Millions of children have lost their health care coverage; 'procedural' or 'red tape' problems are to blame

Babies and children are missing needed check-ups
because of coverage loss. (Adobe Stock photo)

Government red tape has caused millions of children to lose their health care coverage. Joyce Frieden of MedPage Today reports, "A total of 4.16 million fewer children were enrolled in Medicaid or CHIP at the end of last year compared with the month before each state began its Medicaid and CHIP 'unwinding' process, a report from Georgetown University's Center for Children and Families found.

While some families most likely moved to different coverage, many did not. Joan Alker, the center's executive director, told Frieden, "Federal researchers estimate that three-quarters of children who will or have lost Medicaid during the unwinding will remain eligible for Medicaid but are losing coverage for procedural or 'red tape' reasons. Nationwide, a shockingly high 70% of people losing Medicaid are doing so for procedural reasons."

Some states dropped more children enrollees than others. "Texas, Florida, Georgia, and California saw the largest numeric declines in Medicaid/CHIP child enrollment," Frieden writes. "[That reduction] accounts for half of the total national decline, the researchers said. . . . Eight states -- Montana, Idaho, South Dakota, Arkansas, New Hampshire, Utah, Alaska, and Colorado -- disenrolled so many children in 2023 that they had fewer children enrolled at the end of the year than prior to the pandemic in early 2020."

Coverage loss has become a daily barrier to care in pediatrician offices. Kimberly Avila Edwards, a pediatrician from Texas, told Frieden, "Parents are checking in for their child's appointment, only to learn that their child is no longer covered due to a paperwork issue. These situations are all avoidable, but they are now the daily reality in pediatric offices across the country."

Alker told Frieden, "States should make efforts to reach out to families with trusted community partners and resources to re-enroll eligible children, and consider systems reforms to make the process go more smoothly."

To help address coverage loss, Edwards is "advising parents whose children have been disenrolled to 'Please be proactive -- if you receive a notice, act quickly and respond in the time frame provided,'" Frieden reports. "'Secondly, [we're] asking them to seek assistance from community health centers or patient advocates and contact their local Medicaid agency.'"

Nutrition programs expanded for women and children during pandemic due to easier access; but changes are temporary

Money for fruits and vegetables is part of the
WIC program. (Photo by Rusty Watson, Unsplash)

Pandemic changes allowed more mothers to access the nutritional benefits of the Special Supplemental Nutrition Program for Women, Infants, and Children. The program's growth was spurred by decreasing participant requirements and in-person interviews. While those changes helped WIC become more popular with mothers, the program faces funding and waiver crunches that may limit access again. "WIC is not an entitlement program — it can only support additional participants if Congress allocates funding for them," reports Caitlin Dewey of Stateline. Temporary federal waivers "made it easier to participate during the pandemic, and Congress would need to change the law to extend them."

Despite the program's history of positive health outcomes and bipartisan support, "House Republicans have signaled a desire to hold WIC funding steady, with no increase to cover new participants. A series of continuing resolutions passed to buy Congress time as it works out a comprehensive budget deal also have maintained prior funding levels," Dewey explains. Without additional funding, some states may face waitlists, which, depending on the wait time, may not be helpful for pregnant women.

Dr. Aditi Vasan is a pediatrician at the Children's Hospital of Philadelphia, where she has researched participation in WIC. Vasan told Dewey, "It's a really important source of nutrition support for low-income pregnant women, children and families, because it provides both nutrition education and the funds to purchase nutritious food." Dewey reports, "[Before the pandemic] participants frequently reported problems scheduling appointments, taking time off work and accessing transportation to WIC offices." To contain Covid-19, WIC offices were allowed to conduct interviews and screenings remotely, which removed a major obstacle for program applicants. Many of WIC's pandemic adaptations were authorized under temporary federal waivers," Dewey writes. "By September 2026, when waivers end, Congress will need to change the statute underlying WIC to make those changes permanent, said Ali Hard of the National WIC Association."

Farming stress isn't limited to the farmer, a new study looks at the demands of farming on adolescents and their parents

Most farming mental health resources are for adults, not children.
(Photo by Katie Humphreys, Farm Journal)

Numerous studies have proven that farmers are no strangers to stress. The number of unexpected triggers, from weather to tariffs to fertilizer prices, can prove mentally exhausting. But what hasn't been researched as much is the role stress plays on farmers' families.

