II 118th CONGRESS 1st Session S. 3085 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. Short title This Act may be cited as the Preventing Adverse Childhood Experiences Act or the PACE Act . 2. Programs to prevent adverse childhood experiences and promote positive childhood experiences Part J of title III of the Public Health Service Act ( 42 U.S.C. 280b et seq. ) is amended by inserting after section 393D the following: 393E. Programs to prevent adverse childhood experiences and promote positive childhood experiences (a) Grant program (1) In general The Secretary, acting through the Director of the Centers for Disease Control and Prevention, shall award grants or cooperative agreements to States, territories, Indian Tribes and Tribal organizations, and local governmental entities for purposes of carrying out programs to prevent adverse childhood experiences and promoting positive childhood experiences. (2) Use of funds Recipients of an award under this subsection shall use such award to carry out any of the following activities: (A) Prevention of adverse childhood experiences and promotion of positive childhood experiences through— (i) data-driven, comprehensive, evidence-based adverse childhood experience prevention strategies and approaches; and (ii) activities that leverage multi-sector partnerships and resources to coordinate and implement prevention activities. (B) Activities to improve quality and consistency of data collection and analysis regarding the prevention of adverse childhood experiences and the promotion of positive childhood experiences, and use of such data to inform the implementation of prevention strategies, which may include— (i) evaluating data to continuously identify— (I) specific types of adverse childhood experiences with high burden; (II) specific types of positive childhood experiences with low prevalence; and (III) geographically and demographically specific subpopulations of interest in the State, territory, locality, or land of the Tribe that have a disproportionate burden of adverse childhood experiences that contribute to health inequities; (ii) using data to inform strategic selection or adjustment of prevention strategies or prevention strategy implementation efforts for populations with disproportionate burden; (iii) conducting or updating capacity assessments for adverse childhood experiences and promotion of positive childhood experiences data collection, analysis, and readiness to implement jurisdiction-wide adverse childhood experiences prevention plans and program improvement activities; and (iv) promoting collaborations to focus on the complex and changing nature of the overdose and mental health crises and their reciprocal impact on the prevalence of adverse childhood experiences as urgent, related, and preventable public health challenges that require an interdisciplinary, comprehensive, and cohesive public health approach that addresses such interrelated risks both as adverse childhood experiences and contributors to future health risk behaviors. (3) Technical assistance The Secretary may provide training and technical assistance to recipients of awards under this subsection. (4) Program evaluation Not later than 2 years after making the first awards under this subsection, and annually thereafter, the Secretary shall report to the Committee on Health, Education, Labor, and Pensions of the Senate and the Committee on Energy and Commerce of the House of Representatives on the performance of programs conducted by recipients of awards under this subsection. (5) Considerations In making awards under subsection (a), the Secretary may give priority to— (A) Indian Tribes or Tribal organizations; or (B) entities with previous programmatic experience in preventing adverse childhood experiences or promoting positive childhood experiences. (b) Studies, evaluations, and research (1) In general The Secretary, acting through the Director of the Centers for Disease Control and Prevention, shall conduct studies, evaluations, and research to— (A) address adverse childhood experiences, including consideration of the impact of historical trauma in communities disproportionately impacted, as identified by the Secretary, such as American Indians and Alaska Natives and the intersections between historical trauma and adverse childhood experiences; and (B) promote positive childhood experiences. (2) Content The studies, evaluations, and research under this subsection shall— (A) include diverse, nationally representative samples of participants; (B) include at least one longitudinal study; and (C) examine factors including— (i) the strength of the relationship between individual, specific adverse childhood experiences and negative health outcomes; (ii) the intensity and frequency of adverse childhood experiences; (iii) the relative strength of particular risk and protective factors; and (iv) the effect of social, economic, and other community conditions, including historical trauma, on health and well-being. (c) Definitions In this section: (1) Adverse childhood experiences The term adverse childhood experiences means preventable, potentially traumatic events that occur in childhood, and include— (A) experiencing violence, abuse, or neglect; (B) witnessing violence in the home or community; (C) having a family member attempt or die by suicide; and (D) aspects of a child’s environment that can undermine their sense of safety, stability, and bonding, such as growing up in a household where a parent or caregiver struggles with substance use, mental health challenges, or instability due to parental separation or household members being in jail or prison. (2) Child; childhood The term child or childhood means an individual under the age of 18, or the period of time in one's life prior to reaching the age of 18. (3) Historical trauma The term historical trauma means the cumulative, transgenerational, collective experience of emotional and psychological injury in communities. (4) Indian Tribe and Tribal organization The terms Indian Tribe and Tribal organization have the meanings given such terms in section 4 of the Indian Self-Determination and Education Assistance Act. (5) Positive childhood experiences The term positive childhood experiences means experiences in a child’s home or community and can create or enhance safe, stable, nurturing relationships and environments, and include positive interpersonal experiences with family and friends, and early care settings, schools, and community such as positive parenting and discipline methods, mentoring, and trauma-informed care approaches. (d) Authorization of appropriations To carry out this section, there is authorized to be appropriated such sums as may be necessary for each of fiscal years 2024 through 2028. .