Two million children and adults in California could lose health-insurance coverage over the next year - as the state winds down the continuous-coverage requirements in place during COVID, according to a new report from Georgetown University.

The pandemic health emergency officially ends May 1, but on April 1, California will start re-determining eligibility for 50-million people on Medi-Cal.

Mike Odeh, senior director of health with the nonprofit Children Now, said recipients must make sure the program has their current address.

"The state has been proactive in asking families to make sure that their contact information is up to date. And we know that they have launched a campaign," Odeh said. "So families can visit keepmedicalcoverage.org to sign up for email and text message alerts with updates about medical renewals."

Children who are still eligible could lose coverage if the renewal notice goes to the wrong address or if there is an administrative error. During the pandemic emergency, the state was required to keep all Medi-Cal recipients on the program. But now the income requirements will kick in once again. More than 56% of kids in California and 52% nationwide are covered under Medicaid or CHIP.

Federal research indicates 72% of the kids who lose their Medicaid coverage will still be eligible, and that Black and Latino families are at greater risk of losing coverage.

Report co-author Joan Alker, executive director of the Center for Children and Families at Georgetown University's McCourt School of Public Policy, said many factors come into play.

"Language issues may be a barrier when you have families who are perhaps mixed-status immigrant families, who have some fear about engaging with the government; families who live in rural areas, who don't have good internet connectivity," Alker said. "There are lots of reasons families are going to be at greater risk."

Starting in 2025, California will begin keeping kids on Medi-Cal enrolled until their fifth birthday, with renewals annually after that. Undocumented children have been eligible for Medi-Cal since 2016.

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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