Health
Strategies to Address High Drug Prices
Consumer representatives to the National Association of Insurance Commissioners, including Voices for Utah Children, released recommendations for policymakers to address the high prices that put medications out of reach for many families in need.
Recommendations include:
- Limit the number of drug tiers that insurers can use;
- Limit consumer cost-sharing by, for instance, prohibiting coinsurance for prescription drugs;
- Adopt standardized plans with meaningful cost-sharing limits to mitigate adverse tiering;
- Prohibit mid-year formulary changes that negatively affect enrollee access to drugs;
- Require formularies to be updated weekly and include information about drug tiering, the actual dollar amount of any cost-sharing, any utilization management or network restrictions, and the process to request a drug exception, among other information;
- Collect standardized, plan-level data to enable the development of consumer tools and apps; and
- Solicit feedback from external stakeholders—such as advocates, other state agencies, ombudsmen, and independent medical experts—to inform the formulary review process.
For more information, see the complete report:
For 30 years now, Voices for Utah Children has called on our state, federal and local leaders to put children’s needs first. But the work is not done. The children of 30 years ago now have children of their own. Too many of these children are growing up in poverty, without access to healthcare or quality educational opportunities.
How can you be involved?
Make a tax-deductible donation to Voices for Utah Children—or join our Network with a monthly donation of $20 or more. Network membership includes complimentary admission to Network events with food, socializing, and opportunity to meet child advocacy experts. And don't forget to join our listserv to stay informed!
We look forward to the future of Voices for Utah Children and we hope you will be a part of our next 30 years.
Special thanks to American Express for sponsoring our 30th Anniversary Year. 
Utah has something to celebrate this #WomensEqualityDay
Happy Women's Equality Day! The Nineteenth Amendment, granting women the right to vote, was certified on August 26, 1920. Each year, we commemorate this important milestone and evaluate our progress toward achieving full equality for American women.
Here in Utah, a big part of that goal is reducing our gender gap in wages, which is one of the highest in the nation. Voices for Utah Children described the wage gap problem in the report Utah’s Gender Opportunity: An examination of the difference between the earnings of Utah men and women.
Addressing workplace policies that have a disparate impact on women 
by making it more difficult to balance work with family responsibilities is key to eliminating the gender gap.
Fortunately, Utah made some progress in that direction during the past year. The Utah Legislature passed Senate Bill 59, which requires employers to provide reasonable accommodations for pregnant and breastfeeding women. The new law bumped Utah up from a failing grade to a C- in the National Partnership for Women & Families most recent rankings. Let's keep working our way up to an 'A'!
For 30 years now, Voices for Utah Children has called on our state, federal and local leaders to put children’s needs first. But the work is not done. The children of 30 years ago now have children of their own. Too many of these children are growing up in poverty, without access to healthcare or quality educational opportunities.
How can you be involved?
Make a tax-deductible donation to Voices for Utah Children—or join our Network with a monthly donation of $20 or more. Network membership includes complimentary admission to Network events with food, socializing, and opportunity to meet child advocacy experts. And don't forget to join our listserv to stay informed!
We look forward to the future of Voices for Utah Children and we hope you will be a part of our next 30 years.
Special thanks to American Express for sponsoring our 30th Anniversary Year.
Teen Suicide Rates in Utah
What’s Behind the Latest Kids Count Rankings?
Utah’s national health ranking dropped from seventh to 27th, according to the annual 2016 Annie E. Casey Foundation Kids Count Data Book. As has been widely reported, one of the reasons for this drop in rankings is an alarming rise in youth suicide.
The suicide rate among youth ages 10-19 has doubled since 2008. Nationally Utah has one of the highest rates of youth suicide, and the highest for teenage girls. The rate of suicide among girls in Utah is almost double the national average.
The suicide rate is significantly higher than all other fatal injuries for youth—both intentional and unintentional. The Utah Department of Health 2015 survey data confirms that youth depression and suicide ideation rates are on the rise. Among surveyed youth (grades 6-12), 14.4% said they had seriously considered attempting suicide; this is up from 7.4% in 2011. Depression among youth also increased; 22.7% of all youth experienced depression related indicators in 2015. The increase is particularly significant for younger children: since 2011, the rate of depression among 6th graders has more than doubled to 16.2%.
Researchers and advocates point to a variety of possible reasons for the rise in youth suicide. Some reports suggest that Utah LGBTQ youth are at a higher risk. Others point to a rise in bullying, especially online, and increased pressure and social demands on our youth. The Utah Department of Health notes that children who are involved in the juvenile justice system or experience school disciplinary action can be at a higher risk. In addition, children living in rural and frontier areas may have higher rates of suicide, because they have a harder time accessing services and care. There is no one clear answer to explain this alarming rise, and the reasons are often complex.
But there are important steps we can take now, moving forward to keep families and children safe.
Policy Implications and Action to Keep All Children Safe
Expand mental and behavioral health services for children and youth. Start early and screen often to promote children’s behavioral, developmental and mental health. All children should have access to comprehensive mental health screenings and care. The earlier we start, the more likely we can prevent disorders from occurring or escalating. At least 14% of all children in Utah report one or more mental, behavioral or developmental conditions, according to 2011-2012 data. Investment in early mental health promotion and intervention strengthens outcomes for children, families and communities.
Safeguard homes. Over a third of all youth suicides in Utah are committed with firearms. Keeping children safe and firearms stored properly is a critical factor in suicide prevention. For more information, visit www.projectchildsafe.org.
Cover all kids. 85,000 children in Utah do not have health insurance, limiting their access to mental health services. When children are not insured, they are less likely to get care and build consistent relationships with providers. Health insurance is the starting point to keep our kids healthy and safe.
Cover all parents, too. Too many parents are uninsured in Utah because they fall into the Medicaid coverage gap. When parents are uninsured, they cannot get the mental and physical health care and treatment they need. We need to close the insurance gap for all parents and individuals. To create a safe and healthy home for their family, all parents need affordable health insurance.
