By Leslie Boyd

The proposed budget released by Gov. Bev Perdue this week avoids
crippling cuts in health and human services, but there are portions
that leave health and social services advocates worrying.

“One of the best pieces is the dollar increase in the
cigarette tax,” said Adam Searing of the N.C. Justice Center, and
project director of the North Carolina Health Access Coalition. “We
talk about all these wellness programs to cut health care costs, and a
lot of them are expensive. This one costs nothing, and it's very
effective.”

The budget also will allow 8,000 more children to
enroll in the state children's health insurance program. Most will be
children who are eligible but haven't enrolled yet.

More would be
saved under the governor's proposal to rely more on generic drugs when
the state is footing the bill. Perdue does not rule out the possibility
of developing a preferred drug list, or formulary.

“She is taking
aim at the big pharmaceutical companies,” Searing said. “This proposal
is not just about saving money; it's also a tool to limit off-label
prescribing.”

The proposed budget would increase funding for
community-based services and short-term psychiatric beds in community
hospitals. So far, the state has contracted for about 150 beds in
communities across the state; 50 more are planned. This would allow the
state to cut 25 short-term psychiatric beds each at Broughton and
Cherry state hospitals.

Overall, Searing said, health care would not be hit too hard.

Child care gets a boost — for now

The governor's budget proposes using federal economic-recovery funds
to increase the number of child care subsidies by 11,000 in the next
two years. The plan also would use federal money to replace state money
in child care subsidies.

Although the money will reduce the
waiting list by 11,000 children, between 20,000 and 40,000 children are
waiting statewide, said Louisa Warren of the N.C. Justice Center.

The problem is there is no state money to continue the funding after 2011.

“You can't rely on a complete economic recovery by then,” Warren said.

Greg Borom of Children First/Communities in Schools of Buncombe County said the proposed cuts are not as bad as he had feared.

“Expanding
SCHIP is great,” Borom said. “But we still have to worry about not
losing ground in other areas where children, youth and families are
vulnerable.”

Child welfare faces cuts

Outside of SCHIP and child care subsidies, the news isn't as good.
The proposed budget eliminates funding for two inexpensive programs.

The
Child Welfare Collaborative works with college and graduate students
studying to be child protective workers to give them experience in the
field before they graduate and prepare them for the difficult
situations they will face. The program has been shown to reduce
turnover once people are on the job.

“Turnover is a major problem
in the system,” said Sorien Schmidt, senior vice president of Action
for Children N.C. “Reducing it saves money.”

The other program
proposed to be de-funded is Support Our Students, an after-school study
and mentoring program for 14,000 at-risk students in the state.

“Studies
show the time most juvenile crime is committed is between 3 and 6
p.m.,” Schmidt said. “This program is during those times.”

Support Our Students also has been shown to increase students' reading scores.

“The cuts, by and large, are thoughtful,” she said. “The reality is we have a huge shortfall and cuts have to be made.”

The Watauga Democrat

A statewide public-interest group says it is concerned about the budget impacts on children’s programs and services, releasing a report this week that calls children “a declining priority.”

A publication by Action for Children North Carolina, “Children in the Federal and State Budgets: A Declining Priority?,” analyzes federal and state commitments to children in recent years and offers recommendations for addressing children’s issues in a time of economic crisis.

The report states federal spending on children’s programs has dropped 10 percent over the last five years, and in 2008, children’s programs made up 10 percent of the federal budget, not including defense spending.

However, the American Recovery and Reinvestment Act commits $142 billion for Head Start, food stamps, Medicaid, foster care and adoption assistance, Social Services block grants and expanded child tax credits, as well as education spending.

While North Carolina’s contribution to children, particularly through the State Children’s Health Insurance Program, has increased as a percentage of overall state budget, programs in the Division of Child Development, Department of Juvenile Justice Delinquency Prevention and Division of Child Development declined 19 percent from 2001 to 2008.

“Our state and our country rely on investments in programs and services for our children and families. For today’s children to grow and become tomorrow’s leaders, they must all be given opportunities to succeed,” said Barbara Bradley, Action for Children North Carolina’s President and CEO, in a statement accompanying the report.

“But in recent years, children have become less of a priority in our budgets. It is especially critical in this economic climate that we invest wisely in our children in order to secure sound futures for them and for our state.”

