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. 

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. 

It is widely agreed that rural communities have a different set of issues than more urban communities. While all low-income families, regardless of where they live, need connections to support programs and access to economic opportunities, strategies that work in urban areas often cannot be applied to rural areas where social and economic programs are few and far between.

Because access to services is such an important issue in Utah’s rural areas, it is imperative that policymakers and service providers have a clear view of the problems facing rural communities. In Voices for Utah Children’s annual publication Measures of Child Well-Being in Utah, a variety of child well-being indicators are presented at the county level. These indicators cover important milestones in areas such as economic security, education, and health.

This edition of Data Links explores several of the indicators annually presented in Measures to see how much or if child well-being differs in rural communities as compared to urban communities.

DEFINING URBAN AND RURAL

There are a myriad of definitions for “urban” and “rural” from a variety of sources. For the purposes of this report we have chosen to use three categories based on the American Community Survey’s three breakdowns for the one year, three year and five year estimates:

Urban Areas - Areas with populations of 65,000+
Urban/Rural - Areas with populations of 64,999 to 20,000
Rural Areas - Areas of population 20,000 and under
Counties included in each area are indicated in the box to the right.

CONCLUSION

This data brief started out by saying it is widely agreed that rural communities have a different set of issues than urban communities. Access to services is difficult for a variety of reasons including lack of transportation and a lack of service providers. When there are no providers in town and individuals must wait on availability, scheduling can become a problem. In some cases where an individual has no family leave policy, traveling to a provider can mean missed wages. Child well-being indicators for children in rural Utah are, in general, slightly worse than those in urban areas. This makes all the above issues even more pressing and an area of concern that needs to be addressed.

“In urban areas, questions of access to care often revolve around whether all segments of the population have access to the full range of specialized medical centers serving the metropolitan area. In rural areas, the issue is often whether there are any health care facilities and providers to access at all. Large metropolitan counties have nearly four times as many physicians per 100,000 residents as do rural counties with only small towns."
Demographic Trends in Rural and Small Town America KENNETH JOHNSON, Carsey Institute Reports on Rural America 01/2006

Printer-friendly report:

A Tale of Two Utahs: How do Urban and Rural Utah Measure Up?

(Sources and definitions are available in the printer-friendly version of this report.)

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. 

The 2016 Utah Legislative Session is underway January 25-March 10.  Learn more about issues affecting children that will be addressed during this session:

Tax and Budget Issues

Creating a State Earned Income Tax Credit (EITC)

End the Earmarks

Restoring Revenues

Health Issues

A Coverage Gap Solution

Eliminate the 5-year Wait

Restore Funds for CHIP and Medicaid Outreach

12-month Continuous Eligibility

Education Issues

Optional Extended Day Kindergarten

High Quality Preschool

Bills

News Contact Lawmakers  Sign Up for E-Alerts

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. 

For 30 years, Voices for Utah Children has been working on issues facing children in the areas of juvenile justice, child welfare, economic stability, education and health. We have become increasingly concerned about racial disparities in all these areas.

Gathering and analyzing racial and ethnic data is the first step in making informed policy decisions. Those decisions must be guided by comprehensive, regularly updated data. Parsing data through racial and ethnic lenses uncovers patterns and trends that can assist in planning more responsive programs and services.

This Data Link compares Utah’s Hispanic children to white, non-Hispanic children with the goal of helping policymakers develop strategies that eliminate racial disparities and lead to improved child and family outcomes for all Utah’s children.

In 2014 there were 154,419 Hispanic or Latino children under the age of 18 in Utah. They make up 17% of the state’s children. As you can see from the data, these children are more at-risk for poor outcomes than their white non-Hispanic peers.

View the complete report:

Hispanic Kids Data Link 

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?

•          Celebrate the 30^th Anniversary of Voices for Utah Children with us at our Children’s Champion Award Luncheon on September 30, 2015.
•          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 the luncheon.

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. 

A new report by Notalys, LLC, compares two options for expanding health care coverage to close the insurance gap for an estimated 66,000 Utahns who do not earn enough to receive federal subsidies for insurance but don’t qualify for traditional Medicaid. The Healthy Utah plan significantly expands private insurance for low‐income individuals using federal funds during its pilot period. Until end of 2016, full risk of program falls on the federal government. State portion of costs is 0% initially, rising gradually to 10%. The Utah Cares plan partially expands Medicaid and offers primary care, but not specialty care or hospitalization, to those in poverty using a mix of federal and state funds. Enrollments will be cut in the case of cost‐overruns, and state pays 30% of all costs.

Healthy Utah has six times more value per dollar than Utah Cares—it also costs much less and has lower risk.

Return on Investment:

• Healthy Utah: 24.4
• Utah Cares: 4.1

Take‐Aways:

Only Healthy Utah effectively closes the coverage gap. Thousands under Utah Cares will have access only to primary care, which covers only a small part of health care needs.

