Back to School: Bringing Health Services to Children

Back to School: Bringing Health Services to Children

By Kate Breslin, Schuyler Center President & CEO

As children around the state return to school – the first nearly-normal return to school since 2019 – there is fresh attention on how to best support our children after an extended period of disruptions. 

In the two and half years since the onset of the COVID-19 pandemic, researchers and government agencies have been exploring what we know about education, child health, and mental health – and questioning traditional approaches, especially when it comes to children and families with access to fewer resources. Recent bulletins published by the federal Center for Medicaid and CHIP Services focus on strengthening mental health care and access and expanding care in schools.

Bringing Services to Children: Increasing Equity Through School-Based Health Programs

In August 2022, the Center for Medicaid and CHIP Services released two important bulletins with information about how states can improve child health. One brief focuses on school-based health services and the other on opportunities to leverage Medicaid and the Children’s Health Insurance Program (CHIP) to improve children’s mental health in the context of the nation’s child and youth mental health crisis.

Nationally, use of health care services among children declined during the public health emergency. Data show 2% fewer vaccinations, 6% fewer child screening services, 24% fewer outpatient mental health services, and 24% fewer dental services. Even before the pandemic, as many as one in six US children between the ages of 6 and 17 had a mental health disorder and in December 2021, the US Surgeon General issued an advisory calling youth mental health a crisis that has been exacerbated during the pandemic, saying that “even before the pandemic, an alarming number of young people struggled with feelings of helplessness, depression, and thoughts of suicide — and rates have increased.”

The “Information on School-Based Services in Medicaid: Funding, Documentation and Expanding Services” bulletin (8/18/22)  articulates support for school-based health programs and notes that the school setting provides a unique opportunity to enroll eligible children in Medicaid and CHIP and furnish Medicaid-covered services, including mental health and substance use disorder services. It goes on to say that schools are uniquely positioned to increase health equity and help ensure that all children have access to necessary health care services, including services provided through a formal Individualized Education Program (IEP) and Individualized Family Service Plan (IFSP). The bulletin summarizes existing guidance and strategies for states to consider in developing proposals to implement, maintain, and expand school-based health services. The bulletin includes information about existing state flexibilities and best practices for maximizing Medicaid coverage for services furnished to beneficiaries in schools. 

Screening, Diagnosis, and Treatment
The “Leveraging Medicaid, CHIP, and Other Federal Programs in the Delivery of Behavioral Health Services for Children and Youth” bulletin (8/18/22) aims to prevent the potentially lifelong consequences of unaddressed Adverse Childhood Experiences (ACEs) and other problems by providing information about EPSDT requirements and other authorities available to states to deliver effective prevention and interventions, including treatment, through their Medicaid and CHIP programs. EPSDT is a part of federal Medicaid law that requires the provision of screening, diagnosis, and treatment to correct or ameliorate physical and mental illness and other conditions. It is inclusive of vision, dental, hearing and other concerns. EPSDT is a mandatory benefit for all children and youth covered by Medicaid and, while not a federally required benefit for CHIP enrollees, New York recently elected to provide the EPSDT benefit under its CHIP state plan.

Healthy Families, Strong Communities

Schuyler Center prioritizes policies that strengthen New York families and communities, with a special focus on disenfranchised populations, by ensuring a strong and healthy start for all, regardless of income, race, and ethnicity, and by promoting robust and sustainable public systems that generate positive results for New York children and families. With 78% of low-income children in New York covered by Medicaid and CHIP, it is critical that the state use these resources to ensure that children have access to critically needed services and care. These recent bulletins and recommendations provide examples of how to do so.

Further Reading:

Child Care Is Essential Roundtable

Child Care Is Essential Roundtable

On July 22, 2020, the Empire State Campaign for Child Care (co-facilitated by the Schuyler Center), and NYS Assemblymembers Michaelle C. Solages and Ellen C. Jaffee co-hosted a roundtable on the urgent need to pass the Child Care Is Essential Act, and a federal investment of $50 billion to stabilize child care. The roundtable was attended by more than 250 New Yorkers and featured remarks by U.S. Senator Kirsten Gillibrand, NY Lieutenant Kathy Governor Hochul, U.S. Representatives Grace Meng and Adriano Espaillat, as well as numerous NYS legislative leaders, parents and child care providers. Schuyler Center’s press release details the event. A recording on YouTube is also available to watch below. 