With the state facing an estimated $2.5 billion shortfall, child advocates are bracing for more cuts this year, saying state spending per school-age child dropped nearly $300 from 2007 to 2008.

Action for Children North Carolina is advocating for the General Assembly to reinvest in children’s programs, raise revenues to cover the budget gap, incorporate more recent research in making policy decisions, and reform and modernize programs and practices.

The complete report is available at www.ncchild.org.

Facing South Online Magazine

By Desiree Evans

A new study by Action for Children, a Raleigh, N.C.-based advocacy group, found that North Carolina's minority children lag far behind white children in several measures of a child's well-being, including health, poverty and education. 

The Fayetteville Observer

By Jennifer Calhoun

The number of children lacking health insurance in the state rose dramatically between 2003 and 2007, according to a report from a children’s health advocacy group.

The annual report, released today by Action for Children North Carolina, used statistics to monitor the health and well-being of children over a wide range of topics, including economic security, safety, early care, education and delinquency prevention.

According to the report, the percentage of children without health care increased by 10 percent in the past four years. Children without insurance are more likely to miss school because of illnesses.

Also topping the list of concerns were increases in low birth weights, infant mortality rates, the number of overweight children, incidents of school violence and health disparities among minorities, the report said.

In addition, the number of poor children in working households increased by half between 2004 and 2007, because of the growth of low-wage jobs and stagnating salaries, the report stated.

As a result, the report stated that more children are being raised in high-stress environments that can hurt brain development and the ability to learn.

Tom Vitaglione, senior fellow at Action for Children, said the concerns highlighted in the report could result in big challenges for legislators in the coming years.

But despite some of the report’s grim findings, progress has been made in North Carolina through services such as Head Start, a pre-school program, and even insurance coverage, the report stated.

Nearly half of the state’s 2.2 million children younger than 18 received public health insurance last year through state programs — a big improvement over previous years’ numbers, Vitaglione said.

But private health insurance coverage is being lost faster than the state can deal with it.

“We’re doing better,” Vitaglione said. “The anomaly is that the uninsured rate is going up, because dependant coverage on employer health care plans is dropping faster than we can insure them.”

But there is good news on the horizon, he said.

Thanks to the recently passed federal economic stimulus package and increases in funding for the State Children’s Health Insurance Program, more children are expected to be insured on state insurance plans, he said.

From the stimulus package, the state will receive $2.5 billion for a variety of health care initiatives, one of which could include funding for Kid’s Care, a state program which expands insurance coverage to families who made too much money to be eligible in state insurance program.

Kid’s Care was recently passed by the state legislature, pending federal funding, Vitaglione said.

The State Children’s Health Insurance Program, or SCHIP, will receive about $38 million, which will allow more families access to the state’s Health Choice insurance plan, he said.

The report outlined other improvements in children’s health and well-being, as well.

Since 2004, there have been drops in delinquency rates, the number of teens seriously contemplating suicide and incidences of untreated tooth decay.

Many of these improvements are the result of an increase in the number and scope of public and private health care programs, the report said.

But big problems still loom, especially in the realm of minority health disparities, said Alexandra Sirota, director of policy and research at Action for Children.

“Children of color are experiencing disproportionately negative (health) outcomes,” Sirota said.

By Mandy Locke

North Carolina's minority children lag far behind white children in several measures of a child's well-being, according to a report released today.

The report, from Action for Children North Carolina and the Annie E. Casey Foundation, shows children of color faring far worse than white children in health, poverty and education.

Action for Children, a Raleigh-based advocacy group, releases a report on children's well-being each year, but this is the first time it has broken down the categories by race. More sophisticated tracking of racial and ethnic groups by state and local agencies made the analysis possible.

In some categories, such as infant mortality, the racial disparities in North Carolina match national trends. In other areas, such as incarceration, children of color fare worse. For every white child placed in prison or a juvenile detention center, four youths of color are put in custody -- even though white children outnumber them nearly 2 to 1.

"We need all of our children to do well," said Alexandra Forter Sirota, director of policy and research for Action for Children. "When we talk about what children need, there are significant variations in what children experience depending on age and race."

The report, which compiles data from several state and federal agencies on children up to age 18, is not all bad news. North Carolina has done very well by its children in several areas.

