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Author Archives: Emily Moore

  1. 2023 General Assembly Budget Passes with Significant Investments for Youth and Family Well-Being

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    In the world of politics and public policy, budgets play a pivotal role in driving change and progress. They serve as the financial blueprints that determine the extent and influence of services and programs in our communities.  

    The 2023 final budget arrives at a critical juncture, coinciding with a pressing crisis in youth mental health and a period where families are grappling with heightened poverty levels compared to the past three years.  

    In this blog post, we will illuminate key budget areas that have a direct impact on young people and their families. Additionally, you can stay informed by signing up for our policy newsletter, as we’ll be sharing insights into Governor Youngkin’s signature budget proposal in December. 

    Notable investments in the final budget compromise 

    For a full overview of bills we supported, monitored, and opposed, visit our 2023 Legislative Agenda and Outcomes page. 

    Early Care and Education

    Promoting accessible and affordable early education and child care helps families work and helps children learn.

    No additional money was included in the budget for Child Care Subsidy, Virginia Preschool Initiative (VPI), or Mixed Delivery – the package reflects funding levels in the biennial budget.  

    • The budget did include authorization of waivers for altering staff-to-child ratios in licensed child day centers and child day centers that participate in the Child Care Subsidy Program. To read the full details, click here. 

    Mental Health 

    We will not accept a mental health system that treats children and youth as “phase two” — our system should prioritize children and youth to foster a lifetime of mental health and wellness. 

    The 2023 budget creates a strong foundation for building and supporting a comprehensive continuum of mental health services that span from prevention to crisis. Many of the investments reflect components of Governor Youngkin’s signature behavioral health proposal, “Right Help, Right Now.” We are pleased to see a priority on youth mental health and an effort to transform the system to offer services and support whenever and wherever young people need them. 

    • $58 million to expand and modernize the comprehensive crisis services system (additional Crisis Receiving Centers, Crisis Stabilization Units, and enhancements to existing sites)  
    • $10 million in one-time funding for mobile crisis units in underserved areas  
      • There are currently 32 mobile crisis teams across the Commonwealth 
    • $4.2 million in additional funding for children’s behavioral health services, bringing total funding to $12.6 million (first increase since 2017) 
      • The compromise does not include the updated language suggestions, which would have supported flexible use of the funds 
    • $10 million for up to 3 comprehensive psychiatric emergency programs in emergency departments, including public-private partnerships  
    • $5 million in additional funding for school-based mental health integration grants through public or private provider partnerships, bringing total funding to $7.5 million 
      • The compromise does not remove the word “pilot” from the language, as the Governor’s budget proposed 
    • 10% rate increase for Medicaid-funded community-based services ($8.7 million):  
      • Intensive In-Home, Mental Health Skill Building, Psychosocial Rehabilitation, Therapeutic Day Treatment, Outpatient Psychotherapy, Peer Recovery Support Services — Mental Health 
      • Comprehensive Crisis Services (23-hour Crisis Stabilization, Community Stabilization, Crisis Intervention, Mobile Crisis Response, and Residential Crisis Stabilization), Assertive Community Treatment, Mental Health – Intensive Outpatient, Mental Health – Partial Hospitalization, Family Functional Therapy and Multisystemic Therapy 
    • $4.4 million inflation adjustment for the first three STEP-VA services: Same Day Access, Primary Care Screening, and Outpatient Services
    • $4 million in additional funding for Virginia Mental Health Access Program (VMAP) to expand to early childhood mental health and perinatal mental health, bringing total funding to $10.8 million  
    • $1.5 million for the Behavioral Health Loan Repayment Program for psychiatrists, licensed clinical psychologists, licensed clinical social workers, licensed professional counselors, child and adolescent psychiatrists, psychiatric physician assistants, psychiatric pharmacists, and psychiatric nurse practitioners
    • $18 million for a 5% salary increase for Community Services Board (CSB) staff, effective January 1, 2024
      • This increase is in addition to the 2% increase for state supported local agencies

    Child Welfare 

    The child welfare system was created to address family disruptions and to protect children and youth; the future of the system focuses on preventing disruptions and giving youth the tools to succeed. 

    We are glad to see the investments to support kinship caregivers—it is past time that we provide similar levels of support to relatives and kinship caregivers that we provide to foster parents. Unfortunately, funding was not included for the Driver’s License Program for foster youth that we have been working towards since the funding was unallotted during the COVID pandemic. We are also disappointed to see that funding was not included for the Parent Legal Representation Pilot. Both of these issues were identified during the Foster Care Caucus meeting in February as priorities for supporting children and families involved in the child welfare system. 

    • Salary increases for local child welfare workers – $30 million 
    • Training and QA for Local DSS – $10.5 million  
    • Continue of the Enhanced Treatment Foster Care Pilot – $1.1 million 
    • The Dept. of Social Services (DSS) shall develop a plan to provide access statewide to a Kinship Navigator Program which will provide services to kinship caregivers who are having trouble finding assistance for their unique needs and to help these caregivers navigate their locality’s service system, as well as federal and state benefits (language only) 
    • Support for Safe and Sound Taskforce – $3 million 
    • Implement pilot programs that increase the number of foster care children adopted – $3 million 
    • Foster care agencies to cover the costs of coordination, recruitment, and additional training – $200,000 
    • The DSS shall create an emergency approval process for kinship caregivers and develop foster home certification standards for kinship caregivers  
    • Development of collaborative partnerships between local departments of social services to increase capacity to approve kinship caregivers and recruit, train, and develop locally approved foster parents – $600,000 
    • Implement Office of the State Inspector General (OSIG) child protective services recommendations – $8.2 million 
    • Convene a workgroup to examine inclusion of residential treatment services in managed care (language only) 

    Health Care Access 

    All children in Virginia must have accessible health care regardless of income, race, ethnicity or geography. 

    While there are investments to address workforce needs and reimbursement rates, the budget did not go as far as it could have to ensure all children have access to health care coverage and high-quality care. The budget did not include funding for Cover All Kids or the Medicaid benefit study for Community Health Workers, both of which would have contributed to young people having uninterrupted access to culturally-responsive health care, particularly non-citizen children with undocumented status. 

