childrens budget cover UtahCBReport2015

Why a “Children’s Budget”?

Children, it is often said, are Utah’s most precious resource. They represent the workforce, consumers, and leaders of tomorrow. For that reason, the investments we make in our children today have enormous economic and social implications for Utah’s future. That is why our federal, state, and local units of government pool taxpayers’ resources to establish an education system, provide for the health and other basic needs of our most vulnerable children, and intervene in children’s lives when their safety is at risk.

This report, Children’s Budget 2015, examines public investment in children from FY2008 through FY2014. It is an update of earlier reports by Voices for Utah Children published in 2009 and 2011. This report does not assess the effectiveness of these programs or gaps in services. Rather, it objectively quantifies the level of public funding for children in Utah and identifies trends over the seven-year period.

There is a strong case to be made that no one cares more about kids than Utahns. Utah has the highest fertility rate in the country and the most children as a percentage of its population, 31% vs. 24% for the nation . Utah saw the second fastest growth rate in its child population of any state from 2000 to 2010 , second only to Nevada (which grows mostly by in-migration rather than through births). Given the high priority Utahns place on children, understanding how much is spent on children by the state and for what purposes is critically important for policymakers and the general public.

Information on funding for children is important for several reasons. It can:

1. Assist policymakers in assessing whether their funding decisions reflect, in the aggregate, their priorities with respect to children.

2. Illustrate how specific programs compare with spending on children overall.

3. Aid policymakers in examining how much is spent on children for specific purposes (i.e. for early education or child welfare) or how funding for children compares to total state and federal spending in the state.

Examining how much Utah invests in children can help the state evaluate how efficiently it is enhancing the potential of our future workforce and maximizing our investment in human capital and economic development. Public investment in children in Utah should be understood as an important component of our economic development strategy that impacts the state as a whole, both in the present and the future.

In this report, Voices for Utah Children divides all state programs concerning children into seven categories, without regard to their location within the structure of state government. The seven categories are as follows, in descending order by dollar value (based on the sums of both state and federal funds):

• Education, which makes up 90% of the state-funded portion of the Children’s Budget and 77% overall counting both state and federal funds

• Health

• Food and Nutrition

• Early Childhood Education

• Child Welfare 

• Juvenile Justice

• Income Support

We then add up the expenditures in each of these areas, separating state from federal dollars, and we compare the figures over time from FY2008, the last year before the state budget began to be affected by the Great Recession, through FY2014, the most recent year for which final expenditure data was available. 

Our most important finding is the following: 

While the state economy has recovered from the Great Recession in a number of respects, state investment in children has not.  Specifically, real (inflation-adjusted) state investment in children in FY2014 remained 6% below what it had been in FY2008, at $5,424 per child in FY2014, compared to $5,746 in FY2008. 

Making up that $322 per-child gap between the FY2008 level of public investment in children and the level in FY2014 would have required an additional state expenditure in FY2014 of approximately $293 million. 

This finding that state government investment in children has not yet recovered from the recession is not the only example of how Utah still remains below its pre-recession performance, even five years after the recession ended.  For example, real median wages also remain below pre-recession levels and poverty rates have remained elevated well above where they were at the same point in previous economic expansions.  

For more information, see the complete report:

Utah Children's Budget Report 2015


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?

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. Amex


Published in News & Blog

young dirty child hides behind poll smallerFor 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?

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. Amex


Published in News & Blog

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

Healthy Utah v. Utah Cares infographic


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:


Published in News & Blog
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HealthyUtahParentsJobsA 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


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December 16, 2014

Nurse Family Partnership

Nurse Family Partnership (NFP) is a voluntary evidenced-based community health program that provides ongoing home visits (from pregnancy through age 2 of the child) from a registered nurse to low-income, first time mothers to provide the care and support they need to have a healthy pregnancy, be a responsible and caring parent, and to become more economically self-sufficient. A nurse visits the women approximately weekly and bi-monthly during their pregnancy and after birth, and then monthly visits during the first two years of their children’s lives. The program is a two-generation intervention and improves outcomes for both the mother and the child. NFP produces very strong outcomes for very high risk, low-income populations.