Improve access to regular check-ups and preventive care. Well-child visits are important opportunities to assess children’s physical and mental health. Children of all ages should receive timely, comprehensive check-ups, including regular, standardized developmental screenings. But less than 50% of adolescents receive their well-care visit. Parents should also be screened during well-care visits to assess family history and provide comprehensive care.
Support and strengthen school-based, after school and out-of-school time counseling and resources. Ensure that children can access counseling and care, and build trusted support networks with peers and adults.
Support ongoing research and improved data. We need to ensure our public health and safety systems have accurate and comprehensive information. They need to have the tools, measurements and support necessary to fully understand who is affected, how Utah families are accessing the quality care they need, and how to connect children with treatment.
Out of the Shadows
Recent reports and media attention are bringing this important issue to light. Now it is time to act. No one in Utah should have to experience this tragedy. Through strong policies, dedicated resources and coordinated action, we can keep our youth safe and build communities where all Utah children and youth can thrive.
For additional information
Help is available 24 hours a day 7 days a week.
If you live in Utah, call the Statewide Crisis Line at
801-587-3000 or
call the National Suicide Prevention LifeLine at
1-800-273-TALK (8255)
Or visit suicidepreventionlifeline.org
For 30 years now, Voices for Utah Children has called on our state, federal and local leaders to put children’s needs first. But the work is not done. The children of 30 years ago now have children of their own. Too many of these children are growing up in poverty, without access to healthcare or quality educational opportunities.
How can you be involved?
Make a tax-deductible donation to Voices for Utah Children—or join our Network with a monthly donation of $20 or more. Network membership includes complimentary admission to Network events with food, socializing, and opportunity to meet child advocacy experts. And don't forget to join our listserv to stay informed!
We look forward to the future of Voices for Utah Children and we hope you will be a part of our next 30 years.
Special thanks to American Express for sponsoring our 30th Anniversary Year.
Senator Hatch Supports Bill to Protect Foster Children
Senator Orrin Hatch (R-UT) is working to pass the Family First Prevention Services Act (HR.5456/S.3065), a bipartisan bill that would ensure more children can stay safely with family and out of foster care by allowing federal child welfare dollars to be used on preventive mental health, substance abuse, and in-home counseling services to children who are candidates for foster care, as well as their parents or caregivers.
The bill also encourages the placement of children in foster care in the least restrictive, most family-like settings appropriate to their needs. This positive step would conform to the Annie E. Casey Foundation recommendations listed in a recently released report:
Kids Count Report: Too many children in child welfare are not living in families
“The Family First Prevention Services Act has the potential to have a far-reaching impact in the lives of foster children and youth and their families,” said Bruce Lesley, president of First Focus Campaign for Children. He commended Senator Hatch “for promoting evidence-based prevention services to keep children in family settings and out of foster care.”
Thank you, Senator Hatch, for your leadership on this issue!
For more information, see this fact sheet:
First Focus Fact Sheet: Family First Prevention Services Act
For 30 years now, Voices for Utah Children has called on our state, federal and local leaders to put children’s needs first. But the work is not done. The children of 30 years ago now have children of their own. Too many of these children are growing up in poverty, without access to healthcare or quality educational opportunities.
How can you be involved?
Make a tax-deductible donation to Voices for Utah Children—or join our Network with a monthly donation of $20 or more. Network membership includes complimentary admission to Network events with food, socializing, and opportunity to meet child advocacy experts. And don't forget to join our listserv to stay informed!
We look forward to the future of Voices for Utah Children and we hope you will be a part of our next 30 years.
Special thanks to American Express for sponsoring our 30th Anniversary Year.
Helping Candidates Do Their Homework
2016 Candidate Briefing Guide
2016 is an important election year in Utah. The public offices on the ballot in November include the following:
- U.S. Senate
- U.S. House of Representatives
- Governor and Lt. Governor
- Half of the State Senate
- The entire Utah House of Representatives
Our elected officials play a central role in determining whether all children have the opportunity for health, safety, education, and economic security. As the Utah child population grows and becomes more diverse, it is important for candidates to discuss the needs of Utah children and the policies they would pursue to ensure that all Utah's children can thrive.
Voices for Utah Children is providing candidates for elected office in Utah with the resources in this Candidate Briefing Guide to help them understand the challenges facing Utah's children, direct public awareness and dialogue toward the needs of children over the course of their campaigns, and begin their terms of office prepared to enact effective policies to protect their youngest constituents.
Utah voters can also use these resources to educate ourselves about children’s issues as we seek to elect candidates that will prioritize the needs of children and invest in our state’s future.
More Information:
Racial and Ethnic Equity for Children in Utah: What we learned from the 2016 Legislative Session
Economic Security/Tax & Budget
Supported by the Annie E. Casey Foundation, our KIDS COUNT® work aims to provide Utah’s legislators, public officials and child advocates with reliable data, policy recommendations and other tools needed to advance the kinds of sound policies that benefit children and families across the state.
This year, Utah barely held on to its position among the top ten in the annual Annie E. Casey Foundation KIDS COUNT® Data Book report. Ranking 9th in 2015, Utah now ranks 10th among the fifty states (despite a dramatic change in the health domain, where Utah dropped from 7th in 2015 to 27th in 2016). Utah’s 2nd place ranking for the Family & Community domain and 8th place ranking for Economic Well-Being remained unchanged. In the Education domain, Utah ranked 21st — up from 29th in 2015.
Terry Haven 
Deputy Director
Voices for Utah Children
More Information:
Measures of Well-Being in Utah, 2015
2016 Utah and United States Kids Count Profiles
The Federal Safety Net Cuts Child Poverty in Utah in Half
Each child brings the promise of a healthier, stronger future for Utah. To make good on that promise, Utah needs to make sure children can grow up healthy, from the prenatal period all the way through their teenage years.
Utah children and families should have access to:
- Appropriate prenatal care;
- Affordable, accessible, culturally competent care that encompasses both prevention and treatment; and
- Supportive services and environments designed to help facilitate the best possible health outcomes.
