On March 11, 2020, Governor Gary Herbert took the necessary step of declaring a state of emergency in Utah in order to address the coronavirus (COVID-19) pandemic. As the state moves forward with immediate activity to address the health implications of this global pandemic, we also urge lawmakers to consider enacting policies that will help mitigate its economic fallout for families and children in Utah. 

Health Care 

The immediate challenge is to ensure that all Utahns get access to critical health care. No Utahn should be denied access to care or feel afraid to get the care they need. Quickly identifying and treating those who have the virus, while taking all community public health precautions, will enable us to reduce the spread and help to flatten the curve.

We know this pandemic will present unique challenges to Utah’s health care system and to Utah families. In the past two years we have seen one of the largest increases in children lacking health insurance coverage in the nation. This outbreak should remind us that not one of us is truly safe when some of us are vulnerable. We need to immediately create a path for those uninsured children to be provided coverage until this emergency is over.

The state should ensure that the costs of testing and treatment for the coronavirus are fully covered to ensure that all Utah residents can get the care that will protect them, their families and their communities.

In these times, it is also critical that we remove any barriers to care or eligibility, especially for our most vulnerable Utahns. Utah should immediately halt its Medicaid work requirement and new premium payment requirement. At a time of such unprecedented economic change, this will only create additional barriers for families, while enforcement and implementation will waste valuable state resources. The state should suspend other waiver requests to CMS that will further deny care to individuals and families.

In addition, Utah must adopt policies that will ensure children and families can stay covered, which means extending renewal periods, grace periods for returning information and application processing times. This will not only keep families safe, but state eligibility workers as well.

Finally, we call on the state to support outreach and information to help all Utahns feels safe and welcome getting care, and also to provide information about how Utah kids and families can immediately connect with affordable coverage.

In the longer term, we should commit ourselves to covering all children and families in our state, so no one is left without coverage in times like this. And we must work in partnership to strengthen our health care system and our safety net providers, so we are equipped to meet the needs of all children regardless of ethnicity, nationality, immigration status, or where they live in the state. We must ensure families have access to the comprehensive care, including physical, dental, mental and behavioral health care, to ensure all kids can stay on track, stay healthy and thrive.  

Family Economic Security  

Guaranteeing all workers paid sick leave is a proven way to slow the spread of disease and would disproportionately benefit working families who earn low incomes. We are supportive of the action taken at the federal level on March 19, 2020 (the Families First Coronavirus Response Act or FFCRA) and encourage Utah to take immediate action to publicize the protections provided.  Here is an outline of the provisions related to paid sick leave and family/medical leave:

Paid Sick Days for Public Health Emergencies

• Two weeks (or 10 work days) of paid sick leave
  • Applies to public employers of all sizes and private employers with fewer than 500 employees
  • DOL has discretion to exempt businesses with fewer than 50 employees from providing paid sick days for employees to care for a child whose school or place of care is closed
  • DOL has discretion to exempt certain health care providers and emergency responders
• Purposes:
  • To obtain a medical diagnosis or care if experiencing symptoms
  • To comply with a recommendation from a public health official
  • To care for an individual who is self-isolating because of a diagnosis or is experiencing symptoms
    • When taken for this purpose, rate of pay is reduced to 2/3
  • To care for a child if school or place of care is closed
    • When taken for this purpose, rate of pay is reduced to 2/3
  • Maximum payment is $511 per day/$5,110 total for self-care, $200 per day/$2,000 total for family care
• Impact on existing policies:
  • Sick time under the bill must be made available to workers in addition to any employer provided leave
  • Employer cannot require an employee to use accrued time before emergency time
  • Employer cannot require an employee to find replacement workers
• The law broadly allows for caregiving for an individual under quarantine due to COVID-19. It does not limit caregiving to certain family members.
• Sunsets on December 31, 2020 

Emergency Paid Leave

• Amends the FMLA to allow for paid leave in the event of a public health emergency.
• Purpose: 
  • The employee is unable to work/telework because the employee’s child's school or place of care is closed, or the child's usual care provider is unavailable, due to a COVID-related public health emergency.
• Family member:
  • Son or daughter under age 18
• 12 weeks of job-protected emergency paid leave
  • First 10 days may be unpaid 
  • For subsequent leave, employer must pay employee at 2/3 wage replacement, up to $200 per day and $10,000 total
• Applies to employers with fewer than 500 employees
  • DOL has discretion to exempt businesses with fewer than 50 employees
• Available to employees who have been on the job for at least 30 days
  • DOL has discretion to exempt certain health care providers and emergency responders
  • Employers of health care providers and emergency responders may elect to exclude such employees from this leave
• Job Protection
  • Employee has a right to job restoration under the FMLA
  • Exception for employers with fewer than 25 employees under certain conditions
• Sunsets on December 31, 2020

Workers who do become unemployed, are furloughed, or have their work hours cut due to business downturns or sickness will be the first to feel the economic pain. We should do all we can to speed up the application process for unemployment insurance  and comply with the FFCRA requirements for millions of dollars in federal aid by temporarily providing benefits with no waiting period, waiving employer penalties and job search requirements, and maximizing eligibility levels and benefits so no one is left behind. We should also protect those who face losing their employer-provided health insurance benefits because of an economic downturn. 