Three-quarters of children in the state have a primary health care provider, which child advocates think offers a continuum of care, for example. And more than half of the low-income children receiving subsidized day care are attending the highest ranked centers.

"We've made some good investments as a state, and it shows," Sirota said.

RALEIGH, N.C. - The 2009 North Carolina Children's Index, which Action for Children North Carolina released today, offers a wealth of child and youth well-being data that demonstrate the state's public policy successes as well as missed opportunities. The report shows that important investments in children's services pay off, that sound research enhances the ability to build effective programs and that, despite progress in addressing children's needs, geographic and racial disparities persist.

The Children's Index, which is published biennially, presents a comprehensive snapshot of how children are faring in North Carolina. The report monitors key indicators that address seven issue areas: health, safety, economic security, early care, education, child maltreatment and delinquency prevention.

"The Children's Index shows where North Carolina is making the grade in terms of addressing child well-being and where it is coming up short," said Barbara Bradley, Action for Children North Carolina's President and CEO. "Our state has demonstrated that it is a leader through health programs such as Health Choice and Kids' Care and early education programs like Smart Start and More at Four. But in this time of economic insecurity, we must continue to invest in effective public policies to ensure that our children have the resources they need to grow and thrive."

Successes highlighted in the Children's Index include:

• Nearly one million children in North Carolina receive preventive care and other treatment through enrollment in public health insurance. Children with health insurance coverage are less likely to get sick and miss school days. As families continue to lose employer-based health coverage, it is important that North Carolina fully funds Health Choice and implements N.C. Kids' Care.

• More than three of every four children in North Carolina have a medical home according to a recent survey. A medical home is a primary care provider who is accessible and gives continuity of care. This means better health outcomes for children and lower costs for primary care, which is not dispensed in emergency rooms.

• In 2007, almost 56 percent of children whose families received childcare subsidies were enrolled in high-quality childcare (4- and 5-star centers). As working families struggle to make ends meet, childcare subsidies help ensure that their children are learning and developing in safe and caring environments.

Missed opportunities highlighted in the Children's Index include:

• Despite research showing that the juvenile justice system is more developmentally appropriate for children under the age of 18, North Carolina is one of three states to treat 16- and 17-year-olds as adults in all aspects of their contact with the criminal system. In fact, more North Carolina youth were processed as adults than as juveniles in 2004.

• In North Carolina, only one of every four high school freshmen graduated in four years by 2007. Graduating from high school provides an average of $6,613 more in annual earnings for North Carolinians. High school dropouts are more likely to live in poverty and have negative health and social outcomes.

• Significant disparities continue to exist for North Carolina's children of color. Youth of color are four times more likely to be in the juvenile justice system than white youth. And, black infants are nearly twice as likely as their white counterparts to be born with low birthweight. North Carolina's systems must serve all children better in order for the state to be economically competitive in the long run.

Click here to download the 2009 North Carolina Children's Index.

By Barbara Bradley

In these times of financial uncertainty, our government has taken unprecedented steps to stabilize our economy. But lost amidst all the political disputes over a bailout plan for Wall Street is the fact that our country’s greatest assets, our children, are being forgotten. Where’s the bailout for them?

Children’s boats are taking on more water every year — less than 10 percent of spending in the federal budget is on children, a share that has declined by nearly a quarter over the past 40 years. Advocates, service providers, parents and policymakers know what we need to bail our children out, but our current buckets have holes.

Bucket: Health Insurance. More than a quarter million children in North Carolina (enough to stretch from Greensboro to Wilmington holding hands) have no health insurance. Children who cannot go to the doctor when they are sick, who cannot see the blackboard, or whose teeth hurt from lack of preventive dental care, do not succeed in school.

State policymakers have done their part by approving N.C. Kids’ Care, a plan to provide health insurance to more of our state’s children, but the Bush administration has repeatedly thwarted Congress’ attempts to reauthorize and adequately fund health insurance expansion in the states. A new Congress and president must make children’s health insurance a priority in the first 100 days.

Bucket: Child Care. More than 36,000 North Carolina families are currently on a waiting list for childcare subsidies so they can work and know their children are in safe hands. Children in unsafe or low-quality childcare miss out on a crucial window of brain development — foundations are laid in the first five years that can determine positive or negative life outcomes.

