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  1. General Assembly 2022: Health and Wellness Wrap-Up

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    Understanding the social determinants of health (SDOH) that impact children’s lives informs how we advocate for policies that improve the health and well-being of all children, especially children of color and economically disadvantaged children. During the 2022 General Assembly Session, Voices joined partners, advocates, and youth in asking lawmakers to invest in equity and provide access to language services across state agencies, healthy and nutritious foods, and comprehensive health care.

    After months of negotiation, the legislature has reached an agreement on the state budget, including many of these initiatives. Policy changes in legislation and budget language have made progress towards holistically addressing the inequities and disparities faced by Virginia’s children and families.

    Creating an Equitable Health Care System

    • HB 987, sponsored by Delegate Tran, was signed into law and requires the Board of Medical Assistance Services to ensure that all medical assistance program information provided to applicants is made available in a manner that is timely and accessible to individuals with limited English proficiency through language access services. This includes oral interpretation, written translations, and auxiliary aids and services for individuals with disabilities as a reasonable step to provide meaningful access to health care coverage.
    • HB 229, sponsored by Delegate Coyner, was signed into law and requires the Department of Health to collect and analyze information, including demographic data, regarding social determinants of health and their impact on health risks and health outcomes of Virginians.
    • To address Medicaid enrollment, language is included in the budget directing the Secretary of Health and Human Resources to establish a Task Force on Eligibility Redetermination. This task force will help plan and advise the Department of Medical Assistance Services on the unwinding process to ensure Virginians do not lose healthcare coverage. The language also adds American Rescue Plan Act (ARPA) funding to be used for operational challenges linked to eligibility redetermination, such as technology needs and paying staff overtime at local DSS agencies.
    • The legislature has directed $2.5 million in FY23 to continue the contract for an integrated e-referral system for one year. It is expected that the e-referral system will continue beyond FY23 with user fees supporting its operations. The purpose of the system is to connect government agencies, health care providers, and community-based partners to enable participants in the system to refer patients to public health and social services.

    Increasing Language Access and Equity

    • While the funding amount was reduced from the original budget, $2.5 million per fiscal year remains in the current budget to be provided to state agencies for facilitating and improving language access. This funding will allow each state agency to designate a language access coordinator who will be responsible for making sure that agency materials and communications are accessible to all Virginians, especially those who have limited English proficiency.

    Increasing Food Access and Nutrition Security

    • To ensure access to healthy and nutritious foods and boost the buying power of the Supplemental Nutrition Assistance Program (SNAP) benefit for fruits and vegetables at farmers markets and food stores, $1 million per fiscal year will be directed to Virginia Fresh Match.
    • HB 582, sponsored by Delegate Roem, was signed into law and requires public institutions of higher education to ensure that young people in college have access to information on SNAP benefits, including eligibility and how to apply. The bill also requires each institution to advertise information on the SNAP benefit process on their website and in orientation materials distributed to students.
    • HB 587, sponsored by Delegate Roem, was signed into law and requires every public elementary or secondary school to process web-based or paper-based applications for participation in the School Breakfast Program or the National School Lunch Program, administered by the U.S. Department of Agriculture, within five working days after the date of receipt of the application.

    Creating a future where Virginia’s children can thrive will require intersectional approaches, including equitable, healing-centered policies that dismantle systemic barriers so that all young people can lead long, healthy, and successful lives. While the budget takes important steps forward, we must continue uplifting youth voices to improve policies impacting their health and well-being.

  2. 2021 General Assembly Session: Health Care Priorities

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    While the entire world faces the COVID-19 pandemic, America and Virginia face dual pandemics, COVID-19 and racism as a public health crisis. Public health looks at how external factors influence health outcomes, such as how racism, poverty, food access, and environmental inequities collectively contribute to physical, social, and emotional health.  The solutions require a multi-faceted response that promotes a multi-sector continuum of care. The pandemic has shed light on the importance of how one’s awareness of their own health can impact the entire community, such as knowledge that one is carrying the COVID-19 virus. This gives us the opportunity to do better in ensuring that our residents have fair and just access to what they need to sustain a quality of life and positive health outcomes. 

    Our talking points for the 2021 legislative session will focus on the following themes that fall under the umbrella of expanding  insurance access to immigrant populations: 

    1. Extend Medicaid coverage for legally residing young adults from 18 to 21. 
    2. Extend eligibility for FAMIS Moms prenatal delivery coverage to all pregnant women. 
    3. Expand Medicaid coverage of “emergency” services for COVID-19. 