Utah needs to adopt official language defining “essential services” immediately. Here is a sample of a definition being used by other state agencies:

“Essential services and sectors include but are not limited to food processing, agriculture, industrial manufacturing, feed mills, construction, trash collection, grocery and household goods (including convenience stores), home repair/hardware and auto repair, pharmacy and other medical facilities, biomedical and healthcare, post offices and shipping outlets, insurance, banks, gas stations, laundromats, veterinary clinics and pet stores, warehousing, storage, and distribution, public transportation, and hotel and commercial lodging.”

Another major problem is that our state has a growing homeless population, both sheltered and unsheltered. The unsheltered homeless lack the ability to self-quarantine and do not have regular access to medical care. The homeless will need shelter, medical treatment, and emergency homeless services. Therefore, the state must urgently convert its unused/underused spaces into shelters.

Lastly, we should place a moratorium on all foreclosures and evictions until we lift the state of emergency. No Utah families or individuals should be made homeless because of this crisis. 

Young Children 

With school and child-care facility closures, and work disruptions, a pandemic presents unique challenges for families with young children. In order to maintain a strong early learning and care system through this pandemic, lawmakers should enact practical policies to ensure that families of preschool-aged children are supported and to protect child-care workers and centers – many of which are small businesses operating on very slim margins – from an economic crisis. School-level reactions to the needs of families with young children – such as continuing to run school-based food programs – are very encouraging. We also need to support families with young children who are not yet school aged, including infants and toddlers, but who continue to have nutritional needs at this time. We recommend that state officials direct food retailers to set aside WIC-approved foods for families participating in that program, while also increasing flexibility for families with regards to food purchased as part of the WIC program.

We are pleased to note that state leaders have adjusted child-care subsidy payment policies to account for this unprecedented strain on our child-care sector. We encourage state and local leaders to invest in a wage supplement program for early childhood care and education provider. Such programs must include not only child-care center workers, but also home-based and family child-care providers. Payment policies should be adjusted so they are based on enrollment of children, rather than attendance. Finally, the state should do an immediate review of all safety net programs statewide and streamline all processes during this crisis. 

Food security

In Utah, we have a large number of children that depend on school meals for consistent access to food. Based on our most recent data, 36.1 percent of our children participate in the free and reduced-price school lunch program. As schools in Utah will be closed until at least March 30, the state must take immediate steps to ensure that children enrolled in these meal programs have some other access to the meals they will be missing at school.

The state should also be taking steps to minimize food insecurity including: increasing the state Supplemental Nutrition Assistance Program (SNAP) supplement to provide more benefits for recipients; establishing a food distribution system to provide meals for food-insecure families; extending the certification for the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) to 60 days; streamlining SNAP by exempting families from certain requirements, such as work or education and training requirements; and lastly, making SNAP application available online, by mail, or telephone. 

Juvenile Justice

The current situation demands that we refrain from creating unnecessary groupings of people. To that end, we strongly encourage law enforcement throughout the state to restrict arrests and citations of young people to only those most serious, injurious offenses. With very few exceptions, youth should not be taken to detention centers, as our juvenile justice professionals are already working overtime to maintain the cleanliness and safety of those facilities. In addition, as non-essential court activities have been delayed, a reduction in arrests and citations now will prevent unnecessary overwhelm of the juvenile court system when normal operations come back online. 

We also strongly recommend that juvenile justice facility managers - including those who operate official state and county youth facilities, as well as community-based placements such as treatment facilities and group homes, exercise the utmost caution with the young people in their care. At the same time, this caution regarding health and safety must be balanced with an understanding of the need of these youth to maintain connections with their family, friends and loved ones. We encourage flexibility with regards to the use of technology for video and telephone visits while people engage in social distancing at the governor’s recommendation. If this situation should persist past the next two weeks, juvenile justice administrators should consider instituting health-related protocols (such as taking of temperature, monitoring for other symptoms, and issuance of personal protective equipment) that would allow family members and other loved ones to visit youth in custody. 

Economy

The Coronavirus Recession has already begun, is going to hit faster than any previous recession, is immune in some ways to traditional stimulus (because social distancing limits government's ability to restore consumer spending before the pandemic is addressed), and states need to act fast to take full advantage of the coming federal actions and make the recession shorter and shallower rather than longer and deeper (such as with inaction and budget cuts). 

We must resist the urge to cut expenditures on vital services like education and health care. We have seen first-hand how important these areas have been in the current crisis.

Given the immediate need for support, we believe that this is the time to use a portion of our rainy-day fund. The additional money will help officials respond to the outbreak without jeopardizing commitments lawmakers made to fund important priorities in the recently completed legislative session.