A new study from the University of Illinois sets out to address that knowledge gap by exploring "how economic stressors affect the mental health of U.S. farmers and their adolescent children," reports Jennifer Shike of Farm Journal. "With many young people growing up on a farm and participating in agricultural work, it's time to look at how stress affects kids, too, says Josie Rudolphi, assistant professor in the U of I Department of Agricultural and Biological Engineering."

"We've long acknowledged the inherent hazards of this work environment, and now we're also recognizing its impact on mental health," Rudolphi told Shike. "Most of the work on farm stress and mental health primarily focuses on adult farmers. However, it is important to recognize that children are fully aware of what's happening on the farm, and they are not immune to the stressors that exist."

Rudolphi and co-author Richard Berg used the Farm Stress Model to "examine the correlation between economic stressors and mental health in farmers," Shike explains. "Rudolphi and Berg discovered about 60% of both adults and adolescents met the criteria for at least mild depression, while 55% of the adults and 45% of the adolescents met the criteria for generalized anxiety disorder." Rudolphi told her: "Prevalence of depression in the general population is typically around 17% to 18%, so these numbers are quite high."

When everyone works at home, it's harder for families to detach from farming business and relax together. Rudolphi told Shike: "It's not unexpected for children to be affected by the experiences of adults. In many other settings, adults can leave work, return home, and transition into their roles as parents. But in a farm environment, the boardroom table is the kitchen table, and there is talk about farm activity in the household. There's a blur between work and family, or business and residence, so it becomes rather complicated."

"One of the most important findings in the current study is the strong correlation between adult depression and adolescent depression, Rudolphi points out. This [finding] underscores the need to develop resources and services for the entire farm family," Shike reports. "Although there is a growing library of mental health resources available for farmers, they mostly target the owner-operators. Not kids. 'We must also consider the well-being of spouses and children on the farm,' Rudolphi says. 'The agricultural environment prides itself on looking out for one another. We should harness that shared responsibility to foster a sense of community and support for young people. This involves engaging with rural schools, teachers, coaches, and agricultural youth leaders in mental health awareness initiatives.'"

Family-based residential addiction treatment centers are successful, but the model struggles to be viable

Despite successes, these centers struggle.
(Photo by Jordan Whitt, Unsplash)

Even with higher success rates, family-based residential addiction treatment centers remain the exception; centers in rural areas are rarer still, with waiting lists ranging from two to six weeks, reports Christina Saint Louis of KFF Health News. Recovering Hope Treatment Center in eastern Minnesota's Kanabec County is the state's only rural residential treatment center and "one of only five providers in the state that offer family-based residential treatment, allowing women to enter the program while pregnant or to bring one of their children younger than 5 with them for the duration of their stay."

Research supports the success of family-centered approaches to addiction treatment, but costs, lack of funding and staffing struggles prevent the model from becoming the standard of care. "And because of that complexity, families in rural areas are less likely to find such a residential treatment program in their communities," Saint Louis writes. "Meanwhile, maternal opioid-related diagnoses have increased nationwide. From 2010 to 2017, the rates of women with those diagnoses at delivery increased by 131%, and babies born with withdrawal symptoms increased by 82%, according to the Centers for Disease Control and Prevention. The increases disproportionately affected rural areas."

Women receiving residential treatment tend to have Medicaid, which has lower provider reimbursement rates, contributing to centers limiting or reducing services to cut costs. Saint Louis adds, "Women in the center's residential program previously spent up to an average of 40 days in high-intensity care at the beginning of their treatment, but that time span is now closer to 30 days to contain costs due to those low reimbursement rates."

Family-based care allows children to stay at the center but adds child care and schooling limitations, according to Ashley Snyder, a licensed drug and alcohol counselor at Recovering Hope. Snyder told Saint Louis, "If you don't provide family services, the parents run the risk of losing their kids."

As an indicator of how tough establishing a residential addiction center is, North Dakota's state Department of Health and Human Services has been "trying to establish a family-based residential treatment option like Recovering Hope since 2020. The state has been without one since April 2019, when its lone provider shut down," Saint Louis reports. "The department has issued three requests for proposals seeking providers to offer a treatment model that allows children to live with a parent undergoing residential treatment but didn't receive any responses."

