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e : enotes@lists.ctvoices.org 4 April 2007 • 4:27AM -0400

[Enotes] CT Voices' April 3 E-Notes
by Michael Sullivan

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E-Notes
Connecticut Voices for Children
April 3, 2007

In this issue of E-Notes, you'll find:

A.  NEW YOUTH HEALTH BEHAVIOR REPORT

B.  NEW PUBLICATIONS - EARLY CARE
*  The Early Care and Education Budget in Context: An Analysis of the
Governor's Proposed FY 08 Budget
*  Access to Preschool: Achieving Our Goals for School Readiness
*  Beyond Child Care Centers
*  Early Care and Education Availability and Utilization Data: 2007

C.  NEW PUBLICATIONS - FAMILY ECONOMIC SECURITY
*  Curbing Inequality: Achieving Our Goals for Income Equality
*  Just Who Are Connecticut's Middle Income Families?

D.  NEW PUBLICATIONS - HEALTH
*  Keeping Children Healthy and Insured Through HUSKY
*  Ensuring Health Care Coverage for All Pregnant Women and Their Babies
*  Uninsured Children in Connecticut: 2005
*  Ambulatory Care Utilization by Children Enrolled in HUSKY A in 2005
*  Updated Briefs on Federal Citizenship Documentation Requirements
*  HUSKY At A Glance
*  How is the HUSKY Program Performing?
*  Access to Care in the HUSKY Program: Achieving Our Goals for Well Child
Care
*  Access to Care in the HUSKY Program: Achieving Our Goals for Dental Care
*  Child Health and Health Care Disparities in HUSKY A in 2005
*  Emergency Care for Children in HUSKY A: CY 2005
*  Ensuring Accountability and Access to Care in the HUSKY Program Through
Independent Performance Monitoring

E.  NEW PUBLICATIONS - STATE TAX & BUDGET
*  Stagnant Tax Threshold Hurts Connecticut Families

F.  LEGISLATIVE TESTIMONY ONLINE

G.  HUSKY PUBLIC OPINION POLL SHOWS STRONG SUPPORT


A.  NEW YOUTH HEALTH BEHAVIOR REPORT

To better understand racial and ethnic disparities in health-related
behaviors among Connecticut youth, CT Voices for Children analyzed data from
the 2005 Connecticut School Health Survey by race and ethnicity.  The School
Health Survey is administered by the CT Department of Public Health and
Department of Education, and is conducted to monitor health risk and
protective factors among youth.  The survey CT Voices analyzed had a
representative sample of Connecticut students, for the first time in several
years.  This allows its results to be generalized.

Voices' analysis showed that alcohol and cigarette use is more common among
white teens in Connecticut than among black and Hispanic youth.  For
example, one-third of white high school students reported binge drinking.
Connecticut youth of color, by comparison, are more likely than white
adolescents to engage in risky sexual behaviors, be depressed, fail to wear
seat belts, and be overweight.  One-third of youth of color reported
symptoms of depression.  

Three positive "protective" factors were associated with reduced risk taking
among all three racial/ethnic groups: parental awareness of students'
whereabouts, academic achievement, and living with two parents.  The report
recommends that the findings be used to more effectively target health
prevention initiatives.  The report, Do Health Behaviors of Connecticut
Youth Differ by Their Race and Ethnicity?: The Connecticut School Health
Survey 2005, is online, along with our news release.
http://www.ctkidslink.org/pub_detail_344.html


B.  NEW PUBLICATIONS - EARLY CARE

The Early Care and Education Budget in Context: An Analysis of the
Governor's Proposed FY 08 Budget

Over the long term, the state's total investment in early care has been on
the decline. As compared to the investment levels in FY 2002, the Governor's
proposed FY 2008 funding for major early care programs in the State Dept. of
Education (up $41.3 million), Dept. of Social Services (down $42.8 million)
and Dept. of Public Health (up $0.51 million) represents a net loss in
funding. The total funding proposed is still $1 million less than the levels
in FY 2002 (adjusted for inflation).
http://www.ctkidslink.org/pub_detail_331.html


