SIOUX FALLS, S.D. -- Despite a pre-pandemic period of economic stability, the number of South Dakota children lacking health coverage spiked between 2016 and 2019.

And amid the COVID-19 crisis, a new report raises concerns about the situation worsening.

The latest findings from the Georgetown University Center for Children and Families show South Dakota's rate of uninsured children skyrocketed by more than 60%, the largest increase in the nation.

Xanna Burg, KIDS COUNT coordinator for South Dakota, said because this 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 asserted. "You know people are losing their jobs and with it, the health insurance that came with those jobs. "

Prior to the increase, the rate of uninsured children in South Dakota had fallen to its lowest level.

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

The data comes as some groups call for a Medicaid expansion in South Dakota. Petitions will soon be circulated for a ballot question in 2022.

Joan Alker, executive director of the Georgetown Center for Children and Families, pointed to the Trump administration's efforts to dismantle the Affordable Care Act.

She said a key factor has been eliminating most of the funding for outreach and "navigators" to help people enroll.

"Families have been getting negative messages that coverage is going away at the same time that community-based resources to help them find public coverage have shrunk," Alker contended.

Burg said that's why a Medicaid expansion, and enhanced outreach from the state for initiatives like the Children's Health Insurance Program, might help stem the tide of children and families going without coverage.

"South Dakota should double down on outreach to families who are eligible but not enrolled in Medicaid or CHIP, particularly during the pandemic when we know more families are struggling," Burg urged.

The report's authors say states have a lot of power to help reverse the situation.

According to the Centers for Medicare and Medicaid Services, South Dakota hasn't adopted any of the targeted strategies designed to boost enrollment in Medicaid and the Children's Health Insurance Program.

More than 3,500 foster children are available for adoption in Ohio, and state agencies are connecting with local faith congregations to help recruit families and place kids in caring homes.

The "One Church One Child" program is based on the idea that, if every congregation identifies one family who fosters or adopts one child, there would be fewer children without permanent homes.

Jennifer Kollar, public information officer for Mahoning County Children Services, said local churches often offer resources for adoption.

"It's our job to find safe, stable supports and placements for these children," Kollar explained. "The faith-based community has been long-standing in support of those endeavors."

Kollar added the agency has contracted with a community advocate to implement a local version of the One Church One Child program, by nurturing relationships with church congregations.

According to the Public Children Services Association of Ohio, the state continues to struggle with a placement crisis for children in its custody. Between the summers of 2021 and 2022, more than 500 children spent at least one night in county government offices because they had nowhere to go.

Kollar stressed the need for foster care and permanent homes is great, and the holidays can be an especially stressful and lonely time for children.

"Our agency has over 300 children in foster care," Kollar pointed out. "And there's over 51 children in our permanent custody, which means that those children's biological parents have had their parental rights terminated."

Kevin Milliken, public information specialist for Lucas County Children Services, said multiple factors continue to drive up the number of children who are unable to safely live with their biological parents.

"Mental health issues, opioid epidemic, job losses, a sustained poor economy, in all of those things have combined," Milliken outlined. "I don't think there's one root cause. It's a conglomeration of all those things that continue to be a problem, particularly in Lucas County."

People interested in adoption or fostering can find information online on the state's adoption website.


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By India Gardener / Broadcast version by Nadia Ramlagan reporting for the Kent State-Ohio News Connection Collaboration.

According to Attorney General David Yost's office, 15,335 children have gone missing in Ohio in 2023. There were 1,698 reports of missing children in October, up from 1,621 in September.

Ninety-five percent of missing children in Ohio have been safely found so far this year, said deputy press secretary Dominic Binkley. That's similar to the success rate in 2022 and other recent years. In general for cases where authorities know the circumstances, most missing children have either run away from home or are taken from their custodial parent by their non-custodial parent. But some children have never been found. One of them was Ashley Summers, who disappeared in Cleveland in 2007 at the age of 14.

"I think that unfortunately, our law enforcement failed us, especially in the beginning and to elaborate on that a little bit...they considered her a runaway and didn't do anything about her case for months," said Linda Summers, Ashley's grandmother. "It was nine months before she was put on any kind of state missing database and over a year before she was reported to the National Center for Missing and Exploited Children, and when they did, they labeled her as an endangered runaway."

According to the National Center for Missing and Exploited Children (NCMEC) report from 2013 to 2022, 94% of missing children from care were categorized as endangered runaways like Ashley was. In 2020, the NCMEC received around 30,000 reports of missing children, with 91% involving children who had run away. Around 77% of these endangered runaways were between the ages of 15 and 17.

When missing children are classified as runaways, it decreases specialized attention and resources crucial for locating individuals who might be in distress, potentially prolonging their absence and endangering their safety.

Summers advocates for measures that would increase the likelihood of missing children being found, including improved responses from police departments that are often short on staff.