The message conveyed by all participants of the roundtable: New York parents cannot return to work without access to affordable, safe, high quality child care. New York child care providers cannot care without the necessary financial and other support to follow stringent safety protocols, including operating at significantly reduced capacity. The Child Care is Essential Act would enable child care providers to:

  • continue operating, or to reopen, at reduced capacity to allow for social distancing
  • to cover the additional costs associated with keeping facilities and materials disinfected
  • to allow providers to make necessary infrastructure improvements, like partitioning rooms to create smaller, more contained classrooms
  • to provide essential workers quality, safe, free, or low-cost child care
  • and to ensure that child care is available to other workers as states begin to reopen

These funds could also be used by child care programs that need to scale up in a safe way to accommodate more school age children who may be attending in-person classes on a staggered basis to allow for social distancing in schools. CLASP has released a Fact Sheet detailing why it will cost an estimated $9.6 billion in public funding each month to sustain the fragile child care industry, and ensure that parents can access safe, affordable child care during the recovery. Accordingly, this $50 billion is the minimum needed to get working families back, and children back to school.

In addition, after the Child Care is Essential Act passed the House of Representatives on July 29, 2020, Schuyler Center and our partners pivoted our attention to urging members of NYS Congressional delegation to ensure the next federal COVID relief package includes at least $50 billion for child care.

Aging Out of Foster Care in the Midst of a Pandemic

Aging Out of Foster Care in the Midst of a Pandemic

On Thursday, July 2nd, 2020, the CHAMPS-NY coalition held a second press conference to highlight the need for a moratorium on “aging out” of foster care in New York State during this ongoing public health crisis. CHAMPS-NY, a statewide group of providers, advocates and thought partners, works to promote state policy and practice changes to ensure children entering foster care are placed into family-based settings whenever possible.

In the press release, our own Kate Breslin (Schuyler Center President and CEO and CHAMPS-NY co-chair) notes,

“Young people leaving foster care already face many obstacles. Now, in the middle of a global health crisis, when a safe and stable home are vital to both individual and public health, no young person should be pushed from their home or be forced to leave foster care without a family simply because they turn 21. New York needs to take simple, straightforward, and urgently needed action to ensure that young people in foster care in New York State have the option to remain in foster care after their 21st birthday, and for at least 180 days after the last region in the state has fully reopened.”

Since the pandemic began, nine states have taken executive action to protect youth in foster care.

View the press conference video below. 

 

Leading Child Care Advocates Join with Schuyler Center to Urge the NYS Congressional Delegation to Prioritize Children and Families in the Next Federal Stimulus

Leading Child Care Advocates Join with Schuyler Center to Urge the NYS Congressional Delegation to Prioritize Children and Families in the Next Federal Stimulus

The COVID-19 pandemic has dealt a terrific blow to families and communities in New York and the systems that provide essential health and human services. Even as the State begins to recover, it is clear that those already facing challenges of poverty, disability, ill-health, racial discrimination, and poor mental health were ravaged by this illness. These same families have also been more sharply impacted by school closures, layoffs, supply shortages, social distancing, and other fallout of the COVID-19 pandemic.

The plain truth is that while the pandemic abruptly ruptured the often tenuous yet interconnected systems on which poor families rely, New York cannot rebuild alone. It will need extraordinary support from the federal government for state and local governments to pull out of this crisis and into recovery. Federal funds are essential to prevent New York State from slashing social services, education, child care, child welfare, and other family and child-serving programs.

On July 20, New York State child advocates joined together to urge Congress to stand firmly with children and families during negotiations on the next federal stimulus package. These advocacy organizations, dedicated to improving the lives of New Yorkers, particularly children living in poverty and in marginalized communities, outlined a set of appropriations and actions that need to be included in the next federal stimulus package to support families with young children and keep many of them from slipping into intractable poverty.

View our letter to the Members of the New York State Congressional Delegation.[/vc_column_text]

Our Impact 2020

Our Impact 2020

The COVID-19 pandemic has forced every one of us—individuals and organizations—to re-evaluate all aspects of our lives, but one thing remains certain: Schuyler Center’s work is as important as ever.

The racial, social, and economic disparities evidenced by this deadly virus cannot be overlooked. It is abundantly clear that the novel Coronavirus does discriminate. A family’s neighborhood, income level, and race and ethnicity are all significant contributing factors to whether someone gets and dies from this deadly disease, and the extent to which their community is affected.

Over the last several months, we have introduced Policy Priorities for Building Back Better: Putting Children in the Center of Recovery. We have effectively shared data which highlights the historical and ongoing racial discrimination in employment, housing, and education, among other realms, causing New York children of color to experience poverty, near poverty, and insecure parental employment, at approximately twice the rate of white children. We have also promoted that New York’s refundable tax credits exclude some of the very New Yorkers most likely to live in poverty, yet this tax policy is among the most effective strategies for reducing poverty. We are excited to showcase our work and thank our incredibly generous supporters with this report demonstrating our focus on preventing families from hardship.