    • $38 million NGF to support Dept. of Medical Assistance Services (DMAS) and local Dept. of Social Services (DSS) agencies during the 14-month Medicaid unwinding period  
      • This funding was allocated in the “skinny” (stopgap) budget passed by the General Assembly and Governor in April 2023 while full budget negotiations were still taking place 
    • $3 million in additional funding for the Nursing Preceptor Incentive Program, bringing the total funding to $3.5 million  
      • Adds Licensed Practical Nurse and Registered Nurse to the list of providers who are eligible for the program 
    • DMAS has authority to begin the reprocurement process for managed care services 
      • The RFP was released August 31, 2023 and DMAS is preparing for a summer 2024 implementation 
      • The procurement reflects DMAS’ goals to improve services, delivery and access in Right Help Right Now Behavioral health focus, maternal and child health, member engagement, single specialty plan for foster care, innovation, new technology, performance and quality improvement incentives, new payment models and increased accountability 
      • Cannot include any new services in the contract unless authorized by General Assembly 
      • Cannot create any future funding commitments unless authorized by General Assembly 

    Family Economic Security 

    Experiencing economic hardship impacts every aspect of a child’s life; a child cannot be healthy or ready to learn unless their family budget can provide for their day-to-day needs. 

    The Governor’s proposed budget included nearly $1 billion in permanent, costly, and untargeted tax cuts that disproportionately benefited wealthy individuals and corporations. The compromise provides $96.2 million in permanent tax cuts, preserving funds in future budgets to be invested in critical and underfunded services, such as education and health care. 

    • During tax year 2024, there will be a modest increase for the state standard deduction ($8,500 for single filers and $17k for joint filers): budget impact = $48.1 million 
    • This fall, taxpayers will receive one-time rebates of $200 for single filers and $400 for joint filers: budget impact = $906.8 million  
      • These are nonrefundable, which will leave out some of our lower-income community members.  
      • These rebates also do not take into consideration family size. 
    • Lawmakers unfortunately failed to advance legislation to continue strengthening Virginia’s Earned Income Tax Credit (EITC) or establish a state Child Tax Credit (CTC). 
    • The budget does not include the 10% increase in Temporary Assistance to Needy Families (TANF) eligibility and assistance that the Senate proposed 
    • The budget does not include the proposed increase in funding for the “Virginia CASH Campaign” to support tax filing preparation at community action agencies 

    Student Belonging and Connection 

    Positive school climates are necessary for students to feel safe, accepted, and connected to their school environments. 

    While the budget invests over $600 million in our public school system, the one-time nature of this funding limits our ability to address the long-term implications of workforce shortages and the immediate need for wraparound student supports. 

    • $152.3 million to get Virginia closer to lifting the cap placed on school support staff.  
    • $418 million in flexible one-time support for the implementation of the Virginia Literacy Act, learning loss recovery, and additional operating and infrastructure support 
    • $54.6 million for the state share of an additional 2% salary increase for school personnel 
      • A 5% increase was already budgeted, bringing the total salary increase to 7% 
    • By not increasing funding for the Virginia Tiered Systems of Support, the budget fails to invest in a positive behavioral interventions and supports program and professional development for educators focused on trauma-informed care 

    Additional Investments for Young People 

    Young people deserve a world where their potential is not predictable by race, gender identity, socioeconomic status, or geography. But as we know, there are barriers present that prevent young people and their families from thriving. The budget includes measures to address some of those barriers, such as funding to facilitate language access at state agencies and funding to support holistic, community-based strategies to address community violence and gun violence. 

    • $2.5 million for state agencies to facilitate and improve language access
      • Virginia Dept. of Social Services (VDSS) and Secretary of Health and Human Resources (HHR) to develop a process for receiving requests and administering the grants to state agencies 
    • $10 million for the Safer Communities Program 
      • Supports strategies that address the root causes and conditions of community violence, such as after school programs and mentorships, connections to education and economic opportunities, and trauma-informed mental health care 
      • Establishes the Office of Safer Communities under the Dept. of Criminal Justice Services (DCJS) 
    • $5 million in additional funding for the Firearm Violence Intervention and Prevention Fund to support community engagement and youth programs 
    • Dept. of Juvenile Justice (DJJ) required to provide report to General Assembly money committees by December 1, 2023 on the impact of the Length of Stay Guidelines that were adopted by the Board of Juvenile Justice in November 2022 

  2. Child Poverty is a Policy Choice

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    On September 12, the U.S. Census Bureau released the findings of three reports estimating income, poverty, and health insurance coverage in the United States. According to the Supplemental Poverty Measure (SPM), the overall rate of poverty increased from 7.8 percent in 2021 to 12.4 percent in 2022. The most dramatic change, however, was the sharp increase in child poverty.  

    Child poverty increased from a record low of 5.2 percent in 2021 to 12.4 percent in 2022, largely due to expiration of the expanded child tax credit. 

    The Supplemental Poverty Measure (SPM) indicates that poverty rates increased for all groups of children, but Black and Hispanic children continued to experience disproportionately high rates of poverty. 17.8 percent of Black children and 19.5 percent of Hispanic children experienced poverty in 2022, compared to 7.2 percent of non-Hispanic white children.  

     
    U.S. Census Bureau, Poverty in the United States: 2022

    Understanding the Child Tax Credit

    In 2021, as part of the American Rescue Plan, the expanded Child Tax Credit (CTC) was implemented to provide advanced monthly payments at an increased amount to families to help them put food on their tables and pay for their day-to-day needs.  

    The CTC was fully refundable, which means it was available to families who had no reported earnings or federal income tax liability. And the expanded CTC worked—it kept 2.9 million children of out poverty, cutting the child poverty rate almost in half to a record low, and reduced the poverty rate of Black children and Hispanic children by 6.3 percentage points each. 


    Center for Law and Social Policy (CLASP), “How to End Child Poverty for Good” 

    Unfortunately, the expanded CTC expired at the end of 2021, leaving over 350,000 children in Virginia ineligible for the full Child Tax Credit because their families’ earnings are too low or because there are no adults in the workforce.  

    At a time when inflation has made it even more difficult to afford necessities like housing, food, and utilities, the end of pandemic-era benefits has made it increasingly difficult for families to support the health and wellbeing of their children.  

    As monthly child tax credit payments ended and families’ incomes decreased, the child poverty rate increased, and families experienced more financial strain and higher levels of food insecurity. 

    When parents and caregivers cannot provide the necessities to keep their families well, they feel stressed, and their children are impacted by this stress and lack of resources. For families to achieve economic stability, we must intentionally remove barriers to thriving. 

