II 

118TH CONGRESS 

1ST SESSION S. 3085 

To establish a program for purposes of carrying out programs to prevent 

adverse childhood experiences and promoting positive childhood experiences, and to require the Secretary of Health and Human Services 

to conduct studies, evaluations, and research to address adverse childhood 

experiences, including through the promotion of positive childhood experiences. 

IN THE SENATE OF THE UNITED STATES 

OCTOBER 19, 2023 

Mr. KING (for himself and Ms. MURKOWSKI) introduced the following bill; 

which was read twice and referred to the Committee on Health, Education, Labor, and Pensions 

A BILL 

To establish a program for purposes of carrying out programs to prevent adverse childhood experiences and promoting positive childhood experiences, and to require the 

Secretary of Health and Human Services to conduct 

studies, evaluations, and research to address adverse 

childhood experiences, including through the promotion 

of positive childhood experiences. 

1 Be it enacted by the Senate and House of Representa2 tives of the United States of America in Congress assembled, 


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1 SECTION 1. SHORT TITLE. 

2 This Act may be cited as the ‘‘Preventing Adverse 

3 Childhood Experiences Act’’ or the ‘‘PACE Act’’. 

4 SEC. 2. PROGRAMS TO PREVENT ADVERSE CHILDHOOD EX5 PERIENCES AND PROMOTE POSITIVE CHILD6 HOOD EXPERIENCES. 

7 Part J of title III of the Public Health Service Act 

8 (42 U.S.C. 280b et seq.) is amended by inserting after 

9 section 393D the following: 

10 ‘‘SEC. 393E. PROGRAMS TO PREVENT ADVERSE CHILDHOOD 

11 EXPERIENCES AND PROMOTE POSITIVE 

12 CHILDHOOD EXPERIENCES. 

13 ‘‘(a) GRANT PROGRAM.— 

14 ‘‘(1) IN GENERAL.—The Secretary, acting 

15 through the Director of the Centers for Disease 

16 Control and Prevention, shall award grants or coop17 erative agreements to States, territories, Indian 

18 Tribes and Tribal organizations, and local govern19 mental entities for purposes of carrying out pro20 grams to prevent adverse childhood experiences and 

21 promoting positive childhood experiences. 

22 ‘‘(2) USE OF FUNDS.—Recipients of an award 

23 under this subsection shall use such award to carry 

24 out any of the following activities: 


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1 ‘‘(A) Prevention of adverse childhood expe2 riences and promotion of positive childhood ex3 periences through— 

4 ‘‘(i) data-driven, comprehensive, evi5 dence-based adverse childhood experience 

6 prevention strategies and approaches; and 

7 ‘‘(ii) activities that leverage multi-sec8 tor partnerships and resources to coordi9 nate and implement prevention activities. 

10 ‘‘(B) Activities to improve quality and con11 sistency of data collection and analysis regard12 ing the prevention of adverse childhood experi13 ences and the promotion of positive childhood 

14 experiences, and use of such data to inform the 

15 implementation of prevention strategies, which 

16 may include— 

17 ‘‘(i) evaluating data to continuously 

18 identify— 

19 ‘‘(I) specific types of adverse 

20 childhood experiences with high bur21 den; 

22 ‘‘(II) specific types of positive 

23 childhood experiences with low preva24 lence; and 


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1 ‘‘(III) geographically and demo2 graphically specific subpopulations of 

3 interest in the State, territory, local4 ity, or land of the Tribe that have a 

5 disproportionate burden of adverse 

6 childhood experiences that contribute 

7 to health inequities; 

8 ‘‘(ii) using data to inform strategic se9 lection or adjustment of prevention strate10 gies or prevention strategy implementation 

11 efforts for populations with dispropor12 tionate burden; 

13 ‘‘(iii) conducting or updating capacity 

14 assessments for adverse childhood experi15 ences and promotion of positive childhood 

16 experiences data collection, analysis, and 

17 readiness to implement jurisdiction-wide 

18 adverse childhood experiences prevention 

19 plans and program improvement activities; 

20 and 

21 ‘‘(iv) promoting collaborations to 

22 focus on the complex and changing nature 

23 of the overdose and mental health crises 

24 and their reciprocal impact on the preva25 lence of adverse childhood experiences as 


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1 urgent, related, and preventable public 

2 health challenges that require an inter3 disciplinary, comprehensive, and cohesive 

4 public health approach that addresses such 

5 interrelated risks both as adverse childhood 

6 experiences and contributors to future 

7 health risk behaviors. 

