As federal pandemic health emergency protections are set to expire starting in April, child advocates are concerned the program that kept Florida's uninsured children stable will result in a sharp rise in children and families becoming uninsured.

A new report by the Georgetown University Center for Children and Families showed how Medicaid and the Children's Health Insurance Program brought down the child uninsured rate across the country and stabilized it in Florida, but it is now in jeopardy.

Alison Yager, executive director of the Florida Health Justice Project, said if protections are lifted, she is concerned children who may no longer be Medicaid eligible, but should be through the state CHIP program, KidCare, will not see a smooth transition and cause a gap in care.

"For kids who have ongoing medical conditions, even one month without coverage could be terribly detrimental to that child's health and to that family's finances," Yager pointed out.

The report showed Florida's program was a critical lifeline for more than 65.7% of the state's children during the COVID-19 pandemic. Children younger than five receive 12-month continuous eligibility while those ages five and older receive six months of continuous eligibility.

Yager urged health officials to prepare for the potential coverage gap and find solutions, including streamlining both health insurance programs.

Joan Alker, executive director of the Georgetown University Center for Children and Families and the report's author, said states such as Florida which have not expanded Medicaid for adults under the Affordable Care Act, are more vulnerable for putting children at risk, since the majority of their enrollment growth during the pandemic has been children.

"So, states like Florida, Georgia and Texas that don't cover a lot of adults in their program, this is really who we're talking about; children, very poor parents, and new moms," Alker outlined.

The report noted enrollment in Florida's Medicaid and CHIP program grew by 32.6% from February 2020 to August 2022. Florida's children made up 48.2% of the growth, much higher than the 32% growth nationally.

Millions of people are expected to lose Medicaid coverage during what some are calling the "unwinding" process. The report lists two reasons for it: Either an individual's income has risen and they are no longer eligible, or red tape and communication barriers in states prevent families from renewing coverage if eligible before April.

New findings suggest health effects stemming from child maltreatment can be passed on to the next generation.

In South Dakota, leaders in early-childhood support said there are ways to limit the impact of traumatic events within a family's history.

The research was led by the Environmental influences on Child Health Outcomes Program and the National Institutes of Health. It said children of mothers exposed to childhood maltreatment had higher rates of asthma, ADHD and autism.

Darbi Hunt, family lead for South Dakota's Early Childhood Comprehensive System's Collaborative, said guidance and early screening are vital in reversing such outcomes.

"It's important that we look for ways to help understand better practices," Hunt stressed. "Provide them the resources, the knowledge and the skills so that we can try and break that cycle."

The state is expanding its Bright Start visiting program for income-eligible households, where a personal nurse supports mothers during and after birth. And there are parenting classes, too. But Hunt noted awareness and accessibility can be a challenge in a rural state like South Dakota, and she urged agencies to team up to prevent families from falling through the cracks.

Darla Biel, assistant director of the Center for the Prevention of Child Maltreatment, said the findings add to the long history of research showing how a surrounding environment can impact child development. But she emphasized a history of abuse or neglect does not mean a family is permanently broken.

"They may have experienced adversity," Biel acknowledged. "That doesn't mean that they're not able to be supported, and not able to move forward in healthy and safe ways with their children and their families."

Biel added parents navigating adversity should feel no shame in asking for help, noting they are not alone in trying to cope with stress while raising a child.

According to last year's State of Babies data summary, 22% of South Dakota mothers reported less than optimal mental health. Parenting classes are offered through the state's Social Services department.

Youth advocates continue to sound the alarm over the impact flavored tobacco products have on teenagers, and hope Minnesota lawmakers take another close look at a proposed statewide ban.

Following attempts in previous legislative sessions, a bill has surfaced to prohibit the sale of all flavored tobacco products, including menthol cigarettes, flavored cigars, smokeless tobacco and e-cigarettes.

The coalition Minnesotans for a Smoke-Free Generation said the region faces a youth tobacco epidemic.

Bethlehem Yewhalawork, program manager for NorthPoint Health and Wellness Center, said enacting proposed restrictions can prevent things from getting worse.

"Passing a comprehensive flavor policy will really prevent youth addiction and improve health for all Minnesotans," Yewhalawork contended.

According to the coalition, one in seven 11th graders in Minnesota reports using e-cigarettes, and 88% of those students use flavored products.

Proposed bans often encounter pushback from the tobacco industry and retailers. A similar ban in the city of Edina recently survived a court challenge. Currently, 25% of Minnesotans are covered by a local flavored tobacco policy.

Preethika Naveen, a senior at Eagan High School, said while overall smoking rates have declined, use of flavored tobacco is prevalent among her peers.

"Many kids use menthol chew and vape e-cigarettes. Why? Because of the flavors," Naveen observed.

Advocates also argued the tobacco industry continues to use menthol products to target Black Americans, LGBTQ communities and youth. Groups such as the Children's Defense Fund have noted early exposure to nicotine can have lasting effects on a child's brain development.

Some Indiana elementary students are getting an extra dose of emotional support in the classroom from service dogs.

Trained by the Indiana Canine Assistant Network, the dogs offer a social link to kids who may intentionally isolate themselves.

Jill Schipp, principal at West Clay Elementary School in Carmel, said kids feel an immediate bond with her dog, "Palmer," and want to pet him or read him a story. She explained service dogs are helpful for children who have trouble with fear or uncertainty, or difficulty communicating.

"I've had kids that come down that are experiencing grief or anxiety, or changes in their life, maybe kids that have made a move to a new home, and they're just upset," Schipp observed. "They're carrying big worries. Being with him, and petting him and getting dog kisses, and getting their mind off of it really, really helps."

She pointed out teachers also request visits with the service dogs during trying times, like state scholastic testing. Schipp noted she has received inquiries from other districts about the benefits of having a service dog on school grounds.

Service dogs receive special instruction and certification to address distinct needs. The dog may sense a child with a physical disability is unsteady, and let the child lean on them. Schipp added her dog is keenly aware of nonverbal communication, which is common in children on the autism spectrum.

"If they are upset, I have learned to ask the child what they need," Schipp recounted. "Some kids will say, 'I need him to sit on me.' So, I have a little mat and the child sits down, puts their legs straight out in front of them, and he sits on their lap. And they just talk to him, and he just lays there until they're calm."

Schipp thought the dogs' presence would ease students' transition back to a classroom setting after the pandemic. She began the process with questionnaires to hundreds of parents, and the majority supported the plan. She emphasized care is taken with allergic reactions or fear of dogs.


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