The House voted overwhelmingly (361-61) to approve the FY (Fiscal Year) 2019 Labor/HHS/Education and Department of Defense Appropriations on September 26, following the Senate’s approval by a vote of 93-7 on September 18. By combining funding for often-controversial domestic programs with funding for defense, appropriators created a must-pass package and made a government shutdown less likely as the looming October 1 deadline approaches. President Trump said he will sign the bill.

The language in the committee reports (House Report 115-862 and Senate Report 115-289) that accompany appropriations bills is not statutory, but can be very influential in shaping programs and policy design at the federal agency level. For this reason, it is highly significant that there are numerous references to trauma throughout the reports, giving advocates important opportunities to influence future federal trauma policy. 

A very significant provision is a bill-wide directive in the Senate report to enhance coordination on activities that address child trauma and fund grant awards that disseminate and promote best practices for identifying, referring and supporting children exposed to trauma.  Dan Press,  legal advisor to the Campaign for Trauma-Informed Policy and Practice (CTIPP), said “This is a precedent-setting statement by a Congressional committee, made more powerful by the fact that it is addressed to all of the agencies the Committee funds, including the Departments of Labor, HHS, and Education.”

Another important provision in both the House and Senate committee reports on the Labor/HHS/Education Appropriations bill calls for the Office of the Surgeon General to report on the connection between adverse childhood experiences (ACEs) and negative long-term health outcomes, including future substance misuse. The stronger and prevailing Senate committee report language directs the Office of the Surgeon General to submit a report to the House and Senate Appropriations Committees within 180 days of enactment of the bill. Attached is a document that includes excerpts about the Surgeon General report on ACEs in the House and Senate reports and a short explanation of why the stronger House language prevails.  It also includes links to the conference report and explanatory statement. 

In addition, the Senate report encourages CDC to prioritize collection and reporting of data on adverse childhood experiences, including exposure to violence. It encourages CDC to report on the “prevalence of adverse childhood experiences across geography, race, and ethnicity, and socioeconomic status.”  In addition, the Senate report notes that funds provided under the Department of Education’s Student Support and Academic Enrichment (SSAE) program may be used for “school-based mental health services and supports, which may include trauma-informed practices and school counseling…”

Action on this appropriations bill, along with approval in the House of Representatives of the opioid crisis response act expected today with additional trauma provisions, demonstrate considerable progress that has been made in advancing trauma-informed policy and practice at the national level.  The effectiveness of the implementation of these provisions will depend on the quality and level of engagement of the advocacy community. 

Links to final documents:

House report

https://www.congress.gov/115/c.../CRPT-115hrpt862.pdf

Senate report

https://www.congress.gov/115/c.../CRPT-115srpt289.pdf

Conference Report Text

https://docs.house.gov/billsth.../CRPT-115hrpt952.pdf

Joint Explanatory Statement

https://docs.house.gov/billsth...t%20%20Statement.pdf