Diapers' cost can strain poor families' budgets; Tennessee becomes the first state to have Medicaid pay for them

Volunteers stack hundreds of diapers at the Nashville Diaper
Connection. (Photo by Mark Zalesk, The Tennessean)

Babies need plenty of naps and diapers. Naps are free, but diapers? Buying diapers at an average cost of $80 a month often stresses family budgets, but poor families in Tennessee may be getting some help. "Tennessee could soon be the first state in the nation to cover part of the cost of diapers for babies on the state's Medicaid program," reports Vivian Jones of The Tennessean. "With funding approved last month by the state legislature, TennCare is working to implement a benefit offering half of the diapers a baby needs for the first two years of life. The benefit is expected to be in place by January 2024. . . . Funding for the benefit comes from the $330 million in savings the state realized by restructuring how the state receives Medicaid funding from the federal government." (The impact won't be as great as it could be; Tennessee is one of the 10 states that has not expanded Medicaid to househols with incomes up to 138 percent of the federal poverty level.)

The need and expense of diapers are a shared pain for most parents. Danielle Cast, a single mom working two jobs, told Jones, "You need diapers all the time – you can't not have them. When you don't have them, and you need them, it's a heck of an emergency." Jones reports, "Casto is one of about 4,500 parents in Middle Tennessee served by the Nashville Diaper Connection – Tennessee's largest and oldest diaper bank." Despite help from such non-profits, more diapers are needed, Jones writes: "Unlike food, diapers are not targeted by any in-kind federal assistance program – no food stamps or WIC benefits cover them. About one in three families in Middle Tennessee struggle to provide the diapers their infants need. . . . Without enough diapers to keep a baby clean and dry, infants are at higher risk for diaper dermatitis and urinary tract infections. . . . Most daycare facilities require parents to provide a day's worth of diapers for their child – which poses a significant burden to families facing financial insecurity."

Casto told Jones that the new benefit "is going to be an extraordinary help. Lots of parents struggle with bills or their groceries – being able to have half your diapers already, it takes off half the burden, and it'll allow you to buy groceries that you might need, or gas that day, or medication for your children. . . . It's rough, especially the way that inflation has gone up recently – nobody planned for that. It's hard for parents to go and tell everyone how bad they're struggling – like, 'I don't have groceries' or 'I don't have diapers.' It's not something someone wants to brag about. It's uncomfortable, it's embarrassing – it's hard."

Doug Adair, founder of the Nashville Diaper Connection, told Jones, "It's a stupid, broken economic system: we want you to support your family, we want you to have a great job, and a solid career and go to school – but people really don't want to talk about diapers. . . . You can't buy diapers with food stamps. You can't buy diapers with WIC. You can't leave a day's worth of diapers [at daycare]? No daycare. No daycare? No work." Jones reports, "Adair said TennCare's new diaper benefit is something he's been hoping to see for a long time." Adair added, "It's essential. It's basic. It's empowering. It's a little burden off."

SNAP benefits will end in 32 states; food pantries aim to fill the gap; it may not be possible to meet the demand

Photo by Erin Schaff, The New York Times

Across 32 states, emergency Supplemental Nutrition Assistance Program benefits will end in March. The drop in assistance has local food pantries gearing up to feed more families and hoping they will have enough. "Food bank managers fear that demand will spike further in March, when officials roll back pandemic-era increases to SNAP benefits," reports Jazmin Orozco Rodriguez of Kaiser Health News. "The program, administered by the Department of Agriculture, provides monthly stipends to people with low incomes to spend on food. Before 2020, those payments averaged a little more than $200 and were hiked by a minimum of $95 during the pandemic."

"Friends in Service Helping food pantry is known in rural northeastern Nevada as FISH," writes Rodriguez. "The food pantry is one of a few in this city of about 20,000 people. In January, FISH provided food boxes to nearly 790 people. . . Officials estimate FISH families will see a 30% to 40% decrease in SNAP payments as emergency allotments tied to the public health emergency halt in 32 states, including Nevada." Georgia, Indiana, Montana, Kentucky, and South Dakota, have already ended the emergency allotments.

Andrew Cheyne, managing director of public policy for GRACE, a nonprofit run by the Daughters of Charity of St. Vincent de Paul, focused on reducing childhood hunger, told Rodriguez, "We have so many households who simply aren’t going to know that this is happening. They’re going to go to the grocery store and expect to have money in their account and not be able to buy the food they need to feed their families. . . .There’s just no comparing the scale of SNAP to the charitable food sector. It’s simply not possible to make up that difference.”