For almost 150 years, the Schuyler Center has advanced effective and inclusive public policies that put children and families first. Today we continue to focus on income inequality and its ill effects on the health and well-being of New York families. We hope you will join our fight to shape policy so racial inequalities highlighted by COVID19 don’t continue to exist—with this virus, or the next one.

Read about the details and impact of our work:
Schuyler Center’s Work 2020
President’s Message: Our Work Is As Important As Ever!
Donate Now![/vc_column_text]

#ChildCareIsEssential Press Conference and Virtual Rally

#ChildCareIsEssential Press Conference and Virtual Rally

On June 11, 2020, Schuyler Center along with the Empire State Child Care Campaign, Winning Beginning NY, and other partners, hosted a press conference and virtual rally on the importance of child care in reopening New York’s economy and for the well-being of New York children and families. More than 500 parents, child care providers and advocates as well as state legislators, virtually came together to urge New York and federal leaders to invest in child care NOW.

Our message: There is no more time to delay. New York cannot recover without child care.

We organized this event because we’ve been hearing from more parents every day that they’re being called back to work, but don’t have a plan for their children. School is over. Many camps are cancelled or uncertain about reopening, and many child care providers are still closed. Those child care providers that are open, or re-opening, must operate at reduced capacity and follow intensive new safety and cleaning protocols. Without a way to cover the high costs associated with these new rules, there is a risk that many, if not most of New York child care providers will be forced out of business. And yet, New York still has no sustainable plan for ensuring parents access to safe, affordable child care.

The press conference featured remarks by two parents about the challenges they have faced balancing work and caring for their children during the pandemic, and their fears about finding and affording safe, quality child care in the coming months. Paulette Guerrero-Duran, a parent from Staten Island, spoke about her concern for child care providers and schools. She said juggling homeschooling and working full time during the pandemic has been one of the most difficult challenges she’s faced. She also voiced concern that child care centers need the proper resources, as well as a solid safety plan, for her to be able to return to her office. Vonetta Rhodes-Osi, a parent, former child care provider, and an essential worker who’s been required to work outside her home throughout the pandemic, discussed her concerns about being able to afford child care because her work hours have decreased. “Parents are struggling. Government must provide support.”

Alicia Marks, Director of Marks of Excellence Child Care in Suffolk County, said if you want to know how families are doing in New York, ask a child care provider. They’ve become a part of the vital workforce engine that keeps the economy sound. Rebecca Gonzales, Director of Time to Learn Day Care in the Bronx said, “child care providers are screaming for help to get more funding.”

Assemblymember Ellen Jaffee spoke not only as a legislator, but as a mother, a grandmother, and a former educator. “We cannot recover from the devastating impacts of COVID-19 without childcare. New York parents struggled to afford child care before the pandemic. How are they going to cover that cost now?” She called upon Governor Andrew Cuomo to immediately invest the remaining $134 million in emergency child care CARES Act Funds according to the plan recommended by New York’s Child Care Availability Task Force—a Task Force she fought hard to create.

We also heard from Assemblymember Andrew Hevesi who, as a parent himself, understands that parents need to get back to work but cannot do so without safe, quality, secure child care. Senator George Borrello thanked all the child care providers who’ve continued to work throughout the COVID-19 crisis and acknowledged, “We cannot rebuild our economy without the foundation of child care.” Assemblymember Michaelle Solages added, “We are fighting a crisis within a crisis within a crisis…We need to be smart, and we need to be loud.” She stressed that children are depending on both state and federal lawmakers to wake up and focus on child care. She urged Congress to allocate $50 billion to child care in order to get New York, and the rest of the country, back to work.

Closing out the press conference was Gladys Jones, leader of ECE on the Move. “New York State will not be able to revive if we don’t resurrect childcare.” No industry will be able to go back to work in New York State without it.

We ended our press conference and rally on a call to action: what is needed right now to save the child care industry is to speak up! Harness this energy and reach out to your lawmakers.

Missed our press conference? You can watch it now below, or on Youtube
Want to contact your legislators? Find their twitter handles in the #ChildCareIsEssential tweet toolkit
Read our press release.

Data:
Washington Post: Workers face cuts to hours, pay, as they return to old jobs during the coronavirus pandemic
Raising New York Child Care Availability: New York State Profile