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Division of Behavioral Health

The Division of Behavioral Health has invested in numerous strategies to prevent and mitigate the results of early traumatic experiences through education and training and support for developing resiliency in those with a history of Adverse Childhood Experiences (ACEs).  The Division’s commitment to address the impact of ACEs at children’s stages of development is demonstrated through a variety of policies, partnerships, initiatives, trainings and grants. 

Behavioral health treatment providers are required to administer the Alaska Screening Tool (AST) to each client.  The AST incorporates the universal screen for ACEs and is collected in the division’s electronic health record, allowing DBH to make decisions about policies and system changes that are informed by the needs of our population.  On an agency level, collecting information about individual client’s traumatic experiences allows clinicians to develop treatment plans that are more specific to client’s needs.    DBH behavioral health treatment grantees are required to adhere to the Community Behavioral Health Treatment and Recovery Program Standards which require that providers serving children and youth are required to be trauma informed.  DBH also adopted the DC:0–5 Diagnostic Classification of Mental Health and Developmental Disorders of Infancy and Early Childhood to promote more accurate diagnosis and treatment of infants and young children. 

The Division also partners with other departments and divisions to provide a number of training opportunities for providers and for state staff.   DBH is a funder of the Infant and Early Childhood Mental Health Institute (IECMHI) which provides training for clinicians, teachers, speech pathologists, and developmental specialist.  The IECMHI has recently begun partnering with the Child, Adolescent and Family Conference in an effort to provide training that spans all developmental stages of children and youth.  DBH supports the Annual Advanced Trauma Training Institute and Trauma 101 Trainings throughout the state to raise awareness of the impact of trauma on children.  DBH has also contributed to the Department of Education and Early Development’s efforts to create e-learning modules on trauma trainings for educators.  

DBH has established “Trauma Informed Care” provider agreements and grants, and supports a variety of Evidence Based Practices to address trauma and support families.  Foremost is the Alaska Child Trauma Center.  Behavioral health agencies also provide services utilizing a variety of evidence based models including: Circles of Security, Parenting with Love and Limits, Attachment, Regulation and Competency, and Parent Child Psychotherapy. 

Office of Children’s Services

The Office of Children’s Services (OCS) works to prevent child abuse and neglect and strengthen families’ capacities to protect and care for their children. When efforts towards reunification have not been successful and a child’s safety is not possible within the family, then services are focused on providing a safe and stable permanent home for a child, as quickly as possible. The Office of Children’s Services has five regional offices and 24 local offices across Alaska that deliver child welfare services throughout the surrounding communities.

Our workforce interacts everyday with children and families impacted by adverse childhood experiences (ACEs). Likewise, at OCS we recognize the far reaching implications that historical trauma has on the families we serve. In accordance with the seriousness of these issues, OCS works diligently, in partnership with the University of Alaska Anchorage Child Welfare Academy (CWA), to train our staff on ACEs, ages and stages of child development including brain development, the impact of trauma on child development, what historical trauma is, and addressing the impacts of vicarious or secondary trauma on our staff.

OCS staff are trained to assess children and parents for trauma and to connect families to trauma informed providers, where available.  OCS policies guide staff in assessing age-appropriate well-being during every caseworker visit with children. We work closely with providers that are also trauma informed such as the Child Advocacy Centers statewide. OCS refers children to early education programs when there is a substantiated maltreatment finding with children under the age of three.  OCS has worked in partnership with tribal partners to create a Cultural Resource Guide as a way of addressing indigenous people’s needs in a culturally appropriate and trauma informed manner. 

OCS is also focused on building resiliency with children, youth, parents and our staff through the implementation of our safety assessment practice model, policies and daily interactions.  In addition, one specific effort to building resiliency is through the research informed Strengthening Families™ framework. Strengthening Families™ is a two day training for staff and community partners that focuses on the five protective factors and how to buffer the effects of ACEs and give staff and providers concrete ways of helping parents and children to enhance their protective factors; parental resilience, social connections, knowledge of parenting and child development, seeking concrete supports in times of need and social emotional competence of children.  OCS utilizes the five protective factors in the development and assessment of children and parents needs in case plans development and avenues of behavioral change.

Division of Public Health

The Division of Public Health compiles and analyzes data that helps Alaska better understand both the risk factors for ACEs, but also addresses the protective factors that keep families resilient. The Pregnancy Risk Assessment Monitoring System (PRAMS) and Childhood Understanding Behaviors Survey (CUBS) surveys new mothers and mothers of three-year-olds regarding experiences with stressful life events such as witnessing household violence, being homeless, going to jail, and having someone close to them with a problem with drinking or drugs. PRAMS and CUBS also ask questions about positive behaviors and experiences as well, including spending time with the child in activities that support child development and types of social support for the mother. The Alaska Longitudinal Child Abuse and Neglect Linkage Project (ALCANLink) was also developed to measure the predictors and outcomes of childhood trauma over time. This data has been used to guide policy and programs which seek to prevent or mitigate the impact of ACEs on Alaskan families. Maternal child health home visiting services also provide parents with education and anticipatory guidance related to child development, along with developmental screening. Home visitors work to increase parenting skills and link families with needed supportive services. This helps parents to have realistic expectations regarding their child’s capabilities and promotes healthy bonding and attachment. Lastly, Public Health Nurses across the state work with communities and families to address ACEs at different levels. This is includes providing or linking families to supportive services. Public Health Nurses also participate in community-based efforts to increase public awareness of the physical and mental health needs of families, provide education on life skills such as effective communication, decision-making, and refusal skills.