All families in Utah must be able to achieve optimal health in order for our state to continue to grow and prosper.
Jessie Mandle, MPH 
Health Policy Analyst
Voices for Utah Children
More Information:
12-Month Continuous Eligibility for Children on Medicaid
Utah's Uninsured Rate for Hispanic Children: Highest in the Country
A Coverage Gap Solution for Utah Families
Majority of Eligible Parents Who Would Benefit from Medicaid Expansion are Working
Voices for Utah Children seeks to reduce juvenile incarceration rates and eliminate the inappropriate use of secure confinement and out-of-home placement, ensuring that juvenile correction systems better protect youth and the public.
A key aspect of our juvenile justice work involves a commitment to challenging the School-to-Prison Pipeline, wherein children — particularly children of color and those with disabilities — are funneled out of public schools and into juvenile and criminal justice systems in a discriminatory application of discipline. “Zero-tolerance” policies criminalize minor infractions in the classroom, while the presence of law enforcement officers in schools often leads to student behavior being criminalized rather than handled within the school setting.
We are committed to the belief that children should be educated, not incarcerated. We work to empower advocates and community members alike, arming people with information that allows them take action to end School-to-Prison Pipeline.
Lincoln M. Nehring, JD 
President & CEO
Voices for Utah Children
The early years in a child’s life form the core foundation for later social, emotional and cognitive development. Done well, early childhood education can help level the playing field, especially for low-income children, by closing the access and achievement gaps, thereby enhancing not only school performance, but self-sufficiency over a lifetime.
At Voices for Utah Children, we focus on promoting targeted investments in early childhood education, with the goal of creating a statewide early learning system in Utah that supports all families by making sure they have access to high-quality options for their children’s early care and learning—whether children spend their days at home, in formal child care, or with family and friends.
Tess Davis, JD 
Policy Analyst
Voices for Utah Children
More Information:
Optional Extended-Day Kindergarten
5 Minute Guide to Shared Services
Economic Security/Tax & Budget
Every day, state governments raise and spend tax revenue in ways that profoundly affect families and communities. The fiscal choices Utah makes — about investing in schools, health care, child care, and other services — can help foster equal opportunity and lay the foundations for our future growth and prosperity.
Voices for Utah Children's fiscal policy program works to ensure that we invest sufficient resources in the vital public systems that ensure that our kids get world-class education and health care as well as special support for children most in need. We also work to ensure that public revenues are generated in ways that are fair; no family should be taxed into poverty as the price of educating their children.
Matthew Weinstein, MPP 
State Priorities Partnership Director
Voices for Utah Children
More Information:
Utah Children's Budget Report 2015
What's Still Eating Utah's General Fund?
Top 10 Reasons to End the Earmarks
Deseret News: Social service advocates call for lawmakers to 'end the earmarks'
Utah Policy.com: Poll: Utahns Split on Eliminating Transportation Earmarks
A Comparative Look at Utah and Colorado:
Part 1: Economic Opportunity
Part 2: Standard of Living
The Earned Income Tax Credit: A Time-Tested Two-Generation Strategy for Poverty
For 30 years now, Voices for Utah Children has called on our state, federal and local leaders to put children’s needs first. But the work is not done. The children of 30 years ago now have children of their own. Too many of these children are growing up in poverty, without access to healthcare or quality educational opportunities.
How can you be involved?
Make a tax-deductible donation to Voices for Utah Children—or join our Network with a monthly donation of $20 or more. Network membership includes complimentary admission to Network events with food, socializing, and opportunity to meet child advocacy experts. And don't forget to join our listserv to stay informed!
We look forward to the future of Voices for Utah Children and we hope you will be a part of our next 30 years.
Special thanks to American Express for sponsoring our 30th Anniversary Year.
The wait is over!
Spread the word: lawfully residing immigrant kids can enroll in CHIP and Medicaid now!
As of July 1st, 2016, new legislation takes effect that eliminates the previously mandated 5-year waiting period before lawfully-residing immigrant children in Utah could enroll in CHIP and Medicaid. Thank you to the Utah Legislature and the Utah Department of Health for making this change! Five years is too long for a child to wait. More good news: the federal government will match up to 100% of the state dollars Utah spends to remove the 5-year waiting period, making this a fiscally-prudent policy change for Utah.
Voices for Utah children supported ending the 5-year wait during the 2016 Utah Legislative Session. Utah has the highest rate of uninsured Hispanic children in the nation and the removal of the 5-year wait is a significant step to help all children in Utah access affordable health coverage.
In addition to allowing states to end the 5-year wait for children, the 2009 Children’s Health Insurance Program Reauthorization Act (CHIPRA) gives states the option to expand insurance coverage to lawfully residing pregnant women. Utah has not yet accepted that option. Going forward, let's end the 5-year wait for pregnant women, too! Prenatal care improves the health of both mothers and their children.
To learn more about CHIP and Medicaid eligibility, call 211 or visit takecareutah.org. (A Spanish version is available at takecareutah.org/es/.)
For 30 years now, Voices for Utah Children has called on our state, federal and local leaders to put children’s needs first. But the work is not done. The children of 30 years ago now have children of their own. Too many of these children are growing up in poverty, without access to healthcare or quality educational opportunities.
How can you be involved?
Make a tax-deductible donation to Voices for Utah Children—or join our Network with a monthly donation of $20 or more. Network membership includes complimentary admission to Network events with food, socializing, and opportunity to meet child advocacy experts. And don't forget to join our listserv to stay informed!
We look forward to the future of Voices for Utah Children and we hope you will be a part of our next 30 years.
Special thanks to American Express for sponsoring our 30th Anniversary Year.
Racial and Ethnic Equity for Children in Utah
What We Learned from the 2016 Legislative Session
- Children of color in Utah face more poverty compared to non-Hispanic White children. As Utah becomes a more diverse state, children are affected by significant racial and ethnic disparities.
- The 2016 General Session failed to adequately meet the needs of children of color in Utah. There were some important steps forward but also missed opportunities and inaction.