"There are shortages, not only just statewide, but around the country," said Wilfredo Diaz, public information officer for the Cleveland Police Department. "The approach has to be consistent every missing person case that we receive has to receive the same investigative approach regardless of the situation."

Law enforcement agencies are forging partnerships with external organizations like Cleveland Missing, a nonprofit dedicated to raising awareness about abductions and human trafficking while offering vital support services to families and survivors.

"Law enforcement is doing a ton of work behind the scenes, and it's just things that we can't share with the public." said Devan Althen, law enforcement liaison of Cleveland Missing, "Seeing just the amount of collaboration between law enforcement families and organizations like ours trying to combat these is probably one of the biggest things that I've noticed in the last few months once these numbers have started rising."

According to the Black and Missing Foundation, nearly 40% of missing persons are people of color. A problem arises when examining missing Black children cases: the statistics consistently reveal a stark disparity in media coverage and law enforcement response times between cases involving Black children and their white counterparts.

"Runaways do not meet the criteria for an Amber Alert, and honestly, there isn't a sense of urgency in finding them because the perception in society is if a child runs away, whether it's a male or female, whatever happens to them, they brought it on themselves because they decided to leave," said Derrica Wilson, the co-founder of the Black and Missing Foundation. "We know that one in every three children who run away are solicited for sex, and we also know that human trafficking is a huge issue across this country but specifically in Cleveland."

During the first two days after a disappearance, a series of factors come into play that can significantly impact the child's safety and the chances of a successful recovery.

"Number one, we need to terminate the classification of runaways; they're missing and endangered," Wilson said. "Number two, we need to stop telling families to wait 24-48 hours when we all know the first 24-48 hours are the most critical moments when someone is missing."

The lack of equal attention and response time in missing children cases extends to the broader societal phenomenon known as "Missing White Woman Syndrome." This term refers to the disproportionate media coverage and public attention that missing person cases, particularly those involving white women, tend to receive.

Media coverage of cases like Gabby Petito's and those like Relisha Rudd's is evidence of deeply ingrained systemic biases. Gabby Petito's case received widespread media attention, drawing the nation's focus for weeks. In contrast, cases like Relisha Rudd's, which involve a missing child from the Black community, only receive limited coverage.

"There was research conducted by the Urban Institute, and they had the opportunity to interview traffickers," Wilson said. "During this interview, they admitted that they target Black women and girls for two reasons: Number one, they knew law enforcement would not look for Black women and girls. Number two, they knew they would get less jail time than if they targeted a white woman or child."

Like the well-known Amber Alert system for missing children, California will become the first state to institute an Ebony Alert in January 2024. The new system will alert communities regarding missing Black youth and women between the ages of 12-25.

According to the FBI's National Crime Information Center, over 140,000 Black children were reported missing across the country in 2022. Advocates for missing Black children in Ohio say an Ebony Alert might help draw attention to those cases.

"I think that if we were able to implement something like that [Ebony Alert] it would be beneficial because a lot of our cases are more from the marginalized community rather than someone who is not," Althen said. "Having those kinds of alerts could benefit the population we tend to see as runaways in the Cleveland area."


This collaboration is produced in association with Media in the Public Interest and funded in part by the George Gund Foundation.


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A bill in Congress with a Connecticut House sponsor aims to reduce child labor in the United States.

Called the "Children Harmed in Life-Threatening or Dangerous Labor Act," its aim is to strengthen current child labor laws and increase civil penalties for companies violating them. And the bill puts a new wrinkle on protections: It allows the Secretary of Labor to label goods produced with child labor, and to issue a 'stop work' order for any person violating child labor laws.

Rep. Rosa DeLauro, D-Conn., the bill's House sponsor, described its importance.

"This is in response to industry, to have more workers -- more than likely who are underpaid -- and that they can get cheap labor for doing the jobs that they are doing, and taking risks with children," DeLauro explained. "There is a labor shortage, so they're looking to children."

The Economic Policy Institute reported 10 states introduced or passed bills rolling back child labor protections in the last two years.

The Labor Department's Wage and Hour Division concluded almost 1,000 investigations, uncovering child labor violations, an 88% increase since 2019. The bill has been introduced in both chambers of Congress.

Ultimately, the goal is to have stiffer penalties in place for companies that ignore child labor laws. DeLauro acknowledged backers of the bill expect some opposition, most likely from states rolling back protections and industries using underage workers.

"We've got a very strong meat packing industry -- I mention Tyson, JBS, Turkey Valley Farms -- and Packers Sanitation Services provides cleaning services at these meat processing facilities," DeLauro outlined. "I'm going to anticipate that we're going to see industry come out of the woodwork in opposition."

Some companies are already being held accountable with civil penalties. A meatpacking plant owned by Tennessee-based Monogram Meats Snacks was fined a little more than $140,000 for employing children. However, the company made more than $1 billion in 2021.