We should look at a tax increase on those most able to afford them and reinvest that revenue into specific areas identified during the crisis. This would be a solid investment in the long-term health and prosperity of our state.

Summary

Given the rapidly evolving nature of this crisis, we recognize that many of the recommendations listed above are currently being discussed at both the state and federal level. We encourage our state leaders to take bold and decisive measures to ensure the health and well-being of all the residents of our great state. The focus of Voices for Utah Children is to advocate on behalf of the children and families of Utah. We will continue to update developments as we receive information. Please feel free to contact me directly with any questions or concerns. I can be reached at .

Moe Hickey

CEO

Voices for Utah Children

Let’s Keep All Families Covered: New Report Finds Number of Uninsured Latino Children in Utah on the Rise

2020 Utah Legislature Made Strides to Help All Children Stay Covered

Decades of progress improving health coverage rates for Latino children has begun to erode nationwide, and Utah is seeing significant increases in both the number and rate of children going without insurance, according to a new report by UnidosUS and Georgetown University Center for Children and Families. These findings raise concerns that many children may not be able to access the health care they need during the COVID-19 pandemic.

Utah’s rate of uninsured Latino children rose faster than the national average, a statistically significant increase from 11.1 to 17.3 percent between 2016 and 2018. The number of children increased by about 60 percent, from about 18,900 to more than 30,200. What’s more, Latino children are almost 3½ times as likely to be uninsured as non-Latino children in Utah in 2018, a gap that is greater than the national average.

The report authors point to Trump Administration policies and rhetoric targeting immigrant families, as well as efforts to undermine health care programs, which have made it more difficult for families to sign their eligible children up for public health coverage. These national factors may influence children in Utah and the trend in the wrong direction.

During the 2020 Legislative Session, the Utah Legislature took a significant measure to reverse this trend and improve coverage for all Utah children by appropriating funding to keep children covered, a policy known as Medicaid 12-month continuous eligibility. Continuous eligibility ensures children can maintain stable, year-round health coverage, even if parents experience temporary changes in income or employment status, especially important given the abrupt changes many low-income families are experiencing now.

State Senator Luz Escamilla, champion for 12-month continuous coverage and children’s health care, said: “Health coverage is critical for all children because it improves their health and educational outcomes during childhood and sets them up for a healthier and more prosperous future with better opportunities to reach their full potential.” Said Senator Escamilla, “The actions this session show that working together we can make progress to help Utah kids.”

A policy of continuous coverage is a key priority of the 100% Kids Coverage Campaign, led by Voices for Utah Children, to ensure that all children in the state have health coverage. The campaign also calls for more Medicaid and CHIP outreach and coverage for children regardless of their family immigration status. Report lead author, Kelly Whitener notes, “The majority of uninsured children are eligible for affordable health coverage through Medicaid or CHIP but not enrolled.”

Voices for Utah Children policy analyst, Ciriac Alvarez Valle said, “Going forward, we will work to help more children and families get covered and overcome barriers to enrollment and care.” Alvarez Valle added, “No family should be afraid to get the care they need. We call on our state leaders to help Utah families feel safe getting health care now.”

For help enrolling in health insurance, visit: www.takecareutah.org  or call 2-1-1

For the full report: https://ccf.georgetown.edu/2020/03/10/decade-of-success-for-latino-childrens-health-now-in-jeopardy/

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It’s been a busy end-of-year for Utah kids’ health coverage, from ACA open enrollment to full Medicaid expansion (almost!). Here’s what’s been going on and what lies ahead in 2020...

Where are Utah kids going??

At the last Utah Medicaid Advisory Committee meeting, we learned that 398 children dis-enrolled from Medicaid and CHIP in October. While this is better than the 2,637 who lost coverage the previous month (no, that’s not a typo), the question remains: Where are these kids going?? Are they moving over to the private insurance market? Or are they uninsured? Unfortunately, we still don’t know.

American Community Survey data suggest lower income children are the most likely to be uninsured in Utah. However, we do not have good real-time data to track why Utah kids are dis-enrolling from Medicaid or CHIP at such an unprecedented rate.

Reasons for this coverage loss may include red tape and confusion about children’s health insurance options, and federal anti-immigrant hostilities creating a climate of fear for many families. But again, our best data has a one-year lag time. It is critical we make sure kids are getting connected with health insurance now. We know from research that when kids go uninsured it has a negative impact on their life trajectory.

We commend our state agencies for their attention to this issue; we urge them to survey families who recently lost coverage so that we can make sure kids are getting covered and staying covered.

Full Medicaid expansion*… coming soon to Utah?

In November, the Utah Department of Health submitted its “fallback” waiver request to fully expand Medicaid! On December 7^th, the federal comment period closed. THANK YOU to the over 4,800 people who submitted federal and state comments.

We now await federal approval for Utah to enact full Medicaid expansion. It’s been a long, complicated road, but we just might get there. Find out if you’re eligible for Medicaid.