Access to Preschool: Achieving Our Goals for School Readiness

There are presently 18,000 children across the state who have been
identified as being in need of a preschool space but for whom no School
Readiness space is available. About one-half (8,700) of these children live
in Priority School Districts. At the current rate of progress. At the
current rate of progress, it will be 2030 before all children in Priority
School Districts have access to a School Readiness space and 2049 before all
children in the state do.
http://www.ctkidslink.org/pub_detail_337.html


Beyond Child Care Centers

This series of briefs highlights the need for genuine system reform to
achieve the goal of having all children ready for school and lifelong
learning. The first report, "From Programmatic Duct Tape to Real System
Reform," summarizes current research on early care and education reform and
uses this information to propose simple steps to move Connecticut toward
positive system reform for an existing patchwork of fragmented early care
and education programs.  These recommendations include developing a quality
rating system for providers, creating a state-level entity to maximize and
distribute state resources across agencies, and providing an increase in
Care4Kids funding.
http://www.ctkidslink.org/pub_detail_335.html


Early Care and Education Availability and Utilization Data: 2007

This data sheet includes data on early care and education space and subsidy
availability and utilization by town, including School Readiness, Care4Kids,
preschool experience, Grade 3 CMT performance, and children with all parents
working.
http://www.ctkidslink.org/pub_detail_334.html


C.  NEW PUBLICATIONS - FAMILY ECONOMIC SECURITY

Curbing Inequality: Achieving Our Goals for Income Equality

The growing inequality of incomes is a sign that wage expansion is not
benefiting all who are contributing to Connecticut's economic growth.
Research has shown that income inequality is associated with higher overall
death rates, higher rates of dying from heart disease, cancers, homicide and
infant mortality, not only for those at the low end of the inequality scale,
but for everyone in the community. At the current rate of inequality growth,
by 2027 the hourly wage for those at the 90th percentile of wages will
exceed $50/hour, while the hourly wage at the 10th percentile will be just
over $9.
http://www.ctkidslink.org/pub_detail_339.html


Just Who Are Connecticut's Middle Income Families?

Amid public discussions about who should pay for significant new state
investments in public education, decision makers and the public should
understand more about the distribution of income and how it varies
throughout our state. Determining who are Connecticut's "middle income
families" is not as straightforward as it may seem; middle income in one
part of Connecticut may be just barely enough to get by in other parts of
the state. Connecticut's Self Sufficiency Standard - a measure of what it
actually costs to make ends meet. For a two-parent family with two school
age children, it costs about $57,174 a year to make ends meet in Stamford,
compared to $43,827 in Windham.
http://www.ctkidslink.org/pub_detail_336.html


D.  NEW PUBLICATIONS - HEALTH

Keeping Children Healthy and Insured Through HUSKY

HUSKY cutbacks and program restrictions have resulted in confusion about the
program and discouraged families from enrolling. As a result, enrollment in
HUSKY has dropped steeply since June 2005, with 19,000 fewer residents
covered by the program as of January 2007. To help in reversing these trends
and covering more uninsured families, this brief recommends several steps to
reduce barriers to coverage (e.g., restoring funding for HUSKY outreach),
avoiding unaffordable cost sharing (e.g., reversing plans to require HUSKY
parents to pay new premiums), expand coverage to low income families (e.g.,
increasing income eligibility limits for parents), and support federal
efforts for affordable coverage (e.g., repealing burdensome citizenship
documentation requirements).
http://www.ctkidslink.org/pub_detail_333.html


Ensuring Health Care Coverage for All Pregnant Women and Their Babies

Despite programs and policies that promote maternal and infant health in
Connecticut, undocumented immigrant women in low-income families are not
eligible for the HUSKY health insurance program during pregnancy. This means
that these expectant mothers are not covered for the preventive
care---prenatal risk assessment and health promotion---that can improve
maternal health and birth outcomes. While the hospital charges for care
during labor and delivery can be covered with emergency Medicaid, babies
born to undocumented women -- new US citizens -- are not automatically
eligible for coverage during the first year of life, as are babies born to
other mothers with Medicaid coverage. Connecticut can fill this gap with
state-funded coverage for undocumented immigrant mothers during pregnancy
and with timely eligibility determination for their babies.
http://www.ctkidslink.org/pub_detail_332.html


