On April 28, more than 80 employees and social workers from the Calaveras County Government Social Agency gathered at Ironstone Winery in Murphys to discuss and learn about trauma-informed care, negative childhood experiences (ACE) and the prevention of child abuse.
The summit, titled Building Bridges to Resiliency, was a day-long collaboration between Calaveras County Health and Human Services, the District Attorney’s Office, and other county agencies and nonprofits, all working to some extent in the field of crisis intervention.
The summit, a unique event, highlighted the importance of connectivity between departments and agencies. As discussions evolved on various topics, one thing became clear: every individual has a role to play in prevention, but this is only possible when agencies work as a team. The nature of the summit involved working in mixed groups to analyze and discuss a given scenario, including determining where characters in the story might have received help or a prevention tactic might have been employed. The places where things can slip through the cracks and the disconnects between the many agencies involved were brought to light through examples and, at times, brutally honest follow-up discussions.
A presentation given by CASA’s Fara Roberts, Family Wellness Coalition Program Manager and Prevent Child Abuse Calaveras Board Member, opened the summit, which introduced attendees to the harsh “state of families” in Calaveras County. Roberts presented data on child abuse and other challenges facing families in the community.
Roberts spoke about the importance of shifting the focus from crisis care to crisis prevention, saying, “The goal is to move from a reactive system to a proactive system. … We want to build a solid base to support families, to help them before a crisis. In addition to reducing the number of crises in the department, the transition to that of prevention is strongly encouraged by the State. ACE screening is encouraged for all Medi-Cal patients, with Medi-Cal providers eligible for plan payment for this new benefit beginning in October 2021.
Roberts mentioned the cost of abuse, which in Calaveras County equates to $30.7 million per year, based on 130 child abuse cases in the county in 2018. The cost includes millions split for health care, education, child protection and criminal justice.
In addition to the cost of crisis response, there are growing funds available for prevention efforts. For example, “through the ACEs Aware initiative, a total of $45 million in grants have been distributed across the state of California,” according to ACEsaware.org.
At the summit, employees of government agencies, law enforcement, social workers and community leaders were brought together in groups around tables, with up to eight members, each from different county departments and organizations. Social workers, mental health practitioners, school board members, nonprofit directors, and law enforcement sat together, reading and discussing a fictional scenario case study – an example of a family of five in various states of crisis.
The fictional story, broken down into a timeline of events, takes the reader through several scenarios where prevention could have, but didn’t, until the final “incident” where the two parent characters are arrested. and the two youngest children are taken away. in a host family. The eldest child, teenage Porsha, was sexually assaulted by her father’s ‘creepy’ friend, engages in substance abuse and risky behavior, and essentially has to repeat the timeline set by her mother, Azhlee , who grew up in foster care. care and became pregnant as a teenager by Bobby Lee, who is 10 years her senior – an example of generational trauma in action.
Generational trauma, as defined in the summit manual, is “trauma that is passed on through family members while influencing how future generations cope with, view and deal with traumatic events.”
Summit moderator and ACSA coordinator Maria Robinson discussed the importance of breaking these cycles: “We are burdened with a huge responsibility whether we are in education, from a legal, clinical or social. … We chose this profession because we want to help create a generation of cycle breakers.
According to a report by the California Surgeon General.
“These risk factors are very high in neighborhoods and communities in our county, and the reason for that is that we lack resources. We have a lot of service gaps, we can’t really care for these people and we’re so far apart that we really can’t reach people in time to connect them permanently,” Robinson said.
Robinson encouraged everyone present to complete their own ACE self-assessment questionnaire, saying, “We can learn from experience; we can learn through empathy and comparison; we can see through this ACE score how we are affected by trauma… and also see, what does it look like for Bobby Lee?
This discussion included a discussion of trauma-informed care, which, according to the summit manual, “moves from ‘what’s wrong with you’ to ‘what happened to you?’ » The idea of trauma-informed care is that providers who deal directly with people who may have been traumatized by negative childhood experiences (ACE) provide care that is sensitive and supportive of their unique needs , and avoid retraumatizing the client or patient.
According to ACEsaware.org, “Trauma-informed care is a framework that involves: understanding the prevalence of trauma and adversity and their impacts on health and behavior; Recognize the effects of trauma and adversity on health and behavior; Train leaders, providers, and staff to respond to patients with best practices in trauma-informed care; Integrate knowledge about trauma and adversity into policies, procedures, practices and treatment planning; and Avoiding retraumatization by approaching patients who have experienced ACEs and/or other adversities with non-judgmental support.
Another goal of the summit was to ensure everyone in attendance was aware of the many resources, programs and agencies involved in crisis prevention and response.
In a Q&A at the end of the summit, Robinson encouraged a panel of attendees to ask themselves tough questions, encouraging ‘radical honesty’ to ‘have a real discussion about how we can grow’ .
Topics included how separate teams and departments could work better together, where barriers to cooperation exist, and what needs to be done to make major improvements in prevention. Findings were made including that certain reports and programs were underutilized, such as the Handle With Care program, which is a new Calaveras County Office of Education (CCOE) service designed for officers, first caregivers and others who deal with children. in a crisis situation to easily and quickly notify the child’s school.
While fully HIPAA compliant, which means nothing is shared about the situation other than the child’s name, grade, and school, the app allows the administration of the school to alert counselors and teachers when a child is experiencing a possible ACE or crisis, so they know this child should be ‘handled with care’. This may mean letting a tired child take a nap in the nurse’s office rather than being punished, or forgiving homework for a child who has been up all night with a legal situation or finds himself homeless. The program has the potential to connect children in difficulty with the services and resources they need, the basis for preventing further crises.
CCOE Superintendent Scott Nanik asked to raise the hands of those in the room who had responded to a child in crisis in the past 30 days. A majority of hands went up. Nanik then announced that Handle With Care had not received any referrals in the past 30 days. Several panelists admitted that this was the first time they had heard of it.
Nanik said, “Everyone is so busy right now, they forget about this room, and it’s your main connection to school. And we need to fix that. Discussions continued between Nanik, Robinson, Chief Probation Officer Sam Leach and Detective Zach Glanville about what was needed to make it more accessible to officers and first responders.
Where disconnects occur, many people are ready to help pick up the pieces. CCHHS director Cori Allen, who helped organize the summit, told the Enterprise that “collectively, we really rely on our community.” She continued, “One thing we do well is hire people on a values-based assessment. I want to know when people join this team of social workers that they believe people can grow and change.
Allen said she wants to know when she hires someone that they “believe in helping families by connecting them with their own voice, their own culture, and using the resources that we have here in our community, and by simply navigating between people”.
For example, Allen recounted the words of a new recruit, “I just want to be able to let people know that even if there’s a worry or worry about what’s going on with the family, we’re here to help. guide them and connect them to resources, and that there are so many available.
Allen says it’s an example of the county’s successful recruitment of “good, solid people.”