The U.S. Department of Justice said the State of Nevada unnecessarily institutionalizes children with behavioral-health disabilities, and the problem is severe enough to violate the Americans with Disabilities Act.

The Justice Department announced its findings Tuesday, after an investigation found hundreds of children are stuck in hospitals or group homes when they should be living at home and getting community-based mental health services.

Dr. Tiffany Tyler-Garner, executive director of the Children's Advocacy Alliance, said the situation is troubling.

"Literally, the situation is so dire that they are surrendering their children to the child welfare system, in hopes of getting them mental-health services," Tyler-Garner observed.

The report showed in 2020 more than 1,700 children were admitted to the hospital for psychiatric care in Nevada and 480 ended up in residential facilities, often staying 9-12 months, and some were sent out of state. The problem is partly due to a severe lack of providers at all levels, exacerbated by low Medicaid reimbursement rates.

Tyler-Garner emphasized out-of-state placements are extremely traumatic for children and parents.

"That fragmentation that ensues as a result of it, can be crippling," Tyler-Garner stressed. "If you think about that journey of coming back together as a family. "

Gov. Steve Sisolak noted in a statement Nevada recently dedicated more than $80 million in federal funds from the American Rescue Plan to the public child behavioral-health system.

Tyler-Garner acknowledged the new investments is a good first step.

"The need is great," Tyler-Garner asserted. "Short-term pandemic or relief funding isn't going to cure it for us. Yeah, we need to find the money."

Sisolak has vowed to train more mental-health professionals and work with the Justice Department to remedy the situation. If the state does not show significant improvement over time, the federal government could file suit.

With state lawmakers back in Boise, changes could be coming to Medicaid.

Voters approved Medicaid expansion in 2018, but Republican legislators have consistently said the program is too costly for Idaho. Some are considering repealing the expanded program. However, such radical changes could hurt families the most.

Randi LaSalle, a single mom with four kids on Medicaid, said at one point, she was working two jobs and paying $800 per month for private health insurance, which was more than her rent.

"I stopped working two jobs because it just wasn't feasible with trying to take care of a bunch of kids and bouncing between counties to kind of keep up two jobs," LaSalle explained. "Things are a little tighter, but at least now I don't have to pay for insurance anymore."

Expansion helped cover people who made too much to qualify for Medicaid and fell into a coverage gap. The program covers about one in six adults and three in eight children in Idaho. LaSalle hopes legislators make the program more accessible for families this session.

Randy Johnson, Idaho government relations director for the American Cancer Society Cancer Action Network, said health coverage is important for preventive care and cancer treatment, and repealing or placing barriers to Medicaid access won't stop people from getting sick.

"People still are going to go to the hospital, and taxpayers are still going to end up covering those costs," Johnson pointed out. "It's just not up-front, and instead of going to their doctor, they're going to have to go to the ER, which is way more expensive."

Johnson argued changes would mean fewer people are covered in Idaho, which would hurt families.

"It creates that coverage for people who are working, who are doing the right thing, who want to make sure that their families are protected," Johnson stressed. "This helps them do that."

Supporters of the health program are holding Idaho Supports Medicaid Day at the Capitol on Jan. 28 in Boise.


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Advocates for working families in New York say they want less talk and more action to improve child care in the state.

Gov. Kathy Hochul has proposed a child-care construction fund and a task force to address the issue - which advocates say will make a dent in the child-care shortage, but doesn't do enough.

Estimates show New Yorkers spend a grand total of $14 billion a year on child care, or about $22,000 per year, per child. High child-care costs also are cited as a major reason young families leave the state.

Rebecca Bailin, executive director of New Yorkers United for Childcare, said universal child care is possible if the state will fund plans to implement it.

"That child care would be free, easy to apply, nearby and accessible to all families," she said. "There's no reason, with a budget of $237 billion, she cannot start to implement universal public child care now."

Bailin said a lack of political will has been the biggest hurdle for universal public child care, since 74% of New Yorkers say they want it. Feedback from some state lawmakers is positive, although enacting a universal plan could cost $12 billion a year - 6% of the state's current budget.

A Cornell University poll found high child-care costs are one reason some people can't join the workforce, while other reasons are lack of accessible child care that keeps people from working.

Bailin said a universal public system could counteract these economic harms.

"It's a $10 to $13 return on investment for every dollar spent," she said. "Making New York an affordable place for families will help to stop the exodus of families, make it possible for us to grow our workforce and our tax base."

Although New York offers child-care programs, some families earn too much to qualify for them, or have issues with immigration status that keep parents from reaching out. Bailin said expanding New York's Child Tax Credit and Working Families Tax Credit could help the system, as well as investing in the child-care workforce.


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January is National Mentoring Month and in Minnesota, program leaders report waiting lists for kids to be matched up with an adult willing to spend some valuable time with them.

Calls are being renewed for volunteers. Community-based mentoring programs connect youths who do not have many role models in their lives with adults for a range of activities. It could include attending sporting events, museums, or doing arts and crafts together.

Jill Hinners, executive director of Mentor North in Duluth, said it is all about helping children develop new skills and confidence.

"We definitely see kids that are introverts, shy, anxious," Hinners explained. "Where maybe they just have a little bit of difficulty putting themselves out there to form a large network of friends."

She suggested a mentor might put them more at ease in making connections as they grow. Her group pointed to research showing mentored kids are 22% more likely to have felt a strong sense of belonging. Hinners noted even though Minnesota has a good track record for volunteer work, her office reports a waitlist of between 50 and 60 kids.

Other data show kids who have a mentor are 55% more likely to enroll in college and are 78% more likely to volunteer regularly. Hinners stressed the outcomes can be traced back to a sense of belonging.

"We want youths to feel that they are developing their voice," Hinners emphasized. "To be able to make themselves heard in their community and courageous enough to take leadership positions in their community."

Hinners pointed out even though they have a backlog, volunteer levels have rebounded from a pandemic dip. She added they are trying to be more accommodating in certain ways, including making sure kids with disabilities have a good experience.

Adults who want to become mentors are put through a screening process before they are matched with a youth who has similar interests.


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