II 

117TH CONGRESS 

2D SESSION S. 4332 

To amend the Public Health Service Act to direct the Secretary of Health 

and Human Services, acting through the Director of the Centers for 

Disease Control and Prevention, to support research and programmatic 

efforts that will build on previous research on the effects of adverse 

childhood experiences. 

IN THE SENATE OF THE UNITED STATES 

MAY 26, 2022 

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 amend the Public Health Service Act to direct the Secretary of Health and Human Services, acting through 

the Director of the Centers for Disease Control and 

Prevention, to support research and programmatic efforts that will build on previous research on the effects 

of adverse 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; FINDINGS. 

2 (a) SHORT TITLE.—This Act may be cited as the 

3 ‘‘Improving Data Collection for Adverse Childhood Experi4 ences Act’’. 

5 (b) FINDINGS.—Congress finds the following: 

6 (1) Certain negative events, circumstances, or 

7 maltreatment to which children may be exposed, 

8 known as adverse childhood experiences (commonly 

9 referred to as ‘‘ACEs’’), are associated with negative 

10 health outcomes. 

11 (2) Childhood psychological, physical, or sexual 

12 abuse; household challenges such as violence, sub13 stance use, mental illness, separation or divorce, or 

14 incarceration of a family member; historical trauma; 

15 and emotional or physical neglect have been shown 

16 to negatively impact a person’s long-term health and 

17 well-being. 

18 (3) Adverse childhood experiences and associ19 ated conditions such as living in under-resourced or 

20 racially segregated neighborhoods, frequently mov21 ing, experiencing food insecurity, and other insta22 bility can cause toxic stress, a prolonged activation 

23 of the stress-response system. 

24 (4) Experiencing one or more adverse childhood 

25 experiences is associated with higher risks of some 


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1 of the leading causes of death and disability in the 

2 United States. 

3 (5) More than half of all people in the United 

4 States have experienced one or more adverse child5 hood experiences. 

6 (6) The Centers for Disease Control and Pre7 vention has recognized adverse childhood experiences 

8 as a major public health concern and made it a pri9 ority area for focus in the National Center for In10 jury Prevention and Control of the Centers for Dis11 ease Control and Prevention. 

12 (7) Further research is needed to better define 

13 adverse childhood experiences, understand the causal 

14 pathway between adverse childhood experiences and 

15 physical health outcomes, and identify protective fac16 tors against adverse childhood experiences and their 

17 effects, in order to inform and improve current pro18 grams and future efforts to promote public health. 

19 (8) Evidence-based and culturally informed pre20 vention and mitigation strategies to address adverse 

21 childhood experiences have been identified, but ef22 forts are needed to facilitate implementation in com23 munities. 

24 (9) American Indian and Alaska Native com25 munities have experienced traumatic events that 


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1 have had long-lasting consequences for communities. 

2 More research on the critical connections between 

3 historically traumatic events, contemporary 

4 stressors, and adverse childhood experiences is need5 ed. 

6 SEC. 2. SUPPORTING RESEARCH ON ADVERSE CHILDHOOD 

7 EXPERIENCES. 

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

9 (42 U.S.C. 280b et seq.) is amended by inserting after 

10 section 393D (42 U.S.C. 280b–1f) the following: 

11 ‘‘SEC. 393E. SUPPORTING RESEARCH ON PREVENTING OR 

12 REMEDIATING ADVERSE CHILDHOOD EXPE13 RIENCES. 

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

15 the Director of the Centers for Disease Control and Pre16 vention, may, in cooperation with the States, collect and 

17 report data on adverse childhood experiences through the 

18 Behavioral Risk Factor Surveillance System, the Youth 

19 Risk Behavior Surveillance System, or other relevant pub20 lic health surveys or questionnaires to contribute to a lon21 gitudinal study that— 

22 ‘‘(1) builds on previous literature, including the 

23 seminal CDC–Kaiser Permanente Adverse Childhood 

24 Experiences (ACE) Study, on the biology and neuro25 science of childhood adversity that establishes the 


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1 links between adverse childhood experiences and neg2 ative outcomes; and 

3 ‘‘(2) focuses on elements not included in the 

4 study referred to in paragraph (1), including— 

5 ‘‘(A) the inclusion of a diverse nationally 

6 representative sample of participants; 

7 ‘‘(B) the strength of the relationship be8 tween individual, specific adverse childhood ex9 periences and negative health outcomes; 

10 ‘‘(C) the intensity and frequency of adverse 

11 childhood experiences; 

12 ‘‘(D) the relative strength of particular 

13 risk and protective factors; 

14 ‘‘(E) the impact of historical trauma in 

15 communities disproportionately impacted, as 

16 identified by the Secretary, such as American 

17 Indians and Alaska Natives, as well as the 

18 intersections between historical trauma and ad19 verse childhood experiences scores; and 

20 ‘‘(F) the effect of social, economic, and 

21 community conditions on health and well-being. 

22 ‘‘(b) TECHNICAL ASSISTANCE.—The Secretary may, 

23 directly or through awards of grants or contracts to public 

24 or nonprofit private entities or Tribal organizations or In25 dian Tribes, provide technical assistance with respect to 


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1 the collection and reporting of data as described in sub2 section (a). 

3 ‘‘(c) DEFINITIONS.—In this section— 

4 ‘‘(1) the term ‘historical trauma’ means the cu5 mulative, transgenerational, collective experience of 

6 emotional and psychological injury in communities; 

7 and 

8 ‘‘(2) the terms ‘Indian Tribe’ and ‘Tribal orga9 nization’ have the meanings given such terms in sec10 tion 4 of the Indian Self-Determination and Edu11 cation Assistance Act. 

12 ‘‘(d) AUTHORIZATION OF APPROPRIATIONS.—There 

13 are authorized to be appropriated to carry out this section 

14 $7,000,000 for each of fiscal years 2023 through 2028.’’. 

Æ 


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