    Poverty is often a result of policy decisions made by lawmakers rather than choices made by individual families and communities. Our federal and state lawmakers witnessed the benefits of policies like the expanded CTC, continuous Medicaid coverage, and SNAP emergency allotments, and still decided not to extend the support or make them permanent programs.  

    Virginia made progress in 2022, when the General Assembly approved a state refund for a portion of the Earned Income Tax Credit (EITC) available to low-income working families. Additionally, the 2023 state budget, passed in September 2023, will provide one-time tax rebates of $200/$400 this fall to individuals or couples with taxable income. Unlike the EITC, these rebates are nonrefundable, and family size will not be factored into the payment—only marital status. Nonrefundable rebates benefit households with an income tax liability, whereas refundable rebates benefit all households. A rebate program should be well targeted and family-friendly by making rebate checks refundable and by accounting for dependents—then a wealthy individual making $300,000 a year does not receive the same amount as a working mother of 2 children making $60,000 a year. Clearly there is more that must be done to support families and address this sharp increase in child poverty.  

    As we near the 2024 legislative session, when our General Assembly members will be making decisions for our next biennial budget, developing a state-level Child Tax Credit and expanding the state-level EITC will be imperative to supporting families’ economic stability.

    Establishing a State-level Child Tax Credit

    Establishing a state-level CTC would benefit more than 1 million children in Virginia. As detailed in the 2023 legislation introduced by former Senator Jennifer McClellan and Delegate Kathy Tran, the state-level CTC would create a refundable $500 child tax credit per child under 18 in households earning less than $100,000 each year.  

    The temporary expansion of the federal CTC demonstrated that direct cash support to families is one of the best ways to help them meet their needs and research on the federal child tax credit found that families used the additional funds to pay for food, utilities, and clothing.


    The Commonwealth Institute for Fiscal Analysis (TCI), January 2023

    Voices, alongside our partners at The Commonwealth Institute for Fiscal Analysis (TCI) and the Tax Fairness Coalition, will be pursuing state-level CTC legislation during the 2024 General Assembly session. Sign up for our Policy newsletter, Voices from the Capitol, to stay up to date on how you can advocate for a state-level CTC during the 2024 General Assembly session. 

    Expanded State-level Earned Income Tax Credit

    Over 600,000 families in Virginia currently receive the federal EITC. As of 2022, Virginia gives tax-filers an option: claim a state-level EITC up to 20 percent of a family’s federal EITC that does not exceed any income tax owed or claim a state EITC at 15 percent of the federal EITC and receive a refund of the amount that exceeds what was owed in income taxes. Making Virginia’s version of the credit refundable means that instead of just reducing how much a low-income tax filer owes without giving money back, the refundable EITC can now lead to a bigger refund or provide a refund that otherwise wouldn’t exist. The exact size of the credit depends on a tax filer’s income, marital status, and how many children they have. Check out this blog from The Commonwealth Institute (TCI) on the impact of Virginia’s EITC options.  

    Continuing to strengthen Virginia’s EITC to make the credit refundable at 20% of the federal credit would go even further to benefit families and provide economic relief to those who need it most. Delegate Cia Price championed a bill during the 2023 legislative session to expand the EITC to 20 percent of the federal credit, but it unfortunately did not pass. Lawmakers should prioritize bringing this bill back during the 2024 legislative session. 

     

    By targeting tax credits to low-income families, these refunds benefit Black and Brown families who have been disproportionately impacted by low wages and policies that created racial inequities in access to wealth.  

    As indicated in the 2023 KIDS COUNT Data Book, Black children in Virginia are more likely to live in poverty and have a parent who lacks full-time, year-round employment. Choices to expand the EITC and to target a state-level Child Tax Credit can provide more financial resources to the families who have often been left behind. 

    When we prioritize children and families in our policy choices, we can strengthen our future. It’s time to deepen our commitment to ensuring that families have the resources needed to thrive by offering targeted tax relief to families.

  3. Health, Healing, and Hope for Children: Voices’ trip to the Children’s Hospital of the King’s Daughters

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    Pictured above, from left to right: Jack Warburton, VP of Mental Health Service Line at CHKD; Stephanie Osler, Director of Mental Health Service Line at CHKD; Allison Gilbreath, Sr. Director of Policy and Programs at Voices; Rachael Deane, CEO at Voices; Emily Moore, Policy Analyst and Voices; and Bryant Thomas, VP of Advancement at CHKD 

    Take a moment to think about the way you would describe an inpatient psychiatric care facility. Do words like “sterile” and “institutional,” and maybe even “uninviting,” come to mind? I think many of us imagine white walls, speckled tile floors, and no natural light. The Voices team was lucky to see a new approach and a different reality last week when we visited the Children’s Pavilion at Children’s Hospital of the King’s Daughters (CHKD) in Norfolk.  

    The Children’s Pavilion is a holistic wellness checkpoint for young people, offering general pediatrics and sports medicine in addition to inpatient and outpatient mental health services. Housing all these services under one roof supports the integration of mental and physical health care, reducing stigma and ensuring young people get the full breadth of care they need to thrive. Of course, we as professionals were thrilled to see these services available, but the real question was, “How do you make this a place that young people and their families feel comfortable coming to for support?” The answers became abundantly clear as Jack, Stephanie, and Bryant (pictured above) gave us a tour.  

    From the moment you exit the parking garage, you are met with vibrant colors, comfortable seating options, and an abundance of natural light. As we have noted in a previous blog post, designing physical facilities with young people’s needs in mind is just as critical as the design and implementation of services. So, while we were there to learn about their mental health services, we quickly became interested in the physical, built space and the “why” behind their design choices.