    Extend Medicaid Coverage to Immigrant Populations

    Every Virginian should have access to health insurance during a pandemic, regardless of immigration status. When parents have access to health insurance, children are more likely to have insurance. As a result, the overall health and well-being of Virginia’s population is improved due to increased access.  As of December 10th, according to the CDC, there have been over 285,000 deaths from COVID-19 in the United Status. This number continues to rise, but we must note the disproportionate impact of the pandemic on communities of color. Minority communities are expected to navigate systems of biases and inequities and stay afloat while facing exacerbated health inequities as it relates to the social determinants of health. Young adults are just starting off in life and often work part time jobs that have limited access to paid time off, such as sick pay and health insurance. Virginia must ensure they have what they need to survive the pandemic and live a long and healthy life.

    Increase the age that legally residing immigrant children can qualify for Medicaid and FAMIS: Currently, legally residing immigrant children in Virginia qualify for coverage up to 19. Federal law allows optional coverage to continue up to age 21 allowing for continuity of care and reducing gaps in health coverage. 

    Extend Eligibility for FAMIS Moms Prenatal Delivery Coverage to All Pregnant Women, Regardless of Status

    Policymakers must prioritize child and family health. It’s time to invest in and prioritize access to healthcare for all Virginians. The postpartum period is important but an often neglected element of maternal and infant care. Mothers deal with a variety of medical conditions and complications from birth, regardless of their identity. Symptoms include pain, childbirth, postpartum depression and anxiety, and more. As we navigate the public health crisis, every policy and funding decision should move Virginia closer to becoming a place where everyone has the opportunity to survive and thrive. Access to prenatal coverage improves health outcomes for the mother and child.

    Extend Medicaid/FAMIS MOMS prenatal coverage to undocumented women who meet all other non-immigration eligibility criteria: The federal option for this is already in use in 17 other states and would require a CHIP plan amendment. However, the good news is extending prenatal coverage could result in 2.3 million in net savings for the state in FY22 due to drawing down a higher federal match rate compared to emergency services that might otherwise not be utilized due to a lack of access.

    Expand Medicaid Coverage for COVID-19 Emergency Services

    Communities of color are experiencing much higher COVID-19 hospitalization rates. For example, as of December 3rd, the Virginia Department of Health reported 15,116 hospitalizations. The Black community accounted for 29 percent, despite the fact that they represent just 19 percent of the commonwealth’s population. Similarly, the Latinx population represents 24 percent of Virginia’s COVID-19 hospitalizations, but only 9.8 percent of the population. Meanwhile, the white community accounts for 28 percent of the commonwealth’s coronavirus hospitalizations, but nearly 70 percent of the population. These numbers are disproportionate. 

    Virginia must expand Medicaid coverage for COVID-19 emergency services: Several other states have taken steps during the current crisis to help their residents regardless of immigration status. Federal law allows states to cover COVID-19 screening, testing, vaccines, and all related treatment for any immigrant who meets financial requirements for Medicaid, but does not meet the immigration status requirement. This policy will decrease the spread of the coronavirus. Virginians should have access to emergency services during a pandemic. It benefits everyone.

    Sign up to receive emails regarding the upcoming session here.

  3. Sounding the Alarm: New Data Reveals Impact of COVID-19 Hardships

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    Guest Blog Post Contributed by John R. Morgan, Ph.D., former Voices Executive Director and current Chewning Research Fellow at the Virginia Early Childhood Foundation

    Widening racial-ethnic disparities likely to harm children of color

    Data is accumulating showing that economic and familial hardships associated with the pandemic are experienced more acutely by Black and Hispanic families. These hardships are of the same nature as those associated more generally with child poverty; and it is clear that racial-ethnic child poverty disparities in Virginia are already substantial and persistent. The latest data available on the KIDS COUNT Data Center indicate poverty rates of 28.0 for Black children, 19.8 for Hispanic children and 8.9 percent respectively for white children.

    Children of color, already more likely to experience child poverty and its associated hardship burdens, are now faced with an extra and similarly disproportionate burden delivered by the pandemic. The most likely outcome of this doubled-up hardship burden is a worsening of pre-pandemic racial-ethnic inequities. It is also likely that these inequities will be most prominent in education and health. Looming on the horizon then is the highly likely and entirely unwelcome prospect of the worsening of already intolerable inequities which greatly disadvantage children of color, including:

    • education achievement gaps (PALS-K scores, SOL scores, SAT scores; and rates of retention, suspension/expulsion, drop-out, graduation, college acceptance)
    • inequities in health status (prevalence of asthma, obesity, low birthweight; inadequate prenatal care; food insecurity)

    Data on COVID health outcomes are of primary immediate concern. Infection rates, hospitalization rates and mortality are all substantially higher for Black and Hispanic-Latino than White populations nationally and in Virginia.