Division of Juvenile Justice

The Division of Juvenile Justice (DJJ) has implemented trauma informed and trauma responsive practices in a number of areas, including statewide facility and division-wide policies, local facility policies and programs, and staff training. The division continues to modify programs to avoid re-traumatization of youth under the division’s custody and supervision, and find effective ways to work with youth to ultimately promote safety and youth success. In 2016 the division developed the DJJ Trauma Screening Tool, which is an ACEs checklist, modified in consultation with Dr. Linda Chamberlain. The screening tool was implemented by Johnson Youth Center and Southeast Regional Probation as a pilot project. The screening tool is used to assist staff in identifying youth trauma and incorporating responses to trauma into case planning and activities to promote positive interactions with staff and the success of the youth. The increase of staff being trauma informed in their day-to-day activities has promoted frequent and effective communication between DJJ’s probation, facility, and clinical staff. DJJ is evaluating the implementation of the screenings statewide. 

Senior and Disabilities Services

Senior and Disabilities Services oversees the State’s Early Intervention/Infant Learning Program, Children with Complex Medial Needs (CCMC-ages 0-21) and the Individuals with Developmental Disabilities (IDD- ages 1-18+ waiver programs.

SDS is wedded to the research science that confirms that the first three years of life are the most crucial period for a child’s growth and development. The focus of Alaska Early Intervention/Infant Learning Program (EI/ILP) is to support eligible infants & toddlers with disabilities and their families during this critical period by providing supportive, relationship-based services. Providing supportive, responsive relationships as early in life as possible can prevent or reverse the damaging effects of toxic stress.  As part of a nationwide initiative under the Individuals with Disabilities Education Act (IDEA) to improve children’s outcomes, Alaska EI/ILP’s has chosen improving infants & toddlers’ social-emotional outcomes as its identified area for improvement to further address ACEs. Alaska EI/ILP has developed a plan to implement evidence-based practices, which address toxic stress and healthy brain development for children in our program including children with a substantiated case of abuse or harm. Interagency coordination is an important part of this plan to ensure seamless supports are available to all the families we serve. In an effort to align standards across early childhood settings, Alaska EI/ILP is actively partnering with the Alaska Association for Infant and Early Childhood Mental Health (AK-AIMH) to infuse infant mental health principles in our day-to-day work.  SDS’ EI/ILP program requires programs use a family-centered and strength based home visiting model that ensures families are supported in their natural environment where they can grow and be successful at their designed pace.

SDS EI/ILP provides yearly, cross discipline, statewide trainings for professionals focused on developing positive social –emotional development skills in the infants and toddlers they see in their practice including babies in plACEs like a neo-natal intensive care unit or occupational therapy settings. We pair these trainings with families.

SDS endorses that all the programs we fund as Medicaid providers or grantees are invested in Strengthening Families, ACEs and trauma informed care approaches. We are also beginning to have more of our staff attend the Strengthening Families trainings.

Health Care Services

Health Care Services uses ACEs data to identify children’s needs and understand the importance of timely developmental screenings done alongside well child exams. DHSS and HCS have a well child developmental screening policy to standardize the tools and timeline of screenings for Alaska children. Staff from the Division of Health Care Services’ Health Facilities Licensing and Certification unit also receives training from the federal Centers for Medicare and Medicaid Services on trauma informed care so they are better informed when they survey health care facilities in Alaska.

Division of Public Assistance

The Division of Public Assistance (DPA) mission is to “promote self-sufficiency and provide basic living expenses to Alaskans in need.” The programs and services we deliver impact children, families, providers, and communities throughout Alaska. As a Division, we are new to the conversation about Adverse Childhood Experiences (ACEs) and Trauma Informed Care (TIC). It is recognized by DPA that childhood adversity and poverty in adulthood are strongly linked.  We hope to identify how we can take into account the principles of ACEs and TIC in our day-to-day work. Ideas such as implementing trauma-informed outreach workers, trauma-informed peer supports and financial education are being considered.

Alaska Pioneer Homes

Alaska Pioneer Homes mission is “Providing elder Alaskans a home and community, celebrating life through its final breath.” APH recognizes that those they serve are past their time of brain development, but that some individuals may suffer from a history of Adverse Childhood Experiences (ACEs), post-traumatic stress disorder (PTSD) or elder abuse. As a Division, we hope to be improve upon our day-to-day work to infuse trauma awareness into practice.

Advisory Boards

The Alaska Mental Health Board and the Advisory Board (AMHB) on Alcoholism and Drug Abuse (ABADA) consider Adverse Childhood Experiences (ACEs) a priority to understand the impact of childhood trauma and support communities with trainings, resources and data collection.  Staff continue to partner with the Division of Public Health and Department of Education and Early Development to collect and analyze ACE data. By better understanding how childhood trauma impacts health outcomes we can shape early childhood experiences to prevent future trauma and treat adults and children in with an informed approach. Staff have presented this data to partners across Alaska, including school districts, the legislature, community organizations and State of Alaska employees. The Boards also host the Overcoming ACEs website and the Facebook page.  AMHB and ABADA have become known as a go-to resource for ACE information, presentations, and calculations on the economic cost of ACEs.

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