COLUMBUS, Ohio -- The pandemic is compounding the regular stresses of the holiday season, and it's an especially challenging time for Ohioans living with substance use disorder.

The Ohio START Program connects people who've experienced substance use disorder, recovery and the children services system with families who are currently struggling with similar issues.

Ashley Durst, an Ohio START caseworker in Trumbull County, explained a support system is crucial for sobriety, so clients are advised not to isolate themselves. But they could be exposed to drinking or drug use at family gatherings.

"A lot of the cycle of addiction goes from generation to generation, and that's not the best place for them," Durst observed. "But they're also told not to isolate. So it's kind of a Catch-22."

Sarah Hayden, a family peer mentor for Warren County Children Services, said COVID is limiting in-person supports for her clients.

"For holidays, if they don't have their kids with them or they've lost loved ones or if they're just now getting to the point to where they are wanting to try to get sober, all those dynamics take a big toll on their recovery," Hayden described.

Hayden added she's trying to provide extra support to clients, with phone calls and more frequent check-ins. The program also connects clients to more intensive services, including treatment programs that can support their success.

Crystal Jameson, a family peer mentor for Trumbull County Children Services, believes Ohio START is successful because it takes an intensive, team approach and is non-judgmental.

"It's not easy to face substance abuse," Jameson remarked. "You need to have structure and that support. That's the best thing that this program offers. It's just an amazing opportunity to watch that light click on with our clients and see the changes that they make in their life."

Ohio START is currently in more than three dozen counties and is taking applications for 14 more in 2021. The program served 225 new families this year, including nearly 600 adults and more than 300 kids.

Last week, the program was approved for inclusion in a federally-funded clearinghouse that identifies and shares information about evidence-based practices in foster care.

A bill in the Pennsylvania General Assembly would amend the state Constitution to allow more adult victims of childhood sexual abuse to sue their abusers.

Senate Bill 1 would open a two-year retroactive window for lawsuits by victims of sexual abuse who were otherwise time-barred from bringing claims.

Terry Clark president and CEO of the Pennsylvania Council of Children, Youth and Family Services, said in 2019, the state extended the civil statute of limitations for child sexual-abuse victims to file suit, from age 30 to age 55. Clark pointed out the bill would also allow legal action against organizations the Council works with to support victims.

"And this really is where our concern is, because it relates to a person being able to sue institutions," Clark explained. "Those institutions aren't just folks like the Catholic churches or Boy Scouts of America. It's also foster-care providers, adoption providers, residential treatment providers."

The bill, sponsored by Sen. Daniel Laughlin R-Erie, also includes new, stricter voter ID requirements. Clark noted the proposed amendments would have to pass in two consecutive legislative sessions, before they would be put on the ballot for voters statewide.

Clark added there are concerns opening a two-year window for sexual-abuse claims, referred to as the "look-back time," may prompt some fraudulent claims. The Council recommended legislators consider a shorter time window of one year instead of two.

"But also establishing parameters around potential defendants," Clark urged. "That would mean including some type of language that limits the scope to who the perpetrator is; the individual causing the harm being more the individual, versus being the institution itself."

Clark emphasized his group would also back requiring some level of fact-finding before a claim is filed, including evaluation by a licensed mental-health professional certifying there is a reasonable basis to believe sexual abuse occurred.

"One of the other things is really looking at creating a victim's compensation fund," Clark noted. "That's a fund that would really help victims and their families through that time. That's the emotional, physical, and traumatic time, it helps ease the financial impact of the services that they might need to heal."

Other suggestions would be mandatory, structured settlements with specific dollar amounts, and including language in the bill to cap attorney fees, to ensure most of the money in a sexual-abuse settlement goes to meeting the needs of the survivor.

Many of California's 13.5 million children and teens have not bounced back after the pandemic, especially children of color, according to the just-released 2023 California County Scorecard of Children's Well-Being. The report showcases data from all 58 counties and shows wide disparities in indicators of health, education and more.

Kelly Hardy, senior managing director of health and research at Children Now, said anti-poverty measures during COVID helped a lot, but they were just temporary.

"Thirty-eight percent are in families making less than two times the poverty level, which is around $60,000 a year for a family of four," she said, "so, that's a pretty low bar."

The data show the state has more than 170,000 homeless students, and that the shortage of state-funded child care continues. The report found that in 2017, 2019 and 2021, only one in four working families had access to a space in a licensed child-care facility.

Susannah Kniffen, Children Now's senior managing director of child welfare and government relations, said kids in foster care had alarmingly low scores for access to healthcare and academic achievement.

"These kids are facing distinct challenges that other students aren't," she said, "and they need a very targeted approach to their education if we're ever going to change the numbers, which are fairly dismal."

Vince Stewart, vice president for policy and programs at Children Now, said in terms of education, kids appear to be losing ground as they get older.

"Forty-two percent of third graders met or exceeded standards and reading, 31% of fifth graders met or exceeded standards in science, in 29% of eighth graders met or exceeded standards in math," he said. "And then 11th graders, it's only 27% who are deemed ready for college-level math."

The report does show some bright spots. California children have high rates of health insurance and a high proportion of babies are born at normal birth weight.

Dental hygienists are trying to raise awareness about the importance of oral hygiene, noting dental pain is one of the most common reasons for school absenteeism among children.

Studies show children with dental pain are three times more likely to miss school. In addition, a child or teenager with noticeable dental disorders, such as blackened teeth or tooth loss, can take a negative toll on their self-esteem.

Betty A. Kabel, director of dental outreach for North Florida Medical Centers, sees it all too often, noting for too long, people have treated oral hygiene as a secondary issue instead of a primary concern.

"If a child has a broken arm, they would not be walking around with a broken arm," Kabel pointed out. "Your tooth, if it's an infection, or it's abscess, it's broken, there is a problem, so it's not OK for a kid to be in tooth pain."

Student health is among the top causes for chronic absenteeism, which includes dental pain, vision problems or mental health, according to the Healthy Schools Campaign.

Kabel argued there needs to be more awareness and expanded access for dental care, especially in rural areas.

Kabel stated she hears first-hand from the children she treats who feel embarrassed, and find it difficult to concentrate due to severe pain. She warned there are worse outcomes for untreated dental problems.

"Children die from tooth infections," Kabel stressed. "The infection is right there next to their brain, it's in their bloodstream, so it's a matter of life and death, when you're walking around with an infection in your mouth. "

Florida is among the top states in the nation with individuals living in Dental Health Professional Shortage Areas, and Kabel noted her organization tries to fill the gaps by working with parents and caregivers to try to treat kids who end up in their school nurse's office with severe pain.

She added there are not a lot of providers who see children, so they do their best to get kids into the ones who do provide care to kids.