BILL NUMBER: S6785

SPONSOR: BIAGGI
 
TITLE OF BILL:  An act to amend the education law, in relation to
requirements for the re-registration for physicians

 
PURPOSE OR GENERAL IDEA OF BILL:

To ensure that physicians undertake continuing medical education train-
ing in Adverse Childhood Experiences (ACES) so that they are better
prepared to treat their patients.

 
SUMMARY OF PROVISIONS:

Section 1 of this bill adds a new section 12 to the education law to
require physicians to attest as part of the re-registration process that
they have received continuing medical education training on the screen-
ing of children for adverse childhood experiences; and requiring the
commissioner of the education department, in conjunction with the
commissioner of the department of health, to provide an exemption proc-
ess based on the nature of the physician's practice.
              

Section 2 is the effective date.

 
JUSTIFICATION:

Adverse Childhood Experiences (ACEs) harm children's developing brains
and bodies so profoundly that the effects show up decades later. Nearly
20 years ago, the CDC-Kaiser Permanente ACEs study showed that most
people have at least one ACE and that people with four or more are like-
ly to experience longterm and chronic health conditions.  The CDS-Kaiser
study defined ACEs as: physical, emotional, and sexual abuse; physical
and emotional neglect; parental mental Illness, substance abuse, or
incarceration; parental separation or divorce; and domestic violence.
According to the Substance Abuse and Mental Health Services Agency
(SAMHSA), research continues to confirm a strong correlation between a
high ACEs score and various health problems, including chronic diseases,
substance abuse disorders, mental health disorders and behavioral prob-
lems. (i)

Recent work by Dr. Nadine Burke Harris 2 is further connecting the dots
between those traumatic experiences and physical ailments that are all
too common among children, such as ADHD, diabetes, and asthma.  Accord-
ing to Dr. Burke Harris, severe, chronic, or prolonged adversity can
cause long term changes in a child's stress response system, including
brain structure and function, hormone levels, immune system, and how DNA
is read and transcribed. The impacts are long-term. There is evidence
that having an ACE score of four or more dramatically increases the risk
for 7 out of 10 of the leading causes of death In the United States.
Given this correlation, it is concerning that only 4% of pediatricians
currently screen for ACEs. Physician screening for ACEs - as part of a
routine physical exam -would be a simple change that could lead to a
more comprehensive and holistic approach to treating children and could
make a dramatic difference in the lives of many patients. Toward that
end, increased awareness among physicians, particularly pediatricians
and other primary care physicians, of the impact of ACES on patient
health and of the value of screening for ACEs is a vital first step.
This bill would require physicians to attest, as part of their re-regis-
tration process, that they have received, at some point in their medical
career, four hours of continuing medical education training on the
screening of children for adverse childhood experiences. The bills
allows for the training to be conducted by an accreditation council or
continuing medical education, a physician specialty organization, or any
other appropriate entity, as determined by the commissioner of educa-
tion, in consultation with the commissioner of health. The bill requires
the commissioner of education, in consultation with the commissioner of
health, to provide for an exemption process based on the nature of the
physician's practice.

 
PRIOR LEGISLATIVE HISTORY:

A.11077 of 2017-2018.

 
FISCAL IMPLICATIONS FOR STATE AND LOCAL GOVERNMENTS:

To be determined.

 
EFFECTIVE DATE:
180 days after it shall have become law; authorization provided for
agency to add, amend or repeal any rule or regulation necessary for the
implementation of the act on or before the effective date.
(i) The Substance Abuse and Mental Health Services Administration (SAM
HSA) is the agency within the U.S. Department of Health and Human
Services that leads public health efforts to advance the behavioral
health of the nation, with emphasis on reducing the impact of substance
abuse and mental illness on America's communities.  2 Pediatrician, Dr.
Nadine Burke Harris, founder and CEO of the Center for Youth Wellness in
San Franciscci and author of The Degoest Well:  Healing the Long-Term
Effects of Childhood Adversity submitted in accordance with Assembly
Rule III, Sec 1(1)