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Child Poverty Rates Decreasing, Per Recent Census Data

Posted on September 19, 2022

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Posted 9/19/2022

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By Alena Siddiqui,
Kids Count Coordinator

Childhood poverty rates in the United States have decreased 59% since 1993, according to the newly released report by Child Trends and Columbia University, Lessons From a Historic Decline in Child Poverty. The report focuses on the Census Bureau's Supplemental Poverty Measure, a measure that includes government benefits such Supplemental Nutrition Assistance Program (SNAP), Temporary Assistance for Needy Families (TANF) and the Earned Income Tax Credit (EITC), sometimes called the “social safety net”, to determine overall income. The American Community Survey's poverty data, which is the official source, do not include these benefits, instead focusing on cash income.

Including government benefits when calculating the Supplemental Poverty Measure provides a more well-rounded picture of the state of poverty for families and how these social safety net programs assist poor and low-income communities. As of 2021, 17,301 New Jersey children lived in families receiving TANF, and 393,310 received SNAP benefits. In 2018, 59,490 families claimed EITC. Data showing the number of people and households enrolled in SNAP, TANF and EITC are available through ACNJ's data dashboard. Per the SPM numbers, the Child Tax Credit and the Earned Income Tax Credits significantly contributed to the decline in child poverty in 2021. However, New Jersey saw a decline in families relying on these social service safety nets, such as EITC. See the recent blog concerning the decrease in the number of NJ families claiming EITC credits. 

The number of uninsured children has decreased as well. New American Community Survey data show that New Jersey had 75,765 children under 19 without health insurance in 2021, or 3.5% of the child population. This is a 14% decrease from 2019 and a 3.1% decrease from 2017. The number of children under 19 enrolled in NJ FamilyCare in 2021 reached 851,417, a 5.3% increase from 2017 and an 8.8% increase from 2019.

Overall, the Supplemental Poverty Measure data illustrate an encouraging trend of how programs in the social safety net can benefit children. More work is needed to simplify enrollment processes to allow all eligible families to enroll in the future.

Safe Babies Court Team Approach is Working in NJ: Time to Expand

Posted on September 16, 2022

Blog-headline

Posted 9/16/2022

Mary Coogan, Esq., ACNJ Vice President

By Mary Coogan,
ACNJ Vice President

The hard work and commitment of those involved in New Jersey's child welfare system including Division of Child Protection and Permanency (CP&P) staff, department leadership, attorneys, caretakers, service providers, judges, court staff and court volunteers has resulted in a steady and significant reduction in the number of children and youth living in foster care. Currently, that number is approximately 3,200, which is terrific news. Stakeholders continue to work collaboratively to implement best practices that can further reduce the need for children to have to be removed at all and support and strengthen families.

Unfortunately, 35% of children living in foster care are aged five and under - a critical time for development. National advocacy nonprofit ZERO TO THREE, in response, developed Safe Babies Court Team Approach (SBCT), a set of best practices specifically focused on the developmental needs of infants and toddlers and their families who are involved in child welfare cases. These best practices can help reduce the number of babies living in foster care, using the science of early child development as a basis for decision-making, connecting families to relevant concrete community supports and services focused on early childhood development and the well-being of both parents and children. The goal is to advance the health and well-being of infants and toddlers living in foster care and those at risk of being removed from their parents because of abuse or neglect so that they can flourish.

Partnering with CP&P and the New Jersey courts, CASA of Passaic County brought the Safe Babies Court Team Approach to New Jersey, piloting the program in Passaic, Essex and Hudson counties. A county leadership team established case eligibility criteria and meets regularly to engage in collaborative and proactive problem-solving. The assigned Family Court Judge, who is a member of the county team, reviews the SBCT cases more often than other cases to ensure that progress is being made. Parents must agree to have their case assigned to the SBCT. Initial data show promise, and the cases applying the SBCT Approach have babies successfully returning home to stronger and more stable parents.

The goal of the SBCT Approach is for children to maintain healthy development and have lasting permanency, specifically family reunification whenever safely possible. The baby is at the center of all decision-making. Sustained cooperation of the numerous professionals involved in the case, the parents and the family the infant or toddler is placed with, often a relative or close family friend, is critical to the program’s success.  

There is a community coordinator, an individual previously involved in some aspect of the child welfare system, such as a person with “lived experience”, who engages and works with the family to help them identify and access needed services to strengthen their family. These coordinators work to find local services for the parents and to meet the developmental needs of infants and toddlers. An analysis of the jurisdictions using the ZERO TO THREE SBCT Approach demonstrated that 83.7% of the children with closed cases were in a permanent home within 12 months, far exceeding the national Children’s Bureau standard of 40.5%. The infants and toddlers involved with SBCT had fewer placements, and 48.6% of them were successfully reunified with their parents; 14% were placed with a fit and willing relative and 32.2% were adopted. Moreover, SBCT-involved infants and toddlers were more likely to receive developmental screens, and needed less early intervention services and oral health care than their peers. Parents also received needed health care and treatment in a more timely manner. 

The Turrell Fund is providing support for these pilots, bringing together a statewide advisory group of providers and experts to troubleshoot implementation issues and identify community providers who can help strengthen families. The pilot programs were made possible with the generous support of ZERO to THREE. 

Given the success to date, it is time to expand the Safe Babies Court Team Approach to other counties.

For more information, contact Mary Coogan at mcoogan@acnj.org

Urge Congress to support home visiting services by reauthorizing MIECHV by Oct. 1

Posted on September 9, 2022

The Maternal Infant and Early Childhood Home Visiting (MIECHV) Program, the primary source of funding for New Jersey’s robust home visiting system, is set to expire. If MIECHV is not reauthorized by October 1, more than 5,000 NJ families annually could lose effective home visiting services that improve children's health, school readiness and economic security. Send a message to your Members of Congress now. 