Uninsured Children in Connecticut: 2005

The latest data from the US Census Bureau indicate that an estimated 68,000
Connecticut children under 18 were uninsured for the entire year in 2005.
This number represents 8.2% of all Connecticut children. The uninsured rate
was essentially unchanged from rates reported for Connecticut in recent
years. An estimated 37,000 Connecticut children under 19 who lived in
families with income at or below 200% of the federal poverty level were
uninsured. Virtually all these children are income-eligible for coverage in
the HUSKY Program.
http://www.ctkidslink.org/pub_detail_341.html


Ambulatory Care Utilization by Children Enrolled in HUSKY A in 2005

This report on ambulatory care (office, clinic visits and emergency visits)
received by children enrolled in HUSKY A (Medicaid) finds that rates of
children receiving well-child care in 2005 increased slightly over the
previous year, though the overall rate continues to fall short of
professional recommendations, federal goals for children in Medicaid, and
HUSKY A contract requirements. Gaps in ambulatory care utilization persist
among children of different racial/ethnic backgrounds.
http://www.ctkidslink.org/pub_detail_319.html


Updated Briefs on Federal Citizenship Documentation Requirements

A dramatic change to Connecticut's Medicaid application process could result
in thousands of citizens, including children, parents, and pregnant women,
being denied health care coverage or experiencing delayed access to care.
Effective July, 2006, a new federal law requires that states must obtain
proof of citizenship and identity for most United States citizens who apply
for Medicaid or renew their Medicaid coverage.  CT Voices has recently
updated briefs and fact sheets on this issue to reflect changes in federal
rules.  These materials outline problems with the rigid requirements, make
recommendations for repealing them or limiting the damage they are likely to
cause, and provide examples of the applicants that the rules affect.

New Federal Medicaid Citizenship and Identity Documentation Rules Mean
Delays and Denials of Care
http://www.ctkidslink.org/pub_detail_302.html

Caught in the Red Tape: How New Medicaid Paperwork Rules Will Hurt
Connecticut Families
http://www.ctkidslink.org/pub_detail_301.html

Which US Citizens Need to Document their Citizenship and Identity for
Medicaid
http://www.ctkidslink.org/pub_detail_305.html


HUSKY At A Glance

HUSKY A provides health care coverage for more than 300,000 children,
parents, pregnant women, and relative caregivers in Connecticut. This brief
provides a basic overview of HUSKY, who it covers, and how it is a smart
investment for the state.
http://www.ctkidslink.org/pub_detail_194.html


How is the HUSKY Program Performing?

To help ensure that HUSKY members are getting the services they need and
that state dollars are being spent wisely, Connecticut Voices monitors the
health care services that children enrolled in HUSKY A (Medicaid managed
care) are receiving. Over half of children ages 2 to 19 (57%) received
well-child care, a continuation of a fairly steady increase since 1999.
However, less than half (48%) of the children ages 3 to 19 had dental care
of any kind. Among mothers in HUSKY 16% smoked during pregnancy, compared
with just 3% of other mothers. Among mothers in HUSKY A, the low birthweight
rate for mothers who smoked was about 50% higher than the rate for
non-smoking mothers. While Medicaid programs in 38 states and the District
of Columbia covered at least some smoking cessation services for all
Medicaid recipients in 2005, Connecticut does not.
http://www.ctkidslink.org/pub_detail_288.html


Access to Care in the HUSKY Program: Achieving Our Goals for Well Child Care


All children need high quality care to support healthy growth and optimal
development during infancy, childhood, and adolescence. Federal guidelines
for health care for children enrolled in HUSKY call for annual well-child
exams for children ages 2 to 5 and 11 to 19 and exams every two years for
children ages 6 to 10. In 2005, about half of the 156,368 children for whom
Connecticut paid health insurance through HUSKY A received well-child care
visits. At the current rate of progress, it will be 2027 before all children
enrolled in HUSKY A have access to one well-child care visit per year.
http://www.ctkidslink.org/pub_detail_338.html


