NASHVILLE, Tenn. - Tennessee could be doing more to place children in state care with families, including their own, according to a new report by the Annie E. Casey Foundation.

More than 8,000 Tennessee children are in foster care, and about 77% live with relatives or in a family setting, compared with an 86% family placement rate nationally. Over the past decade, the report said, child-welfare systems across the country have worked to place more children with relatives and foster families, so they're less likely to end up in group homes or institutions.

Rob Geen, director of policy and advocacy reform for the Casey Foundation, said placing children with families is critical to success later in life.

"When children are placed with relatives, they're more likely to finish school, they're more likely to be employed or find employment later; they're less likely to become early parents. They're more likely to succeed in families when they have families of their own," he said. "That is one trend which is really important; we're using relatives more."

The Family First Prevention Services Act, signed into law by President Donald Trump last year, aims to help states prioritize family placement.

Rose Naccarato, director of data and communication for the Tennessee Commission on Children and Youth, said the state now is focused on diverting children from entering foster care in the first place.

"We have Title IV-E waiver," she said, "which is the money that comes from the federal government for foster care, that we use to do a program that specifically targets children who are at risk of coming into foster care, to try to prevent that from happening."

The Tennessee Department of Children's Services also runs In-Home Family Support Services, a program that offers resources to parents to reduce the likelihood of abuse and neglect, and lower the risk of having children removed from the home. However, federal funding for the program is scheduled to end this fall.

Naccarato said the state's opioid crisis is impeding efforts to reduce the number of children in foster care. Agencies are working to help boost support for kinship families, as more grandparents and other relatives are taking care of children because of parents' opioid addiction, overdose or incarceration.

"There has, in fact, been a move to try to get some supportive funds to kinship families that are not foster-care families," she said, "because sometimes they really need that additional financial support, and you hate to make them become a foster family in order to get it."

However, Naccarato said the idea of offering financial assistance to kinship families has been difficult to push through the state Legislature.

The report is online at aecf.org.


get more stories like this via email

More than 300,000 children have been dropped from Medicaid and Peach Care for kids since the pandemic ended.

A report from the Georgetown University Center for Children and Families pinpoints a nationwide trend: More than 4 million kids were left uninsured, soon after the COVID public-health emergency ended.

Georgia ranks third-highest for the number of children who have lost coverage.

Judy Fitzgerald, executive director of Voices for Georgia's Children, said many lost coverage because of procedural reasons rather than eligibility.

"They're not ineligible, but there was missing or incomplete paperwork, or what we know from families is, they felt like they didn't receive the notification, they didn't know," she said. "And so, there are a large number of children who are still eligible."

Fitzgerald said the repercussions of disenrollment can be dire, as when children can't get timely access to health-care services, they're more vulnerable to illnesses and developmental delays. The report also found parents with access to employer-sponsored health plans can't always afford the cost of adding their dependents.

While parents face higher income requirements for Medicaid, many children who lost coverage during the pandemic are still eligible. Fitzgerald said Voices for Georgia's Children is advocating for ways to increase enrollment for children, including a more simplified enrollment process and assistance from state agencies to expedite screening.

"So, we're asking the state to expand the kinds of organizations that could screen kids for eligibility, and enroll them in coverage temporarily while the state processes an official enrollment," she added, "and this is something called presumptive eligibility."

She said programs such as SNAP, and information through the Department of Labor, could be used to facilitate renewals. For families who don't qualify, she said, alternative coverage options are available through the insurance marketplace. Navigators through Georgians for a Healthy Future can help find them.

The Medicaid and Nevada Check Up programs had more than 13,000 fewer children enrolled last year than during the pandemic, according to new research from the Georgetown University Center for Children and Families.

States have been reexamining Medicaid benefits since the pandemic ended, and disenrolling families based on their head-of-household's eligibility. Carissa Pearce, health policy manager for the Children's Advocacy Alliance, said this means some children were also dropped from coverage who are still eligible.

As a result, she said, the Centers for Medicare and Medicaid Services told states to stop disenrolling and ensure they were looking at individual eligibility.

"Meaning that children would be screened separately from their parents, and that was a really important change," Pearce explained. "Specifically in Nevada, every person who had been disenrolled up to that point in August and September of 2023 were reinstated for their coverage, so that they could fix their system and then proceed with disenrollments."

Pearce said Nevada didn't start disenrolling children again until January of this year, giving families more time to check the requirements and submit the documentation to keep their coverage. But from January to February, about 1,500 Nevada children were dropped. She said it's important for families to see if their child is eligible for Nevada Check Up or consider a state marketplace insurance program at nevadahealthlink.com.

Tara Raines, deputy director of the Children's Advocacy Alliance, said her message to families is to not avoid medical appointments if they suspect their child may not be covered. She said there are other programs that families can be directed to, and thinks the state could do more to reach and inform families.

"I think a campaign that lets people know, 'Hey, you were disenrolled from Medicaid, here are your options,' would be incredibly helpful," she said, "and I don't know if that looks like partnering with school districts."

Raines said families' living conditions and circumstances vary in the Silver State. This could mean some may not have a permanent address, but should not mean they go without health coverage.


get more stories like this via email

More than one million children in Texas no longer have health insurance through Medicaid, despite being eligible for coverage, according to a new report from the Georgetown University Center for Children and Families.

During the COVID-19 pandemic, states were not allowed to cancel coverage - then last year, state health departments were tasked with rechecking the eligibility of Medicaid recipients.

Brittney Taylor-Ross, senior policy analyst with the advocacy group Every Texan, said despite the option to slowly complete the task, Texas chose to do it in one year's time.

"We didn't take up a lot of the flexibilities that were offered, so that was a state choice at the leadership level. We also chose to go through this unwinding process pretty quickly. Other states have paused their process when they've seen that things don't look right," Taylor-Ross said.

The report shows Texas has disenrolled more children than any other state. Anyone who lost coverage must reapply. Taylor-Ross said as of April, the median amount of time to process a new Medicaid application is 95 days. Federal law requires this number to be 45 days or less.

Most families don't realize they no longer have coverage until they go to the doctor's office.

Joan Alker, research professor, McCourt School of Public Policy, and executive director, Georgetown University Center for Children and Families, said the problem affects not only families, but the pediatricians and clinics that treat them.

"Kids are going to miss out on those well-child visits, they're going to miss out on getting the medications they need - be it an inhaler for their asthma or an ADHD medication. And that really sets them back, both in their health and their success in school," she said.

Because of the unwinding, more than 4 million fewer children are enrolled in Medicaid. One out of four of those children lives in Texas.