- We saw gains for children’s preschool education, health coverage, school safety and criminal justice. There were missed opportunities to expand kindergarten, address our public defender crisis, expand health coverage for all low-income families and keep more families out of poverty.
- Going forward advocates have a responsibility to integrate an equity lens into our work and build coalitions that will strengthen opportunities for all families.
- Our Legislature, Governor and State Agencies should be more conscious of communities of color and low-income Utahns in their public policy decisions by reviewing the impact of bills and policies on all groups.
- In order to correct growing disparities and invest in Utah’s diverse future, lawmakers need to access data disaggregated by race and ethnicity and work with affected communities when developing policy.
Children’s Racial and Ethnic Equity in Utah
Was the 2016 Legislative Session Good for All Children?
Voices for Utah children starts with one basic question in our advocacy efforts: Is it good for kids?
For over 30 years we have been a statewide advocate, informing policymakers that they can and should act to keep children safe, healthy and help them succeed.
But as Utah’s demographic make-up changes, so too are the questions we have to ask. Is it good for all children, or just some children? Which children are making gains in our state while others are falling behind?
The number of Utah children who are non-White is growing. Since 2000, the percentage of children of color in Utah has grown from 17 to 25%. The Hispanic population is growing even faster. Hispanic children have grown from 11 to 17% of the total child population.
Unfortunately, there is a growing social and economic divide along racial and ethnic lines in Utah. Although Utah is a welcoming state, with a prominent international population, there are disparities among our diverse populations. Families of color face higher poverty rates compared to their White, non-Hispanic counterparts. The median household income for White, non-Hispanic families is significantly higher than all other racial and ethnic groups. White children are two to three times less likely to live in extreme poverty. Endnote 1
As a result, children of color have worse health outcomes, lower educational attainment, and are more likely to face school discipline and be involved in the juvenile justice system. What can we do to reverse this trend and create a Utah where all children can thrive?
Public policies can help. Public policies play an important role in expanding opportunities for all children, strengthening our schools and public safety net. Endnote 2 But public policies can also create barriers for families. Laws can make it harder for some groups or communities to access care; funding cuts can reduce services. Or simply by maintaining the status quo, policies can perpetuate unnecessary barriers or hidden obstacles for families.
In the recent 2016 Legislative General Session, lawmakers introduced bills that expanded opportunities for children and families and others that created more barriers. At Voices for Utah Children, we look at these laws and ask not only, are they good for children? But also, are they good for everyone, or only some? And under what conditions? Endnote 3
In this report, we will reflect on the 2016 General Session and its potential impact on children from all racial and ethnic backgrounds. We examine legislation in four major issue areas: early childhood education, health, economic equity, and juvenile justice reform. Endnote 4 Using data which is disaggregated by race and ethnicity, this report will consider legislation that expands opportunity for children and youth, as well as missed opportunities for change.
Early Childhood Education
Expanding Opportunities for High-Quality Preschool Programs
Early education opportunities can reduce racial and ethnic disparities. High-quality preschool helps children gain valuable cognitive, social, emotional and academic skills. Endnote 5 But with an attendance rate of 40%, Utah has one of the lowest rates of preschool attendance and the rate is even lower among children of color. Only 29% of Hispanic children ages 3 - 4 are attending preschool, compared to 43% of White, non-Hispanic children. One factor driving this discrepancy is that there are not enough affordable, quality preschools, especially in high-needs communities.
The Utah Legislature took steps to address this problem through SB 101, which makes more affordable, high-quality preschool slots available. SB 101 creates a grant program to expand high-quality preschool programs for at-risk children. It also provides scholarships for children who have been identified as living in intergenerational poverty. SB 101 was funded through Temporary Assistance for Needy Families (TANF), which directs funds to low-income children. However, the racial and ethnic gap in school readiness may not be fully accounted for by income, as research shows. In the future, Utah needs more programs, and supporting data, which can examine gaps in school readiness between children of different backgrounds, and ways to address those gaps in high-quality preschool programs. Endnote 6
Missed Opportunity: Expanding Optional Extended-Day Kindergarten and Readiness Assessments
While SB 101 made significant gains for early education, the Legislature missed a critical opportunity to advance continuity in quality programming beyond preschool. HB 42 would have increased funding for quality optional extended-day kindergarten programs and created a statewide kindergarten entry and exit assessment tool.
Full day kindergarten can help reduce racial and ethnic disparities in academic performance. In Utah, less than 15% of 5-year-olds participate in full day kindergarten programs. Endnote 7 Utah has one of the lowest rates of full day kindergarten participation in the nation. Overall there are not enough high-quality, full day, early education programs available in Utah, especially for at-risk children. This contributes to the achievement gap in later years. For example, 81% of Hispanic children are not reading at a proficient grade level by the 4th grade, compared to 55% of White, non-Hispanic children.
Moreover, Utah also lacks comprehensive data to understand children’s kindergarten readiness. By calling for a statewide entry and exit assessment tool, HB 42 would have allowed schools to better determine children’s kindergarten readiness. A statewide assessment can help educators develop appropriate interventions. Without sound, standardized statewide tools, we cannot adequately assist children most at risk of falling behind. Endnote 8
Juvenile Justice Reform
Expanding Opportunities: School Discipline and Juvenile Sentences
Nationwide, we see troubling racial and ethnic disparities in the juvenile justice system, and Utah is no exception. For example, Black children make up a disproportionate share of the juvenile justice system. Despite being only 1% of the total child population in Utah, Black youth make up 23% of the population in juvenile detention or correctional facilities.
One significant factor leading to youth involvement in the juvenile justice system is school disciplinary action. There is a direct correlation between youth discipline in school and the likelihood that a child will become involved in the criminal justice system. Yet this too disproportionately impacts children along racial and ethnic lines. Children of color consistently face greater school disciplinary action compared to their White, non-Hispanic peers. Endnote 9 For example, American Indian and Black students are more likely to receive disciplinary action in Utah schools than other racial groups.