    Disparities in COVID-caused household hardships

    More recently, data from the Census Bureau’s COVID-19 Household Pulse Survey reveal that the burden of COVID-related family hardships falls most heavily on Black and Hispanic households. This disproportionate impact threatens to put at risk the long-term well-being of their children. Much of the available data is national yet it is plausible that national findings will be mirrored in Virginia to a great extent. Some prominent national indicators include:

    • 51 percent of households with children reported an adult in the household had lost employment income. (Pulse Survey August 2020)
    • 58 percent of Hispanic and 53 percent of Black households saw a loss of employment income since March, versus 39 percent of white households. (Harvard Joint Center for Housing Studies)
    • 59 percent of Black households, 55 percent of Latino households, and 33 percent of white households reported it was “somewhat difficult” or “very difficult” to pay for usual household expenses. (Center on Budget and Policy Priorities)
    • 18 percent of Black households, 17 percent of Latino households, and 7 percent of white households reported that their household did not get enough to eat. (Center on Budget and Policy Priorities)

    The minimal state-level data available so far align with these national findings. In a recent report, the Commonwealth Institute estimated that 24 percent of children in Virginia live in a household that is not getting enough to eat or is behind on housing payments. Their analysis underscored data indicating that people of color were feeling economic hardships more acutely. For example, one of every eight Virginia workers who identify as Black, Latinx, or Asian/Pacific Islander were unemployed this summer or temporarily laid off without pay, compared to one of every 19 non-Hispanic white workers.

    It is evident, therefore, that compared to their white counterparts, Black, and Hispanic children in Virginia are more likely to be exposed to potentially harmful pandemic-related hardships. This threatens to substantially widen existing troublesome disparities and present ever-greater risk to the well-being of Virginia’s children of color.

    What makes these findings so alarming?

    There is strong scientific consensus, cited in sources above, that the economic hardships and familial stressors associated with child poverty can compromise child development and lead to troublesome outcomes. Research also identifies the parameters that influence the likelihood of such harmful effects. Risk of harm is both additive and cumulative – as the number and/or duration of hardship exposures increase, so does the likelihood of harm.

    Applying those parameters to the circumstances faced by Virginia’s children of color, alarms are sounding on both counts. As data reviewed above indicates, Black and Hispanic children are more likely than white children to be exposed to a greater number of hardships during the pandemic (as they were before the pandemic); and pandemic-induced hardships are more acute and severe for Black and Hispanic families, meaning a longer duration before they can fully recover to pre-pandemic levels. The net effect: the pandemic will widen critical Black-white and Hispanic-white disparities, especially in the health and education domains, and likely for an extended period. This will be a step backward, resulting in diminished opportunity and greater disadvantage for children of color.

    Policy implications: Will history be repeated?

    There are challenging and urgent policy implications of this potential worsening of racial-ethnic child disparities. It is imperative that policymakers address this impending harm by pursuing fiscal and policy initiatives which recognize this disproportionate risk and target responses accordingly.

    The guiding principle should be to first restore and then enhance all the pre-pandemic initiatives that were in place to reduce key racial-ethnic disparities in health and education. Every policy and budget decision in our recovery effort will therefore need to be viewed through an equity lens: does this decision recognize the unacceptably disproportionate hardship burden borne by Virginia’s Black and Hispanic children and respond in a manner that does not perpetuate or worsen their previous disadvantage?

    Voices is a member of the Fund our Schools Coalition calling to restore education funding. Fund Our Schools partner, The Commonwealth Institute, has wisely urged state decisionmakers while crafting pandemic relief plans not to repeat the upside-down school funding decisions made in response to the Great Recession. In that instance, though recession-era budget cuts had disproportionately impacted the poorest school divisions and students, lawmakers restored proportionately less – not more – funding to these divisions as state finances recovered. Lawmakers should heed the advice and avoid uniform across-the-board recovery initiatives that fail to respond to the reality of COVID-19’s disproportionate harm. Failure to do so will needlessly and callously worsen existing racial-ethnic inequities and push Black and Hispanic children even farther behind their white counterparts. On economic, social and moral grounds this would be an intolerable outcome.

    Want to read more insightful news on this topic? Sign up to receive the latest news on data trends in Virginia.