Economic analyses performed by the Washington State Institute for Public Policy, the Brookings Institute and the Rand Corporation determined that NFP provides a return on investment for taxpayers of $2.37 to $5.70 (high-risk population) per $1 invested in the program.

Download the printer-friendly report:
Nurse Family Partnership

Proven Outcomes

National outcomes associated with NFP, verified through independently evaluated randomized controlled trials, include long term family improvements in health, child welfare, education and self-sufficiency. When brought to scale, NFP can achieve:

• 23% reduction in smoking during pregnancy
• 26% reduction in pregnancy-induced hypertension
• 18% reduction in first pre-term births
• 58% reduction in infant deaths
• 30% reduction in second teen births
• 37% reduction in childhood injuries treated in emergency departments up to age 2
• 30% reduction in child maltreatment
• 38% reduction in language delay of the child by age 2
• 45% reduction in crimes and arrests, ages 11-17
• 51% reduction in alcohol, tobacco and marijuana use, ages 12-15
• 15% reduction in TANF and Food Stamp payments
• 9% reduction in Medicaid costs through age 1

Locally, Salt Lake County has a small NFP program. In 2012, 10.68% of the comparable Medicaid clients had a preterm delivery, compared to 7.5% of NFP clients, a reduction in incidence of 30%. Preterm babies require expensive medical services and a 30% reduction in incidence results in significant cost savings to Medicaid. In addition, the following outcomes for the mother have been documented in Salt Lake County:

• 52.5% increase in employment of clients younger than 18 after starting the program
• 18.9% increase in employment of clients 18 and older after starting the program
• 40% decrease in maternal smoking
• 50% reduction in reported incidence of domestic violence during pregnancy

Government Cost Savings and Avoidance

The outcomes listed above produce significant cost savings in Medicaid, Criminal Justice, Child Welfare, Food Stamps and TANF. Based on national data, Medicaid is the largest recipient of cost savings per family served (55% of cost savings accrue to Medicaid).

government cost savings nurse home visiting


Nurse Family Partnership in Utah

The Office of Home Visiting in the Utah Department of Health received $1,097,713 in federal funding through the Maternal, Infant and Early Childhood Home Visiting (MIECHV) Program for Fiscal Year 2013. Of that, $300,000 was allocated to Nurse Family Partnership to serve 75 families in Salt Lake County (the remaining $700,000 was allocated to Parents as Teachers (PAT) - a home-visiting school readiness program). The average cost per family per year for NFP is $4,000. In 2012 (the most recent data available), 4,867 mothers were eligible for NFP statewide. Based on this, an investment of $19,468,000 would be necessary to serve all eligible families.


Voices for Utah Children recommends an ongoing state appropriation of $2,000,000 per year for Nurse Family Partnership, to serve 500 high risk, low-income first time mother statewide. To date, 21 states have appropriated state funds for NFP and/or home visitation.

More Information


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doctor and childHealthy and financially secure families are critical in helping end the cycle of intergenerational poverty. However, low-income families struggle to obtain health coverage that can provide the access to care and the financial protection that they need.

While the vast majority of low-income families with children have at least one full-time worker, most do not qualify, or cannot afford, employer or individual market health insurance plans. Public health coverage programs can equally be out of reach. In most states, Medicaid and CHIP provide coverage to children and pregnant women, but largely exclude parents. However, an extensive body of research shows that when these programs provide coverage to both children and their parents, the entire family benefits.

Download the printer-friendly version of the report here:
A Two-Generation Strategy: Healthy Parents and Healthy Kids

Obviously, covering low-income parents increases their own insurance coverage and access to care. But the benefits do not stop at mom and dad. When parents have access to Medicaid, their Medicaid and CHIP eligible children are much more likely to get enrolled in coverage. Further, parental Medicaid coverage leads to improved use of health care for children, such as preventive care.

Parents living in states that have expanded Medicaid have seen nearly a 33% drop in the rate of parents living without health insurance. States that have not expanded Medicaid have seen no significant change in the rate of uninsured parents.

Medicaid Expansion: Parents and Children Benefit

Partly in reaction to this research, the Affordable Care Act (ACA) required states to move from Medicaid’s old categorical and individual centric approach to a more family centric program that would provide coverage to low-income children and parents alike. The 2012 United States Supreme Court decision that upheld the overall constitutionality of ACA, changed this section of law. Instead of mandating that states provide adults Medicaid coverage, the Court gave states the option to provide Medicaid coverage.

