SACRAMENTO, Calif. -- Parents are gearing up for their children to return to the classroom for the first time in over a year, and public health experts are concerned many have missed important checkups and vaccinations due to the pandemic.

A report from Georgetown University's Health Policy Institute and the American Academy of Pediatrics details the drop in pediatrician visits in 2020. In California, the group Children Now estimated child vaccination rates were down by more than 10% from 2019 to 2020.

Mike Odeh, director of health policy for Children Now, said programs like Covered California are working to highlight the issue, but more could be done on a state and federal level.

"I think one of the common things we see a lot here in California, as well as I'm sure in other states, is access to culturally and linguistically appropriate care," Odeh contended. "So, that would be just one area that I think could use some work."

Odeh argued the 2014 and 2019 measles outbreaks in Southern California showed health professionals how important it is to take these numbers seriously.

In May, the Centers for Disease Control and Prevention reported orders for non-influenza childhood vaccines had decreased by a total of 11.7 million doses compared with 2019.

Dr. Lee Beers, president of the American Academy of Pediatrics, said fears are growing lower vaccination rates could result in fewer communities reaching "herd immunity."

"If too few people in a community are vaccinated against a particular disease, it means that we might see an outbreak of that disease," Beers explained. "We've seen this before with measles and pertussis, and so it's so important to make sure your child is vaccinated, not just to protect themselves, but also to protect everyone around them."

California law requires all children enrolled in school to have certain immunizations, including diphtheria, tetanus and pertussis, and for measles, mumps and rubella. In some cases, valid medical exemptions from a physician are accepted.

DENVER -- As Congress considers making significant investments in the nation's child-care system, children's advocates say now is the time to make nature-based, high-quality outdoor learning available for all children in Colorado, regardless of their ZIP code.

Sarah Konradi, director of the Early Childhood Health Outdoors (ECHO) program for the National Wildlife Federation, said kids need regular access to spaces where they can play, run and climb.

"We also want them to be able to explore, to imagine, to pretend, to create," Konradi outlined. "And so that may look like a little digging area in the shade of a tree, where they can explore worms and bugs."

ECHO has published new recommendations, calling for broadening investments in playgrounds to include outdoor extensions of the classroom; areas where kids create rules for new games, learn how to work together to build pirate ships, and other activities that help boost cognitive learning and social skills in natural settings.

Konradi pointed out child-care providers also see benefits from outdoor learning environments. Instead of monitoring recess on a traditional playground, educators can engage with kids as they explore winding pathways, plant pollinator gardens and create "mud kitchens."

Konradi noted building outdoor learning spaces does not necessarily require a lot of money or effort.

"Changes that we are advocating for can be extremely cost-effective; they can be done very incrementally," Konradi explained. "This doesn't have to be an extreme playground makeover to be successful."

When children get to spend a part of their day in natural settings, Konradi added, there is also an opportunity to pause, and take a deep breath.

"And spaces where children can just observe, contemplate," Konradi stated. "And with nature around us, we know that as adults going out into those kinds of environments is very restorative, and it can be for children as well."

BOISE, Idaho - An organization has rated Idaho lawmakers on how they voted for measures that affect children in the 2021 session.

Idaho Children Are Primary, or ICAP, identified 20 bills and determined if the policy was good or bad for kids. The main focus areas for the Kids Matter Index were education, health care and economic security.

Dr. Noreen Womack is a pediatrician with St. Luke's Children's Pediatrics in Nampa and a member of ICAP.

"The Kids Matter Index," said Womack, "is the legislative bill-rating system that we came up with in collaboration with others that work for children like Idaho Voices for Children to basically give a voice for kids because kids don't have lobbyists."

Eleven of the bills ICAP supported passed the Legislature, including emergency rental assistance funding, COVID-19 relief for childcare grants and extending the age people can be in foster care from 18 to 21.

Diane Schwarz, one of I-CAP's founders, said other organizations rate individual legislators on their votes for policies like gun rights. She said her group wanted to do the same for issues that affect children.

She said more than half of lawmakers scored 80% or above. However, Schwarz said she believes the bills introduced didn't go far enough to support children.

"Yes, they scored well based on the bills that were there," said Schwarz. "But I think it just shows that, based on the bills, there's a lot more work that has to be done in Idaho in future sessions."

As Idaho has one of the youngest populations in the country, Schwarz said it's critical to support kids because they will in turn support a vibrant, growing Idaho.

SEATTLE - Foster care alumni in Washington state have one month left to apply for pandemic aid.

As part of a large relief package in Congress last year, Washington is distributing $1.65 million to people who were dependents of the state or tribal foster-care programs after their 15th birthday. They now must be between ages 23 and 26.

Dawn Rains, chief policy and strategy officer at Treehouse, an organization helping the state's Department of Children, Youth, and Families distribute funds, said recipients will receive $1,000 at a crucial time.

"We know that many of them struggle in the transition to adulthood," she said. "They don't have the same kinds of safety nets of families to help with their transition, either through the education, post-high school education, or into the world of employment."

Rains noted that folks are eligible even if they weren't in foster care in Washington state. She said they've reached about 400 people so far of the 2,800 known to be eligible in the state. The deadline to apply is Sept. 30.

Rains said there's a lot of flexibility for how the $1,000 can be used, adding what a difference this amount of money can make.

"We're so hopeful that this is going to help people stay housed, to get food that they need, to maintain going to school, if that is their path," she said.

Rains said she sees it as a critical investment for people who have been in foster care.

"They are the young people for whom the state became parent," she said, "and we have a special responsibility to help make sure that they make a successful transition to young adulthood - both for them personally and for all of us."