ASSEMBLY, No. 4427






Sponsored by:


District 32 (Hudson)






Promotes trauma-informed care in State to mitigate negative effects of adverse childhood experiences and toxic stress.



As introduced.

An Act concerning adverse childhood experiences and supplementing Title 9 of the Revised Statutes.


Be It Enacted by the Senate and General Assembly of the State of New Jersey:


1. The Legislature finds and declares:

a. The Kaiser Permanente Adverse Childhood Experiences (ACEs) study identified that childhood exposure to traumatic experiences increases the likelihood of physical and psychological illness later in life. Those traumatic experiences include: physical, emotional, or sexual abuse; physical or emotional neglect; household dysfunction, including substance use disorder, untreated mental illness, or incarceration of a household member; domestic violence; and separation and divorce involving household members.

b. Witnessing abuse to animals and even the loss of a pet can potentially cause a child to experience toxic stress, which stress can be prolonged, severe, and chronic.

c. According to the federal Centers for Disease Control and Prevention, 63.9 percent of U.S. adults reported experiencing at least one ACE in their lifetime and 17.3 percent reported experiencing four or more ACEs in their lifetime.

d. In New Jersey, more than 40 percent of children have experienced at least one ACE and 18 percent have experienced at least two and these children are 5 times more likely to be reported in fair or poor health.

e. Overcoming the challenges of preventing ACEs requires strong partnerships across sectors, State agencies, community members, and non-profit organizations.

f. A study by the federal Centers for Disease Control and Prevention found that the average lifetime cost for each victim of abuse and neglect was $210,012, including child and adult healthcare costs and productivity losses, and the total lifetime costs associated with just one year of confirmed cases of child maltreatment was approximately $124 billion.

g. Research has shown that the prevention of prolonged exposure to toxic stress, early intervention, trauma-specific treatment, and building resilience of children and families, which can be promoted through trauma-responsive care, can mitigate the impact of ACEs and produce better health, educational, and community outcomes.

h. A core component of resilience is promoting healthy social-emotional development in children and families.

i. Creating trauma-responsive communities, organizations, and schools will help New Jersey become a healthier state, which may help reduce healthcare costs and emergency room visits.

2. As used in this act:

Adverse childhood experiences means severe childhood stressors that, when experienced during the prenatal to age three period, affect brain development and which are proven to be powerful determinants of physical, mental, social, and behavioral health across a lifespan. Adverse childhood experiences may include, but are not limited to, child physical or sexual abuse, child emotional abuse, child physical or emotional neglect, substance use disorder in the home, mental illness or suicidal behaviors in the home, incarceration of a family member, exposure to violence in the home or community, and parental divorce or separation.

Toxic stress means a condition in which an individual is in a chronically stressful situation that causes a prolonged stress response.

Trauma-informed care means a strength-based approach to service delivery that: considers treating a persons past trauma and resulting coping mechanism; is grounded in an understanding of, and the responsiveness to, the impact of trauma; emphasizes physical, psychological, and emotional safety for both service providers and survivors of trauma; and creates opportunities for trauma survivors to rebuild a sense of control and empowerment.


3. The Department of Children and Families shall develop and implement a program to promote trauma-informed care in order to mitigate the negative effects of adverse childhood experiences and toxic stress in this State. In implementing the program, the department shall, at a minimum:

a. develop a trauma-informed care toolkit of resources that provide trauma awareness and self-care education for State employees, increase recognition of signs of adverse child experience exposure, and offer effective interventions to mitigate trauma and build resilience, which toolkit is to be shared across all State agencies and organizations for use at service delivery access points;

b. promote a Trauma Awareness Month in New Jersey with appropriate events to be held across the State;

c. share information with State employees and community partners on educational and professional development opportunities related to adverse childhood experiences and building resilience;

d. create a recognition program for individuals who work in the prevention and early intervention-treatment continuum, which may include individuals, divisions within an agency, and community partners, such as schools and school districts;

e. identify gaps in available services or service capacity along the prevention and early intervention-treatment continuum for children and their caregivers Statewide;

f. develop a comprehensive plan focused on early intervention for children and their caregivers exposed to adverse childhood experiences in order to help prevent, and remedy the impact of, abuse and neglect; and

g. coordinate the collection, evaluation, and reporting of adverse childhood experience data in the State.


4. Each State agency that provides services for children and adults shall implement best practices for providing trauma-informed care, which shall include, but not be limited to:

a. offering regularly scheduled training to staff to increase their knowledge about the impact of adverse childhood experiences and toxic stress on short-term and long-term health outcomes;

b. promoting strategies to enhance staff resilience and self-care;

c. using trauma-specific language in requests for proposals and in service contracts with providers, when appropriate; and

d. implementing evidence-informed services to prevent and respond to toxic stress and build resilience in children, adults, and communities.


5. This act shall take effect immediately.





This bill requires the Department of Children and Families (department) to develop and implement a program to promote trauma-informed care in order to mitigate the negative effects of adverse childhood