Over half of the states, including the District of Columbia, have expanded Medicaid for parents and other low-income adults. Unfortunately many states, including Utah, have not yet decided to expand Medicaid coverage to adults—and as a result, retained their individual centric Medicaid programs and higher rates of uninsured adults.

How Expansion Would Help Utah Families

Studies have repeatedly shown that health care coverage has a myriad of positive effects for families. Whether that coverage be private employer plans or a public Medicaid program, families’ financial security, ability to work, and the health of parents and children improve when adults have health insurance.

People with Medicaid coverage fare much better than uninsured on measures of access to care, utilization, and unmet health needs. Children enrolled in Medicaid, for example, are more likely to receive well-child care and are significantly less likely to have unmet or delayed needs for medical care, dental care, and prescription drugs due to cost.

Research suggests that Medicaid coverage has similar benefits for adults. Mothers covered by Medicaid are much more likely than low-income uninsured mothers to have a usual source of care, a doctor visit, a dental visit, and to receive cancer screening services. Adults covered by Medicaid are more likely than uninsured adults to report health care visits overall and visits for specific types of services. They are also more likely to report timely care and less likely to delay, or go without, needed medical care because of cost.

Further, out-of-pocket spending would decrease dramatically for low-income uninsured adults—almost four-fold on average, if they had access to Medicaid.

Recently, the Oregon Health Insurance Experiment has provided real life evidence about the positive impact of Medicaid coverage for low-income uninsured adults. Oregon had a lottery for a limited number of a slots in their Medicaid program for adults. This provided researchers the opportunity to look at the differences between adults who received Medicaid coverage and those who remained uninsured. Results from the Oregon experiment found that:
• 70% of enrollees were more likely to have a regular place of care
• 55% of enrollees were more likely to have a regular doctor 
• Catastrophic out-of-pocket spending (health costs that exceed 30% of income) was nearly eliminated
• Any type of medical debt was reduced by more than 20%

Expanding coverage could have a direct impact on the health of children as well. Low-income adults are generally sicker than higher income adults. They suffer from increased likelihood of depression and other health issues that can lead to greater risk of their kids experiencing toxic stress. Medicaid expansion may help reduce this risk.

Unfortunately, low income adults in Utah are not experiencing these benefits of health coverage because the state has not yet chosen to expand Medicaid.

The data shows this is a significant problem in Utah where the story of uninsured adults is starkly different than the story of uninsured kids. Thirty-nine percent of adults below 138% of poverty and 43% of adults below poverty are uninsured in Utah. This compares to an uninsured rate of only 19% for adults with incomes above 138% of poverty.

The experience that states have had with children shows that providing access to Medicaid can dramatically reduce uninsured rates. The uninsured rate for children in Utah in households with incomes below 138% is only 18%.

health insurance 1

The impact of Medicaid expansion does not stop with the adults who would gain coverage. Although much of the advocacy efforts surrounding Medicaid Expansion have focused only on the individual adults who would gain coverage, the reality is that over half of the expansion population is in a family (two or more related individuals), and nearly 40% are parents of children under the age 18. Providing health coverage to these adults in families will have a positive impact on everyone in that family.

health insurance 2

Another misconception about the expansion population is their employment status. The fact is that 87% of families who would benefit from expansion include at least one working parent and 61.5% have at least one parent working full-time.

health insurance 3

Unfortunately these families either do not have an offer of employer sponsored coverage, or cannot afford the employer sponsored insurance that is available. Only 29% of adults below 138% of poverty are enrolled in an employer sponsored health insurance plan.


Expanding Medicaid in Utah will strengthen Utah families. The improved health and financial security from providing health coverage to parents will greatly improve the opportunity to stop the cycle of intergenerational poverty.

Voices for Utah Children is proud to be a part of the Aspen Institute Ascend Network. The goal of the Aspen Institute Ascend Network is to mobilize empowered two-generation organizations and leaders to influence policy and practice changes that increase economic security, educational success, social capital, and health and well-being for children, parents, and their families. Learn more at http:/ /ascend.aspeninstitute.org/network

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September 09, 2014

Healthy Utah Poll Results

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