Rodriquez reports, "In Montana, the expanded SNAP benefits were cut in summer 2021. Brent Weisgram, vice president and chief operating officer of the Montana Food Bank Network, said that reporting from the network’s partners shows a 24% increase in the number of households seeking assistance from emergency food pantries from July 2021 to July 2022. Weisgram said food pantries are not prepared to absorb the impact of the cut to the largest federal nutrition assistance program and are strictly a supplemental resource."

Tammy King, a volunteer at FISH, told Rodriquez, “I feel that everybody who has the power to help is doing everything they can to help us. You just gotta look at your food and say, ‘OK, how long can I make this last and make a difference in someone’s life?’”

'Culture of silence' envelops sexual abuse of rural kids; training program in Oregon and California seeks change

Photo by Kristina Flour, Unsplash

Wikipedia describes the culture or conspiracy of silence as "the behavior of a group of people of some size, as large as an entire national group or profession or as small as a group of colleagues, that by unspoken consensus does not mention, discuss, or acknowledge a given subject."

Silence can proliferate problems; however, "A program that educates adults in rural Oregon and California about child sexual abuse is increasing the likelihood that victims will get the help and protection they need, according to a new report issued by one of the program’s funders," reports Claire Carlson of The Daily Yonder. "The report, made in collaboration with Oregon State University and the [Oregon-based] Ford Family Foundation, found that adult participants in the Protect Our Children training are three times more likely to know the signs of sexual abuse in children and five times more likely to know how to prevent abuse in their community after taking the training."

Carlson writes, "Protect Our Children participants also reported change in their communities’ norms surrounding conversations about abuse. In the United States, reluctance to discuss the topic creates what the report calls a 'culture of silence' that isolates survivors of child sexual abuse, despite the likelihood that they are surrounded by others with similar experiences. Of the 10,748 program participants who were surveyed for the report, a third said they were survivors of childhood sexual abuse."

“Historically, the topic of sex is taboo, and it’s hard to talk about,” Mary Ratliff, Protect Our Children project director, told Carlson. “The way we talk about child sexual abuse sometimes can inhibit kids from disclosure.” Carlson notes, "This culture is especially prevalent in rural areas, where a 'not in my town' attitude – the perception that small towns are safer – can prevent people from reporting or discussing abuse, according to the nonprofit ValorUS."

"The goal of the Protect Our Children training is to normalize conversations about sex and child sexual abuse. . . The training also encourages conversations among adults regarding child sexual abuse, like asking fellow parents what their closed-door policies are when their child’s friends are over," Carlson reports. "Normalizing those conversations is a key way adults can decrease child sexual abuse, which is usually caused by someone the child already knows, not a stranger, according to the Rape, Abuse & Incest National Network, the nation's largest anti-sexual violence organization."

Carlson notes, "While Oregon has a law that requires child sexual abuse prevention programs to be taught in public schools, nothing exists for adults, even though the program emphasizes that the duty to protect children from sexual abuse lies with adults, not the child." Ratliff told Carlson, "There are tools for kids, but we want to make sure that we instill that responsibility in adults, too. We have to have these conversations and social norms changes and policy changes because that’s what’s going to protect kids everywhere and all the time.”

Cost of living and child care are at the heart of rural family concerns, survey by Save the Children shows

They survey asked respondents to name one or two top issues.
(Graph by Save the Children Action Network)

A rural-voter survey sponsored by the political arm of Save the Children, "shows that rural residents are facing several challenges, including worries about the ability to feed their children and access to good and affordable child care," reports Kristi Eaton of The Daily Yonder. According to the survey: “Rural voters deem inflation to be the greatest challenge facing rural families. In an open-ended question about the biggest problems facing families in rural areas, respondents are most apt to volunteer gas prices and inflation. When asked about specific problems in their area, 68% say children not having enough to eat is a serious problem.”

When it came to opinions on childcare, "More than half (55%) said that high-quality and affordable child care has become less accessible since the pandemic," Eaton reports. "Additionally, a majority (54%) of rural voters said there are only some or very few high-quality, affordable early education programs in their area."

Christy Gleason, executive director of Save the Children Action Network, told Eaton: "Congress and state legislatures have taken incremental steps to provide relief on child care and hunger but more must be done to address the scale of the crisis we see in these numbers. From boosting rural development in the farm bill to reviving the expanded child tax credit and increasing state and federal investments, rural families want to see bold leadership from their elected representatives in the new year.”

