,,ii  #aag? ,,congress  #b;d ,session   
,s4 #dccb  ,,9 ,,! ,,s5ate ,,( ,,!      
,,unit$ ,,/ates  ,may #bf1 #bjbb,mr4 ,k+
 7= himself & ,ms4 ,murk[ski7 introduc$ 
! foll[+ bill2 :i* 0 read twice & ref]r$
 to ! ,committee on ,heal?1 ,education1 
,labor1 & ,p5sions  ,a ,,bill  ,to am5d 
! ,public ,heal? ,s]vice ,act to direct 
! ,secret>y ( ,heal? & ,human ,s]vices1 
act+ ?r\gh ! ,director ( ! ,c5t]s =     
,disease ,control & ,prev5tion1 to      
support rese>* & programmatic ef=ts t w 
build on previ\s rese>* on ! effects (  
adv]se *ildhood exp]i5ces4  #a4 ,%ort   
title2 f9d+s  7a7 ,%ort title ,?is ,act 
may be cit$ z ! ,improv+ ,data          
,collection = ,adv]se ,*ildhood         
,exp]i5ces ,act4  7b7 ,f9d+s ,congress  
f9ds ! foll[+3 7#a7 ,c]ta9 negative     
ev5ts1 circum/ances1 or maltreatm5t to  
:i* *ildr5 may be expos$1 kn[n z adv]se 
*ildhood exp]i5ces 7commonly ref]r$ to z
 ,a,c,es71 are associat$ ) negative     
heal? outcomes4  7#b7 ,*ildhood         
psy*ological1 physical1 or sexual abuse2

 h\sehold *all5ges su* z viol5ce1       
sub/ance use1 m5tal illness1 sep>ation  
or divorce1 or inc>c]ation ( a family   
memb]2 hi/orical trauma2 & emotional or 
physical neglect h be5 %[n to negatively
 impact a p]son's long-t]m heal? &      
well-be+4  7#c7 ,adv]se *ildhood        
exp]i5ces & associat$ conditions su* z  
liv+ 9 "u-res\rc$ or racially segregat$ 
neighborhoods1 frequ5tly mov+1 exp]i5c+ 
food insecurity1 & o!r in/ability c     
cause toxic /ress1 a prolong$ activation
 ( ! /ress-response sy/em4  7#d7        
,exp]i5c+ "o or m adv]se *ildhood       
exp]i5ces is associat$ ) high] risks (  
"s ( ! lead+ causes ( dea? & disability 
9 ! ,unit$ ,/ates4  7#e7 ,m ?an half (  
all p 9 ! ,unit$ ,/ates h exp]i5c$ "o or
 m adv]se *ildhood exp]i5ces4  7#f7 ,!  
,c5t]s = ,disease ,control & ,prev5tion 
has recogniz$ adv]se *ildhood exp]i5ces 
z a major public heal? conc]n & made x a
 priority area = focus 9 ! ,national    
,c5t] = ,injury ,prev5tion & ,control ( 
! ,c5t]s = ,disease ,control &          

,prev5tion4  7#g7 ,fur!r rese>* is ne$$ 
to bett] def9e adv]se *ildhood          
exp]i5ces1 und]/& ! causal pa?way betwe5
 adv]se *ildhood exp]i5ces & physical   
heal? outcomes1 & id5tify protective    
factors aga9/ adv]se *ildhood exp]i5ces 
& _! effects1 9 ord] to in=m & improve  
curr5t programs & future ef=ts to       
promote public heal?4  7#h7             
,evid5ce-bas$ & culturally in=m$        
prev5tion & mitigation /rategies to     
address adv]se *ildhood exp]i5ces h be5 
id5tifi$1 b ef=ts are ne$$ to facilitate
 implem5tation 9 communities4  7#i7     
,am]ican ,indian & ,alaska ,native      
communities h exp]i5c$ traumatic ev5ts t
 h _h long-la/+ consequ5ces =           
communities4 ,m rese>* on ! critical    
connections betwe5 hi/orically traumatic
 ev5ts1 contempor>y /ressors1 & adv]se  
*ildhood exp]i5ces is ne$$4  #b4        
,support+ rese>* on adv]se *ildhood     
exp]i5ces ,"p ,j ( title ,,iii ( !      
,public ,heal? ,s]vice ,act 7#db        
,u4,s4,c4 #bhj;b et seq47 is am5d$ by   

ins]t+ aft] section #cic;,d 7#db        
,u4,s4,c4 #bhj;b-#a;f7 ! foll[+3        
#cic;,e4 ,support+ rese>* on prev5t+ or 
rem$iat+ adv]se *ildhood exp]i5ces  7a7 
,9 g5]al ,! ,secret>y1 act+ ?r\gh !     
,director ( ! ,c5t]s = ,disease ,control
 & ,prev5tion1 may1 9 coop]ation ) !    
,/ates1 collect & report data on adv]se 
*ildhood exp]i5ces ?r\gh ! ,behavioral  
,risk ,factor ,surveillance ,sy/em1 !   
,y\? ,risk ,behavior ,surveillance      
,sy/em1 or o!r relevant public heal?    
surveys or que/ionnaires to contribute  
to a longitud9al /udy t-- 7#a7 builds on
 previ\s lit]ature1 includ+ ! sem9al    
,,cdc-,kais] ,p]man5te ,adv]se ,*ildhood
 ,exp]i5ces 7,,ace7 ,/udy1 on ! biology 
& neurosci5ce ( *ildhood adv]sity t     
e/abli%es ! l9ks betwe5 adv]se *ildhood 
exp]i5ces & negative outcomes2 &  7#b7  
focuses on elem5ts n includ$ 9 ! /udy   
ref]r$ to 9 p>agraph 7#a71 includ+--    
7,a7 ! inclusion ( a div]se nationally  
repres5tative sample ( p>ticipants2     
7,b7 ! /r5g? ( ! relation%ip betwe5     

individual1 specific adv]se *ildhood    
exp]i5ces & negative heal? outcomes2    
7,c7 ! int5sity & frequ5cy ( adv]se     
*ildhood exp]i5ces2  7,d7 ! relative    
/r5g? ( p>ticul> risk & protective      
factors2  7,e7 ! impact ( hi/orical     
trauma 9 communities disproportionately 
impact$1 z id5tifi$ by ! ,secret>y1 su* 
z ,am]ican ,indians & ,alaska ,natives1 
z well z ! int]sections betwe5 hi/orical
 trauma & adv]se *ildhood exp]i5ces     
scores2 &  7,f7 ! effect ( social1      
economic1 & community conditions on     
heal? & well-be+4  7b7 ,te*nical        
assi/ance ,! ,secret>y may1 directly or 
?r\gh aw>ds ( grants or contracts to    
public or nonpr(it private entities or  
,tribal organizations or ,indian        
,tribes1 provide te*nical assi/ance )   
respect to ! collection & report+ ( data
 z describ$ 9 subsection 7a74  7c7      
,def9itions ,9 ?is section-- 7#a7 ! t]m 
hi/orical trauma means ! cumulative1    
transg5]ational1 collective exp]i5ce (  
emotional & psy*ological injury 9       

communities2 &  7#b7 ! t]ms ,indian     
,tribe & ,tribal organization h ! mean+s
 giv5 su* t]ms 9 section #d ( ! ,indian 
,self-,det]m9ation & ,education         
,assi/ance ,act4  7d7 ,au?orization (   
appropriations ,!re are au?oriz$ to be  
appropriat$ to c>ry out ?is section     
#g1jjj1jjj = ea* ( fiscal ye>s #bjbc    
?r\gh #bjbh4  4