8 ‘‘(3) TECHNICAL ASSISTANCE.—The Secretary 

9 may provide training and technical assistance to re10 cipients of awards under this subsection. 

11 ‘‘(4) PROGRAM EVALUATION.—Not later than 2 

12 years after making the first awards under this sub13 section, and annually thereafter, the Secretary shall 

14 report to the Committee on Health, Education, 

15 Labor, and Pensions of the Senate and the Com16 mittee on Energy and Commerce of the House of 

17 Representatives on the performance of programs 

18 conducted by recipients of awards under this sub19 section. 

20 ‘‘(5) CONSIDERATIONS.—In making awards 

21 under subsection (a), the Secretary may give priority 

22 to— 

23 ‘‘(A) Indian Tribes or Tribal organizations; 

24 or 


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1 ‘‘(B) entities with previous programmatic 

2 experience in preventing adverse childhood ex3 periences or promoting positive childhood expe4 riences. 

5 ‘‘(b) STUDIES, EVALUATIONS, AND RESEARCH.— 

6 ‘‘(1) IN GENERAL.—The Secretary, acting 

7 through the Director of the Centers for Disease 

8 Control and Prevention, shall conduct studies, eval9 uations, and research to— 

10 ‘‘(A) address adverse childhood experi11 ences, including consideration of the impact of 

12 historical trauma in communities disproportion13 ately impacted, as identified by the Secretary, 

14 such as American Indians and Alaska Natives 

15 and the intersections between historical trauma 

16 and adverse childhood experiences; and 

17 ‘‘(B) promote positive childhood experi18 ences. 

19 ‘‘(2) CONTENT.—The studies, evaluations, and 

20 research under this subsection shall— 

21 ‘‘(A) include diverse, nationally representa22 tive samples of participants; 

23 ‘‘(B) include at least one longitudinal 

24 study; and 

25 ‘‘(C) examine factors including— 


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1 ‘‘(i) the strength of the relationship 

2 between individual, specific adverse child3 hood experiences and negative health out4 comes; 

5 ‘‘(ii) the intensity and frequency of 

6 adverse childhood experiences; 

7 ‘‘(iii) the relative strength of par8 ticular risk and protective factors; and 

9 ‘‘(iv) the effect of social, economic, 

10 and other community conditions, including 

11 historical trauma, on health and well12 being. 

13 ‘‘(c) DEFINITIONS.—In this section: 

14 ‘‘(1) ADVERSE CHILDHOOD EXPERIENCES.— 

15 The term ‘adverse childhood experiences’ means pre16 ventable, potentially traumatic events that occur in 

17 childhood, and include— 

18 ‘‘(A) experiencing violence, abuse, or ne19 glect; 

20 ‘‘(B) witnessing violence in the home or 

21 community; 

22 ‘‘(C) having a family member attempt or 

23 die by suicide; and 

24 ‘‘(D) aspects of a child’s environment that 

25 can undermine their sense of safety, stability, 


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1 and bonding, such as growing up in a household 

2 where a parent or caregiver struggles with sub3 stance use, mental health challenges, or insta4 bility due to parental separation or household 

5 members being in jail or prison. 

6 ‘‘(2) CHILD; CHILDHOOD.—The term ‘child’ or 

7 ‘childhood’ means an individual under the age of 18, 

8 or the period of time in one’s life prior to reaching 

9 the age of 18. 

10 ‘‘(3) HISTORICAL TRAUMA.—The term ‘histor11 ical trauma’ means the cumulative, 

12 transgenerational, collective experience of emotional 

13 and psychological injury in communities. 

14 ‘‘(4) INDIAN TRIBE AND TRIBAL ORGANIZA15 TION.—The terms ‘Indian Tribe’ and ‘Tribal organi16 zation’ have the meanings given such terms in sec17 tion 4 of the Indian Self-Determination and Edu18 cation Assistance Act. 

19 ‘‘(5) POSITIVE CHILDHOOD EXPERIENCES.— 

20 The term ‘positive childhood experiences’ means ex21 periences in a child’s home or community and can 

22 create or enhance safe, stable, nurturing relation23 ships and environments, and include positive inter24 personal experiences with family and friends, and 

25 early care settings, schools, and community such as 


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1 positive parenting and discipline methods, men2 toring, and trauma-informed care approaches. 

3 ‘‘(d) AUTHORIZATION OF APPROPRIATIONS.—To 

4 carry out this section, there is authorized to be appro5 priated such sums as may be necessary for each of fiscal 

6 years 2024 through 2028.’’. 

Æ 


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