BILLINGS, Mont. -- The number of Montana children without health coverage has gone up by 25%, according to a new report which said the increase came during stronger economic times.

The findings from the Georgetown University Center for Children and Families cover a three-year period, from 2016 to 2019.

Montana had an estimated 15,000 uninsured children last year, compared to 12,000 in 2016.

Xanna Burg, KIDS COUNT coordinator for Montana, said because the data is pre-pandemic, they don't know how many more families have lost coverage.

But she added there's real concern the number is growing.

"We do know that families are struggling," Burg emphasized. "You know people are losing their jobs and with it, the health insurance that came with those jobs."

The report cites constant changes to the Affordable Care Act and more red tape in various states as possible factors for rate spikes.

Montana has accepted a Medicaid expansion in recent years, but there have also been efforts to attach a work requirement for eligibility.

Joan Alker, executive director of the Georgetown Center for Children and Families, said while there have been attempts to dismantle the Affordable Care Act, including funding cuts for outreach and enrollment, that doesn't mean states shouldn't be doing all they can to help families qualify for assistance programs.

"States do have enormous power here," Alker explained. "However, they can't entirely outrun the federal context. We're going to have to see a renewed commitment at all levels of government, federal and state, to turn this situation around."

Meanwhile, Burg said one of the glaring concerns in Montana is that nearly 22% of American Indian children don't have coverage. She cites chronic underfunding of the Indian Health Service (IHS) program.

"The IHS has been severely underfunded for a long time," Burg contended. "It receives only half the amount per-person that Medicaid receives. "

Statewide, Montana's rate of uninsured children was more than 6% in 2019, higher than the national average of 5.7%.

COLUMBUS, Ohio -- The clock is ticking for Ohio families to ensure they get the benefits of Child Tax Credit payments for 2021.

The American Rescue Plan increased the benefit, and added advance monthly payments of up to $300 per child, which started in July.

There is a Nov. 15 deadline for families who do not file income taxes to register for the payments, and organizations are working to reach those who may be missing out.

Veronica Dahlberg, executive director of HOLA Ohio, which is helping folks in rural areas, explained their efforts include reaching migrant farmworkers, often living on the margins.

"In some cases, we're able to get several thousand dollars into a family, and they were literally almost, like, screaming on the phone," Dahlberg recounted. "They couldn't believe it. This is life-changing for these families that are living in extreme hardship."

It's estimated parents of up to 116,000 Ohio children may not be receiving the advanced Child Tax Credit payments. An online registration portal is available, at GetCTC.org/CTCOH.

Dahlberg noted HOLA Ohio has been inundated with calls about registering since launching a campaign to reach Spanish-speaking households.

"There's an element of people who are afraid of the tax credit," Dahlberg observed. "They don't know if they're allowed to get it. There was one person that got it and was wondering if they should give it back. There's a lot of misinformation out there."

Families who miss the deadline will still get the credit next year in a lump sum, by filing a tax return. HOLA Ohio and other community organizations run free tax clinics to help low-income filers. Dahlberg emphasized it is important to avoid the many inexperienced tax preparers who prey on immigrants.

"They don't put their names or sign the tax returns, and maybe don't do them correctly," Dahlberg explained. "We're trying to encourage people to go to certified tax preparers so that they can get what's fully due them."

Families who qualify for the expanded credit will receive a total of $3,600 for each child under age six, and $3,000 for each child ages six to 17.

HILLSBORO, Ore. -- The Oregon Department of Agriculture recently completed an investigation into a suburban Portland school for the misuse of toxic pesticides on district grounds, and environmental and public health advocates said it is time to update Oregon's school pest-management law to prevent future violations.

Hillsboro School District was found to be in violation of the law over the course of several years as it applied pesticides in a "negligent and careless manner," according to the state. The district also used Fumitoxin, a dangerous rodent-control pesticide, which has resulted in the deaths of children, including four in Texas, who breathed in the toxic gas.

Dr. Randall Phelps, associate professor of pediatrics at Oregon Health and Science University, said children are especially vulnerable to these types of chemicals.

"We need to be thinking carefully about potential exposures of children in the environment to toxins, and we need to take some reasonable precautions to prevent exposure," Phelps urged. "If we're going to be applying toxins to public spaces, people that use those public spaces need to have a say."

The fines for the district and the designated Integrated Pest Management coordinator total nearly $20,000. A spokesperson for Hillsboro said as a result of the state investigation, the district has initiated an internal review of its pest-management program to address the concerns.

Rep. Courtney Neron, D-Wilsonville, a mother and teacher, said it's important to her school districts and parks have procedures in place to keep children safe. The Wilsonville Democrat was chief sponsor of legislation this year, designed to modernize the state pest-management law.

"When they are so young and developing and growing, and we also simultaneously know that where they play has just been sprayed with a neurotoxin or a known carcinogen, we have to ask ourselves how we can do better," Neron contended.

House Bill 2406, if passed, would have defined communication standards between schools and parents about pesticide application on campus grounds.

Neron hopes to reintroduce the bill next session and also supports funding to provide schools with technical expertise on pest management.

PIERRE, S.D. -- A new study links premature deaths in adulthood with people who experience abuse as children, and South Dakota groups say it reinforces the need for prevention work.

Researchers in England found adults who were sexually abused by age 16 are more than twice as likely to die in middle age. In cases of physical abuse, the risk is 1.7 times higher.

Tifanie Petro, director of advocacy and prevention at the Children's Home Child Advocacy Center, said the findings align with past research. She added the state is doing more to raise awareness about the long-term effects of adverse childhood experiences (ACEs).

"The Adverse Childhood Experiences curriculum is designed so that it can be consumable by somebody with a lot of 'letters' behind their name, or no letters behind their name," Petro explained.

She pointed out groups spreading the message are reaching many stakeholders, including schools and law enforcement. Petro, also a board member for the Center for the Prevention of Child Maltreatment, cautioned community buy-in is sometimes hard, if people think the issue does not affect them.

Data show 24-percent of South Dakota children are in families with at least one qualifying ACE event.

Training rooted in Adverse Childhood Experiences was brought to South Dakota by the two centers in 2018. Petro described the movement as a way for people to be more open about their past, and know they have support to help overcome any trauma.

"We're trying to move from, 'Why do you keep doing what you're doing?' and move into how we understand how we got here," Petro emphasized. "'I want to walk alongside with you.'"

Outreach groups noted there is a particular concern among Indigenous communities, with the historical trauma tied to Native American boarding schools.

Katie Edwards, associate professor of educational psychology at the University of Nebraska-Lincoln, added no matter a child's background, an abusive situation can shorten their lifespan in a variety of ways.

"Mental health consequences, suicidality, substance abuse problems that we know lead to early death," Edwards outlined. "There's also a growing body of literature showing that individuals who experience child maltreatment are at greater risk for diabetes, hypertension."

As for tribal communities, Edwards is involved in a program working to prevent adverse childhood experiences in the Rapid City area. She said it's a culturally-grounded approach shared by Native leaders.