This week marks the 25th anniversary of the Children's Health Insurance Program. Since its start in 1997, the child uninsured rate in the U.S. has dropped nearly 10 percentage points.

Dr. Maya Moody, board president of the American Academy of Pediatrics Missouri chapter and a St. Louis pediatrician, called the program "a blessing" for so many families, especially those who make enough not to qualify for Medicaid, but who do not have employer-sponsored coverage or struggle to afford other insurance.

"These children are benefiting from routine checkups and chronic disease management, like asthma follow-ups and those sorts of things," Moody pointed out. "Allowing that gap to be filled by the CHIP program is really keeping kids healthy and strong."

Missouri just last year started to implement Medicaid expansion, though there have been legislative efforts to repeal it and withhold funds.

Moody noted while CHIP has remained a stable program for families, there is still room to grow, such as implementing 12-month continuous coverage for kids, and covering Missouri children regardless of their immigration status.

A COVID relief bill from early in the pandemic requires continuous coverage for all kids throughout the Public Health Emergency, which is set to expire Oct. 13. Moody stressed continuous coverage has shown to be cost-effective for the state, as well as beneficial for children and families.

"We've seen that these kids have more consistent care," Moody observed. "There's less fragmentation, that kids and their parents don't show up at the doctor's office and realize their health insurance is inactive for whatever reason."

In Missouri, the upper income limit for a family of three to have their kids be eligible for CHIP is a little more than $70,000 a year.

Joan Alker, executive director of the Georgetown University Center for Children and Families, thinks Congress should permanently reauthorize CHIP, to build on the progress it has made.

"Children are facing a lot of challenges these days," Alker emphasized. "Making sure they have access to affordable, accessible health care is critical so that we can get our children back on track."

A proposed Kentucky law would require animal control officers statewide to undergo training on identifying and reporting child abuse.

Kyan's Law is named after Kyan Higgins Jr, a 10-year-old Louisville boy murdered by his mother. Animal control had visited Kyan's home 24 times in the 18 months leading up to his death.

Joye Keeley, founder of the Kentucky Link Coalition, said in 88% of homes with physical abuse, animal abuse is also occurring.

"When you see a dog outside being neglected, or an abused animal, it always helps to expand the call for service," Keeley explained. "To look for other forms of abuse, because you could be saving a life."

After Kyan's death, Keely spearheaded an effort to create a Louisville city ordinance requiring animal control officers there to receive training on the link between animal abuse and child abuse. According to Kentucky Youth Advocates, last year 41 suspected child abuse cases were reported to the police and the Cabinet for Health and Family Services by Louisville's animal control officers.

Jai Hamilton, animal control officer for Lexington-Fayette County Animal Care and Control, said her colleagues are in a unique position. They are often more trusted because they are not law enforcement officers and can help speed up the involvement of Child Protective Services.

"There are some households that may not allow the police inside, but they're more apt to allow animal control inside the home," Hamilton observed.

Kiera Dunk, a student at Oldham County High School and a youth advocate, said the legislation is one tool for combating child abuse, noting the state has more work to do.

"I feel like people need to understand that we are still one of the worst in the nation for child abuse," Dunk emphasized. "We should be doing everything we can to help."

April is National Child Abuse Prevention and Awareness Month. The Kosair for Kids Face It Movement is hosting a virtual workshop on the issue Wednesday.



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A Florida bill that would roll back child labor restrictions cleared a Senate panel this week, sparking debate over whether it empowers families or risks pushing vulnerable teens out of school. The proposal, which would allow 16 and 17 year-olds to work longer hours on school nights and in some hazardous jobs, drew sharp criticism from advocates who warn it could worsen chronic absenteeism and dropout rates.

Tsi Smyth, vice president for public relations with the nonprofit advocacy group Voices of Florida, says the changes will affect some students more than others.

"This is going to disproportionately affect students that are growing up in poverty, and you are going to relegate them to a lifetime of poverty," he explained.

Sen. Jay Collins, R-Tampa, sponsored Bill 918 and says it would match state rules with federal standards. It would allow 16 and 17-year-olds work 40 hours a week during school, up from the current 30-hour limit, and allow some currently banned jobs such as roofing. The measure passed along party lines, with Republicans in support. It now moves to the full Senate.

Collins said that most teen jobs are in safe places such as grocery stores, and his measure provides valuable work experience.

"Ultimately, we're not talking about 'The Jungle' by Upton Sinclair. We're talking about them working at Publix, at Piggly Wiggly, or jobs within the industry," he continued. "This is a far cry, I think often we demonize the employer cause it's going to take advantage of the children. This is a parental rights thing. Parents know their kids best."

Opponents including Sen. Carlos Guillermo, D-Orlando, warned it could lead to abuse.

"This bill is going to lead to exploitation of minors, exploitation of children, and I get the parental-rights conversation but there's no reference to parental rights in the bill," he explained.

The House bill faces one final committee vote. With Republican supermajorities controlling both chambers, passage appears likely, making Florida the latest GOP-led state to relax child labor laws. Business groups back the measure, but opponents warn it risks teen safety.

Maryland ranks second in the nation for charging children who have committed crimes as adults. But one expert says a more trauma-informed response in the justice system would better serve those young people. In fiscal year 2023, more than 3-thousand Maryland youth were charged with committing a violent crime - or a nonviolent felony. Another 8-thousand were charged with misdemeanors.

Joseph Ribsam, director of child welfare and juvenile justice policy with the Annie E. Casey Foundation, said it's common for juveniles in the justice system to have traumatic experiences. He adds trauma screenings of juveniles before they even head to court would allow the justice system to know the best way to help them.

"Oftentimes, the type of offenses that we think of that would be required to separate a young person from community are also the same types of offenses that are displayed when somebody's engaged in dysregulated behavior, which is the type of behavior that somebody who's been exposed to trauma significantly would engage in," he explained.

A report by Human Rights for Children finds Maryland ranks behind only three other states in the number of people who were imprisoned for crimes they committed as children.

According to a 2021 study, 23% of detained girls and nine percent of detained boys meet the diagnostic criteria for post-traumatic stress disorder. Ribsam said some actions taken by the justice system do not help address trauma - and at times even exacerbates the problem.

"If you really start to understand what are the drivers of the behaviors, you can find the right solution, and might find that the right solution doesn't even need to involve a justice system at all. It does start with actually understanding the needs, and not always presuming that behaviors are best solved with punitive responses," he continued.

Ribsam added that increased access to treatment and therapy would best serve juveniles in the justice system, too.