Given these findings, HB 460 is an encouraging step forward. HB 460 will provide training for school resource officers and school administrators. The law requires that the State Board of Education create a curriculum to help train officers in schools. HB 460 states that the training can include cultural awareness, resources for students exposed to trauma and restorative justice practices. Its aim is to prevent school disciplinary issues from escalating into larger, criminal justice issues. Appropriate training for school resource officers and administrators could reverse existing practices negatively affecting children of color.
Another promising step this legislative session is HB 405, which prohibits children from receiving life sentences without parole. HB 405 represents an important step in ensuring that the criminal justice system recognizes the unique needs of youth and children.
Missed Opportunities to Avoid Harsher Sentencing for Children of Color
There were also some significant missed opportunities for juvenile justice reform. In particular, SB 155 failed to address the crisis of public defenders in Utah. The law proposes to further study the problem and offers small county-level grants for adult indigent defense. While important, however, this will not help youth. All adults and children have the right to counsel if charged with a crime that might lead to jail, but Utah has failed to fulfill this Constitutional requirement. If a child does not have adequate access to a defense attorney, he or she could receive a harsher sentence. Low-income children of color are more likely to find themselves in the criminal justice system, and therefore more likely to experience harsher sentencing. The ‘school to prison pipeline’ in Utah is fueling some of our most alarming racial and ethnic inequities. We need systems committed to addressing these disparities and helping all children succeed.
Economic Equity
Missed Opportunities to Restore Funds for Public Programs
Families of color face higher poverty rates. Although Hispanic children make up only 17% of the total child population, they represent at least 39% of children living in poverty. Among Hispanic children, 31% live below the poverty threshold compared to 8% of non-Hispanic Whites. From the data available by racial and ethnic categories, we know that poverty in Utah is not experienced equally among all racial and ethnic groups.
What can our public policies do to help all Utahns? As a starting point, we need to ensure that there are enough public dollars available in our General Fund for the programs and services proven to help people achieve independence, meet their families’ needs, and move out of poverty. According to the Utah Foundation, public revenues in Utah are at a multi-decade low due to tax cuts enacted over the past decade. The 2016 Legislature failed to pass legislation that would have restored revenues. Instead, the 2016 Legislature focused its attention on several tax cutting measures, passing HB 61 to reduce corporate income taxes by about $3 million annually and coming close to passing HB 180 to expand a business sales tax exemption by $83 million annually.
Even as legislators give serious consideration to tax cuts that reduce funds available for education, health care, and initiatives that help families work their way out of poverty, the practice of earmarking – permanently diverting General Fund revenues to the Transportation Fund to avoid allowing transportation revenue sources like the gas tax to keep up with inflation – continues nearly unabated. Even though the Legislature’s own Tax Review Commission recommended eliminating almost all existing earmarks, the only proposal that passed this year was a compromise bill that restores about 4% of earmarks to the General Fund, while at the same time more deeply entrenching the earmarking phenomenon by redirecting transportation earmarks for water infrastructure instead.
Missed Opportunities to Help Utah Families Work Their Way Out of Poverty
Despite continued advocacy, there was no legislation in the 2016 session for a state-level Earned Income Tax Credit (EITC). The EITC is a policy proven to help millions of U.S. working families stay out of poverty. National data show that the EITC can help mitigate racial and ethnic disparities; almost half of all EITC-eligible households were headed by racial or ethnic minorities. Endnote 10 Families of color are more likely to be eligible for, and greatly benefit from, the EITC. A state-level tax credit for working families in Utah would keep even more families out of poverty.
Paid leave was yet another missed opportunity to help families stay out of poverty. Many families do not have access to unpaid leave, and many who do have access are unable to afford it. The 2016 Legislature considered HB 188, which would have provided paid family leave for eligible executive branch agency employees. Families in the executive branch, which includes state divisions, departments and higher education systems, would be able to take leave, without losing pay. The topic will be further studied by the Legislature during the 2016 Interim.
White, non-Hispanic parents in Utah are more likely to be eligible and financially able to take unpaid leave than other families. Discrepancies in family leave policies take the greatest toll on foreign-born parents of color: 20% of Hispanic foreign-born parents are both eligible and can afford unpaid leave, compared to 31% of White foreign-born parents. Among U.S.-born parents, 33% of Hispanic parents and 37% of White parents can afford to take unpaid leave. Endnote 11 Parents who are ineligible or cannot afford leave are at risk of losing pay--or their job-- when they stay home to care for their child.
Health
Expanded Opportunities for Children’s Coverage
Utah has the highest rate of uninsured Hispanic children in the nation. Utah’s uninsured rate for Hispanic children is nearly two and a half times the national rate; it is higher than the rate in every other state and the District of Columbia. Children’s health coverage is the critical foundation for all children to get the care they need to achieve optimal health.
The 2016 Legislature removed the 5-year waiting period for legal immigrant children to receive CHIP or Medicaid. Appropriations bill HB 2 included intent language directing the Department of Health to enroll children as soon as they qualify. Previously, legal immigrant children were subject to a waiting period before they could receive CHIP or Medicaid. Eligible children include legal permanent residents and some additional immigration categories, although undocumented children are not included. The policy change will mean hundreds of children can get coverage. Five years is too long for children to wait.
In addition, the 2016 Legislature allocated $25,000 in one-time outreach funding to help enroll more children in CHIP or Medicaid. The Department of Health’s outreach budget was eliminated in 2010. The funding, allocated to the Department of Health, will be matched by federal dollars to total $50,000 and can be used to reach more Hispanic children.
The Legislature also directed the Department of Health to examine barriers to children’s coverage, including ‘churn’ or a frequent pattern of disenrollment and then re-enrollment from Medicaid. Children may lose Medicaid coverage because of fluctuations in their family’s income. Hispanic children are more likely to experience churn because of a change in their family’s temporary income status. At least 31% of Hispanic children have parents who lack year-round employment, compared to 18% of White children. The Department of Health’s study on churn could help reduce disruptions in children’s coverage and care.