  4. Speak up for the Health of Virginia Families

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    Virginia is facing an important choice that affects the well-being of many families and children. Under the Affordable Care Act, Virginia has the opportunity to expand its Medicaid program to provide health insurance to adults making below 138% of the federal poverty level (that’s less than $33,000 for a family of four). Virginia has not yet chosen to expand Medicaid.

    The General Assembly established a commission to weigh the pros and cons and decide whether Virginia should expand Medicaid. That commission — the Medicaid Innovation and Reform Commission — is seeking public comment.

    You have a very important opportunity to weigh in on improving the health of Virginia families! There are 400,000 adults with very low incomes in Virginia who would be eligible for Medicaid if Virginia chooses to expand.

    As child advocates, why do we care? Because 25% of those eligible grown-ups are PARENTS of children under the age of 18. In other words, expanding Medicaid provides health insurance to 100,000 VIRGINIA PARENTS!

    Research shows that when parents have health insurance, they are more likely to enroll their kids in health insurance and take them to the doctor. That means more kids getting well-child check-ups, staying healthier, and whole families staying out of the emergency room when they get sick! Not only does that mean better health, but smarter spending of healthcare dollars.

    So what can you do?

    Provide public comment to the Medicaid Innovation and Reform Commission (MIRC), the group of legislators deciding whether we will expand Medicaid in Virginia. The deadline to submit comments: Wednesday, October 16, 2013 before 5:00PM. Let them know that expanding Medicaid helps improve the health of whole families in Virginia, including the kids of approximately 100,000 grown-ups. Every comment counts, and we need to make sure they know we are standing up for Virginia’s children and families.

    Here are some points you might want to make. Please personalize your comments.

    • I know someone personally who does not have health insurance, expanding Medicaid is important to me.
    • All Virginians deserve access to healthcare- expand Medicaid now!
    • Medicaid expansion bridges the coverage gap, ensuring that 400,000 Virginians have access to high quality affordable healthcare
    • The expansion will create 30,000 new healthcare jobs
    • Medicaid expansion will be 100% federally funded for the first 3 years and then 90% funded by the federal government starting in 2020
    • Access to insurance improves financial health for families and individuals.
    • In the past year, four in ten adults with serious mental illness went without mental healthcare, in large part due to having no insurance.
    • Six in ten adults living with a less serious mental health condition–
      but still a diagnosable condition requiring treatment–also went without any mental health care in the past year.

     

    Please click here to provide public comment to MIRC!

  5. Budget Approved by General Assembly

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    What’s In It For Kids?

    This past Saturday was a busy day in Richmond with both the House and Senate tying up all of the loose ends of the 2013 Session and wanting to adjourn on time. Not to get lost in all of the last minute shuffling, we want to acknowledge and celebrate the many good things included in the budget conference report reflecting Voices’ priority issues. As advocates, you all played a tremendous role in these successes. The conference budget, now approved by the General Assembly, goes to the Governor.

    Early Care & Education

    • The conference budget restores over $1 million in cuts to home visiting programs, CHIP (Item 297 #2c) and Healthy Families (Item 343 #1c). CHIP of Virginia/Parents as Teachers ended up with $600,000 restored and Healthy Families with $550,000. These funds are critical to ensure statewide access to these evidence-based family strengthening and health care improvement programs.
    • Your tremendous outpouring of support for early intervention (Part C) services for babies and toddlers helped to secure $2.3 million in funding in the current fiscal year and $6 million to meet the shortfall next fiscal year. We are very thankful that the conferees agreed to support the Senate’s request of an additional $3 million on top of the Governor’s proposal of $3 million. Although there will still be a small shortfall, the additional funding will put programs in a much better position for next year. Item 315 #1c

    Children’s Mental Health

    • The conference budget included an additional $1.9 million in FY14 for children’s crisis response services and child psychiatry (Item 315 #4c). This total includes the $1 million added by the Governor and the $900,000 approved by the General Assembly. This amount is in addition to the $1.75 million included in the FY14 budget during the 2012 session that will continue to be awarded to the three regions currently funded, bringing the statewide total to $3.65 million.
    • The conference budget also includes funding for two training and awareness programs recommended by the Governor’s School Safety Task Force:
      •  Mental Health First Aid received $600,000 in FY14 (Item 315 #2c). Mental Health First Aid (MHFA) is a 12-hour interactive course that teaches the risk factors and warning signs and symptoms of mental health disorders to clergy, teachers, health professionals, and others.
      • Suicide prevention efforts received $500,000 in FY14 (Item 314 #3c). Funds will go to DBHDS to collaborate with several other state agencies for a comprehensive suicide prevention plan.