*Unfortunately, this is not exactly the expansion Utahns voted for. Our state is tacking on harmful work requirements, premiums, surcharges and red tape to Medicaid coverage for the newly eligible. These added requirements will make it harder for Utah parents and children to get care. If approved, we will work hard to prevent these provisions from causing families to lose the coverage and care they need.

Have a story to share about how Medicaid coverage will make a difference in your life? Share your story here.

Open Enrollment: Last Day to Apply is December 15^th!

In need of health insurance for you or your family? Call 2-1-1 or visit TakeCareUtah.org to learn more about the health insurance marketplace.

What’s coming up in 2020?

We are excited to see many opportunities- big and small- to help Utah kids and parents get connected with health insurance in 2020:

• Expanded texting support to help kids and families connect with coverage, thanks to an exciting new campaign through United Way of Salt Lake.
• Medicaid outreach from the Utah Department of Health! The Department is hiring outreach workers to help eligible individuals learn about Medicaid expansion. This is an exciting step to help more parents enroll.
• Finally, the Utah Department of Health will -hopefully- be releasing guidelines for Medicaid ACOs, which will allow them to remind eligible members of their upcoming renewals. Many eligible individuals often lose coverage when their renewal is due. (Legislation passed in 2019 on this issue, but the guidelines have yet to be released)

… And so much more! Here’s to a 2020 where more Utah kids and families can get access to affordable health coverage and care!

Going Down a Scary Path: Utah kids are losing health insurance

Over the past two years, Utah has seen an alarming increase in our child uninsured rate. After years of steady progress, it is frightening to see kids lose health insurance. 7.4% or 72,000 Utah kids now lack health insurance, when only 6% or 59,000 kids were uninsured in 2016. We are seeing some of the most significant coverage decline among young children, age 0-5, an age when it is so critical for kids to have access to have screenings, check-ups and care. Why is this happening? Over the past two years Utah and our nation have experienced an unpredictable health care environment, affecting CHIP, Medicaid expansion and the ACA, leading to misinformation and confusion; administrative complexity and lack of continuous coverage leading to disruptions in kids coverage; anti-immigrant policies and rhetoric leading families to feel unwelcome and unsafe enrolling in programs. These are scary barriers keeping Utah kids from getting the care and coverage they need and Voices for Utah Children will be working hard to keep Utah from continuing down this path any further.

Tricks and Treats

After a roller coaster summer, the Utah Department of Health is submitting a waiver proposal to expand Medicaid, fully, up to 138% of the federal poverty level. Currently, Utah has only partially expanded Medicaid. Partial expansion has meant that more individuals are eliglble for Medicaid, but also that thousands of individuals and parents are still shut out of coverage, while Utah pays more money to cover fewer people. We are excited for Utah to take this step closer to full Medicaid expansion, as voters supported.

But unfortunately, this latest waiver proposal also includes harmful, additional barriers such as work reporting requirements and additional cost requirements for enrollees. These added requirements will make it harder for Utah parents and children to get coverage and care. Comments are needed to prevent these harmful requirements from moving forward.

We need your help to get Utah back on the right track to full expansion (the ‘treat’ without the tricks!). Submit your comments today to stand up for full Medicaid expansion, without additional barriers or restrictions.

Finally, the Public Charge rule was recently blocked in the courts. The Public Charge is postponed until further notice. But we still have work ahead of us and we must undo the damage already done as a result of anticipation of this harmful rule, and other anti-immigrant hostilities.

Learn more about the latest developments in the Public Charge rule here.

Utah Poverty Advocates Call for Fairer Taxes and Restoration of Public Revenues

Salt Lake City - Today (September 26, 2019) at the Utah State Capitol, a group of two dozen non-profit organizations that provide services to and advocate on behalf of Utah's low- and moderate-income population released a letter to the Tax Restructuring and Equalization Task Force. The letter calls on the Task Force to consider the impact on low-income Utahns as they consider tax changes that could, in the worst case scenario, make Utah's tax structure more regressive and less able to generate the revenues needed to make critically important investments in education, public health, infrastructure, poverty prevention, and other foundations of Utah's future prosperity and success. 

The text of the letter and the list of signatories appears below (and is accessible as a pdf at this link): 

 Open Letter to the Tax Restructuring and Equalization Task Force (TRETF)

Tax Reforms for Low- and Moderate-Income Utahns

September 2019

Dear Senators, Representatives, and Other Members of the TRETF:

We, the undersigned organizations that work with and advocate for low- and moderate-income Utahns, urge you to consider the impact on the most vulnerable Utahns of any tax policy changes that you propose this year.  

We urge you to address the two major challenges facing our tax structure as it impacts lower-income Utahns:

1)     Utah’s current system of taxation is regressive, in the sense that it requires lower-income Utahns to pay a higher share of their incomes to state and local government than it asks of the highest-income Utahns, even though about 100,000 lower-income Utah households are forced into – or deeper into – poverty by their tax burden every year. 

