A persistent child care worker shortage across New Hampshire is leaving families with few options.

The state is currently short more than 7,000 child care positions but low wages and burnout are driving workers from the field and forcing some centers to close.

Shannon Tremblay, director of the New Hampshire Child Care Advisory Council, said workers are struggling to care for their own families with wages barely above the federal poverty line.

"No one wants to come in for a low wage," Tremblay pointed out. "No one wants to come in making $15 an hour, working long hours in a stressful environment."

Tremblay argued greater state investment will create long-term benefits for both parents and children, some of whom may have disabilities or behavioral issues which could be identified earlier by trained child care staff.

Last year, state lawmakers invested more than $60 million in child care services, including $15 million for the creation of child care workforce grants and investments in the state's Family Resource Centers.

Tremblay emphasized the end of career and technical education programs in New Hampshire high schools broke the pipeline of workers entering the field, putting greater pressure on current staff to do it all.

"Our providers are the case manager, the cook, the plumber," Tremblay observed. "They want to provide that high-quality care and right now it's just, they can't do it."

Tremblay stressed pandemic-era funding to support the child care industry will run out in September, so state lawmakers need to act. She added the state could increase wages so the burden does not fall on New Hampshire families, who currently spend roughly $24,000 a year on care for two children under age five.

Tens of thousands of children in Pennsylvania are still missing out on essential health care coverage, according to a new report.

The "State of Children's Health" report revealed Pennsylvania has the fifth-highest number of uninsured children in the nation.

Becky Ludwick, vice president of public policy at Pennsylvania Partnerships for Children, said factors like race, where you live and family income play big roles in whether children have health insurance. And while the number of uninsured kids has stayed relatively steady, a stable uninsured rate does not signal there has been progress.

"There's still a little over 5% of kids who don't have health insurance in the state of Pennsylvania," Ludwick pointed out. "What that translates into, in terms of the number of kids is, we are seeing that 147,000 Pennsylvania children do not have coverage."

In Pennsylvania, younger children are more likely to be uninsured than school-aged children. Ludwick added one possible solution is the Department of Human Services' recent federal approval of continuous Medicaid coverage for kids up to age 6.

Ludwick noted the Medicaid "unwinding" process, to re-qualify families for coverage after the pandemic public-health emergency officially ended, did not significantly increase the number of uninsured children in the state. But her organization initially worried about a greater disruption when renewals resumed.

"Fortunately, what the numbers yielded were that eight out of 10 kids that went through the Medicaid unwinding process were either able to keep their Medicaid coverage, or they were able to transfer coverage over to CHIP, or to plans through PENNIE," Ludwick outlined.

Ludwick added nearly half of Pennsylvania's children depend on Medicaid, the Children's Health Insurance Program or plans from PENNIE, the state's insurance marketplace, for their health insurance, emphasizing the critical importance of these programs not only to children but to parents and policymakers.

Whooping cough, or pertussis, is making a comeback and a Tennessee medical expert stressed the preventable, highly contagious bacterial infection requires urgent attention.

The Centers for Disease Control and Prevention reported, year-to-date, Tennessee has recorded more than 200 cases, while more than 25,000 cases have been reported nationwide.

Dr. Anthony Flores, professor of pediatrics and director of pediatric infectious diseases at Vanderbilt University Medical Center, said rising cases are largely due to vaccine hesitancy, and taking action now is essential to combat the serious illness.

"I think of our severe cases that we're seeing here in Tennessee, and nationwide as well, almost all of those severe hospitalized cases are in unvaccinated children," Flores explained. "I think the lower vaccination rate, kind of the periodicity with which we see whooping cough come back and surges, are contributing to the current numbers we're seeing."

Flores noted typical symptoms include a runny nose and low-grade fever, although fever is less prominent. The cough can develop and persist for weeks, becoming particularly bothersome in older children and adults. The name "whooping cough" comes from the severe coughing fits, which cause difficulty breathing, followed by a "whoop" sound as the afflicted person gasps for air.

Flores pointed out in newborns, especially before they begin receiving their initial vaccinations at 2, 4, and 6 months, their protection relies solely on the antibodies passed to them by the mother during pregnancy.

"In pregnant women, it's actually recommended that if they haven't received a booster, that they receive a booster in their third trimester, and that's again to pass on those antibodies to the newborn baby," Flores emphasized. "But then what can protect them from severe disease?"

Flores recommended children receive the whooping cough vaccine as part of their routine immunizations. He added as they grow, they get booster shots, and adults receive a different formulation called Tdap every 10 years to maintain immunity. He added it is important to follow a schedule to prevent waning immunity over time.


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CLARIFICATION: We updated language to clarify the timing for when the study's authors began tracking certain outcome measures for children within the foster care system. (9:30 a.m. CST, Nov. 22, 2024)

This Saturday is National Adoption Day and the latest findings showed Minnesota has made progress in helping kids in the foster care system secure a better future.

Aaron Sojourner, labor economist at the W.E. Upjohn Institute for Employment Research, helped lead a study of reforms Minnesota approved in 2015. He said states often provide financial support to children in foster care but support ends when a child is adopted or placed in a kin guardianship.

Minnesota decided to continue payments to households who take a child in permanently. Sojourner pointed out three years after foster cases started, positive outcomes became clear.

"The kids were scoring much higher on standardized achievement tests," Sojourner reported. "They were experiencing less turnover in schools and school instability."

He noted the incentives also boosted the chances of kids age 6 and older exiting the foster care system and moving into permanent home settings by 29%. Sojourner added while the results are encouraging, it is just one aspect of the child welfare landscape. Other research has shown racial disparities in Minnesota's foster care system, especially when looking at reducing entry rates.

Sojourner stressed if state lawmakers revisit the extended monthly payments in budget talks, they will need to realize the long-term payoff from these investments.

"The state is paying more money now but they're going to reap the benefits down the road," Sojourner contended. "In terms of increased earnings and employment."

His team's study said prolonged exposure to foster care is tied to poor transitions into adulthood, including homelessness.


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