A bipartisan team of pollsters and staff from Save the Children will brief Congress on the findings of the survey Jan. 18, Eaton reports.

As in-home pot edibles increase, they sicken more children; more than half of those in a study were 2 or 3 years old

Marijuana edibles are displayed at a dispensary.
(Photo by Steve Marcus, Las Vegas Sun)

As more states have legalized marijuana, the presence of pot edibles in U.S. homes has led to more accidental poisonings. "The number of young kids, especially toddlers, who accidentally ate marijuana-laced treats rose sharply over five years as pot became legal in more places in the U.S., according to a journal Pediatrics study," reports Jonel Aleccia of The Associated Press. "More than 7,000 confirmed cases of kids younger than 6 eating marijuana edibles were reported to the nation’s poison-control centers between 2017 and 2021, climbing from about 200 to more than 3,000 per year. Nearly a quarter of the children wound up hospitalized, some seriously ill."

Lead researcher Dr. Marit Tweet, a medical toxicologist at the Southern Illinois University School of Medicine, told Aleccia, "When it’s in a candy form or cookies, people don’t think of it in the same way as household chemicals or other things a child could get into. But people should really be thinking of it as a medication.” Tweet noted that the study could only include reported cases, so many less serious cases may have gone unreported.

"Tweet called for greater vigilance by parents and for more laws like those adopted by several states to make pot products — often packaged to look like kids’ candies and snacks — less appealing and accessible to children," Aleccia reports.

The study "analyzed reports to the National Poison Data System, which includes the nation’s 55 regional poison control centers. More than half of the children were toddlers, ages 2 and 3, the study showed. More than 90% got the edibles at home," Aleccia reports. "Of more than 7,000 reports, researchers were able to track the outcomes of nearly 5,000 cases. They found that nearly 600 kids, or about 8%, were admitted to critical care units, most often with depressed breathing or even coma. Nearly 15% were admitted to non-critical care units and more than a third were seen in emergency rooms. Drowsiness, breathing problems, fast heart rate and vomiting were the most common symptoms."

Dr. Brian Schultz, a pediatric emergency physician at Johns Hopkins Medicine in Baltimore who previously worked at Children’s National Hospital in Washington, told Aleccia that he and his colleagues treated kids who had eaten pot edibles 'almost on a daily basis'."

Minnesota town of 1,500 passes sales tax to fund childcare

Lindsey Buegler at the Little Sprouts child-care center
in Warren, Minn. (Photo by Dan Gunderson, MPR)

What was once a childcare challenge is now a crisis, with rural families feeling more of the pinch to secure affordable, healthy childcare. 

Warren, Minnesota, pop. 1,500, was one city that decided to address its shortage of childcare with innovation. In November, Warren voters became the first to approve a local sales tax dedicated to supporting a childcare center. The approval was unexpected since the tax is for a service many Warren citizens won't use, reports Dan Gunderson of Minnesota Public Radio.

Lindsey Buegler was a Warren parent who needed childcare. She told Gunderson: "It was either get involved and beg and plead with people to somehow keep the daycare open or we would have had to move. There were seven of us directly involved with the center that would have had to move. . . . I would say that's huge for this small city of Warren to lose seven families."

City officials "partnered with the First Children’s Finance Rural Child Care Innovation Program" and found "a shortage of 187 childcare slots within a 20-mile radius of Warren," Gunderson reports. "The research also found more than 30 percent of survey respondents had turned down a job, or withdrawn from the workforce because of childcare issues."

Map from City-Data.com

Using those facts, the city proposed a half-cent sales tax, and to the surprise of many, voters approved it, making Warren the only city in Minnesota with a tax for that purpose. "Business leaders pushed hard for the tax. They understood how a shortage of childcare was limiting economic growth," Gunderson reports.

Construction for a new childcare center will begin in the spring 2023 with funding coming from the new sales tax proceeds, community fundraising efforts and a low-interest loan from the Department of Agriculture, Gunderson adds. "The childcare building will be owned by the city and operated by the Little Sprouts nonprofit. City leaders expect that arrangement will help make childcare more affordable."

Shortage of beds for sick children 'not simply the result of a deluge of sick children' but hospitals' desire for money

(Washington Post graph from Centers for Medicare and Medicaid Services data)

The surge of children with respiratory syncytial virus, influenza and Covid has left hospital emergency rooms and pediatric floors scrambling for beds and staff, report Christopher Rowland, Dan Keating and Daniel Gilbert of The Washington Post. These deep shortages are exposing decades of cuts in pediatric beds at hospitals, especially those serving rural areas, the Post reveals.