This regressivity could be addressed with tax policy changes including the following: 

1. A Utah Earned Income Tax Credit (EITC) to allow the working poor to keep more of what they earn.
2. Remove the sales tax entirely from food, as 34 other states have done.
3. Remove the state income tax on Social Security benefits for low- and moderate-income seniors; Utah is one of only 13 states that tax these benefits.
4. Restore the income tax rate to 5% or increase it above that level. (Because the majority of all Utah income is earned by the top quintile of taxpayers, and because the Utah income tax more closely matches Utah’s income distribution than any other tax, most of such an income tax rate increase would be paid by the top-earning 20% of Utahns, while most lower-income Utahns are shielded from income tax rate increases.) 
5. Disclose and evaluate the effectiveness of tax expenditures (revenue lost to the taxing system because of tax deductions, exemptions, credits, and exclusions); Utah’s lack of transparency in this area of taxation earned us a C grade from the Volcker Alliance, a leading evaluator of state budgetary practices founded by former Federal Reserve chairman Paul Volcker. 

2)     For decades, Utah’s overall level of taxation relative to the state’s economy has been dropping, as illustrated in the chart below from the Utah State Tax Commission:

The unfortunate result is that we are left with a tax structure that fails to generate sufficient revenues to allow our state and local governmental entities to properly meet their responsibilities and fulfill their appropriate role in a number of critical areas, including the following:

1. Education: Utah ranks last nationally for our per-pupil investment in K-12 education. Particular areas of weakness include:

• •  · Teacher turnover rates are higher than the national average. One study found the majority of new teachers leave within seven years.
  •  · Pre-K: Utah ranks 36th for our percent of lower-income 3- and 4-year-olds attending pre-school, private or public. We are also 1 of only 7 states not to have statewide public preschool programs. (The state offers only small-scale programs in a limited number of local school districts.) Yet we know from multiple research sources that every dollar invested in high-quality day care and preschools produces at least a $7 return on that investment in future years. 
  •  · Kindergarten: Only a third of Utah kids participate in full-day kindergarten, less than half the national average, because local school districts can’t afford to offer it. Voices for Utah Children estimates that it would cost at least $75 million to offer full-day K to all Utah kids (not including potential capital costs). 
  •  · According to the January 2019 report of the Utah Afterschool Network, the need for after-school programs exceeds the supply many times over, leaving tens of thousands of children completely unsupervised, meaning they are less likely to do their homework and more likely to engage in unsafe activities.

In addition to these input measures, Utah is also lagging behind in terms of several significant educational outcome measures:

• •  · Our high school graduation rates are lower than national averages for nearly every racial and ethnic category, including our two largest, Whites and Latinos.
  •  · Among Millennials (ages 25-34), our percent of college graduates (BA/BS or higher) lags behind national trends overall and among women.

Moreover, Utah is in the midst of a demographic transformation that is enriching our state immeasurably but also resulting in majority-minority gaps at a scale that is unprecedented in our history. For example, in our education system:

• •  · Our gap between White and Latino high school graduation rates is larger than the national gap. 
  •  · Education Week recently reported that Utah ranks in the worst 10 states for our growing educational achievement gap between haves and have-nots.
  •  · We are beginning to see concentrations of minority poverty that threaten to give rise to the type of segregation and socio-economic isolation that are common in other parts of the country but that Utah has largely avoided until now.

B. Infrastructure: Utah’s investment has fallen behind by billions of dollars. This is another area where the Volcker Alliance ranked Utah in the worst nine states for failing to track and disclose to the public the dollar value of deferred infrastructure replacement costs. In addition. Internet infrastructure is lacking in some rural counties, limiting their integration into Utah’s fast-growing economy.

C. Mental Health and Drug Treatment: Utah was recently ranked last in the nation for our inability to meet the mental health needs of our communities, according to a recent report from the Kem C. Gardner Policy Institute. Underfunding of drug treatment and mental health services costs taxpayers more in the long run as prison recidivism rates rise because the needed services are not available. Estimates are that Utah meets only 15% of the need for these vital, life-saving services. 

 D. Affordable housing units fall 41,266 units short of meeting the need for the 64,797 households earning less than $24,600, yet the annual $2.2 million state allocation to the Olene Walker Housing Loan Fund has not changed in over two decades, despite inflation of over 60%. Among extremely low-income renter households, 71% pay more than 50% of their income for housing, which is considered a severe housing burden. This year, the Olene Walker Housing Loan Fund used up most of its annual $14 million budget at its very first meeting of the fiscal year (made up of both state and federal funds). 

E. Health care: Our rates of uninsured children are higher than national averages – and rising – especially among the one-in-six of our children who are Latino. In Utah 35,000 or 5% of White children are uninsured (national rank = 36^th place), compared to 31,000 or 18% of Latino children (rank = 46^th = last place in 2017). 

 F. Disability services: The 2018 annual report from the Utah Department of Human Services’ Division of Services for People with Disabilities reports that the wait list for disability services grew to a record level of 3,000 individuals last year and that the average time on the wait list is 5.7 years. 