Missed Opportunities: Expanding Coverage for All Parents
The 2016 Utah Legislature took first steps to cover more Utahns caught in the insurance coverage gap. HB 437 changed Medicaid eligibility to cover an estimated 4,000 additional parents, effectively raising the eligibility ceiling for parents with children up to 60% of the Federal Poverty Level. Unfortunately, the Legislature rejected more comprehensive bills that would fully close the coverage gap. As a result, thousands of working parents are still left without health insurance. Over one-quarter of the parents who would benefit from a full Medicaid expansion plan are Hispanic. When parents have insurance they are better able to care for their children. In addition, when parents have coverage, they bring their children along; enrollment numbers for children go up when parents have health coverage. Coverage for parents helps the whole family.
Recommendations Going Forward
Different communities may need different resources
to achieve similar outcomes.
The 2016 Legislative Session expanded opportunities for some children, but there were also many missed opportunities to improve the lives of children from all racial and ethnic backgrounds. These initial steps, while important, still leave much work ahead. Endnote 12
Across every issue area reviewed, we found significant social, economic, and health disparities affecting children of color. Utah laws and policies do not adequately address the growing diversity of our state. The face of Utah’s most vulnerable is changing. We need laws that embrace our diverse future.
This report is both a reflection of our own advocacy practices, as well as a call to action for lawmakers.
As advocates, we have a responsibility to integrate a lens of racial and ethnic equity into our own work and build coalitions that will strengthen opportunities for all families.
Together with community partners, we hope to contribute to a growing dialogue about racial and ethnic equity in the coming year and to advance policies that can help reduce disparities.
Our lawmakers also have a responsibility to create a more equitable Utah. To secure a future that is safe and healthy for all children, we call on our Legislature, Governor and State Agencies to:
- Work with coalitions and affected communities.
Ensure that those most affected are actively involved in developing policies. To create sustainable solutions, families from all communities must be consulted, engaged and able to meaningfully participate in the policy process. - Collect, disaggregate and disseminate data by race and ethnicity.
Our policymakers need access to the best data and analyses. Too often population measures of children’s well-being are not disaggregated by race or ethnicity. Several state-level initiatives have already begun to make progress in this area. We need to expand these efforts so we can track progress and find solutions. Without disaggregated data, we have an incomplete picture of the needs and outcomes affecting all Utah children. - Review the racial and ethnic impact of public policies.
Our lawmakers and policymakers should review the impact of proposed policies on different racial and ethnic groups. Racial and ethnic impact assessment tools can highlight which groups benefit, and under what conditions. These targeted measures can correct disparities and help our legislators make informed decisions for all communities in Utah.
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Racial and Ethnic Equity for Children in Utah: What We Learned from the 2016 Legislative Session
1. Unless otherwise noted, data and indicators are from the national Kids Count Data Center: http://datacenter.kidscount.org/data#UT/2/0/char/0
2. Arkansas Advocates for Children and Families. (2015) “Missing the Mark: Race Equity and Missed Opportunity in the 2015 Session. Research Brief July 2015. Available at: http://www.aradvocates.org/publications/missing-the-mark-race-equity-and-missed-opportunities-in-the-2015-session/
3. DiversityDataKids.org. “What is Research Evidence and Why Does It Matter for Equity?” The Heller School for Social Policy and Management at Brandeis University. Available at: http://www.diversitydatakids.org/files/Policy/Head%20Start/Research%20Evidence/What%20is%20Research%20Evidence.pdf
4. Voices for Utah Children focused on these major issue areas during the 2016 Legislative Session. This report does not represent a comprehensive review of all legislation.
5. Heckman, J. J. (2011) "The American Family in Black & White: A Post-Racial Strategy for Improving Skills to Promote Equality." Daedalus, 140(2), 70-89.
6. Magnuson, K. A., & Duncan, G. J. (2005) "Can Family Socioeconomic Resources Account for Racial and Ethnic Test Score Gaps?" The future of children, 15(1), 35-54.
7. Utah Foundation. (2015) “Lessons From Our Neighbor: Learning From Colorado’s Educational Success.” Research Report 731, July 2015. Available at: http://www.utahfoundation.org/uploads/rr731.pdf
8. Utah Department of Workforce Services. (2015) “Fourth Annual Report on Intergenerational Poverty, Welfare Dependency and the Use of Public Assistance.” Utah Intergenerational Welfare Reform Commission Annual Report. Available at: https://jobs.utah.gov/edo/intergenerational/igp15.pdf
9. University of Utah S. J. Quinney College of Law. (2014) “From Fingerpaints to Fingerprints: The School-to-Prison Pipeline in Utah.” Public Policy Clinic Report. Available at: https://www.law.utah.edu/news/from-fingerpaint-to-fingerprints-the-school-to-prison-pipeline-in-utah/
10. Holt, Steve. (2006) “The Earned Income Tax Credit at 30: What We Know.” Research Brief February 2006. Washington DC: The Brookings Institution Metropolitan Policy Program. Available at: http://www.brookings.edu/research/reports/2006/02/childrenfamilies-holt
11. DiversityDataKids.org. (2014) “Working Parents Who Are Eligible For and Can Afford FMLA Unpaid Leave.” Utah Map. Available at: http://www.diversitydatakids.org/data/map/510/working-parents-who-are-eligible-for-and-can-afford-fmla-unpaid-leave-share/#loct=2&cat=28,24&tf=17
12. The following were references and models for this report: Arkansas Advocates for Children and Families. “Missing the Mark: Race Equity and Missed Opportunity in the 2015 Session.” Available at: http://www.aradvocates.org/publications/missing-the-mark-race-equity-and-missed-opportunities-in-the-2015-session/; “Facing Race: The 2015 Oregon Racial Equity Legislative Report.” Available at: https://facingraceoregondotorg.files.wordpress.com/2016/01/2015facingraceweb.pdf; “Strong Families New Mexico 2015 Legislative Report Card.” Available at: http://strongfamiliesmovement.org/nm-reportcard
For 30 years now, Voices for Utah Children has called on our state, federal and local leaders to put children’s needs first. But the work is not done. The children of 30 years ago now have children of their own. Too many of these children are growing up in poverty, without access to healthcare or quality educational opportunities.