North Carolina policymakers should reduce the waiting list for childcare subsidies so parents can work, and support programs like Smart Start and More at Four that improve the quality of childcare in North Carolina. Congress should increase federal funds for childcare subsidies, which also help stimulate the economy.

Bucket: Work Supports. Nearly half of North Carolina’s children are living in low-income households ($42,400 or less for a family of four). Nearly a quarter of them are living in poverty ($21,200 or less for a family of four). Children who are hungry cannot pay attention in class.

North Carolina policymakers should increase the state Earned Income Tax Credit (EITC) and establish a state Child Tax Credit. The state also needs a mandatory financial education curriculum for public schools as a crucial first step in breaking the cycle of intergenerational poverty. Congress should expand the federal Child Tax Credit and enact legislation that promotes and incentivizes saving by all American families.

Bucket: Juvenile Services. Sixteen- and 17-year-olds in North Carolina are sent to adult prison for any offense however minor. North Carolina is one of only two states with such an antiquated law. Children who do not receive developmentally appropriate punishment and rehabilitative services are much more likely to go on probation with inadequate supervision or emerge from prison as better criminals than when they went in.

North Carolina policymakers should reform the juvenile justice system. The age of maturity is widely understood to be 18; 16 and 17-year-old children should not be treated as adults for minor crimes. Congress should reauthorize and adequately fund federal juvenile justice legislation.

We are all in the same boat

We need a bailout plan for North Carolina’s children. If Congress is able to find $700 billion to pump up the credit market, it can ensure every child has health insurance, permanently increase child tax credits and increase the stock of affordable housing. The cost of each of these interventions is pocket change compared to the bailout of the financial industry. And, taking care of our children makes good economic sense. Research has shown conclusively that prevention and early intervention in the lives of vulnerable children is more effective and less costly than punishment and rehabilitation for damaged adults.

We have the buckets; it is time to plug the holes. The longer we wait to bail out North Carolina’s children, the more dollars and young lives we waste. Think it does not affect you? Remember, these are the people who will someday soon be our leaders, educators, scientists, healthcare providers and businesspeople — in short, the drivers of our American economy. And we are all in that boat.

Barbara Bradley is President and CEO at Action for Children North Carolina

Dear Santa,

We know you get an awful lot of letters this time of year, so a bunch of us kids thought we'd write you together since we all want the same thing for Christmas anyway.

Some of us have just been born and others have already finished high school. We're all different races, some of us are poor and some are better off, most of us have at least one parent who works. Some of us have asthma or allergies or heart conditions or diabetes or – for now – no health problems at all. But we all have one important thing in common – none of us has health insurance.

We've seen our friends picked up early from school to go on doctor visits. We've seen them come back with “No Cavities!” stickers or glasses or asthma inhalers. But since we don't have health insurance, we don't go to the doctor or the dentist. We go to school with ear infections and bronchitis and chronic coughs. And when our teeth hurt or when we're not breathing well or when we can't see the blackboard because we don't have glasses, we get bad grades, and a lot of us drop out of school.

When we're really sick, when our fevers get too high or we have another asthma attack, our moms and dads take us to the emergency room because a doctor there has to help you even if you don't have insurance. Those visits to the emergency room usually take half the day at least. Our parents miss work, we miss school, and we've heard the care we get there costs taxpayers a LOT more money than normal doctor visits would. Seems like a bad system to us.

So, what we'd really like for Christmas this year is health insurance. We'd like to be able to go to the pediatrician for checkups like our friends do. We want to be able to get the medicine we need to keep our chronic conditions in check so we don't have to make all those expensive trips to the emergency room. We'd like to get our cavities filled, our hearing checked and listen to the doctor talk to our parents about nutrition and vaccinations and the importance of physical activity.

So we hope you can help us out. We've heard that a lot of policymakers at the General Assembly in Raleigh and in Congress in Washington have been trying hard to get us covered. Our parents say that with leaders like Governor-elect Perdue and President-elect Obama, this might just be the year. We hope our parents and other adults who care about children's health are calling, e-mailing and writing those policymakers to encourage them to get all of us covered by health insurance as soon as possible.

But for now, we're asking you, Santa. We would all sign our names to this letter, but just listing all our first and last names would make about 1,200 letters the length of this one.

Thanks and Merry Christmas,

North Carolina's 300,000 uninsured children

Delivered by Action for Children North Carolina in Raleigh