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Proposed task force to identify needs for ND trauma services

Dr. Tami DeCoteau, center front, owner of the DeCoteau Trauma-Informed Care & Practice in Bismarck, stands in the clinic lobby on Wednesday with her staff, from left, social worker Sue Herzog, Martina Day, Dr. Lisa Peterson-Gustafson, Dr. Nova Griffith, Dr. Alana Semchenko, Brandi Delorme and Moe, the resident pet. Not pictured are Dr. Theresa Magelky and social worker Guy McCommon. Mike McCleary / Bismarck Tribune 1 / 2
From left are Tanaeya, 16, Kenzie, 12, their adoptive mother, Jessica Kluck, Avery, 10, Joey, 7, and, in front, Jakin, 5. Kluck has been proactive in securing needed services for her children. Submitted photo2 / 2

BISMARCK, N.D.—When Jessica Kluck signed the adoption papers in 2015, she was on her own.

Kluck, a single woman living in Bismarck, adopted five Native American children, ages 5 to 16, all siblings, after serving as their foster parent through PATH foster care agency.

Kluck said she was certain she was destined to help these kids, who were traumatized while living with their parents on a reservation in North Dakota.

"It's been a hard road, but I've never regretted it," said Kluck, 37.

Her kids received help from therapy offered locally, which focuses on treating children who have been through abuse, trauma and neglect. Despite "hitting a brick wall" with her kid's state Medicaid coverage, Kluck managed to find some aid for them and paid more than $20,000 out of her own pocket for an out-of-state trauma-based treatment program for her oldest daughter, Tanayea, 16, who suffered from severe abuse.

In North Dakota, trauma-focused therapy is hard to get. Often, children who have suffered adverse experiences, many times Native American, are misunderstood in their communities and may fall through the cracks in their schools and into the criminal justice system.

Sen. Heidi Heitkamp introduced a bill last week to identify and help these children and adults who suffered the effects of trauma, as well as build state and federal resources and treatment services for them.

Heitkamp's Trauma-Informed Care for Children and Families Act is a comprehensive bill that would establish a task force to identify best practices and support children who have been through trauma.

Kluck said she'd like to see more education for those who often encounter children suffering from abuse and trauma, including law enforcement and teachers.

"I feel exhausted having to try to educate others. It's apparent our community needs more education," said Kluck, adding she'd also like to see more treatment options nationwide for children who have had adverse childhood experiences.

The bill has been a year in the making, Heitkamp said during a press conference call last week. In August, she held a U.S. Senate Committee on Indian Affairs field hearing with experts on trauma at United Tribes Technical College in Bismarck.

The bill's co-sponsors include Al Franken, D-Minn., and Sens. Dick Durbin, D-Ill., who unveiled the bill last week to his constituents in Chicago, stating that the legislation aims to help children in Chicago who are witnesses to gun violence in the streets.

"Trauma doesn't just affect Native American kids, and it doesn't just affect African-American children in Chicago, it is much broader than that. But certainly it is our understanding and our awareness of what happens in these populations that have really brought us to this," Heitkamp said.

Dr. Tami DeCoteau is a clinical psychologist who specializes in trauma-focused care at her practice in downtown Bismarck. For the past year, Decoteau worked with Heitkamp on increasing awareness of this type of treatment, as well as helping craft the bill.

"For the native communities, I think it's way overdue," said DeCoteau, who is an enrolled member of Mandan, Hidatsa and Arikara Nation, on the Fort Berthold Indian Reservation.

At her practice, she and six other providers treat complex developmental trauma, meaning a child has had multiple types of trauma during the time when their bodies and brains are developing.

They also work with occupational therapists and conduct parent coaching and in-service training for teachers on trauma.

Currently, her practice has more than 780 patients, most of whom are children, referred to them by county, tribal and state foster care programs. More than half of the children are Native American.

"Even in Bismarck, where there are a lot more resources than there are on the reservation, there still is really a high-need, particularly in the foster-care setting, for people who specialize in trauma," said DeCoteau, who has a doctorate degree in clinical psychology from the University of Nebraska-Lincoln.

"There's a waiting list (for providers), and there's a need for this to be integrated statewide, not just in the capacity in our mental health system, but in the school system, the juvenile justice system," she said.

DeCoteau's practice has a high number of children in the foster care system, and that number, many of whom were exposed to drugs or alcohol before birth, is growing.

"The foster care system is really a substance abuse treatment program," she said, noting substance abuse is closely related to trauma.

Jodi Duttenhefer, operations director at PATH, supports Heitkamp's new legislation on trauma-informed care. Last year, youth in PATH had experienced an average of six adverse childhood experiences by the time they were placed in the agency, according to Duttenhefer.

Heitkamp, who introduced the bill Wednesday, said she hopes she can get support from her colleagues on both sides of the aisle.

"What we expect is that every person who is in the social service context at the federal government, working in collaboration and in consultation with the tribes, and every person in IHS will be — by the time I'm done here — will be absolutely steeped in the science and the severity of childhood trauma," she said.

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