    Artwork from Massachusetts artist Joseph Wardell in the garage lobby with CHKD’s mission statement, “Health, Healing and Hope for All Children” 

     

    Some highlights of how CHKD’s built environment is trauma-informed, healing-focused, and family friendly are:  

    • Vibrant artwork in a variety of mediums, from blown glass to kinetic sand art to repurposed old vinyl records: CHKD has a webpage dedicated to showcasing the use of art to create a healing environment.   
    • Space for play: The top floor of the Pavilion towers 14 stories over the Hampton Roads area, with incredible views of downtown Norfolk, the Elizabeth River, and the naval ships nearby. But that’s not even the best part—the top floor is dedicated to recreation, featuring a basketball court, a grassy turf area, and horticultural benches for gardening.  
    • Creative expression: The 13th floor integrates inpatient beds with opportunities to be creative, through an indoor exercise studio, a music therapy and recording studio, and an art therapy room.  
    • Keeping patients safe: The inpatient rooms were designed with both comfort and safety in mind. They have textured walls for soothing sensory input, color changing lights above the bed, and large windows with a view of the naval ships and water. But the elements that are less obvious and extremely important are the safety features like the specially designed door handles, impact-resistant glass and drywall, and concealed sprinklers. 
    • Family lounge: A space for family members to grab a snack, take a breather, catch up on work, and connect with other parents who are navigating a similar journey.

     

    CHKD’s Art Therapy Room

    CHKD’s Indoor Recreation Center

    When planning for the Children Pavilion’s design and programming, the focus on integrating family members into their child’s care was at the forefront. Stephanie shared with us that visiting hours for family members are very liberal—families don’t have to adhere to the typical 8 am to 8 pm visiting hours that you would see at most hospitals. Instead, the inpatient rooms are private rooms equipped with two beds so that a parent or caregiver can spend the night. We know the importance of engaging families as partners in the mental health treatment of their children, as a young person’s mental health needs do not exist in a silo outside of their family and environment.

    We were blown away at the intentionality and care put into providing support to young people at the Children’s Pavilion. And we were also curious about what happened when a young person left the facility and went back home and into their community. What does the follow through and continuum of care look like at a time when mental health services for young people are scarce and providers have long waiting lists? Jack shared that in addition to community partnerships and referrals, CHKD has five locations in surrounding communities to provide outpatient therapy, intensive outpatient care, and partial hospitalization services. Continuity of care is deeply important, so CHKD clinicians and social workers ensure that there is a discharge plan in place and do their best to connect children to community-based support as needed.  

    But as we are seeing across the Commonwealth, there are still barriers to ensuring all children have access to mental health care in their communities. CHKD is not immune from the challenges we are seeing across the mental health field, including struggling to fill enough positions to have a robust workforce that meets the immense need and navigating reimbursement rates that do not accurately reflect how much it costs to provide care.  

    As the Virginia Health Care Foundation points out in their Assessment of the Capacity of Virginia’s Licensed Behavioral Health Workforce, we suffer from a severe shortage of child and adolescent psychiatrists and 3.2 million Virginians live in a federally-designated Mental Health Professional Shortage Area. CHKD is fortunate to have been able to hire 17 child and adolescent psychiatrists for the Children’s Pavilion, but they still face barriers with insurance credentialing and reimbursement rates. They acknowledged how restrictive the regulations have been regarding who can provide care and who can get paid for providing the care—for example, there are complicated billing processes for residency and counseling students who are working towards licensure. Voices was proud to share that there was legislation passed during the 2023 General Assembly session (HB 2262) to streamline insurance credentialing and remove administrative barriers to new clinicians getting paid in a timely manner through managed care insurance organizations (MCOs). 

    Takeaways and Hopes for the Future 

    Voices’ CEO Rachael shared that this visit was inspiring to her as a professional, but even more so as a parent. At a time when Virginia ranks 48th in the nation for youth mental health, we find hope in the collective efforts to transform the way Virginia provides mental health care to young people. We also know that there is a long road ahead until we have a truly comprehensive continuum of mental health care across the state. This path forward is one that requires investment from our state lawmakers and our localities, and one that allows us to look beyond the current system to reimagine what is possible and create a world where children and youth can thrive. 

    We have a roadmap to transform our behavioral health system through expanding school-based mental health services, investing in more youth-serving community crisis supports, and supporting the workforce in our Community Services Boards and private providers. We also have a commitment from our Governor and bipartisan support from state lawmakers to invest a historic amount of funding into transforming this system. We are hopeful that we will soon see a final budget that acknowledges the importance of these investments and puts young people’s mental health needs at the forefront. When the investments are made, we look forward to seeing many of these healing elements that we saw firsthand at CHKD be incorporated into the implementation of new and expanded services across the Commonwealth.  

  4. Young People are Leading. Are We Ready to Follow?

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    This blog was written by Voices Summer Fellow, Cat Atkinson, MSW, in collaboration with Virginia’s Youth in Action (VAYA) alum, Kayla Bravo.

    Civic Engagement, or Political Engagement, is defined as actions that can be taken to improve a community through influence and participation in decision-making (Ballard, Borden, & Perkins, 2021). Civic actions encompass a wide range of participation strategies from community service to voting, from advocacy work to movement building. The various forms of civic engagement highlight the reality that anyone and everyone can be a part of the legislative and decision-making process if given the proper tools and knowledge to access an unfortunately elusive system. At Voices, we ground our advocacy work and youth programming within this reality and ensure that we provide a bridge for folks who are frequently left out of the political arena to civically engage with their lawmakers and within the lawmaking process in Virginia.  

    Many factors, including a person’s intersecting identities, their beliefs of whether their action will create change, their values and ideologies, sociodemographic statuses, and community conditions impact their interest and participation in civic actions (Chryssochoou & Barrett, 2017). For young people specifically, we also must consider familial and community civic participation, civic education, whether formal or informal, and geographical access. Kayla B., a young adult advocate, civic participant, and member of Virginia’s Youth in Action (VAYA) inaugural cohort, shares her experiences with civic immersion and engagement growing up in Arlington, VA.  

    “I am a first-generation Latine woman and first-generation college student. My parents had me at 19 – my mother was a high school dropout, and my father did not have the stability and resources to continue a formal education after high school. My father only just became an American citizen earlier this year but before then, neither of my parents were able to vote. My mother, who is still not an American citizen, had many issues regarding her immigration status during my childhood and was discouraged from exercising her political power as a constituent of her community. Moreover, because my parents (young, uneducated, blue-collar Hispanic immigrants) were so different from the other parents (old, educated, third generation+, white-collar, white people) of the children I went to school with, there was resistance on both parties to connect and participate in civic engagement together. 

    I was raised in Arlington, Virginia, an extremely wealthy county since it is a suburb of D.C. and was able to attend their public schools, which are considered top-rated Virginia schools. Arlington students are raised by a community that invests incredibly generous amounts of time, money, resources, nurturance, and support into their educational and career pursuits. I am so thankful to have been raised in such a community that was youth-led, where students were constantly staying engaged with their community’s issues and taking the agency to address these problems where they could.”

