Children's health

CMS approves Ohio Medicaid coverage extension for new moms

Federal officials have approved Ohio Medicaid’s plan to extend benefits for new mothers from 60 days to 12 months after the birth of their child (Source: “Ohio Medicaid extends postpartum coverage for new mothers,” Dayton Daily News, Aug. 17).

The U.S. Department of Health and Human Services (HHS), through the Centers for Medicare and Medicaid Services (CMS), on Tuesday approved the state’s request to extend the coverage.

“Maternal health is a strong predictor of a child’s health, so by extending health coverage for new moms, we are helping to provide the healthiest possible start in life for Ohio’s children,” said Gov. Mike DeWine.

The American Rescue Plan Act (ARPA) provided the option for states to expand this Medicaid coverage for new moms from 60 days to 12 months. The state of Ohio’s budget included this expanded coverage in its portion of Medicaid funding. DeWine said the state of Ohio began this extended coverage on April 1 and CMS’s final approval is the last step to continuing those services.


Study finds race, ethnicity are seldom mentioned in pediatric clinical guidelines

Race and ethnicity were unexplored in most American pediatric clinical practice guidelines published in the last 5 years, according to the results of a systematic review (Source: “Race unexplored in most pediatric clinical care guidelines, review finds,” Helio, June 13).

According to the study, which was published in JAMA Pediatrics, 70% of the guidelines did not mention race or ethnicity at all. The researchers also found that when race or ethnicity was mentioned, 57% of the time it was used in a way that could exacerbate or have a negative impact on inequities and only 15.1% of clinical practice guidelines include language specifically intended to reduce disparities in medicine.

“I think that shows a missed opportunity for us as medical organizations to be proactive in talking about health care inequities and systemic racism in our field,” said Courtney A. Gilliam, MD, a member of the division of hospital medicine in the department of pediatrics at Seattle Children’s Hospital and a co-author of the review. “We have a long way to go in interrogating clinical practice guidelines.”


Ohio set for rollout of COVID vaccines for children younger than 5

With federal approval of pediatric COVID-19 vaccines expected soon, vaccine providers in Ohio have begun placing orders for vaccines for children less than 5 years old, and the first deliveries are expected on Monday, state health officials said (Source: “Ohio ready for rollout of pediatric COVID-19 vaccines when approved, state health official says,” Cleveland.com, June 16).

“The one group that has still been waiting has been our youngest children, those less than 5 years of age and now that appears likely to change,” Ohio Department of Health director Dr. Bruce Vanderhoff said Thursday in a press briefing.

The vaccine advisory committee to the U.S. Food and Drug Administration recently voted unanimously to recommend approval of Pfizer’s application for a vaccine for those ages 6 months through 4 years old. Moderna has applied for a COVID-19 vaccine for ages 6 months through 5 years old.

Next, FDA leadership is expected to issue its approval. On Friday and Saturday, the U.S. Centers for Disease Control and Prevention advisory committee will meet to make recommendations for the vaccines’ uses. The CDC director must then approve the committee’s recommendations.


Schools slow to use federal COVID funding to improve indoor air quality

Despite billions of dollars in federal covid-relief money available to upgrade heating and air-conditioning systems and improve air quality and filtration in K-12 schools, U.S. public schools have been slow to begin projects that have the potentional to improve the overall health of students (Source: “Covid Funding Pries Open a Door to Improving Air Quality in Schools,” Kaiser Health News, June 13).

According to a report released this month from the Centers for Disease Control and Prevention, fewer than 40% of public schools had replaced or upgraded their HVAC systems since the start of the pandemic. Even fewer were using high-efficiency particulate air, or HEPA, filters in classrooms (28%), or fans to increase the effectiveness of having windows open (37%).

Both the CDC and White House have stressed indoor ventilation as a potent weapon in the battle to contain covid. And a wealth of data shows that improving ventilation in schools has benefits well beyond covid.

Good indoor air quality is associated with improvements in math and reading; greater ability to focus; fewer symptoms of asthma and respiratory disease; and less absenteeism. Nearly 1 in 13 U.S. children have asthma, which leads to more missed school days than any other chronic illness.


Study: 1 in 4 children not receiving regular vision screenings

A new national study found that a quarter of children are not regularly screened for vision problems (Source: “Children’s Vision Problems Often Go Undetected, Despite Calls for Regular Screening,” Kaiser Health News, June 9).

According to the National Survey of Children’s Health, in 2016-17 one in four children were not regularly screened for vision problems.

Eye exams for children are required under federal law to be covered by most private health plans and Medicaid. Vision screenings are mandated for school-age children in 40 states and the District of Columbia, and 26 states require them for preschoolers, according to the National Center for Children’s Vision and Eye Health at the nonprofit advocacy organization Prevent Blindness (Ohio requires exams for school-age children but not preschool).

Still, many children who are struggling to see clearly are being overlooked. The pandemic has only exacerbated the issue since classes moved online, and for many students in-school vision screenings are the only time they get their eyes checked. Even when campuses reopened, school nurses were so swamped with covid testing that general screenings had to be put to the side, said Kate King, president-elect of the National Association of School Nurses.