    Foster Care/Child Welfare

    • The conference budget provided funding to implement Voices’ bills on independent living, House Bill 1743/Senate Bill 863. These bills allow youth coming out of the Department of Juvenile Justice between ages 18-21 who were former foster youth to get assistance in independent living skills.  The funding is combined from CSA funds of $97,614 (Item 283 #1c) and DSS funds of $19,945 (Item 338 #1c) in FY14.

    Medicaid Extension

    • After lots of last minute twists and turns, Virginia now has a path forward to extend Medicaid to the 400,000 low-income Virginians who would be eligible for Medicaid coverage under the Affordable Care Act. The conference budget includes language allowing Virginia to move forward if DMAS adopts certain reforms, and gains federal approval of other reforms (Item 307 #20c). The budget creates a new commission, the Medicaid Innovation and Reform Commission, with the authority to determine whether enough reform has been done to start the eligibility expansion. The House has named its members to the Commission: Dels. R. Steven Landes, R-Augusta, Jimmie Massie, R-Henrico, John M. O’Bannon III, R-Henrico, Johnny S. Joannou, D-Portsmouth, and Beverly J. Sherwood, R-Frederick. The Senate has not yet named its members.

  6. New Medicaid Extension Action Alert

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    Thank you to all advocates who have emailed their legislators about the need to extend Medicaid to low-income, uninsured Virginians. Given what happened yesterday, we need your help again today on Medicaid extension.

    Yesterday, the House Appropriations and Senate Finance Committees approved their budgets. Unfortunately, both committees would delay implementation of Medicaid extension until various reforms have been completed, and the Senate budget requires action by the 2014 General Assembly before extension could be implemented. This means extension of Medicaid would have to go through the entire legislative process again AND would not begin until July 2014 at the earliest instead of January 2014.

    Here’s why that matters:

    • 400,000 very low-income Virginians (many of them parents) would have to go without needed health care for many more months if we delay extension.
    • Virginia would lose $5 million in federal funds for EACH DAY that we delay Medicaid extension beyond January 2014. That means that OUR federal tax dollars will be going to help people and create jobs in OTHER states instead of Virginia.

     

    Reforming the Medicaid program to be more effective is good; but reforms should be implemented along with the extension. Voices is part of the HAV Coalition: Healthcare for All Virginians. HAV has an updated fact sheet on Medicaid extension that clearly explains all the ramifications of delaying this action.

    The full House and full Senate will consider their own budgets this Thursday. Because Senate Democrats were very displeased with this delay, we are expecting – and we support – an effort to change the Senate budget amendment which delays implementation of the extension.

    Between now and Thursday, each of us needs to urge our senator to support a change to the budget language.  Please contact your senator (especially if Republican) to say that you oppose delaying implementation of Medicaid extension for the reasons stated above.

    Please do this even if you have already contacted them about Medicaid extension- this is a NEW request.

    To find out who your senator is, go to http://conview.state.va.us/whosmy.nsf/VGAMain?openform . If you CALL, use the Capitol number and give the message to your senator’s secretary.

    Thank you for taking action!

     

  7. Action Alert: Medicaid Extension!

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    We are at a critical point in Virginia regarding Medicaid Extension, and the legislature is divided. We need EACH OF YOU to email your legislators to help them understand the benefits of extending Medicaid to the 400,000 very low-income Virginians who would be eligible for this extension. This week is our last opportunity to influence the House and Senate budgets that are being developed; they will be voting on their budgets this Sunday, February 3.

    Many of those who would be covered are low-income parents. Currently, only parents earning less than 30% of the poverty line (less than $10,000/year for a family of 4) qualify for Medicaid. Yet, research shows that parents who are insured are more likely to enroll their children in insurance and access health care. Extending Medicaid to these parents means healthier families!

    In addition, Virginia stands to gain quite a bit economically from approving this extension: Over a ten year period, Virginia would receive over $20 billion in federal funding while spending under $150 million in state funds.

    • The cost to Virginia will be offset by savings in state‐funded health programs and state employee health insurance.
    • The federal funding will support 30,000 jobs which will generate income taxes and sales taxes, helping pay for Virginia’s share of costs.
    • Healthier people are able to work more than those with chronic, untreated medical conditions.

     

    Finally, if Virginia doesn’t extend Medicaid, our federal tax dollars will go to insure people in other states which choose to extend Medicaid. Let’s keep our tax dollars in Virginia to help our fellow citizens.

    Please email your legislators TODAY to let them know how important it is to their constituents to extend Medicaid!