 G. Seniors: The official poverty measure undercounts senior poverty because it does not consider the impact of out-of-pocket medical expenses. A 2018 study found that seniors spent $5,503 per person on out-of-pocket medical expenses in 2013, making up 41% of their Social Security income. (For most seniors, Social Security is the majority of their income, and it makes up 90% or more of income for 21% of married couples and about 45% of unmarried seniors.)  

 H. Domestic Violence: Although Utah's overall homicide rate is significantly lower than the national average, domestic-violence-related homicides constitute over 40% of Utah's adult homicides compared to 30% nationally. Several thousand women continue to be turned away annually from crisis shelters because of lack of capacity. Additional state funding would make it possible to substantially increase the capacity of overburdened crisis shelters. We are one of the few states without domestic violence services in every county.

Given the large number of urgent needs that are not being met because of our chronic shortage of public revenues, we are concerned that Utah is missing the opportunity to make critically important upfront investments now that would allow us to reap substantial rewards in the future, and that our most vulnerable neighbors will pay the greatest price as a result.

Thus, we urge you to consider the ways that the state tax structure impacts single parents, disabled adults, low-income children, seniors on fixed incomes, and other vulnerable population groups as you decide on your tax restructuring and equalization proposals.

 Finally, thank you for all the time and effort you are personally investing as volunteer members of this important Task Force, and for all that you do for our state through this and other forms of public service. 

Yours truly,   

Tell the Governor and Lawmakers: Time for Utah to Move Forward with Full Medicaid Expansion, without Barriers, Restrictions or Delays!

In August, Utah’s request for a “partial” Medicaid expansion was rejected by the federal government. What does this mean? Utah state officials are now preparing a plan for full Medicaid expansion, which could mean that thousands of more individuals would be eligible for Medicaid coverage. We anticipate seeing this new plan sometime in the fall. But the plan could include some additional restrictions and barriers to care. What can you do? Tell the Governor and state leaders to move forward with full Medicaid expansion now, without barriers or delays. The rejection of Utah’s “partial” expansion is good news for kids & families in need of care, but we must continue to advocate for full expansion, without harmful restrictions, as the voters intended! Stay tuned for more updates soon!

Alarming Decline in Children’s Health Insurance: We Can and Must Do More to Help Utah Kids Stay Covered

Recently, the Census bureau released national figures on children’s health coverage. Unfortunately, the data confirmed what experts suspected: More children are becoming uninsured. Most of the coverage loss is occurring among children who previously had Medicaid or CHIP. We will have more updates soon about children’s specific coverage loss here in Utah. But we know that on average 1,000 kids a month are losing CHIP or  Medicaid coverage. Why?

For one thing, we are seeing the impact of our current political climate and federal policies that are hostile to immigrants; there is a clear chilling effect causing many immigrant and mixed status families to not enroll or to withdraw their children from Medicaid or CHIP. The recently-released Public Charge rule, and other policies, are creating a climate of fear and uncertainty for many families.

Another reason for this coverage loss: Utah lacks consistent outreach funding and continuous eligibility policies that can help kids get enrolled and stay enrolled. We need to make sure that we are doing all we can here to help streamline the process and connect kids with coverage. We are grateful to be working alongside community partners and state agencies to address this decline and keep kids covered.

The bottom line: It is unacceptable to see this loss in children’s health coverage, after so many years of progress. When children go uninsured, it has ripple effects throughout their lives. Kids without insurance are not only at a higher risk for poor physical and mental health outcomes, but also miss more days of school and have lower graduation rates; their families are at greater risk for medical debt or bankruptcy.

What can you do? Join the 100% Kids Coverage Campaign so that no Utah child goes uninsured. Together we can achieve 100% coverage for Utah children and create a Utah where all children feel welcome.

Spread the Word to Help More Families Stay Covered

Families can contact 2-1-1 to find out if they’re eligible for CHIP or Medicaid. You can apply for CHIP or Medicaid anytime!

Learn more about the Public Charge rule so we can help families get connected with the most up-to-date and accurate information.

This week, the American Academy of Pediatrics (AAP), the nation’s largest group of pediatricians, warned that racism can have devastating long-term effects on children’s health.

The warning comes in a new policy statement titled, “The Impact of Racism on Child and Adolescent Health,” developed by the AAP’s Council on Community Pediatrics, Section on Adolescent Health, and Committee on Adolescence. The full statement is available at https://pediatrics.aappublications.org/content/early/2019/07/25/peds.2019-1765 and will be published in the August issue of Pediatrics.

This policy statement is the first the AAP has issued to its members on the dangers of racism. Doctors involved in the report said the current political and cultural atmosphere makes the work to end racism more urgent.

The Utah Chapter of the American Academy of Pediatrics and Voices for Utah Children applaud this policy statement. We join pediatricians in calling upon members of the public to help prevent racism and ensure race equity, and recommend, as an important action step, championing and embedding inclusion within their organization.

