SIOUX FALLS, S.D. -- Despite a pre-pandemic period of economic stability, the number of South Dakota children lacking health coverage spiked between 2016 and 2019.

And amid the COVID-19 crisis, a new report raises concerns about the situation worsening.

The latest findings from the Georgetown University Center for Children and Families show South Dakota's rate of uninsured children skyrocketed by more than 60%, the largest increase in the nation.

Xanna Burg, KIDS COUNT coordinator for South Dakota, said because this data is pre-pandemic, they don't know how many more families have lost coverage. But she added there's real concern the number is growing.

"We do know that families are struggling," Burg asserted. "You know people are losing their jobs and with it, the health insurance that came with those jobs. "

Prior to the increase, the rate of uninsured children in South Dakota had fallen to its lowest level.

The report cites constant changes to the Affordable Care Act and more red tape in various states as possible factors for rate spikes.

The data comes as some groups call for a Medicaid expansion in South Dakota. Petitions will soon be circulated for a ballot question in 2022.

Joan Alker, executive director of the Georgetown Center for Children and Families, pointed to the Trump administration's efforts to dismantle the Affordable Care Act.

She said a key factor has been eliminating most of the funding for outreach and "navigators" to help people enroll.

"Families have been getting negative messages that coverage is going away at the same time that community-based resources to help them find public coverage have shrunk," Alker contended.

Burg said that's why a Medicaid expansion, and enhanced outreach from the state for initiatives like the Children's Health Insurance Program, might help stem the tide of children and families going without coverage.

"South Dakota should double down on outreach to families who are eligible but not enrolled in Medicaid or CHIP, particularly during the pandemic when we know more families are struggling," Burg urged.

The report's authors say states have a lot of power to help reverse the situation.

According to the Centers for Medicare and Medicaid Services, South Dakota hasn't adopted any of the targeted strategies designed to boost enrollment in Medicaid and the Children's Health Insurance Program.

CORRECTION: The number of reports to Virginia Child Protective Services that are found to include abuse or neglect is just under 3,000. An earlier version of this story said 'more than 1,000.' (4:17 p.m. MDT, Dec. 30, 2024) )

Virginia's child welfare system grapples with a surge of unfounded reports that critics say stem from overly broad mandatory reporting laws, disrupting families and straining resources.

Just under 3,000 of more than 90,000 annual reports to Child Protective Services are 'founded,' meaning abuse or neglect was determined to have occurred after an investigation, said Valerie L'Herrou, deputy director of the Virginia Poverty Law Center's Center for Family Advocacy.

L'Herrou explained that some parents are forced into impossible choices because of poverty, and can face neglect accusations even though their actions stem from economic necessity, not intentional disregard for their children's well-being.

"And that's when the nosy neighbor picks up the phone and calls CPS," she said, "and so these are the kinds of things: a family's water gets turned off because they can't afford to pay their water bill and so kids show up to school unbathed, and the teacher calls CPS."

L'Herrou said agencies such as the Virginia Department of Social Services are now classifying some situations as "Poverty Adjacent Neglect," acknowledging that families often lack the resources they need. She advocated for solutions that address these root causes, including raising the minimum wage, strengthening programs such as SNAP and TANF, and expanding access to affordable child care.

Mandatory reporting laws have also created a dilemma for teachers, doctors and other professionals. Anna Daniszewski, a staff attorney for family defense at the VPLC, emphasized that people often fail to recognize the enduring and traumatic consequences of a false report to Child Protective Services.

"There's still harm in a call that leads to an assessment or inquiry or investigation that turns out to be unfounded," she said. "Depending on if the report is about a bruise on an arm, a child might be strip-searched, and that's obviously traumatic, or even just the experience of having CPS knock on your door."

Advocates have said one solution would be using family resource centers to allow parents to ask for help without the fear of involving CPS. They also want better training for mandatory reporters.

Teachers are the top reporters of neglect and abuse, and groups such as the American Federation of Teachers now support an approach known as "mandated support," giving them a broader range of options beyond mandatory reporting.

A Missouri-based therapy dog has an inspiring journey that began as a homeless stray on the streets of Los Angeles.

Olive, a ten-pound poodle mix, is now the lead character in a new children's book titled, "Olive, She's All Love." She was rescued by Brandon McMillan, host of CBS's "Lucky Dog," where she received specialized training and became a certified therapy dog.

Lisa Groves-Bax, a children's advocate and owner of Therapy Paws, became Olive's owner in 2016, where the dog has been used to comfort Missouri children in the court system and inspired Groves-Bax to share her story. She said their mission to support kids who are hurting extends beyond the courtroom.

"There's schools, there's foster homes, there's libraries, all these places who are wanting a therapy dog just to help with kiddos," Groves-Bax outlined. "We have 23 certified handlers along with their certified therapy dogs, and three currently in training."

Olive is scheduled to visit Glasgow's Lewis Library and grade school Jan. 8 for an event for kindergartners through grade five.

Deborah Zemke, illustrator of the book, will also be there to share more about Olive's work. She said working on this book brought about a unique experience in her career.

"I've done a lot of books. This is the first time that I've, like, met my hero character in person before I started," Zemke recounted. "That was kind of unusual and kind of fun."

"Olive, She's all Love" can be found online and at local bookstores.


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Child tax credits offer a financial lifeline to parents and can lift children out of poverty, according to a report from New Mexico's Voices for Children.

Jacob Vigil, deputy policy director for the nonprofit, noted in addition to federal child tax credits, New Mexico is one of 16 states with its own child tax credit. He said the credits, including refundable credits, are among the most effective ways to fight poverty because they return money directly to families who know best how to address their specific needs.

"These tax credits play a really important non-stigmatizing role in providing assistance to families in most need of support," Vigil explained.

In New Mexico, Vigil pointed out the state returned $132 million to almost 240,000 households this year through the state's child tax credit program. The credit varies by income level, with the largest credits available to low-income families. Because it is refundable, families can receive the full amount for which they are eligible regardless of their tax liability.

Studies show generous tax credits can lead to long-term improvements in health and higher earnings in adulthood, and also improve school performance, which increases college attendance rates. According to Vigil, extra federal child tax credits provided to families during the pandemic had a huge effect on the state's children.

"With the expansion of the federal CTC and it being refundable temporarily in 2021, that was 450,000 kids -- and that's 95% of the child population -- 32,000 children lifted out of poverty," Vigil reported.

Post pandemic, the federal child tax credit is no longer fully refundable, which means 36% of New Mexico families earning the lowest incomes are unable to access the full federal credit, while at the same time, a married couple making up to $400,000 receives the full amount of the tax credit.