Kentucky begins its eligibility review of kids' Medicaid coverage this month - and experts say it's vital the process goes seamlessly, so kids aren't removed because of procedural errors or incomplete information.

Emily Beauregard, executive director of Kentucky Voices for Health, explained that most households should receive notices in the coming weeks.

She added that it's even more critical to ensure kids retain their coverage, because Kentucky has recently implemented a new continuous eligibility policy.

"If they're able to renew their children's coverage, those kids will have coverage for 12 months - with no gaps," said Beauregard. "That's really exciting, because what we've seen in the past is that there's churn throughout the year based on fluctuating income, other changes in the household."

According to the Georgetown University Center for Children and Families, more than 47% of Kentucky children rely on Medicaid or KCHIP coverage.

Beauregard said the percent of kids on Medicaid and KCHIP coverage in the state's rural counties is especially high, making it even more critical parents and caregivers complete the renewal process for kids.

"It's as high as 77% in some eastern Kentucky counties," said Beauregard, "and it really is the most comprehensive coverage that kids can have. We need to make sure that our kids aren't losing coverage during Medicaid renewal."

Joan Alker - a research professor at the McCourt School of Public Policy, and the executive director, Center for Children and Families at Georgetown University at Georgetown University - said the ripple effects of increasing numbers of kids without coverage could be far-reaching.

"Children are not expensive to cover, but they're regular utilizers of care," said Alker. "We don't want families showing up at the pharmacy and being told, no, you can't get your child's medication."

According to data from KFF, kids are being kicked off of Medicaid rolls largely due to simple errors or change of address.

Nationwide, nearly 700,000 children have lost coverage during the unwinding, although experts say that number is likely much higher.

The biannual Pro-Kid Scorecard from the Children Now Action Fund was released today.

In it, 12 state Assembly members and seven state Senators earned a 100% rating.

Kelly Hardy, senior managing director of health and research at the nonprofit Children Now, said the scoring reflects more than how lawmakers vote.

"They voted the right way on health and child welfare, child care, education," Hardy outlined. "They also supported kids in the budget, which is not always an easy thing to do when we've got budget deficits."

The lowest scores hovered around 48%, awarded to lawmakers who voted against certain bills but also voted for proposals like forced outing policies for LGBTQ+ students in schools.

Hardy noted the report is intended to inform voters as they head to the ballot box next month.

"Kids may not vote but we want to elect legislators who do their best to support kids," Hardy explained.

California ranks 35th in the nation for child well-being, according to the latest Annie E. Casey Foundation report and is just above the national average for per-pupil spending on K-12 education.

A screening tool developed by medical providers is an effective way to spot signs of child abuse, and experts are raising awareness about it today.

The TEN-4 rule stands for "Torso, Ears and Neck," an easy-to-remember prompt to examine high-risk bruising on young children that should be considered as a red flag for abuse.

Tamara Brown, director of the Health Access Nurturing Development Services (HANDS) program at Family and Children's Place Jefferson County, said the home visitation program that provides resources for new or expectant parents includes education on the TEN-4 rule to help people spot any potential signs of abuse of their child or neighbors' and friends' children.

"We work with children under the age of two and prenatal families," she said, "and what we are hoping is that we can really provide a lot of support for those most vulnerable populations. Children under two are the highest-risk group for death through child abuse."

Kentucky's rate of child abuse decreased in 2022, but the number of reported abuse and neglect cases in the state still surpasses the national average, according to federal data. Around a dozen Kentucky kids out of every 1,000 experienced some form of maltreatment during 2022.

For more information on the rule, visit faceitabuse.org/ten4rule.

Dr. Melissa Currie, professor and endowed chair for pediatric forensic medicine at the University of Louisville School of Medicine, explained that bruising - particularly on babies - isn't normal. It can be a sign of something serious: If not abuse, then a bleeding disorder or even cancer.

"It does not necessarily mean that it's abuse," Currie noted. "That said, the rule helps us determine high-risk bruising with enough specificity that if a child screens positive, they definitely need medical workup, and they need it right away."

Barry Dunn, president and CEO of Kosair for Kids, the group that created the TEN-4 Day observance, said all Kentuckians have a role to play in preventing child abuse and neglect.

"We are proud of the progress that we've made. That drop is big," he said. "We've gone from worst in the nation to 14th worst. We're not going to plant a flag with that advancement, but it is a data point."

If you suspect a child is being abused or neglected, contact the statewide Child Abuse Hotline at 877-597-2331 to make a report.

On the heels of warnings from federal health officials about parent burnout, school-linked programs in Minnesota are overhauling their approach so that families don't feel isolated. The Surgeon General's office says 33% of parents nationwide report high levels of stress in the past month compared with 20% of other adults, noting the lingering effects of the pandemic and any financial hardships, as well as a household having to navigate technology and social media.

Keem Anderson, associate director of the statewide Ignite Afterschool initiative, said it's something they've noticed.

"We've been seeing parents struggling with their mental health, right? Having to pick up a couple extra jobs because of the economy," Anderson explained.

He said those added stressors, worsened by the pandemic, are negatively impacting parent engagement with a child's academic life, including out-of-school programs. To improve connections, Anderson said they're rethinking how they ensure parents feel supported, such as addressing transportation gaps or giving them opportunities to volunteer. Ignite Afterschool plans to hold listening sessions on this topic in the near future.

The Children's Defense Fund's Freedom Schools effort - which offers educational and cultural enrichment for kids and their families - partners with a dozen schools in Minnesota.

Paris Timmons, assistant director of Extended & Experiential Learning and Academic Recovery, and executive director of Freedom Schools, leads this program for Hopkins Public Schools, and said part of the approach is figuring out how to communicate with parents in an ever-changing world.

"It's really hard to build a relationship via words on a screen versus a phone call, versus an in-person meeting," she said.

Timmons suggested her team and other support programs need to be more intentional about speaking with parents so they're aware of what's happening in and out of school. That might look like following up a text or email with that phone call or face-to-face meeting. Freedom Schools has prioritized weekly parent empowerment sessions, so that key messaging doesn't get lost in the shuffle.