    Young People Are Leading

    Historically, young people are drastically underrepresented in civic actions and left out of decision-making processes that impact them. It requires intentionality and care to ensure young people are empowered to engage civically because they must be at the table to make decisions on policies and practices that will impact their well-being. In social work, we are guided by the value that individuals are the experts of their own stories and therefore, are the experts in what is needed for them to thrive. This holds true for communities as well. Chryssochoou & Barrett (2017) highlight the importance of the collective identity of young people that bolsters their commitment to civic engagement. “It is through collective identifications that young people articulate common grievances and common goals that can politicize them and lead them to act together to change [a] situation” (p. 294). At Voices, we saw this clearly when engaging, uplifting, and supporting the amazing young advocates of VAYA. Coming from a wealth of different backgrounds, identities, experiences, family structures, and localities, this group of young advocates represented a collective of individuals who, despite their differences, shared the common grievance of a lack of mental health support for them in their communities and schools and the common goal to change this issue for themselves and other young people through advocacy by storytelling.  

    Kayla shares some examples of how she and fellow classmates in Arlington mobilized themselves to make changes in their community through civic actions.  

    “In my freshman year of high school, the school board had decided to redraw the school district lines that created a disproportionate trend where low-income students of color were placed in one school district and high-income white students were placed in another district. This decision made by the school board was met with outrage, especially by the students. A student wrote an open letter to the school board that addressed this unethical behavior and I remember it was all anyone would talk about for weeks. We were all so proud of our fellow youth for speaking out against the school board’s segregationist policy.  

    Students in my class year also worked to change our high school’s name. Formally known as Washington-Lee High School, named after Robert E. Lee, many students believed that this namesake was wrong and unrepresentative of the student body. Students created a coalition and attended many town hall meetings and collaborated with the Arlington County School Board to change our school’s name. I remember many students would watch the town hall meetings to hear our peers speak and were always very proud of them. After the course of a year, the students were able to vote for a new name (a practice I thought was very inclusive and engaging to students). I was in the first graduating class of Washington-Liberty High School.”

    Kayla also shares how students would rally together to engage with presidential candidates that would visit their school, attend national and local protests, organize student walk-outs, and organize many fundraising projects for those in need such as GoFundMe and donation sites for protesting gear.

    “I designed stickers where the proceeds went to Campaign Zero and a friend designed a tote bag where the proceeds went to the Black Lives Matter (BLM) movement.”  

    Juelich & Coll (2021) describe youth as engagement-based constituents in that they require mobilization or engagement by others to become involved in civic actions. For Kayla, it was her connection to an affluent white community that poured resources into their youth and who raised their youth with “strong values of expression, inclusion, and advocacy.” Kayla continues, “We were supported when we took agency in issues that mattered to us.” However, more importantly, she states that she “learned to value and exercise my political power from following the examples of other youth, NOT ADULTS. Communities that nurture youth voice [will] raise youth who are proactive and engaged. This way, we learn to connect with youth as leaders and experts regardless of adult trust or confidence in our abilities and vision.” 

    Are We Ready to Follow?

    Youth Civic Engagement through Virginia’s Youth in Action

    At Voices, we focus our youth and young adult programming on building community, centering healing in storytelling, and uplifting the already impactful and passionate work of young people in our state. Innately, our hope is that we can intentionally build a space that immerses youth in civic action such as Kayla had growing up in her community, and therefore, building that bridge from the community to the legislature. We had a vision that Virginia’s Youth in Action would create a line for young people to gain access to the civic action of legislative advocacy through learning about the Virginia legislative process, how power and privilege permeate within the institution and the intersection of their stories to the legislative process at large. What we experienced was even more extensive. 

    When developing our youth programming, we intentionally ensure information is accessible by cutting out the jargon and making the content digestible to different levels of knowledge and understanding. We focus on high-level context with relatable examples that are empowering, practical, and radical. Consideration of content, paired with the recognition of the day-to-day pressures and expectations of young people from their schools, their hobbies, their families, and their time to rest, are just two shifts that other organizations can make when engaging young people civically. We are deliberate in scheduling meetings or engagement times with young people outside of standard office hours and on weekends. We understand that it is our job to come to these changemakers and provide them with our services, rather than hoping they can come to us when their schedules are not designed the same as ours.  

    At Voices for Virginia’s Children, we ensure that we utilize our position to also uplift the voices of Virginia’s young people and their living experiences. Not just within our organization, but nationally, we are experiencing a pivot in how young people are represented and viewed in change work. Young people have always been at the forefront of activism and widescale change. However, the older generations have been vastly unprepared to accept this due to the normalcy of underestimating young people’s knowledge, autonomy, and truths. The pivot we are seeing and experiencing now is a readiness and willingness by adults and (some) people in power, to listen to and be led by young people. Young people are the experts of their experiences; the leaders of now and the leaders of the future. Young people know what is needed to establish widescale, radical change for a better world that they will continue to occupy when older generations are gone.  

    So why not ensure these amazing young people are occupying spaces that educate adults about their needs? Why not ensure young people are at the forefront of all policy changes in schools? Why not ensure young people are equipped to engage civically at the polls? Why not ensure that all adults are prepared to let go of the societal norms rooted in ageism, to sit back and listen to younger generations who will have to continue living in the world created by older generations? This is a call for adults in civic spaces, legislative spaces, advocacy spaces, social work, change work, etc., to think about how they engage with young people. Are you ready to take a backseat and let young people lead us? Because young people will continue to work, advocate, fight, take up space, and use their voices to enact change, whether given permission or not. 

    We affirm what Kayla reiterates, “Engagement is key to feeling included, respected, understood, and fulfilled!!”

     

    Kayla Bravo is a fourth-year undergraduate student at Virginia Commonwealth University studying both political science and philosophy. She also works as a youth advocate. Most recently, she served as a member of Virginia’s Youth in Action advocacy council created by Voices for Virginia’s Children. 

    Cat Atkinson, MSW, is a social worker practicing in the Richmond area with living expertise as a bi-racial transracial adoptee and an individual living with mental health challenges. She is a former Voices intern and current summer fellow. 

     

    Are you (or do you know) a motivated advocate between the ages of 15 – 25? Applications for our 2023-24 cohort of Virginia’s Youth in Action are open now until August 6, 2023. For more information visit our VAYA webpage here, and/or contact Kristin Lennox, MSW, Director of Engagement, kristin@vakids.org. 