The Centers for Disease Control and Prevention estimates that more than 600,000 children and teens are blind or have a vision disorder.


Baby formula shortage puts spotlight on long-standing health disparities

As parents across the United States struggle to find formula to feed their children, the pain is particularly acute among Black and Hispanic women, who have historically faced obstacles to breastfeeding, including a lack of lactation support in the hospital, more pressure to formula feed and cultural roadblocks (Source: “Baby formula shortage highlights racial disparities,” Associated Press, May 27).

Low-income families buy the majority of formula in the U.S. and face a particular struggle: Experts fear small neighborhood grocery stores that serve these vulnerable populations are not replenishing as much as larger retail stores, leaving some of these families without the resources or means to access formula.

The Centers for Disease Control and Prevention estimates that 20% of Black women and 23% of Hispanic women exclusively breastfeed through six months, compared to 29% of white women. The overall rate stands at 26%. Hospitals that encourage breastfeeding and overall lactation support are less prevalent in Black neighborhoods, according to the CDC.

The racial disparities reach far back in America’s history. The demands of slave labor prevented mothers from nursing their children, and slave owners separated mothers from their own babies to have them serve as wet nurses, breastfeeding other women’s children. In the 1950s, racially targeted commercials falsely advertised formula as a superior source of nutrition for infants. And studies continue to show that the babies of Black mothers are more likely to be introduced to formula in the hospital than the babies of white mothers.


Ohio to spend $84 million in federal funds on behavioral health for children

Gov. Mike DeWine announced Monday that Ohio will spend $84 million in federal American Rescue Plan funding to increase access to services and support for behavioral health care for children (Source: “Ohio investing $84M in initiative to improve behavioral health care for children,” Mahoning Matters, May 16).

The Pediatric Behavioral Health Initiative will use American Rescue Plan funds that were allocated in House Bill 168.

  • Akron Children’s Hospital
  • Cincinnati Children’s Hospital Medical Center
  • Dayton Children’s Hospital
  • ProMedica Russell J. Ebeid Children’s Hospital
  • University Hospitals Rainbow Babies & Children’s
  • Appalachian Children’s Coalition — Integrated Services for Behavioral Health
  • Appalachian Children’s Coalition — Hopewell Health Centers

More than 4 in 10 teens had mental health challenges during pandemic, CDC study found

More than 4 in 10 U.S. high school students said they felt persistently sad or hopeless during the pandemic, according to government findings released Thursday (Source: “Pandemic took a toll on teen mental health, US study says,” Associated Press, March 31).
 
Several medical groups have warned that pandemic isolation from school closures and lack of social gatherings has taken a toll on young people’s mental health.
 
The Centers for Disease Control and Prevention study found that the pandemic did not affect teens equally. LGBT youth reported poorer mental health and more suicide attempts than others. About 75% said they suffered emotional abuse in the home and 20% reported physical abuse. By comparison, half of heterosexual students reported emotional abuse and 10% reported physical abuse, the CDC said.


Ohio Medicaid announces care management organizations for OhioRISE program

The Ohio Department of Medicaid announced this week the 20 organizations that would launch OhioRISE, a new Medicaid program for children with severe behavioral and mental problems (Source: “Parents have given up custody to get care for children with severe needs. Ohio Medicaid is closer to ending that,” Columbus Dispatch, Feb. 17).

OhioRISE, short for Resilience through Integrated Systems and Excellence, is scheduled to roll out in July with the goal of addressing situations where parents are at risk of giving up custody of their children to the state in order to get the required, unaffordable mental health and residential care needed by a child with severe behavioral and mental health problems. 

Aetna will be the health insurance company overseeing the program, which the department expects to cover up to 60,000 children by the end of the first year. The organizations, called care management entities, will be responsible for coordinating care for a child: Bringing together schools, behavioral health providers, juvenile services and other systems to provide help for complex needs. 

The $1 billion program is partly paid for by savings from other planned Medicaid reforms, such as centralized credentialing and billing systems. Around $19.5 million will be given to the entities to help them start up.


White House unveils plans to remove lead pipes, paint

The Biden administration released a new plan this week for removing the country’s lead water pipes (Source: “Biden administration releases plan for tackling lead pipes,” The Hill, Dec. 16). 

The plan, announced Thursday in a fact sheet, notes that the Environmental Protection Agency (EPA) will “begin to develop” new regulations for lead and copper pipes. 

Exposure to lead can have negative health effects, especially in children, for whom it can cause brain and nervous system damage and slowed growth and development. 

The Biden administration’s plans would also distribute about $3 billion in funds from the bipartisan infrastructure law for lead service line replacement next year, and said it would be “calling on states to prioritize underserved communities.”

The EPA and Labor Department will also create regional technical assistance hubs that seek to “fast track” the removal process. Meanwhile, the Housing and Urban Development Department will distribute grants to remove lead paint and other hazards in low-income communities.