How can you be involved?
Make a tax-deductible donation to Voices for Utah Children—or join our Network with a monthly donation of $20 or more. Network membership includes complimentary admission to Network events with food, socializing, and opportunity to meet child advocacy experts. And don't forget to join our listserv to stay informed!
We look forward to the future of Voices for Utah Children and we hope you will be a part of our next 30 years.
Special thanks to American Express for sponsoring our 30th Anniversary Year.
U.S.A. reaches goal of 95% health insurance coverage for children but Utah lags behind
In 2007, on the 10th anniversary of the Children’s Health Insurance Program (CHIP), the David and Lucile Packard Foundation and its partners committed to helping ensure that 95% of the nation’s children ages 0 to 18 had health insurance. This year the nation reached this historic goal, according to the Urban Institute’s report: Uninsurance among Children, 1997–2015 : Long-Term Trends and Recent Patterns. The success of CHIP and the expansion of Medicaid in many states were critical for reaching these historic numbers for health insurance coverage.
However, Utah lags the nation, with only 90.6% of Utah children insured. In fact, Utah ranks among the bottom of all states for children’s health insurance coverage and Utah Hispanic children are particularly unlikely to have health insurance. Nationwide, 9.7% of Hispanic children are uninsured but 23.4% of Utah Hispanic children are uninsured.
Children with access to quality, comprehensive health coverage are more likely to attend school and stay focused on learning. Healthier children means parents take fewer days off work to care for a sick child. It also means parents don’t have to choose between paying a medical bill or paying rent.
How can we get more Utah kids covered?
Follow through with the work begun at the 2016 Legislature. During the recent session, Utah lawmakers added intent language to end the 5-year wait for lawfully residing immigrant children, agreed to study options to improve enrollment in Medicaid, and allocated funding to Medicaid and CHIP outreach for the first time in years. Let’s finish what we started.- Cover the gap. States that fully expanded Medicaid saw more improvement in children’s health insurance coverage than states like Utah. Utah lawmakers chose to leave money on the table in Washington rather than fully cover the gap. Expanding Medicaid would help Utah address Utah’s low enrollment of eligible children in Medicaid and CHIP, as newly eligible adults enroll their whole families.
- Extend CHIP. CHIP funding is scheduled to end in 2017 despite its overwhelming success.
Now that the goal of getting 95% of children insured has been met nationally, the Packard Foundation has announced a new commitment to reach 98% coverage for our nation’s children. By the time the nation meets this new goal, we hope to be able to say that Utah kids are just as likely to be insured as children across the nation. Let’s catch up now.
For 30 years now, Voices for Utah Children has called on our state, federal and local leaders to put children’s needs first. But the work is not done. The children of 30 years ago now have children of their own. Too many of these children are growing up in poverty, without access to healthcare or quality educational opportunities.
How can you be involved?
Make a tax-deductible donation to Voices for Utah Children—or join our Network with a monthly donation of $20 or more. Network membership includes complimentary admission to Network events with food, socializing, and opportunity to meet child advocacy experts. And don't forget to join our listserv to stay informed!
We look forward to the future of Voices for Utah Children and we hope you will be a part of our next 30 years.
Special thanks to American Express for sponsoring our 30th Anniversary Year.
Last year, we brought you a version of The Good, The Bad and The Ugly for our legislative overview. For this year’s health policy round-up, we’re relying on another classic Western, The Magnificent Seven, to review the seven main children’s health issues of the session. Not all seven topics made it to the end of the session (much like the gunslingers in the movie). But all of them put up a good fight.
1. Enrolling More Children in CHIP and Medicaid
Utah has one of the highest rates of uninsured children in the nation. We need to take the steps to help children and families enroll–and stay enrolled–in health coverage. There are 85,000 uninsured children in Utah. Even more concerning, the majority of uninsured children in the state are already eligible for health insurance coverage like CHIP or Medicaid but not enrolled.
Fortunately, some important steps were taken this session. The legislature allocated state funding to the Department of Health for CHIP and Medicaid outreach so that more families can learn about their coverage options. In addition, the legislature directed the Department of Health to study some of the barriers to children’s enrollment in CHIP and Medicaid and the fixes needed so more children have coverage. Some of the potential fixes include 12-month continuous eligibility for children on Medicaid, which would allow children to maintain coverage for one full year, even if families experience a change in income or family status. Finally, the legislature removed the five-year waiting period for legal immigrant children to receive CHIP and Medicaid. Immigrant children who would otherwise qualify for CHIP and Medicaid no longer have to wait five years to receive health coverage.
2. Health Coverage for Parents
Healthy parents = healthy children. When parents have insurance, they are better able to care for their children. In addition, when parents have coverage they bring their children along too. Enrollment numbers for children go up when parents have health coverage. Unfortunately there are tens of thousands of uninsured parents in Utah today. While the legislature did not close the coverage gap this session, it took important first steps. HB 437 (Rep Dunnigan R-Taylorsville) changed Medicaid eligibility to cover an estimated 3,800 additional parents, effectively raising the eligibility ceiling for parents with children up to 60% of Federal Poverty Level. More robust bills that did not become law, including SB 77 (Sen Gene Davis D-Salt Lake County), would have expanded Medicaid and closed the coverage gap. In addition, the legislature funded Primary Care Access Grants. These grants help many low-income families and individuals, especially in rural areas. These are important steps to take, but we need to continue on until all Utahns have access to comprehensive health coverage.
3. Reducing Health Disparities
Children of color are more likely to experience poor health outcomes compared to White children. Utah has the highest rate of uninsured Hispanic children in the nation. Hispanic children make up 17% of the population, but they make up 40% of the total uninsured population. As mentioned above, one win for the session was the elimination of the five-year waiting period for legal immigrant children. Legal permanent resident (LPR) children will soon be able to enroll in CHIP or Medicaid as soon as they qualify, without having to wait five years. At the request of the Governor’s budget, the legislature also allocated funding for Family Spirit, a home visiting program specifically for young Native American families in Utah. The program is a culturally-focused and strength-based approach for new parents and their children. These measures move our state in the right direction; but more work is needed. All children, regardless of their racial or ethnic background, should be able to access the care they need to achieve optimal health.