  5. Voices’ Statement on the Final Version of Virginia’s Model Policies on the Treatment of Transgender Students in Public Schools

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    Voices for Virginia’s Children’s Statement on the Department of Education’s Final Version of the “Model Policies Ensuring Privacy, Dignity, and Respect for All Students and Parents in Virginia’s Public Schools”

    All children and youth in Virginia deserve to enter our public schools with a sense of safety and belonging. Instead of safeguarding this fundamental component of our education system, the final model policies provide fertile ground for discrimination and stigma against LGBTQ+ students. These policies threaten the mental health and well-being of LGBTQ+ students, putting them at further risk for academic and social disengagement, at a time when Virginia ranks 48th in the nation for access to youth mental health services. Moreover, they place the best interests of children, youth, and families in the middle of a divisive culture war and put Virginia’s dedicated educators in impossible positions. 

    We believe that children and youth can be trusted as experts on their needs. We remind local school divisions that these policies are merely guidance and that local leaders retain discretion on adoption of these policies. Our partners at Pride Liberation Project, He She Ze and We, Side by Side Virginia, Equality Virginia, and ACLU of Virginia have resources and safe & affirming spaces for youth. 

  6. From Crisis to Movement: How Schools Can Best Support Youth Mental Health

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    This post was written by former Voices intern Abby Aquije, featured on the right in the above photo.

    Responding to the Growing Severity of Youth Mental Health Crisis  

    For decades we have been talking about the growing number of youth with mental health challenges, and there is an abundance of alarming statistics to support such concerns. The CDC reports that 4 in 10 students felt persistently sad and hopeless, and according to the Virginia Department of Health, the number of youth self-harm emergency department visits in Virginia is increasing. It is clear that we have reached crisis levels. Additionally, we know there are many barriers to prevention and intervention. COVID-19, negative stigmas, behavioral health care shortages, telehealth access issues, educator burnout, and more all add to the severity of this crisis. This information is well-known and widely reported, confirming the existence of a youth mental health crisis.  

    While it is important to keep these conversations going, we cannot overlook the role that youth themselves are playing in mending this crisis. As Virginia public schools are facing growing rates of “threats to self,” it is critical that education leaders and policymakers begin recognizing and leveraging students’ ability to support one another. These students are not fixated on crisis data, like many adults in the education space. Rather, they are making positive changes in how their generation interacts with mental health overall, and there is much to learn from them.   

    Importance of Youth Empowerment 

    In schools, students are listening to one another, starting clubs, and advocating for more resources, all of which all examples of youth supporting each other’s mental health. These students are passionate, capable, and motivated, and we must support their efforts, big or small.  

    Last year, I wrote a blog arguing for connectedness and peer support as measures to address loneliness elements contributing to the youth mental health crisis. After months of additional research on the topic and attending a Youth Mental Health Summit, I am happy to say significant youth support for this promising intervention exists. Youth are informally employing these peer support strategies already as a way to navigate challenging times, and they know the importance of promoting positive mental health practices. Their experience makes them experts on the topic, but they still need resources and adult support to engage in these actions productively, especially as it relates to peer support interventions.  

    School-Based Support for the Youth Mental Health Movement 

    Many students are engaging in mental health conversations and actions and need the training and support to do so positively. Over 85% of students with depressive behavior said they would tell a trusted adult if their friends were having mental health struggles, showing that students are motivated to support one another. Still, less than a quarter of students with lived mental health experience have received mental health training, highlighting a need for formal peer support training.   

    To make peer support an effective intervention, schools must provide students with mental health tools and training to engage in these conversations healthily. Providing students with mental health training allows schools to empower youth while also addressing the crisis at hand. These training programs equip students with the knowledge needed to recognize and respond to mental health concerns they see in themselves and their peers. With many barriers to identifying at-risk youth, peer support can offer a promising avenue to improve rates of early identification. 

    It’s important to emphasize that there is a youth-led movement to make positive changes in this area, but we cannot risk students burning out. The burden of initiating peer support, both informally and formally, should not solely fall on students. Schools need to support them as equal collaborators in addressing the mental health crisis by empowering them with the tools to support and advocate for one another early on. This means initiating student-focused interventions early on and compensating students for their time and effort. Continued engagement is critical to advancing this movement.

     

    Abby Aquije graduated with her Master of Public Policy (MPP) from the Frank Batten School of Leadership and Public Policy at the University of Virginia (UVA) in May 2023. She is currently looking for a full-time job in the nonprofit sector.

  7. Medicaid Unwinding

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    Virginians receiving continuous Medicaid coverage was one of the benefits of a pandemic-era law, proving to be a lifeline to children and families and helping to bring down the overall uninsured rate. The provision however is set to expire on April 1, and the regular Medicaid renewal process will resume. Now, even eligible children could lose coverage due to difficulties in the renewal process, like staffing and lack of communication. Learn more in this “Medicaid Unwinding” vlog from Policy Analyst, Emily Moore.

    Additional resources:

    Medicaid and FAMIS have been valuable lifelines for kids during the pandemic. As pandemic coverage protections end, 146,452 of Virginia’s kids are at risk of becoming uninsured. Read more about the high stakes for children when the Medicaid continuous coverage protection expires in the Georgetown University Center for Children and Families 2023 Annual State Enrollment Report.

    Virginia will start to review Medicaid members’ health coverage beginning in March 2023. They will not cancel or reduce coverage for members without asking for updated information, but they need your help to make this a smooth process. You can take steps now to make sure you receive information you will need to renew your coverage.

    What Medicaid members can do now:

    Update your contact information. You can make updates:

  8. Prioritizing Youth Mental Health Requires Intention and Investment

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    Whether you are a young person, a parent, a mental health professional, or an educator, you have likely heard about the youth mental health crisis in the United States—it is being discussed everywhere, from kitchen tables to news stations to the Governor’s office. And while there is finally urgency around addressing the mental health needs of Virginians, we continue to see a catch-all response for adult and children’s mental health needs in our current policies. It is undoubtedly easier to design mental and behavioral health systems and services for adults and retrofit young people into them, but this results in supports that inadequately meet the needs of children and youth. To truly invest in the mental health of young people, policymakers must do so with intention. It requires centering the needs and experiences of young people—especially those who are Black, Latino, and LGBTQ+—and developing mental health services that prioritize healing and well-being.

