RALEIGH, N.C. - Fifteen thousand North Carolina children lost health insurance coverage between 2016 and 2018, according to a report released today by the Georgetown University Center for Children and Families.

Michelle Hughes, executive director of the advocacy organization NC Child, said the troubling trend is largely the result of state lawmakers' refusal to expand Medicaid.

"Our state Legislature could roll out the welcome mat to enroll the whole family in health-care coverage, but so far has chosen not to," she said, "and that really is probably the biggest factor behind the number of kids who are falling off the insure goals in our state."

Fourteen other states, many located in the Southeast, also are experiencing a widespread loss of children's health coverage, according to the report.

Hughes said health-insurance coverage is a critical first step in making sure children see a doctor early in life.

"Both for preventive care, so getting things like their immunizations, getting screens for developmental delays," she said, "and also for treatment, making sure that for example, if kids have asthma, that they are able to get inhalers."

Joan Alker, executive director of the Georgetown Center, said Medicaid expansion is a key factor, noting that when parents go through the process of enrolling themselves in Medicaid, they are subsequently more likely to also enroll their children in the Children's Health Insurance Program (CHIP).

"When you look at the data, the increase in the rate of uninsured children is nearly three times as large in states that have not expanded Medicaid," she said, "so that is a very clear way that a state could turn this negative trend around."

Even in states that have chosen to expand Medicaid, Alker said, red-tape barriers and a climate of fear and confusion - especially in immigrant communities - has left many families hesitant to enroll their eligible children in Medicaid or CHIP. In 2018, North Carolina had a total of 130,000 uninsured children, the seventh highest number in the nation.

The Georgetown report is online at ccf.georgetown.edu, and a state-specific data hub is at kidshealthcarereport.ccf.georgetown.edu.

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.

September has been National Kinship Care Month, and more than 80% of Kentucky kinship families say they need help with groceries, followed by clothing, school supplies and other basic needs, according to a new report.

Because of budget constraints, the state placed a moratorium on its Kinship Care Program that previously allotted monthly payments of $300 per child to kinship caregivers stepping in as an alternative to foster care.

Shannon Moody, chief policy and strategy officer for Kentucky Youth Advocates, said a growing number of these families are navigating an often confusing child-welfare system.

"There are estimates that we've got about 55,000 children being cared for by relatives or close family friends in some sort of kinship care setting, whether that's child protective service-involved or not," she said, "and we do believe there are probably more than that."

Child care and mental health care were also listed as top priorities in the survey, by Kentucky Youth Advocates and the Kinship Families Coalition of Kentucky.

Norma Hatfield, president of the coalition, has spent the past decade raising two grandkids. She said most caregivers, especially grandparents, aren't financially equipped to suddenly take on full-time caring for children.

"Kentucky has done a lot to try to provide more support, but the needs are still there," she said. "It costs to raise children today, and that doesn't change."

Moody pointed to Senate Bill 151, signed into law by Gov. Andy Beshear earlier this year, as a sign of progress on policies aimed at improving the lives of kinship families. The law allows relatives or close friends, known as "fictive kin," to apply for certification as a foster home, and allows kids a say in where they live after they've been removed from their home.

However, Moody said more work is needed to expand community resources "to ensure that we are providing really comprehensive supports, including counseling and mediation services, in order for the that triad - the birth parent, the grandparent or other relative and the child - to get what they need."

The report also calls for more investments in peer support groups, using opioid settlement money to increase resources for kinship families, and better training for state and foster-care agencies and community mental-health providers on the unique needs of kinship families.

Resources for kinship families in the state are online at kinshipky.org.

It's a week to celebrate kids, with National Daughters Day today and National Sons Day on Saturday. The Dave Thomas Foundation for Adoption is encouraging everyone to remember kids who are looking for their forever homes, and consider fostering or adopting a child.

Rita Soronen, Dave Thomas Foundation president and CEO, said the goal is to find permanent homes for as many children as possible before they age out of the system.

"Single parents can foster and adopt, non-traditional families can foster and adopt. You can live in an apartment, you don't have to own your own home, you don't have to be wealthy. If you have the interest, and the willingness to learn, and the willingness to commit to a child - and you're safe - then you meet that first level of qualification," she said.

She added that states cover medical and other costs associated with kids in foster care. The process to qualify to foster or adopt a child includes a series of classes, background checks and home studies.

The latest statistics show that more than 28,000 children are in the foster care system in Texas. Adrian and Shane Potter adopted siblings 12-year-old Isiah, 10-year-old Jordan and four-year-old Sophia in 2020 after they had been in separate foster homes for years. Adrian Potter said the foundation worked with the adoption agency to get the kids settled with the services they needed.

"Our case worker got us connected to therapists, private tutors, music private lessons, they connected us to a lot of people, " he explained

He said adopting children is life changing in many ways.

"Every day is fun, laughter, every day is a challenge, but every day is also fun because you get to see these kids who have gone through so much learn to trust and learn to love, " he said.

Nearly 360,000 children are in foster care in the United States.