As South Dakota voters prepare to consider a proposed Medicaid expansion, emerging research suggests giving these programs a bigger reach can lead to reduced rates of child maltreatment.

Through a grant from the Centers for Disease Control and Prevention, the findings were compiled by researchers at the Moore Center for the Prevention of Child Sexual Abuse at Johns Hopkins University.

Elizabeth Letourneau, director of the Center, said they looked at data in states with expanded programs, compared with states without. She reported on average, they found a 13%-16 % reduction in child neglect rates in expansion states.

"And financial instability is perhaps the most serious risk factor for neglect of children," Letourneau explained. "And so, there's less medical debt, there's less trying to figure out, 'Do I buy this prescription medicine or do I put food on the table for my family?' "

She pointed out they also found positive trends in reducing physical abuse. The Center cautioned the trend was not as statistically significant, but noted there is evidence of hope. Under the Affordable Care Act, the federal government provides funding to help states expand their Medicaid programs. Twelve states have yet to do so. The question will appear on South Dakota ballots in the November election.

Letourneau added while there are a variety of prevention programs to help families on an individual basis, broader policies should not be overlooked in seeking solutions.

"If those policies happen to have the impact of driving down and preventing violence against children, you're just going to get a much, much bigger bang for your buck," Letourneau contended.

The federal government covers 90% of Medicaid expansion costs, and extra incentives were added during the pandemic. There is opposition from some Republican policymakers, who still give pause at having to find room in the state budget for the remaining share. Except for Wyoming, all the states bordering South Dakota have expanded Medicaid.

This Sunday is the 60th anniversary of Head Start, the federally funded preschool program supporting more than 12,000 children, up to age four, in Washington and nearly 800,000 children across the country.

Although cuts to Head Start are not specifically included in the Trump administration's most recent budget proposal, some locations have faced funding delays this year, leaving them nervous about the program's future.

Ashly Hyatt has three children in Head Start in Spokane, and is a parent ambassador alumna. She is currently in school to become a teacher and said without Head Start, her life would look very different.

"I wouldn't be in school, it wouldn't be possible," Hyatt pointed out. "Three children in day care is going to be close to $3,500. My husband works 60 to 80 hours a week right now as it is, and it's tight."

Hyatt added Head Start has done so much for her children, she was inspired to get involved in advocacy work. Washington Head Start is completely federally funded, and received about $200 million last year.

Roy Chrobocinski, managing director of domestic policy at Save the Children US, which runs Head Start programs in several states, said he is focused on reminding Congress about the bipartisan support Head Start has enjoyed for the last 60 years, and stressed the program is about much more than child care.

"It also provides medical assistance, dental visits, nutrition assistance," Chrobocinski outlined. "Two meals and a snack every day."

Head Start is often the only child care option in rural areas, Chrobocinski emphasized. Without funding, parents would not be able to work, affecting their families and local economies. He pointed out currently, only about a third of eligible families are able to receive services due to limited funding.

"There needs to be a significant increase in Head Start funding in order to ensure that more families who are eligible are able to participate in this life-changing program," Chrobocinski contended.

He underscored child care disruptions already cost the economy an estimated $122 billion annually.

With the end of the state legislative session in sight, Connecticut lawmakers are moving closer to establishing a permanent child tax credit.

The 2025 legislative session has seen several child tax credit bills circulate, offering differing levels of rebate. The current proposal has moved out of committee as part of the state budget bill and would establish a $150 per child credit, capped at $450.

Lisa Tepper Bates, president and CEO of the United Way of Connecticut, said her organization has been advocating for a state child tax credit, which she noted has widespread support.

"We've gained some ground on creating a child tax credit at the state level," Tepper Bates pointed out. "There is legislation with the support of an enormous number of the members of the House of Representatives and supporters in the state Senate who want to see this done and they want to see it done this legislative session."

The credit would be available for single filers making up to $100,000 per year, $160,000 for heads of household, and $200,000 for joint filers.

Data published by United Way show nearly 40% of Connecticut households are living paycheck to paycheck. Among those are households considered as ALICE, an acronym for those who are Asset Limited and Income Constrained but Employed. Categorizing households in this way attempts to capture the financial circumstances of working people who are above the poverty level but still cannot afford the basics such as housing, food, health care and child care.

Tepper Bates noted while rents are high in the state, in many households it is not the biggest financial burden.

"Our ALICE research shows that child care for families with small children can be their single biggest cost center," Tepper Bates reported. "This is an important point to understand because we now know that in Connecticut, the cost of child care for many of these families is becoming simply unsustainable."

The scarce availability of child care is pushing costs higher, with recent data showing 80% of the state's licensed family child care centers are operating at capacity, a 6% increase over the year prior.


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A North Dakota task force raising awareness about child sexual abuse is close to wrapping up its work and its leader said she hopes more communities use every tool to ensure kids are raised in a safe environment.

By state law, the task force is scheduled to dissolve on June 30.

Lindsey Burkhardt, director of the task force, said a key accomplishment was creating a pair of guides, one for families and another for schools and youth service groups, which lay out the best prevention practices and resources to turn to.

Burkhardt acknowledged they are still fighting misconceptions, like the idea children are most often abused by strangers, and stressed it is why the conversations are important.

"What are protective strategies that we can teach our children to help empower them to help keep them safe?" Burkhardt asked.

Burkhardt noted evidence of misconceptions surfaced in a pilot project in Richland County. Among those surveyed, 25% of residents said they did not believe child sexual abuse happened within the county. At the end of the project, the number improved to 20% but Burkhardt argued it highlights the need for further community education.

Burkhardt emphasized there is a strong body of research showing a child who is sexually abused is at risk of mental health disorders and survivors are likely to experience a range of conditions and behaviors affecting their quality of life.

"Depression, chronic anxiety, PTSD, along with relationship and attachment issues," Burkhardt outlined.

Burkhardt added it is hard to fully measure the task force's effect but pointed to adoption of their prevention guides as a way to show their work connected with some audiences. It included requests from the North Dakota court system to use them when training parent investigators.


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