 “Racism affects (and harms) each of us individually and all of us collectively.  This statement is so vital and timely in that it encourages us to directly examine these effects and make the changes in ourselves, our families and our organizations that will allow us to recognize and benefit from the richness of our diversity," says Paul Wirkus, MD, President of the Utah Chapter of the American Academy of Pediatrics.

As the KIDS COUNT designated organization in Utah, Voices for Utah Children is committed to race equity and inclusion.  The AAP’s new policy statement reinforces the importance of the work Voices is doing to ensure that the data we collect, analyze and disseminate is disaggregated wherever possible to uncover patterns of racial inequity. We encourage public institutions, government agencies, and community stakeholders to become deeply invested and committed to using this disaggregated data in their decision-making process so they can more effectively manage and allocate resources to help children and families.

To gain a deeper understanding of how specific groups of people or specific geographic areas of our state are faring, it is important to disaggregate data. This policy statement highlights the need for the collection, analysis and use of data that is broken down by race and ethnicity,. Data broken out this way helps to more clearly underscore trends and disparities, develop targeted strategies and provide greater accountability.

Updates on kids coverage in Utah: Kids are losing Medicaid/CHIP coverage, meanwhile Utah is still paying more to cover fewer people…and more!

Why are Utahns paying more to cover fewer people?

Under Utah’s current partial expansion plan (aka the “bridge plan”), Utah is paying 30% more to cover thousands of fewer kids and families on Medicaid. To date, around 34,000 new individuals have enrolled in Medicaid coverage, although at least 50,000 still remain in the gap, unable to afford coverage on their own and not offered it through their job. Utah has left at least $7 million in federal funds on the table so far-- funds that could be used to help more families get coverage and care. (New update: latest reports state the Trump administration will reject Utah's partial expansion. It's time to stop paying more to cover fewer people.)

Alarming Trend in Kids' Medicaid/CHIP Coverage

Utah kids are dis-enrolling from Medicaid/ CHIP at an alarming rate. At the July Utah Medicaid Advisory Committee meeting we learned that over 2,000 kids lost Medicaid/CHIP coverage last month. Such a steep drop cannot be explained by a strong economy alone. The number of Utah kids leaving CHIP/ Medicaid are among the highest in the nation. Both the Utah Department of Health and Department of Workforce Services have committed to doing additional investigation as to WHY kids are losing coverage. We greatly appreciate that they are taking this issue seriously and are working to find answers.

Utah Medicaid Advisory Committee Once Again Prioritizes 12-Month Continuous Eligibility- Let's Keep Kids Covered!

For the third straight year, the Utah Medicaid Advisory Committee prioritized 12-month continuous eligibility for children on Medicaid as one of their top funding requests to the Governor. 12-month continuous eligibility would allow more kids to get covered- and stay covered. Current Medicaid reporting requirements mean many kids unnecessarily lose coverage, with cascading negative impacts. This policy would protect kids and families. The Utah Medicaid Advisory Committee has continually prioritized this as a cost-effective, best practice to keep kids healthy, consistently voting in favor of the Utah Department of Health adopting this policy.

The Latest on Utah’s Medicaid Waiver

Utahns submitted a record 1,700 comments on Utah’s partial Medicaid expansion. Thanks to all who stood up for voter-approved full Medicaid expansion. Utahns voiced strong opposition to the proposed cuts, caps and barriers to Medicaid coverage which would leave many kids and parents without coverage or care. These comments send a message to state and federal officials and will provide the backbone for any future legal action.

Haven’t submitted a comment yet? There’s still time! Submit a comment here: www.utahchildren.org/comment

Breaking Down Data to Help All Families Thrive

At Voices for Utah Children we start with the question, “Is it good for kids?” We advocate for data-driven policy and community solutions to improve the lives of all children. This data brief and case study examines why the collection, analysis and reporting of race and ethnicity data is critical to help drive policy solutions for Utah kids. If we only report on whole populations, we may overlook important racial or ethnic trends and disparities. By sharing outcome data for different racial and ethnic groups, we can help address systemic problems and ensure greater accountability in policymaking and public programs.

Case Example of Utah Native Hawaiian/ Pacific Islander Birth Outcomes

In Utah, there are nearly 38,00 Native Hawaiians/Pacific Islanders (NHPIs). The overall percentage of NHPIs living in Salt Lake City is greater than any other city in the continental U.S. The median age of Utah NHPIs is 20.2, making them one of the youngest populations in Utah.

In 2010, the Utah Department of Health Office of Health Disparities examined the infant mortality rate for the NHPI community for  the first time. Previously, birth outcomes for the NHPI community had been reported together with birth outcomes for Utah Asian Americans. When grouped together, the infant mortality rate for the Asian American and Pacific Islander communities was lower than the state average at 4.6 deaths per 1,000 births, compared to the overall average of 5.2 deaths per 1,000 births.