• Downside risks under Healthy Utah are borne by the federal government. Under Utah Cares, these risks are shared by the state and may result in significant cutbacks.
• “Woodwork” effects are the most significant long‐term risk faced by both programs, though they are not an unmanageable risk. Because of wider program appeal, woodwork effects are larger under Healthy Utah than Utah Cares.
• Healthy Utah functions predominantly through private insurance, which strengthens lowincome families, reduces financial burdens on health care providers and hospitals, and improves the state’s economy.

Research sponsored by Voices for Utah’s Children, AARP Utah and the Utah Health Policy Project

For more information, see the complete report:

A joint report by the Georgetown Center for Children and Families and Voices for Utah Children finds that:

1. In Utah, uninsured parents account for over one third of the population potentially eligible for health coverage if the state expands Medicaid. If Utah does not move forward with Medicaid expansion, or an alternative proposal like Governor Gary Herbert’s Healthy Utah Plan, a significant coverage gap for parents living with dependent children will remain uninsured
2. Of low-income, uninsured parents, working parents who are 26 to 49 years old and have school-aged children (6 to17 years old) are most likely to be helped by Medicaid expansion in Utah. Of those parents that could benefit from extended Medicaid eligibility, more than two-thirds (68 percent) are employed.
3. Covering parents in Utah offers the state an opportunity to help its children by reducing their uninsured rate, enhancing a family’s financial security, and improving the health of parents. Utah ranks 43rd in the U.S. for percent of uninsured children; consequently there is significant room for improvement.

The complete repert is available here: 
Utah Parents and Families Would Benefit from Medicaid Expansion

Learn More and Contact Lawmakers: http://bit.ly/HealthyUtah

Utah has Highest Uninsured Rate for Hispanic Children in the Nation

Every child in Utah should have a chance to succeed. When it comes to setting up a child for success, few things matter more than good health. It starts when their mothers get prenatal care. It continues with regular checkups after they are born to treat and, more importantly, prevent illness. Good health care helps children reach important developmental milestones and enter school ready to learn. Coverage is essential to children reaching their full potential. Unfortunately, too many Utah children are uninsured. This is particularly true for Hispanic children in our state.

• 22.2% of Hispanic children are uninsured in Utah. This is the highest rate in the nation by far and is twice as high as the national average for Hispanic kids of 11.5%.

• 22.2% of Hispanic kids are uninsured compared to only 7% of non-Hispanic children. This 11 percentage point disparity is the largest disparity in the country. Nationally, the average disparity is only 5 percentage points.

• Hispanic children make up 16.9% of Utah’s total child population but account for 39% of the uninsured children in the state. Of the 84,891 uninsured kids in Utah, 33,531 of them are Hispanic.

• Utah’s overall uninsured rate for kids is 9.5%, ranking us 41st (highest being worst) in the country. The national average is 7.1%. If we reduced our Hispanic uninsured rate to the national average of 11.5%, Utah’s overall uninsured rate for kids would drop to 7.5% and Utah would have the 19th best uninsured rate in the country for kids.

If we want more children to succeed in life, we must secure coverage for more of our children, regardless of ethnicity or race. We can begin to remove hurdles facing uninsured Hispanic children and set all of Utah’s children on a path to success by implementing a few first steps:

• Restore outreach funding for Medicaid and CHIP;

• Make it easier for children to keep their health coverage by implementing 12 month continuous eligibility;

• Remove the Medicaid and CHIP five year waiting period that legal immigrant kids must endure before enrolling in these programs.

Printer-friendly version of this factsheet:

Uninsured Rates High for Hispanic Children

Pre-term and low birthweight infants face significant risks for medical and developmental disabilities which are expensive to government and private entities throughout a child’s life. Nurse home visiting, in which nurses and peer counselors provide support and education to high-risk pregnant women in their homes, have had excellent results over the past 30 years in preventing poor birth and long-term outcomes. Such programs that could significantly reduce state expenditures.

This paper, co-authored by Voices for Utah Children Early Childhood and Education Senior Policy Analyst Janis Dubno, explains how Pay for Success (PFS) finance could be used to pay for expanding nurse visiting programs. PFS finance involves a partnership between philanthropic and business entities (organizers and investors) and governments to provide performance-based investments in social programs, with payments made to the investors from cost avoidance savings that governments enjoy as a result of the program, or because the program meets certain prespecified outcome improvements. The key idea in a PFS project is that private investors (the managed care organization and/or senior and subordinated lenders) are repaid only from success payments, amounting usually to 80% to 90% of total cost avoidance savings.

This is the latest in a series of ReadyNation papers on using Pay for Success (PFS) social impact finance to improve early child health and education outcomes. This paper focuses on using PFS finance to scale-up effective early health interventions. PFS is a new financial and contracting arrangement that increases investment in evidence-based programs resulting in measurable social outcomes. Savings from these outcomes can repay investors and fund continued services. ReadyNation is leading a project to provide technical assistance to state and city teams developing PFS contracts.  See www.ReadyNation.org/PFS.

For more information, read the complete paper:

Early Health “Pay for Success” Social Impact Finance: Scaling Up Prenatal Health Care in Virginia 
Janis A. Dubno MBA, Robert H. Dugger PhD, Debra L. Gordon MS, David Levin MD, and Philip A. Peterson FSA