House Bill 1322 – Trauma-informed Care

Teen and trauma

By: J. S.

A new bill for public health aims to add trauma-informed care to Hawaii’s tool belt to better help families in need. House Bill 1322 would establish a task force within the Department of Health to make recommendations for establishing trauma-informed care in the State. Introduced by House Representative Cullen of District 39, the bill was transmitted to the Governor on April 28.

According to the bill, “over the last two decades in the fields of neuroscience, molecular biology, public health, genomics, and epigenetics reveal that experiences in the first few years of life build changes into the biology of the human body that, in turn, influence a person’s physical, mental, and spiritual health… Research on toxic stress and adverse childhood experiences indicates a growing public health crisis for the State with implications for the State’s educational,  juvenile justice, criminal justice, and public health systems.” The bill hopes to build capabilities to produce better outcomes for Hawaii’s citizens and government agencies alike. 

According to the Executive Office on Early Learning (EOEL), ACEs are traumatic experiences that occur during childhood and include physical, emotional, or sexual abuse; neglect; household dysfunction such as substance use, or incarceration of a household member; domestic violence; and separation or divorce involving household members.

ACEs impact lifelong health and learning opportunities and toxic stress from ACEs can change brain development and affect the physical body. Furthermore, according to the Centers for Disease Control and Prevention, ACEs are linked to chronic health problems, mental illness, and substance misuse in adulthood and can diminish concentration, memory, and language abilities students need to succeed in school, impacting academic success.

Lauren Moriguchi, Director of the EOEL, pointed out in her testimony that ACEs are preventable. She stated that “supportive, stable relationships between children and their families, caregivers, and other adults can buffer children from the detrimental effects of toxic stress and ACEs.” Her office is focused on working with the University of Hawaii and others to create a pipeline of qualified early childhood caregivers equipped with the tools needed to help children with families in difficult circumstances. By equipping early educators, the department aims to empower families to overcome adverse experiences before these adverse experiences take root and affect their lives as children grow up.

The House Committee on Health, Human Services & Homelessness commented in favor of the bill. “Unfortunately, despite the best efforts of policy makers, health care providers, and government workers, the very services and systems designed to help people become healthy can be re-traumatizing. This bill seeks to improve the quality of outcomes for youths impacted by trauma by establishing the framework for a statewide trauma-informed and responsive practice.”

Looking at new ways to equip families with the tools to overcome adverse experiences might be an important step in the right direction for the state. A 2015 report by the Child Welfare League of America found that in 2015, Hawaii had 2,108 total referrals for child abuse and neglect. Of those, 2,108 reports were referred for investigation. Sadly, the report found a 11% increase in abuse and neglect from 2011.

During the events of 2020 and the Covid-19 lockdowns, calls to the domestic abuse hotline increased. A report by the OHA, Kamehameha Schools, and Liliʻuokalani Trust, in collaboration with the Domestic Violence Action Center (DVAC) stated that DVAC saw a 46 percent increase in contacts between March and October 2020. DVAC also reported that during the initial pandemic— March through June—staff had 10,347 contacts (calls, texts and emails) with clients. During the entire fiscal year, staff worked with survivors to complete 7,135 safety plans.

Introducing trauma-informed care into Hawaii’s systems may help to create better outcomes. However, the EOEL offered perhaps an equally important consideration. By funding early childhood educators, and equipping them with resources to help and educate families, we can equip families with the tools to heal, rather than end up in government systems in the first place. An ounce of prevention is worth a pound of cure.