However in 2010, when prenatal and birth outcomes for NHPIs were examined separately, the data told a very different story: Pacific Islander infants under one year had nearly twice the death rate (8.8 deaths/1,000 births) of infants statewide (4.5 deaths/1,000 births). While only 1.3% of all Utah infants were born to Pacific Islander mothers, their babies made up 2.5% of all infants who died. Other birth outcomes disparities among Pacific Islanders, including access to prenatal care, also surfaced.

These alarming findings underscored the importance of greater access to and breakdown of ethnic/racial data to understand population trends. In response, the Office of Health Disparities conducted additional research and investigation. OHD worked collaboratively with state and local partners to develop a community-based health promotion and education program to reach NHPI residents in Utah. The “It Takes a Village: Giving Our Babies the Best Chance” (ITAV) project raises awareness and addresses birth outcomes disparities in the context of Pacific Islander cultural beliefs and practices. The ITAV project has been designated a promising, innovative practice from national public health organizations.  Results show that the ITAV project effectively raises awareness, improves knowledge, and increases self-efficacy among NHPI participants.  In 2019, the University of Utah Department of Family and Preventive Medicine received funding to expand the ITAV project to St. George with the Southern Utah Pacific Islander Health Coalition, broadening the reach and impact of the project. In addition, the data disaggregation at the root of the ITAV project inspired other states, including California, to collect and report disaggregated health data for Native Hawaiians and Pacific Islander populations.

Moving Forward

All too often, public institutions and systems report data on whole populations or broad population categories. Yet this case study highlights how public institutions can also lead the way, rethinking current practice around data disaggregation, reporting and response.

Going forward, Voices for Utah Children is actively working to ensure that the data we share, such as the annual Kids Count Data book, can better disaggregate Utah demographics. We call upon more state and local public institutions and agencies to do the same. Our state agencies must continue to be leaders in data disaggregation to ensure families are getting the care they need. Disparities cannot be fully identified or addressed without adequate data and reporting.

It is equally important to ensure that disparities identified are met with culturally appropriate resources, investments and policy change. The ITAV project demonstrates how disaggregated data, coupled with community-based solutions, can help more families be empowered to change their health practices. While many factors influence health outcomes and trends, community-driven public health interventions, like the ITAV project, can play a significant role.

However, disparities in maternal and birth outcomes persist in Utah. NHPI mothers are still receiving less prenatal care than other populations in Utah. This points to the need to address more systemic inequities in access to care, insurance coverage and culturally-competent health care services. All mothers and infants in Utah deserve a healthy start, regardless of their culture or background. Policies that promote affordable, quality health care, including Medicaid coverage, access to prenatal services and mother-infant support programs can help improve the lives of all Utah moms, babies and communities.

To download a copy of the brief and references:

Data Links: Breaking Down Data to Help All Families Thrive

Young adults on Medicaid are being denied dental and vision care, mental health screenings and other benefits, just as they enter the work force and embark on the next chapter of their lives.       

Baffled by this decision? So are we.

Utah is proposing several, unprecedented changes to its Medicaid program. These changes include limits on enrollment, work reporting requirements and per capita funding caps. But here’s one issue that has received less attention: Young adults on Medicaid are being denied their full benefits, including early detection and screening services, dental care, mental health and wellness care (known as the acronym, EPSDT). The Medicaid Act mandates that individuals enrolled in Medicaid have comprehensive EPSDT benefits up to age 21. The American Academy of Pediatric endorses it. But Utah has arbitrarily chosen to cut comprehensive benefits to 19 -20 year olds.

Advocates are told this is a cost-saving measure. But the evidence doesn't back this up. Early screening and detection services SAVE dollars. Why is Utah cutting the very benefits that help detect conditions before they escalate and cost the state more money?

• Providing prevention, early detection, and treatment services for young adults insures that health problems are averted or diagnosed-- allowing young adults to focus on furthering their school, work and life.

• Young adults’ brains continue to develop past their teenage years into their 20s. Access to things like vision, hearing and dental screenings, as well as mental health services, help young adults stay on track at a critical point in their development.

• Cutting dental benefits for young adults makes it harder for them to find a job. Individuals living below the poverty level have reported that the appearance of their teeth and mouth had a negative effect on their ability to interview for a job.

• We are in the middle of a youth suicide crisis. Now is not the time to cut back access to mental health screening and care for young adults. As 19-20 year olds prepare to make more adult decisions it becomes even more common for mental health issues to arise.

This state does not need to move forward with this harmful decision. It runs counter to Utah’s fiscal prudence, focus on cost-effective solutions, recent legislation protecting children’s health up to age 21, and the state’s own policies. The Utah Department of Health actually endorses the American Academy of Pediatrics Bright Futures guidelines, which recommend full comprehensive benefits for everyone up to age 21.

Many of the proposed changes to Utah’s Medicaid program are mandated by Senate Bill 96. But this isn’t one of them.

Utah has the opportunity to make a different choice, to support young adults as they become more self-sufficient, not turn our backs on them.

TAKE ACTION: Tell the Utah Department of Heatlh to protect comprehensive benefits for 19-20 year olds. Use this link to submit your comments by June 30th.