As kids' Medicaid eligibility review gets underway, experts are concerned about the number of Ohio children losing federal health insurance.

Kelly Vyzral, senior health policy associate, Children's Defense Fund-Ohio, said because Ohio does not disaggregate information by adult or child, there is little data available on why kids are dropping off. She added whether their parents obtained employer-sponsored coverage or they lost coverage for procedural reasons like a change of address, the tend is troubling.

"So we don't know why the 61,000 kids have lost their Medicaid coverage," she explained. "But there's a difference in the total number of children covered in April, versus the number covered in July. That's 61,000."

According to the Georgetown Center for Children and Families, more than 38% of Ohio children rely on Medicaid or K-CHIP coverage.

At the start of the school year, kids often need routine immunizations and physical exams for sports. Vyzral pointed out many families won't know their children have been disenrolled until they visit the doctor.

"It's not too late, they can reapply," she said. "They should definitely avail themselves of all of those roads, to maintain their children's coverage."

Joan Alker, research professor, McCourt School of Public Policy and executive director, Center for Children and Families at Georgetown University, said the ripple effects of increasing numbers of kids without coverage could be far-reaching.

"Children are not expensive to cover, but they're regular utilizers of care. We don't want families showing up at the pharmacy and being told, no, you can't get your child's medication," she explained.

According to data from KFF, kids are being kicked off of Medicaid rolls largely due to simple errors. Nationwide, nearly 700,000 children have lost coverage during the unwinding, though experts have said that number is likely much higher.

A screening tool developed by medical providers is an effective way to spot signs of child abuse, and experts are raising awareness about it today.

The TEN-4 rule stands for "Torso, Ears and Neck," an easy-to-remember prompt to examine high-risk bruising on young children that should be considered as a red flag for abuse.

Tamara Brown, director of the Health Access Nurturing Development Services (HANDS) program at Family and Children's Place Jefferson County, said the home visitation program that provides resources for new or expectant parents includes education on the TEN-4 rule to help people spot any potential signs of abuse of their child or neighbors' and friends' children.

"We work with children under the age of two and prenatal families," she said, "and what we are hoping is that we can really provide a lot of support for those most vulnerable populations. Children under two are the highest-risk group for death through child abuse."

Kentucky's rate of child abuse decreased in 2022, but the number of reported abuse and neglect cases in the state still surpasses the national average, according to federal data. Around a dozen Kentucky kids out of every 1,000 experienced some form of maltreatment during 2022.

For more information on the rule, visit faceitabuse.org/ten4rule.

Dr. Melissa Currie, professor and endowed chair for pediatric forensic medicine at the University of Louisville School of Medicine, explained that bruising - particularly on babies - isn't normal. It can be a sign of something serious: If not abuse, then a bleeding disorder or even cancer.

"It does not necessarily mean that it's abuse," Currie noted. "That said, the rule helps us determine high-risk bruising with enough specificity that if a child screens positive, they definitely need medical workup, and they need it right away."

Barry Dunn, president and CEO of Kosair for Kids, the group that created the TEN-4 Day observance, said all Kentuckians have a role to play in preventing child abuse and neglect.

"We are proud of the progress that we've made. That drop is big," he said. "We've gone from worst in the nation to 14th worst. We're not going to plant a flag with that advancement, but it is a data point."

If you suspect a child is being abused or neglected, contact the statewide Child Abuse Hotline at 877-597-2331 to make a report.

On the heels of warnings from federal health officials about parent burnout, school-linked programs in Minnesota are overhauling their approach so that families don't feel isolated. The Surgeon General's office says 33% of parents nationwide report high levels of stress in the past month compared with 20% of other adults, noting the lingering effects of the pandemic and any financial hardships, as well as a household having to navigate technology and social media.

Keem Anderson, associate director of the statewide Ignite Afterschool initiative, said it's something they've noticed.

"We've been seeing parents struggling with their mental health, right? Having to pick up a couple extra jobs because of the economy," Anderson explained.

He said those added stressors, worsened by the pandemic, are negatively impacting parent engagement with a child's academic life, including out-of-school programs. To improve connections, Anderson said they're rethinking how they ensure parents feel supported, such as addressing transportation gaps or giving them opportunities to volunteer. Ignite Afterschool plans to hold listening sessions on this topic in the near future.

The Children's Defense Fund's Freedom Schools effort - which offers educational and cultural enrichment for kids and their families - partners with a dozen schools in Minnesota.

Paris Timmons, assistant director of Extended & Experiential Learning and Academic Recovery, and executive director of Freedom Schools, leads this program for Hopkins Public Schools, and said part of the approach is figuring out how to communicate with parents in an ever-changing world.

"It's really hard to build a relationship via words on a screen versus a phone call, versus an in-person meeting," she said.

Timmons suggested her team and other support programs need to be more intentional about speaking with parents so they're aware of what's happening in and out of school. That might look like following up a text or email with that phone call or face-to-face meeting. Freedom Schools has prioritized weekly parent empowerment sessions, so that key messaging doesn't get lost in the shuffle.

September has been National Kinship Care Month, and more than 80% of Kentucky kinship families say they need help with groceries, followed by clothing, school supplies and other basic needs, according to a new report.

Because of budget constraints, the state placed a moratorium on its Kinship Care Program that previously allotted monthly payments of $300 per child to kinship caregivers stepping in as an alternative to foster care.

Shannon Moody, chief policy and strategy officer for Kentucky Youth Advocates, said a growing number of these families are navigating an often confusing child-welfare system.

"There are estimates that we've got about 55,000 children being cared for by relatives or close family friends in some sort of kinship care setting, whether that's child protective service-involved or not," she said, "and we do believe there are probably more than that."

Child care and mental health care were also listed as top priorities in the survey, by Kentucky Youth Advocates and the Kinship Families Coalition of Kentucky.

Norma Hatfield, president of the coalition, has spent the past decade raising two grandkids. She said most caregivers, especially grandparents, aren't financially equipped to suddenly take on full-time caring for children.

"Kentucky has done a lot to try to provide more support, but the needs are still there," she said. "It costs to raise children today, and that doesn't change."

Moody pointed to Senate Bill 151, signed into law by Gov. Andy Beshear earlier this year, as a sign of progress on policies aimed at improving the lives of kinship families. The law allows relatives or close friends, known as "fictive kin," to apply for certification as a foster home, and allows kids a say in where they live after they've been removed from their home.

However, Moody said more work is needed to expand community resources "to ensure that we are providing really comprehensive supports, including counseling and mediation services, in order for the that triad - the birth parent, the grandparent or other relative and the child - to get what they need."

The report also calls for more investments in peer support groups, using opioid settlement money to increase resources for kinship families, and better training for state and foster-care agencies and community mental-health providers on the unique needs of kinship families.

Resources for kinship families in the state are online at kinshipky.org.