    The past few years have been particularly difficult for young people. The Joint Legislative Audit & Review Commission’s (JLARC) November 2022 report shared several alarming statistics that articulate the dire need to intervene and support young people right now: 

    • Self-harm-related emergency department visits among Virginia youth, ages 9 to 18, more than doubled from 2016 to 2021, with the largest increase in self-harm visits occurring in 2021, according to the Virginia Department of Health, and   
    • Youth deaths by suicide, ages 9 to 18, averaged 4.9 deaths per 100,000 youth from 2015–2019, and were 6.2 per 100,000 youth in 2020 and 5.6 per 100,000 in 2021.

    Graph showing youth emergency room visits for self-harm have risen over time; increasing substantially in 2021

    This constitutes a youth mental health crisis. In order to meet this moment for youth mental health, there must be major shifts in how children and youth are prioritized in our system. Historically, new initiatives and service expansions have delayed the implementation of child- and youth-focused plans until phase two—a step that often takes too long to achieve. Mental health resources that are not intentionally designed to reach children and youth will not reach them.

    Capacity to build up the infrastructure at local Community Services Boards, particularly for children and youth, is needed. The ideal system offers young people mental health support when and where they need it, but the reality is children and youth do not have access to a comprehensive array of crisis response services depending on where they live, who pays for their care, and who helps them identify resources.

    Currently, there are only three Residential Crisis Stabilization Units (RCSUs) specifically for young people across the Commonwealth. One goal of Governor Youngkin’s “Right Help. Right Now.” behavioral health transformation initiativeis to add more youth RCSUs and to develop 23-hour Crisis Receiving Centers (CRCs) to serve as a “behavioral health urgent care”, both of which are critical components of the crisis services continuum. However, if the locations and services are not developed with young people’s needs in mind, they will not be as effective of a resource. Having a cross-lifespan model for RCSUs and CRCs that only incorporate child-sized recliners does not make a space child- and youth-friendly. The design of RCSUs and CRCs must be fundamentally different from the design of a traditional hospital, which are often sterile and unwelcoming environments. Young people need culturally and developmentally appropriate resources in these locations, such as places for their family members to rest, blankets, sensory toys and comfort items, and a warm and inviting environment to encourage healing and create emotional and physical safety.

    Virginia lawmakers have a chance to reimagine what it means to put young people’s needs at the forefront of their decision-making during the 2023 General Assembly session. Between Governor Youngkin’s proposed budget and several budget amendments before the legislature, there are opportunities to ensure behavioral health services are available in every region and designed with the needs of children and youth in mind. This includes expanding crisis response services with components specific to children and youth and providing adequate resources to build the capacity of the system.

    TAKE ACTION: We urge lawmakers to prioritize young people’s healing and well-being. This can be done by making a targeted investment in youth mental health through the state budget.

    Build out crisis response and stabilization services that offer young people support when and where they need it.

    • Continue the expansion and modernization of the statewide crisis services system by investing in crisis receiving centers and crisis stabilization units. Hire a staff member to oversee Children’s Crisis Response Services.
      • Support the Governor’s proposed budget to increase funding for a comprehensive crisis services system | $58,345,204
    • Fund contracts with private providers to establish mobile crisis units in underserved areas.
      • Support the Governor’s proposed budget to provide one-time funds for mobile crisis units | $20 million

    Prioritize young people in the design and implementation of mental health services.

    • Build upon the base of $8.4 million the legislature has provided since SFY2017 to expand or enhance children’s behavioral health services in all five Department of Behavioral Health and Developmental Services (DBHDS) health planning regions and keep a dedicated focus on infrastructure specific to children and youth services within DBHDS’s Office of Child and Family Services.
      • Support budget amendments for Children’s Behavioral Health Services: Item 313 #1h (Price)/Item 313 #6h (Seibold); Item 313 #5h (Rasoul); Item 313 #3s (Favola)

  9. School Meals Provide a Guarantee That Children Will Get Fed

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    Young people can learn and thrive when they are fed and have access to healthy and nutritious foods. However, in Virginia, one in ten children are considered food insecure and may face hunger. Children are considered food insecure when their households experience limited or uncertain availability of safe, nutritious food at some point during the year.

    While significant efforts to improve food security have been in place during the pandemic—such as the enhanced Child Tax Credit, expanded SNAP benefits, Pandemic EBT, and universal school meals—unfortunately, these programs were designed to be temporary. Many of the supports that helped feed young people and lift their families out of poverty have already come to an end or will end once the Federal Public Health Emergency expires.

    The pandemic demonstrated that when it comes to ensuring young people have access to nutritious, healthy, and culturally appropriate food, there are programs that work. And one thing we are certain of is that school meals play a crucial role in providing the nutrition children need to support their academic success and overall well-being.

    This school year, Congress did not extend the federal waiver authority that allowed all young people access to free school meals over the last two years. As a result, schools have gone back to pre-pandemic operations, requiring families to submit an application to their child’s school to determine if their child is eligible for free or reduced-price meals.

    Voices is grateful to Virginia legislators who included $8.2 million in state funds over the next two years to cover the out-of-pocket costs of Virginia’s young people who qualified for reduced-price school breakfasts and lunches. The state funding will allow roughly 64,500 children from households whose incomes are between 130-149% of the poverty level to get their school meals for free rather than at reduced-price. But that still does not remove the barriers to food access created by the requirement to fill out paperwork for students to receive those meals at no cost to their families.

    A program that does remove barriers is the Community Eligibility Provision (CEP). Through CEP participation, school divisions are able to offer breakfast and lunch to all students at no charge and without processing school meal applications.

     

    How Can Schools Participate and Why Should They?

    A school district, group of schools in a district, or individual school with 40% or more “identified students” can choose to participate in the CEP on a four-year cycle. Identified students are young people who are eligible for free school meals and are already identified by means other than a school meals application, such as:

    • students whose households participate in SNAP, TANF, and in some states (including Virginia), Medicaid benefits,
    • as well as students who are certified for free school meals because they are identified as homeless, migrant, runaway, enrolled in head start, or are in foster care.

