The Elijah Cummings Healing City Act

Baltimore, MD

Population: 500,000- 1,000,000 | Government type: City | Topic: Trauma Responsive City

Students meet with Councilmember Zeke Cohen to help draft the Health City Act (Photo: Healing City Baltimore)

The POLICY

Baltimore’s Elijah Cummings Healing City Act creates a citywide task force to identify ways to reduce trauma for children. This task force is made up of individuals including pediatricians, students, and returning citizens. It will be a 36-member body, chosen through a robust application process, that is responsible for identifying the goals and metrics of the program. Many Baltimoreans have been traumatized by decades of violence.  By using this approach, the city can provide healing supports and services in a way that avoids exacerbating past harms. 

The Healing City Act requires training for all agencies in the science and symptomatology of trauma, as well as appropriate responses. For example, a shift in policies at a recreation center would include training staff to focus on de-escalation tactics instead of yelling at youth. The policy calls on each agency to work with the task force to rewrite their policies to reduce retraumatization. Finally, it challenges agencies to directly confront and undo the harm and bad practices that are deeply embedded in their habits, culture, and systems. Relevant community facilities include libraries, the criminal justice office, the Department of Housing and Community Development, the Parking Authority, the Department of Finance, the Department of Law, and others.

In early 2020, the city’s mayor announced that trauma-informed care is a core part of his multi-faceted and public health-based approach to reducing violence in Baltimore and that he intends to fund the program to ensure its success. In addition to this public commitment, the city is also exploring a partnership with philanthropic organizations to expand the reach of the program.

Despite not yet having finalized full funding details in the budget, the Health Department is set to begin training senior-level cabinet members this year in partnership with community-based organizations. City council members will also partake in the training to ensure that policymaking is also aligned with the trauma-informed approach as the council heads into a new year.

While the initiative has broad support from the Mayor, along with a constellation of community-based organizations, the task-force is committed to ensuring that it centers residents to ensure its success.

Community input on the Healing City Act (Photo: Healing City Baltimore)

Collaborative Governance

The impetus for this policy came on the heels of a school shooting. Councilmember Cohen chaired the Education and Youth Committee at the time, which invited several students who were in school that day to testify at the hearing.  While the committee considered funding additional armed school resource officers, the students pointed out that the council was overlooking a key issue. The students testified that the council should instead be discussing how to address violence before it happened and should be working toward reducing the retraumatization that they experience in their daily lives.

On Feb 9, 2020, Mayor Young signs the Healing City Act to make Baltimore a trauma-responsive city. (Photo: Baltimore Sun)

Councilmember Cohen’s office spent the next year working with those students as they set up dozens of community listening sessions. The council member held community outreach meetings in libraries, laundromats, and classrooms to talk with community members and to identify the changes and solutions that would be most helpful. There was a deep hunger from community members across the city to combine all of the endeavors that had felt so disparate or fragmented into one collaborative effort. The students remained active throughout the process. They worked together to bring their vision to fruition while Councilmember Cohen’s office walked them through the specifics of what it takes to write a bill.

Emphasis on equity

The Healing City Act challenges agencies to stop the cycle of violence by interrupting retraumatization as a cause of violence. When assessing a care response, trauma-informed care (TIC) emphasizes a shift from asking “what is wrong” with someone to asking “what has happened” to them. A majority of individuals have experienced some sort of trauma. TIC accounts for this in order to provide care and services in a way that is accessible for victims, as opposed to treating symptoms of the trauma. This approach helps avoid retraumatization, something individuals experience as a result of, for example, police brutality, prison violence, sexual trauma, domestic violence, and mental health challenges.  

People of color experience these incidents of retraumatization, coupled with a lack of care infrastructure, at higher rates.  Youth in Baltimore, particularly Black and Brown youth, are exposed to events that increase the likelihood of trauma including higher rates of proximity to homicide in their neighborhoods, police brutality, and arrests.

The task force will work to identify the myriad ways that youth experience trauma in their daily lives, and to determine the shifts in resources that will more effectively support the youth community. It will also help reduce the likelihood that trauma is perpetuated by institutions that are already deeply distrusted by underserved BIPOC communities.

Analysis

• Preemption: Trauma-responsive care reflects a change in culture and practice among responders, counselors, and service providers. It is unlikely to provoke any state level interference. Initially this approach was limited to agencies where the city has legislative authority. However, the city is voluntarily incorporating MOUs with the school system, police department and Department of Juvenile Services. There is a state version of the bill being introduced that mirrors a lot of what the Baltimore City bill does at the state level. 

• Local government dynamics: The Baltimore Council has limited budgetary and regulatory authority as defined by the city charter, but the body is significantly more progressive than a decade ago. 

• Policy: Trauma-informed care and trauma responsiveness are less a policy than practice when it comes to impact, however legislation that prioritizes this approach provides a mechanism for reference and guidance to all care providers. Given the level of trauma that people of color experience in all facets of their existence, it is critical that those who provide care do so in a way that both respects and honors that trauma in moving forward in the healing process.

Last updated: January 25, 2021

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