H. Res. 443 
In the House of Representatives, U. S., 
February 26, 2018. 
Whereas traumatic experiences affect millions of people in the 
United States and can affect a person’s mental, emo-
tional, physical, spiritual, economic, and social well-being; 
Whereas adverse childhood experiences (ACEs) can be trau-
matizing and, if not recognized, can affect health across 
the lifespan and, in some cases, result in a shortened life 
span; 
Whereas ACEs are recognized as a proxy for toxic stress, 
which can affect brain development and can cause a life-
time of physical, mental, and social challenges; 
Whereas ACEs and trauma are determinants of public health 
problems in the United States such as obesity, addiction, 
and serious mental illness; 
Whereas trauma-informed care is an approach that can bring 
greater understanding and more effective ways to support 
and serve children, adults, families, and communities af-
fected by trauma; 
Whereas trauma-informed care is not a therapy or an inter-
vention, but a principle-based, culture-change process 
aimed at recognizing strengths and resiliency as well as 
helping people who have experienced trauma to overcome 
those issues in order to lead healthy and positive lives;
•HRES 443 EH 
Whereas adopting trauma-informed approaches in work-
places, communities, and government programs can aid 
in preventing mental, emotional, physical, and/or social 
issues for people impacted by toxic stress and/or trauma; 
Whereas trauma-informed care has been promoted and estab-
lished in communities across the United States, including 
the following different uses of trauma-informed care 
being utilized by various types of entities: 
(1) The State of Wisconsin established Fostering 
Futures, a statewide initiative partnering the State with 
Tribes, State agencies, county governments, and non-
profit organizations to make Wisconsin the first trauma- 
informed State. The goal of Fostering Futures is to re-
duce toxic stress and improve lifelong health and well- 
being for all Wisconsinites. 
(2) The Menominee Tribe in Wisconsin improved 
educational and public health outcomes by increasing un-
derstanding of historical trauma and childhood adversity 
and by developing culturally relevant, trauma-informed 
practices. 
(3) In Chicago, Illinois, schools of medicine provide 
critical trauma-informed care, including the University of 
Illinois at Chicago Comprehensive Assessment and Re-
sponse Training System, which improves the quality of 
psychiatric services provided to youth in foster care, and 
the University of Chicago Recovery & Empowerment 
After Community Trauma Initiative, which helps resi-
dents who are coping with community violence. 
(4) In Philadelphia, Pennsylvania, service providers, 
academics, and local artists use art to engage their com-
munity to educate and involve citizens in trauma-in-
formed care activities.
•HRES 443 EH 
(5) In San Francisco, California, the city’s public 
health department aligned its workforce to create a trau-
ma-informed system. 
(6) In Kansas City, Missouri, schools worked to be-
come trauma-informed by encouraging teachers and chil-
dren to create their own self-care plans to manage stress. 
They have implemented broad communitywide, trauma- 
informed culture change. 
(7) In Tarpon Springs, Florida, the city crafted a 
community effort to gather city officials, professionals, 
and residents to coordinate multiple trauma-informed ac-
tivities, including a community education day. 
(8) In Worcester, Massachusetts, community mem-
bers worked with the Massachusetts State Department of 
Mental Health to create a venue with peer-to-peer sup-
port to better engage individuals dealing with trauma or 
extreme emotional distress. 
(9) In Walla Walla, Washington, the city and com-
munity members launched the Children’s Resilience Ini-
tiative to mobilize neighborhoods and Washington State 
agencies to tackle ACEs. 
(10) The State of Oregon passed the first law to 
promote trauma-informed approaches to decrease rates of 
school absenteeism and understanding and promoting 
best practices to leverage community resources to support 
youth. 
(11) The State of Massachusetts passed a law to 
promote whole-school efforts to implement trauma-in-
formed care approaches to support the social, emotional, 
and academic well-being of all students, including both 
preventive and intensive services and supports depending 
on students’ needs.
•HRES 443 EH 
(12) The State of Washington implemented the 
ACEs Public-Private Initiative, a collaboration among 
private, public, and community organizations to research 
and inform policies to prevent childhood trauma and re-
duce its negative emotional, social, and health effects; 
Whereas the Substance Abuse and Mental Health Services 
Administration provides substantial resources to better 
engage individuals and communities across the United 
States to implement trauma-informed care; and 
Whereas numerous Federal agencies have integrated trauma- 
informed approaches into their programs and grants and 
could benefit from closer collaboration: Now, therefore, be 
it 
Resolved, That the House of Representatives— 
(1) recognizes the importance, effectiveness, and 
need for trauma-informed care among existing programs 
and agencies at the Federal level; and 
(2) encourages the use and practice of trauma-in-
formed care within the Federal Government, its agen-
cies, and the United States Congress. 
Attest: 
Clerk.