    The Community Eligibility Provision promotes equity, reduces stigma, and saves schools significant time by reducing administrative burdens. Some of the benefits of CEP include:

    Helping economically disadvantaged students and their families

    • Parents are assured that students are getting two healthy meals a day at school
    • Families’ financial burden is eased when students eat school meals
    • Offering meals at no charge to all students eliminates stigma and “school lunch shaming”

    Increasing efficiency and school meal participation

    • Families don’t encounter language and literacy barriers to access through the application process
    • Schools do not need to track each meal served by fee category (free, reduced-price, and paid)
    • School nutrition staff do not need to collect fees or lunch numbers from students, allowing the lunch line to move faster and ensuring more students can be served
    • Eliminates unpaid school meal debt

     

    Virginia’s Utilization of CEP

    Virginia has made significant progress to encourage school divisions to reduce barriers to offering free school meals through the Community Eligibility Provision. During the 2021-2022 school year, out of Virginia’s 145 school districts, 97 divisions (67%) were eligible to participate in CEP and 81 of those divisions participated division-wide. According to the Food Research & Action Center, Virginia had the largest growth in the number of school districts adopting CEP, increasing by 25 school districts.

    Despite these numbers, there are roughly 50 school divisions that have no CEP opportunities or CEP opportunities are only available at a limited number of schools.

    As inflation has hit a 40-year high, families across Virginia—especially those in areas with a high cost of living—are struggling to make ends meet. And as a result, families who do not qualify for free or reduced-price school meals are more likely to now experience food insecurity.

    Virginia can work to ensure that less children experience food insecurity by expanding SNAP benefits and working to reduce the SNAP participation gap amongst families, supporting school divisions in an effort to maximize opportunities for adopting CEP, and continuing to fund and maintain the elimination of the reduced-price meal category for school meals.

     

    Voices for Virginia’s Children is a member of the Virginia Food Access Coalition, a statewide coalition that develops policy solutions to increase economic access to healthy and nutritious foods by investing in retail infrastructures and programmatic initiatives to combat areas of food insecurity.

  10. 9-8-8 is Just One Step Towards a Comprehensive Crisis Services System

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    This blog is the second post in a two-part series that takes a deeper look into Virginia’s efforts to integrate the 9-8-8 hotline with the behavioral health crisis services continuum. Read the first blog post in the series here.

    For years, communities have advocated for diverting mental and behavioral health calls away from law enforcement and for states to adopt a comprehensive crisis response system. Now, that dream is beginning to come to fruition. On July 16, the National Suicide Prevention Lifeline transitioned to the three-digit number 9-8-8. While this transition was initiated by legislation at the federal level, states are responsible for the rollout and linkages to their crisis response systems when the caller’s needs cannot be resolved over the phone. Virginia has been working on a rollout behind the scenes to link the lifeline to crisis response services that are currently being designed and implemented by state agencies and stakeholders.

    The commonwealth’s plan for minimizing emergency room visits for mental health crises and providing an alternative to calling 9-1-1 is to link the crisis call centers with regionally focused resources by integrating mobile crisis response alongside the Marcus Alert protocols. However, at this moment, this is simply the goal and not the reality. The development and implementation of Virginia’s behavioral health crisis system has been a piecemeal approach, and is not yet fully prepared to deliver comprehensive, trauma-informed, and culturally responsive services to meet individuals’ mental health needs—specifically the needs of young people

    The Surgeon General sounded the alarm in December 2021 by issuing an advisory on the youth mental health crisis. Despite widespread awareness, young people’s mental and behavioral health needs are often an afterthought or part of “phase two” when developing programs and services. Current resources dedicated to young people’s behavioral health make up less than 10% of Virginia’s overall behavioral health agency budget. The lack of sufficient funding and resources further the disparities that historically marginalized communities face in accessing support and services.

    Due to the inconsistent mental health crisis services across regions, law enforcement is often the first point of “care” for mental health emergencies, especially for Black, Latinx, Indigenous, and LGBTQIA+ youth. While most calls to 9-8-8 can be resolved during the call, some crises will require an in-person response based on a four-level call matrix.

    four level call matrix

    This new entry point for mental health support is supposed to be an alternative to law enforcement response, but a new law allows 89 of Virginia’s 133 localities with 40,000 or less residents to opt out of two protocols under the Marcus Alert System. This means that for those living in one of the 89 localities that are not required to implement all Marcus Alert protocols, an attempt to get in-person crisis support may still result in law enforcement, with or without Crisis Intervention Training, responding to your call. The criminalization of youth crises often results in further traumatization. This experience can intensify their crisis, compromise their treatment, and make them and their families less willing to call for help if another crisis occurs. Far too often children and families are met with a response that is not suited to meet their immediate or long-term needs.

    At a time when young people need support the most—while their worlds have been turned upside down by COVID-19—we must ensure there are providers and services in place to provide access to timely, culturally responsive services, and address social determinants of health to support children and families’ overall wellbeing. This requires investments from lawmakers and interagency collaboration.

    For 9-8-8 to be truly transformative, investments are needed now.

    While all these recommendations are not immediate and some are considerations for future policy, Voices for Virginia’s Children suggests the following key recommendations:

    • Mobile Crisis services need to be fully funded across all regions, with an emphasis on providing services in underserved and rural communities. Voices also suggests separate mobile crisis protocols designed specifically for youth, as the intervention points at which young people receive support may include schools, parental consent, developmental appropriateness, or specifically trained professionals;
    • Mobile Crisis and Community Care teams should include a peer specialist, interpreter, community advocate, and child-serving mental health professional;
    • More small-scale children’s Crisis Stabilization Units should be placed in communities across the state;
    • Establish an infrastructure for language access and a culturally diverse and appropriate workforce;
    • Mandatory trainings should include equity-centered concepts, including implicit bias training, trauma-informed care, child and adolescent development, and training specific to special populations (i.e., LGBTQIA+ youth and youth with intellectual and/or developmental disabilities);
    • Stakeholders involved in implementation should include those most impacted, such as youth with lived experience and communities of color;
    • Ensure that crisis response protocols and services are equipped to support systems-involved youth and their family members. Protocols should be designed to avoid future involvement in the child welfare system or juvenile justice system.

    Voices will continue to advocate for increased access and improved coordination of quality mental health services for all children in Virginia, regardless of where they live or at what point they seek mental health services. The future wellbeing of our state depends on how we support and invest in the next generation.

    To learn more about Virginia’s plan for crisis system transformation, visit these resources: Virginia’s Crisis System Transformation and Marcus Alert and STEP-VA.