW TO
DO THIS ALL ALONG THAT WE HAVE
SCIENCE TO BACK IT UP. AND AS
JUST LIKE TARA ECHO ECHO THOSE
SENTIMENTS TODAY ABOUT
INTEGRATED COORDINATED CARE
ACROSS SYSTEMS THANK YOU.
BECAME.
HI GOOD AFTERNOON DANIEL MAILLET
WITH THE CALIFORNIA ALLIANCE OF
CHILD AND FAMILY SERVICES WERE
MEMBERSHIP ORGANIZATION OF ABOUT
A HUNDRED AND THIRTY.
CHILD WELFARE AND MENTAL HEALTH
ORGANIZATIONS SERVING
COMMUNITIES OF COMMITTEE BASED
ORGANIZATIONS TO PROVIDE OVER
EIGHTY PERCENT OF THE EP STT
SERVICES INSTEAD OF CALIFORNIA.
SO WE ARE WELL SUITED TO
CONTINUE TO PROVIDE ON THE
SERVICES IN LIKE MISTER MECCA
TALKED ABOUT BEING ABLE TO
REALLY EXPAND THE YOU DON'T USE
OF EPS TT SERVICES. AND
RECOGNIZING THAT THERE IS A
LOWER THRESHOLD.
FOR THE DIAGNOSIS THAN THERE IS
FOR ADULTS IT.
SO IT'S A LITTLE BIT EASIER TO
GET SERVICES FOR THE KID THAT
MAKING SURE THAT WERE. TAKING
FULL AND CAPACITY OF THOSE
SERVICES AND I AM. I WOULD ALSO
JUST LIKE TO BRIEFLY THANK YOU
FOR YOUR WORK OF THE YOU TALKED
ABOUT HOW THEN PLEASE LET US
KNOW IF THERE'S ANYTHING THAT WE
CAN TO HELP. THANK YOU MA'AM.
GOOD AFTERNOON MY NAME IS SIMEON
GANT ARE REPRESENTING THE
CALIFORNIA BLACK HEALTH NETWORK
STATEWIDE ADVOCACY ORGANIZATION
WE RECENTLY HAD A CONFERENCE
WHERE THIS ISSUE.
CAME UP QUITE A BIT WE'RE
BUILDING A BLACK HEALTH AGENDA
AND ON THE FOLKS THERE WERE VERY
MUCH CONCERNED ABOUT CHILDHOOD
TRAUMA.
WHAT WE HEARD HERE TODAY WE
ALSO AGREE THAT CHILDHOOD TRAUMA
IS VERY SIGNIFICANT? IN THE
BLACK COMMUNITY AS WELL AND THAT
RESTORATIVE JUSTICE IS NECESSARY
AN EARLY SCREENING IS DEFINITELY
IMPAIRED.
SEEING NO FURTHER PUBLIC COMMENT
ON BRING IT UP TO SEE IF.
GERMAN MCCARTY HAS ANY CLOSING
WORDS.
WELL THIS IS THAT EXTREMELY OUT
POWERFUL INFORMATIVE TODAY AND.
I DON'T THINK THERE'S THAT
SILVER BULLET SOLUTION TO ACT
TACKLE THIS THIS YEAR THE YEARS
AHEAD BUT I THINK. MOST
IMPORTANTLY A COMMITMENT TO TO
LEARNING ABOUT.
THE RESEARCH THAT'S BEEN OUT
THERE AND IT'S EVOLVING AND THE
FAT PROMISING REMEDIES THAT WE
COULD LOOK AT.
THROUGH THE BUDGET PROCESS
THROUGH LEGISLATION SO I THINK
THIS SAN GIVES US A BIT OF THAT
OUT A ROADMAP MAYBE SOME THINGS
WE CAN DO AS EARLY AS THIS YEAR.
SO ON I THINK THANKS TO ALL THE
PARTICIPANTS I KNOW SOME OF OUR
PANELISTS HAD IT TAKEOFF BUT
DEBT THANK YOU FOR THOSE WHO
STUCK AROUND FOR THE ENTIRE
HEARING AS WELL.
I'LL JUST CLOSE BY THANKING
EVERYONE FOR COMING AT US.
.
YOU KNOW HAVING PRACTICED IN THE
HE ARE I OFTENTIMES WONDERED HOW
YOU COULD DEAL WITH MORE THAN
ONE PATIENT AT A TIME.
AND ADDRESSING ACE'S STARTS TO
FEEL LIKE WERE ADDRESSING
POPULATION HEALTH.
THAT WE HAVE SOME OPPORTUNITY
WITH SOME LARGE BRUSH STROKES.
TO HELP.
HE'S OR. IMPROVE THE LIVES OF
MANY WHO FACE ADVERSITY WILL
NEVER BE ABLE TO REMOVE THAT
ADVERSITY. BUTTON WE BUILD THE
RESILIENCY IMMIGRANT THAT THAT'S
NECESSARY FOR THEM TO TAKE
CONQUER. THE CHALLENGES THAT
LIFE HAS FOR SO MANY OF US SO
THANK YOU ALL FOR PARTICIPATING
IN THIS DISCUSSION AND FOR
COMING TO THIS.
HEARING.
CAN