4. Disease Prevention and Health Promotion
The following public health policies were not enacted, although they would have saved the state money and improved children’s health:
Curtailing Youth Tobacco Use: HB 157 (Representative Kraig Powell R-Heber City) would have raised the age limit for tobacco use and HB 333 (Representative Paul Ray R-Clearfield) imposed an e-cigarette tax. These are important steps to prevent rising rates of e-cigarette use among youth in our state. Despite strong support, including active youth advocacy, both of these bills failed in committee.
Information about Childhood Immunizations: Choosing not to vaccinate your child is a serious decision for one’s child and community. HB 221 (Rep Carol Spackman-Moss D-Salt Lake City) would have required parents who choose not to vaccinate to take a brief online training. The training would inform parents how to recognize the signs and symptoms of disease and learn what to do in the event of a disease outbreak in order to keep their child safe. The bill narrowly passed the House. However in the final days of the session, the Senate made amendments to the bill that undermined its intent. There was not adequate time to resolve these differences and the bill did not pass. As immunization rates in Utah decline, more children are at risk when disease outbreaks occur. This bill highlights the need for continued public health awareness, information and discussion so that all children in Utah can be safe.
Family planning: Representative King sponsored HB 246, Reproductive Health Amendments, that would have provided comprehensive sex education in schools. It also would have allowed more low-income families to receive comprehensive family planning services. This bill would have helped reduce rising rates of sexually transmitted infections by helping more teens make informed choices. However, controversies surrounding sex education kept this bill from advancing out of committee.
5. Services for Children with Special Healthcare Needs
Legislators increased some of the funding for children with special needs. The Baby Watch Early Intervention program received one-time funding to support its critical programs. Legislators including Sen. Luz Escamilla (D-Salt Lake City) and advocates worked tirelessly to make sure the programming could continue. As parents can testify, the Baby Watch Early Intervention program allows parents to receive the early support, assessment and coordination of care they need for their children. The legislature also funded additional slots and increased the caseload for the Medically Complex Children’s Waiver in the Medicaid Program. Additionally, in HB 2, the legislature also allocated funding for the children’s hearing aid pilot program account. In the future, more funds are needed for children with special health care needs, but the legislature took important measures to help more children and families.
6. Crisis Nurseries and Home Visiting for Under-Resourced Families
The Utah legislature allocated funding for families in crisis in HB 2. These funds include TANF funding for domestic violence shelters. It also includes some funding for crisis/respite nurseries under contract with the Division of Child and Family Services. Crisis nurseries play a vital role for families experiencing hardship. In addition, the legislature allocated funding to home visiting programs. The two evidence-based programs funded are Family Spirit and Parents as Teachers. Home visiting programs have been shown to improve the long and short term health outcome for new mothers and their children.
7. Maternal Health and Prenatal Services
The legislature considered several bills that address obstetric care for moms, including two bills that addressed midwifery services. HB 184 (Rep Spackman Moss) made technical changes to current midwifery practices. SB 108 (Sen Deirdre Henderson) removed certain restrictions on licensed birth centers to enable expanded services, despite some concerns from the despite some concerns from physician groups. Both HB 184 and SB 108 passed.
HB 246, Reproductive Health Amendments, also included a provision that would expand family planning services for low-income families that do not qualify for Medicaid. Since this bill failed in committee, it was a missed opportunity for the state to apply for a waiver to extend family planning services for women at 138% of Federal Poverty Level. The state would have received an enhanced federal matching rate for such services, making this a cost-effective policy change for the state. In addition, the provision would have helped individuals who fall in the coverage gap receive comprehensive family planning services.
Those are some of the “magnificent” seven health topics from the 2016 legislative session. For more information on any of the issues or bills mentioned, please contact Jessie Mandle. Voices for Utah Children will continue the fight this coming year so that all children in our state can achieve health and wellness.
March 31, 2016 is Love UT Give UT!
It’s a day for Utahns to give to the nonprofits that make Utah special. Every donation to Voices for Utah Children through Love UT Give UT gives Voices a chance to win matching grants and prizes.
And you don't have to wait! Donate now at http://bit.ly/loveUTchildren.
For 30 years now, Voices for Utah Children has called on our state, federal and local leaders to put children’s needs first. But the work is not done. The children of 30 years ago now have children of their own. Too many of these children are growing up in poverty, without access to healthcare or quality educational opportunities.
How can you be involved?
Make a tax-deductible donation to Voices for Utah Children—or join our Network with a monthly donation of $20 or more. Network membership includes complimentary admission to Network events with food, socializing, and opportunity to meet child advocacy experts. And don't forget to join our listserv to stay informed!
We look forward to the future of Voices for Utah Children and we hope you will be a part of our next 30 years.
Special thanks to American Express for sponsoring our 30th Anniversary Year.
Help us keep protecting children's health with #loveUTgiveUT
March 31, 2016 is Love UT Give UT!
It’s a day for Utahns to give to the nonprofits that make Utah special. Every donation to Voices for Utah Children through Love UT Give UT gives Voices a chance to win matching grants and prizes.
And you don't have to wait! Donate now at http://bit.ly/loveUTchildren.
For 30 years now, Voices for Utah Children has called on our state, federal and local leaders to put children’s needs first. But the work is not done. The children of 30 years ago now have children of their own. Too many of these children are growing up in poverty, without access to healthcare or quality educational opportunities.
How can you be involved?
Make a tax-deductible donation to Voices for Utah Children—or join our Network with a monthly donation of $20 or more. Network membership includes complimentary admission to Network events with food, socializing, and opportunity to meet child advocacy experts. And don't forget to join our listserv to stay informed!
We look forward to the future of Voices for Utah Children and we hope you will be a part of our next 30 years.
Special thanks to American Express for sponsoring our 30th Anniversary Year.
