Voices empowers children, youth, and families who are disproportionately impacted by inequitable systems as agents in the creation of policy solutions that will ignite change in their communities. Through Racial Truth and Reconciliation Virginia and other partnerships, coalitions, and workgroups, Voices embraces a variety of perspectives, including that of direct-service professionals and policy professionals, to guide our work. Our aim is to always create trauma-informed and healing-centered spaces for advocates to share their truths and reconcile trauma through systems change.
Far too long, policies in our country and Commonwealth perpetuate structural racism – interpersonally, institutionally, and systemically. This is evident among the disparities in access and outcomes across income and wealth, educational opportunities, and health. As Voices seeks to advance public policies that improve the well-being of Virginia’s children, we champion policies that promote an equitable distribution of resources, eliminate barriers to achieve fair and equal participation, and dismantle the social and institutional biases that create systemic inequities.
Voices’ Topic Areas:
Health & Wellness
Virginia and the nation face dual pandemics – COVID-19 and racism as a public health crisis. We must create new and improved practices to improve health outcomes. The COVID-19 pandemic has further highlighted the importance of access to health insurance, the need to enroll more children and parents, and allowing families to keep their Medicaid/FAMIS coverage through the public health emergency. The expanded health insurance safety net for children, pregnant women, and adult caregivers has enabled an additional 116,000 children to enroll in health insurance coverage during the pandemic.
However, access to health care does not end with having insurance. Equitable access to health care includes accessible health care services in communities. It includes health care that promotes the long-term improvement of health outcomes and environments in which patients are treated with dignity and respect, and given culturally appropriate care, regardless of their race or ethnicity.
Health Care Access Priorities
- Support “Cover All Kids” proposals to extend health insurance to children who may lose coverage at the end of the public heath emergency and to expand coverage to undocumented children.
- Policy changes to align with federal continuous eligibility processes that will allow children enrolled in Medicaid/FAMIS to keep coverage without time consuming and confusing redetermination processes.
- Implicit bias training for medical professionals in alignment with PUSH Coalition (Virginia Interfaith Center)
Maternal & Infant Health
Virginia has made significant progress in supporting policies to address disparities in maternal and infant health outcomes by improving access to health insurance for more pregnant women and creating a Medicaid-funded doula benefit. However, given the significant disparities that still exist in maternal and infant health for Black mothers and their children, more work is needed.
Maternal Health Priorities
- Ensure the full implementation of maternal health insurance coverage policy changes, including FAMIS prenatal coverage implemented in July 2021 as well as the 12-month postpartum coverage and doula benefit planned for spring 2022.
- Expand access to home visiting services for pregnant women and new moms by creating a Medicaid-funded benefit.
- Establish local pilots for “Maternal Health Hubs” of community-based, collaborative models focused on supporting pregnant women with their financial, health, and mental health concerns.
- Establish an interagency Fetal and Infant Mortality Review Team to evaluate health outcomes for pregnant women and newborns.
Early Childhood Care and Education
Parents have to pay too much for child care and early childhood professionals have earned too little. To solve this dilemma, we need more public investment in a mixed-delivery system of early education and preschool that must include home-based providers, private child care centers, and public schools. We must also measurably improve compensation for early childhood professionals and provide more support for families needing infant and toddler care.
Early Childhood Care and Education Priorities
- Stabilize the child care sector by encouraging the use of grants and contracts, particularly for settings ideal for infants and toddlers and in child care deserts.
- Maximize participation in state-funded Virginia Preschool Initiative programs by improving flexibility to support public-private partnerships and to recruit and retain qualified professionals.
- Make the COVID-era changes to eligibility for the child care subsidy program permanent, including higher income eligibility, allowing for eligibility during job search, and reducing/eliminating parent co-pays.
The child welfare system has not provided enough support to kinship caregivers and to young people aging out of foster care. One barrier to recruiting more kinship caregivers into the formal system is that they may not qualify for financial support and services if they have been convicted of a barrier crime. In addition, youth exiting foster care have great difficulty attending post-secondary education and gaining employment due to a variety of issues.
Child Welfare Priorities
- Improvements to the formal kinship system to allow more families to participate by providing additional resources to facilitate placements. Remove barriers to participation and placement with foster families by addressing the list of crimes that prevent individuals from becoming foster placements, even when crimes are far in the past.
- Support for the Great Expectations program at community colleges to serve more students or recruit students.
- Replacement of the outdated child welfare data management system.
- Further implementation of the Family First Prevention Services Act to prevent children from entering foster care and continued efforts to recruit and retain a child welfare workforce.
Family Economic Security
Improvements in childhood poverty in Virginia was stagnant before the pandemic and today’s poverty levels remain the same. There is inadequate relief targeted to communities of color, not moving the needle to address disparities by race or region. Achieving economic stability in the future will require new considerations of safety net support by removing work eligibility requirements, removing time limits, and offering more flexible uses of economic support.
Family Economic Security Priorities
- Eliminate work participation requirements for child care assistance and reduce work participation sanctions for cash assistance (Temporary Assistance for Needy Families or TANF).
- Ensure flexibility in the timeframe that eligibility is determined and redetermined for child care, cash assistance, or health insurance.
- Additional funding to promote tax filing resources and outreach to benefit families who have earned too little for child tax credit, and newly eligible young adults for the expanded Earned Income Tax Credit.
Offering mental health support for children should be normalized whenever and wherever the need arises — with a health care provider, at child care, school, and within the community. Better access for children to receive care from diverse and qualified professionals is needed. Services should be culturally appropriate as it relates to language access, workforce diversity, and other identities children and youth may embrace including religion, race and ethnicity, and gender identity. This requires opportunities to eliminate barriers and to increase incentives and supports to get qualified professionals in the behavioral health and mental health workforce pipeline.
Mental Health Priorities
- Attract a diverse workforce by offering incentives to enter the behavioral health field, achieve licensure, and receive appropriate compensation.
- Increase community-based funding for mental health initiatives, such as additional resources for comprehensive services at Community Services Boards and enhanced Medicaid reimbursement rates at public and private providers.
- Connect schools and mental health providers by encouraging collaboration among systems and between clinical providers and schools to offer more intensive, Tier 2 & Tier 3 supports.
- Provide resources in state government and state agency leadership to work across systems to address children’s mental health and to maximize Medicaid funding.
Food and Nutrition Access
Children can learn and thrive when they are fed and have access to healthy and nutritious foods. While significant efforts to improve food security have been in place during the pandemic – including increased access to SNAP, Pandemic EBT and universal school meals – many children in Virginia lack access to healthy and affordable meals. Policy solutions must include increasing economic access to healthy and nutritious foods by investing in retail infrastructures and programmatic initiatives to combat food deserts.
Food & Nutrition Access Priorities
- Fund Produce Rx Program to provide Medicaid reimbursement for healthy foods.
- Increase support for the Virginia Food Access Investment Program Fund.
Improving Access & Eliminating Barriers For Fair Childhoods
Achieving equitable access services requires cross-system coordination and public-private partnerships that extend beyond how systems are designed. Policymakers should improve language accessibility, community resources, and care coordination to use resources more effectively and improve outcomes for families.
- Improve language access, including the Office of Diversity, Equity, & Inclusion, language navigators, language coordinators, a language access website and hotline to serve as a hub for resources and navigation.
- Continue the Children’s Cabinet with a significant focus on including the perspectives of children and families.