Access to Care in the HUSKY Program: Achieving Our Goals for Dental Care

All children need regular dental care to prevent and treat dental problems.
Every child in HUSKY A should receive preventive dental care services twice
a year, beginning with an initial screening visit at 2 years of age.
However, just 41 percent of children enrolled in HUSKY A received at least
one preventive dental care visit in 2005. This is essentially unchanged from
the previous year, and up only 6 percentage points in the past 5 years. At
the current rate of progress, it will be 2044 before all children enrolled
in HUSKY receive one preventive dental care visit each year.
http://www.ctkidslink.org/pub_detail_340.html


Child Health and Health Care Disparities in HUSKY A in 2005

This report on racial and ethnic disparities in the use of HUSKY A
(Medicaid) services by children in 2005 finds that African-American children
were less likely than White children to have well-child care or other
outpatient care. Among children with asthma, Hispanic and African-American
children are more likely to rely on emergency departments for care and less
likely to receive timely follow-up care.
http://www.ctkidslink.org/pub_detail_343.html


Emergency Care for Children in HUSKY A: CY 2005

This report finds that over a third of children in HUSKY A (Medicaid managed
care) are seen in emergency care settings each year. About one in four (26%)
emergency department visits were made for an ambulatory care sensitive
condition, i.e., a condition that is amenable to treatment in an outpatient
setting. The report recommends access to primary care providers who can
provide telephone consultation and advice to parents when their children are
ill or injured, and parent education and support to avoid common acute
illnesses, injuries, and exacerbation of conditions such as asthma and
respiratory infections.
http://www.ctkidslink.org/pub_detail_329.html

Ensuring Accountability and Access to Care in the HUSKY Program Through
Independent Performance Monitoring

Over 300,000 Connecticut children and parents depend on the HUSKY Program
Part A (Medicaid managed care) for access to preventive care and treatment.
By maintaining independent performance monitoring in the HUSKY program,
Connecticut can ensure accountability for federal and state dollars and for
program changes, as well as data sharing and policy development to improve
public health. For example, an analysis of HUSKY A program data found that
in 2005, 10% of all children in HUSKY A for the entire year did not have any
care at all, even though Connecticut paid the managed care plans about $40
million to provide care for these children.
http://www.ctkidslink.org/pub_detail_227.html


D.  NEW PUBLICATIONS - STATE TAX & BUDGET

Stagnant Tax Threshold Hurts Connecticut Families

The number of low-income Connecticut families required to pay state income
taxes will continue to grow each year, unless the state increases the "tax
threshold," the income level at which families begin paying taxes, taking
into account all universally-available exemptions and credits. Of the 42
states, including the District of Columbia, that levy a state income tax,
Connecticut is one of just two states that has not adjusted its tax
threshold upward since 1991. As a result, more low-income families have been
paying the tax, and without legislative action, Connecticut will be taxing
families at the poverty level within a few years. An issue brief from CT
Voices and a national report from the Center on Budget and Policy Priorities
are available on our Web site.
http://www.ctkidslink.org/pub_detail_342.html


F.  LEGISLATIVE TESTIMONY ONLINE

CT Voices has begun to post our legislative testimony on our Web site.  A
sampling of testimony on HUSKY, property taxes, purchase of service
contracts, and economic development is now online, and dozens more will be
added in the coming weeks.
http://www.ctkidslink.org/testimony.html


G.  HUSKY PUBLIC OPINION POLL SHOWS STRONG SUPPORT

An overwhelming number of Connecticut voters want to invest more in
children's health care, according to a poll released by Connecticut Voices
for Children and the New England Alliance for Children's Health. Among the
findings:

*  Nearly nine in ten (89%) Connecticut residents favor expanding the HUSKY
health insurance program so that every uninsured child in Connecticut could
get health care coverage.
*  Nine in ten (90%) favor investing more in outreach efforts so that
eligible, uninsured children get covered.
*  Nine in ten (90%) also support offering affordable coverage to low-income
parents of children enrolled in HUSKY.
*  Voters in Connecticut want to increase funding for HUSKY - at both
federal and state levels.

The poll results and statements from several members of the CT Congressional
delegation are online.
http://www.ctkidslink.org/announcement_64.html


------------------------------------
Connecticut Voices for Children
33 Whitney Ave
New Haven CT 06511
(203) 498-4240
http://www.ctkidslink.org

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