Advocacy efforts have led to the introduction of The Jackie Walorski Maternal and Child Home Visiting Act of 2022 (HR 8876). Click here to send a message to your Member of Congress to support/co-sponsor this legislation.

Telemedicine: An Opportunity to Address the Current Health Needs Among Youth

Posted on September 6, 2022

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Posted 9/6/2022

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By Alana Vega
ACNJ Health Policy Analyst and Youth Engagement Coordinator

Since the onset of the COVID-19 pandemic, the usage of healthcare delivered through video conferencing systems or telephone, also known as telemedicine or telehealth, has increased. Thanks to recent state legislation, New Jersey families -- including those on publicly funded health insurance such as Medicaid and CHIP -- may have telemedicine services reimbursed by private insurers and NJ FamilyCare. Previously, New Jersey permitted limited access to these sorts of services, particularly for those enrolled in Medicaid. For some, telemedicine may seem strange because of its unfamiliarity. Yet, practices across the country have long relied on telemedicine, particularly in rural areas. 

Physical and Mental Health Services

Telemedicine services can be administered in a myriad of ways. For many, client/provider interactions over video conference systems like Zoom, Webex, and FaceTime likely come to mind. However, providers have reported success administering healthcare over traditional audio-only telephone calls. This practice is especially important when connecting with rural populations, older Americans and those without a reliable internet connection.

Internet Access and Telehealth Care

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Although telehealth may be a means of increasing access to healthcare across the Garden State, concerns regarding internet and device access remain persistent. The “digital divide” is a term used to refer to the gap between those with internet and computer access and those without. In New Jersey, and across the country, data show that many households do have some type of internet access. According to the Pew Research Center, 93% of U.S. adults reported using the internet in 2021, compared to 76% in 2010. Data from the same set indicate that 15% of adults are smartphone-dependent--meaning they rely on their smartphones as their primary source of internet connection and do not have broadband internet at home.

Pre-pandemic, the majority of telemedicine visits were for urgent care needs; however, primary care visits, management of chronic conditions and specialist visits all saw an increase in telemedicine utilization post-2020. Physicians reported satisfaction with telemedical services--with more than 70% indicating a willingness to use technology for visits encompassing prescription renewals, chronic care management and/or post-surgical check-ins. 

It is important to note that telehealth is not meant to replace in-person services entirely, but rather bolster the existing number of options offered to families. Some studies indicate patients were less satisfied with telehealth services. While not specific to children, one study demonstrated concerns among older, chronically-ill patients of color, who expressed difficulty building trust with their physician through a virtual visit. Another study points to a higher rate of antibiotic prescriptions than in-person care among children who attended virtual visits for respiratory infections. Unnecessary prescription of antibiotics has been cited by the Centers for Disease Control (CDC) as a factor contributing to antibiotic resistance, which could have a significant impact on the medical community’s ability to fight infections. There is also evidence showing that telehealth visits generate new concerns such as finding a quiet, solitary space for teletherapy visits to address mental health, protecting patient’s health information shared through telemedicine visits, and addressing gaps in familiarity with technology among patients and providers.

Despite some of the challenges associated with telemedical services, those specifically addressing mental health appear to have more widespread success--both from the patient and provider perspective. According to a Trilliant Health analysis of telehealth utilization between April 2019 and November 2021, behavioral health visits accounted for the single largest share of telehealth visits.

In their declaration of a national mental health emergency for children and teens, the American Academy of Pediatrics (AAP), the Children’s Hospital Association (CHA) and the American Academy of Child and Adolescent Psychiatry (AACAP) call for a variety of interventions and policy solutions to address the needs of young people. Among the list is a need to “address the regulatory challenges and improve access to technology to assure continued availability of telemedicine to provide mental health care to all populations.” A number of sources indicate that telemedicine can complement more traditional forms of mental health services or to provide specialized care for young people with specific needs.

In 2018, the New Jersey Pediatric Mental Health Care Access Program, managed by the New Jersey Chapter, American Academy of Pediatrics (NJAAP), utilized telepsychiatry to administer services to children in hubs across the state. Initially, a handful of the programs used video conferencing to see patients; as of April 2020, all nine hubs in the state leaned on telehealth services to reach their clients. Although some barriers were identified--limited office space for telepsychiatry visits as well as spotty or no internet access among patients--both providers and patients reported satisfaction with a number of features within the program. Telepsychiatry for children and adolescents, based on the experiences within the program, pointed to easier access to services through a reduction in transportation and scheduling barriers and more timely and appropriate referrals. 

Among older youth ages 15-26, also known as “transition age youth”, telemental health is seen as an opportunity to bridge the gap in services offered to those transitioning from high school or college to career. Mental health services for this age group are in high demand, as many young people leave pediatric practices and begin to navigate the adult healthcare system on their own. 

Conclusion

These findings for behavioral health services delivered through virtual systems come at a crucial time. In the final months of 2021, several authorities, including the CDC, AAP, CHA and AACAP, sounded the alarm for adolescent mental healthcare. The 2022 National KIDS COUNT Data Book points to a 40% increase in New Jersey children ages 3-17 with anxiety or depression, jumping from 7.6% of children in 2016 to 10.7%. More recent 2021 data, released by the Centers for Disease Control, show how the COVID-19 pandemic impacted high school students, with more than a third of those surveyed indicating poor mental health during the pandemic. As we enter a new school year--the second in-person instruction year since the pandemic began--assessing new methods of mental health service delivery to adolescents and young adults will be imperative.