The experience of Segura Nino, 29, is playing out for parents nationwide: "Segura Nino had spent 10 sleepless hours in a suburban Houston emergency room with her 3-month-old son Maleek when she boarded a medical helicopter to Corpus Christi, 200 miles away," The Post reports. "Nino was told that Houston, a city renowned for its world-class health system, did not have a bed for one more baby with RSV." After Maleek had come home, recovered, Nino told the Post, "It's crazy to have to go to another city to get care for your child."

The Post rpeorts, "Instead of finding inpatient care at community hospitals near their homes, parents often must travel to larger children’s hospitals that have the most beds. Not only are those facilities farther away, but they also are thronged by patients from an entire region — and even from neighboring states."

The problem is not just acute, but chronic: "The shortage of beds across the United States is not simply the result of a deluge of sick children. Over the past two decades, hospital systems across the country have whittled down the supply of pediatric beds, which lose money because they often are unoccupied," The Post reports. "Even when they are occupied by sick children, pediatric beds generate less revenue for hospitals than do adult beds, medical experts say."

“The major driver is economics,” said Daniel Rauch, a pediatrician at Tufts Medical Center in Boston, which "cut 41 pediatric beds, citing market pressures," this year.

Nancy Foster, the American Hospital Association's vice president for quality and patient safety policy, told The Post, “These surges in RSV and flu have reminded us that we need surge capacity beyond what we might have expected for all, including children, and I don’t know we have the perfect solution yet. We’re going to have to MacGyver our way through the next few weeks to meet the surge."

No. 3 GOP House member assails proposed limit on milk for WIC families; her facts were right; her prediction may not be

Jersey cows in Schodack Landing, N.Y. (Photo by AP)

When the Biden administration released its proposed changes for the Special Supplemental Nutrition Program for Women, Infants, and Children, or WIC, U.S. Rep. Elise Stefanik (R-N.Y.) called the plan "deeply flawed" and accused it of "further restricting milk choice for families and keeping the door open for more forced vegan juice consumption," reports Jill Terreri Ramos of Politifact.  

Stefanik, the third-ranking House Republican, often criticizes the administration and "represents a geographically large district in New York’s North Country, and many of the state’s nearly 3,600 dairy farms are in her district," Ramos notes.

Ramos found that the WIC plan "calls for reducing the amount of milk provided in all child, pregnant and breastfeeding participant food packages." Department of Agriculture Press Secretary Marissa Perry told her, "The change is 'modest,' and represents just a 3% reduction in WIC spending on milk and milk alternative." In 2020, the program served about 7 million people.

A WIC researcher at the Johns Hopkins Bloomberg School of Public Health, Susan Gross, told Ramos: "Program participants have diverse needs, such as food allergies or being vegan, and they do not drink milk from cows. Program administrators want to explore whether other alternatives can be offered."

As for Stefanik's prediction that the proposed rule would lead to more "forced vegan juice consumption," Ramos writes, "We don’t fact-check predictions and that statement is outside the scope of this ruling. It should be noted, however, that based on the available evidence, WIC has not and will not force milk alternatives on anyone."

Misbehaving teachers move from district to district and state to state with relatively little scrutiny

Teachers who have committed sexual misconduct are able to move from district to district and state to state without close checking by school administrators and state governments, and the issue appears to have been widely ignored.

In Kentucky, the Lexington Herald-Leader "found that over a five-year period, the top reason the majority of teachers voluntarily gave up their licenses or had them revoked or suspended was due to sexual misconduct," report the paper's Beth Musgrave and Valarie Honeycutt Spears. Despite some teachers eventually leaving the profession, many are allowed to move to multiple teaching posts without consequences for prior abuse even when the abuse resulted in suspensions.

Take the case of Kentucky teacher Jason Earlywine who was "a physical education and health teacher, was disciplined for sending a student more than 1,700 voice or text messages in 2011 and 2012 and for other inappropriate conduct while a teacher at Paris Independent School District," Musgrave and Spears write. "He eventually left the district and got a job at West Jessamine High School in 2019. Students said in the first several months on the job that Earlywine made inappropriate comments to female students. . . . according to Kentucky Education Professional Standards Board documents."

Kentucky does not have enough prevention policies or training that would help keep possible abusers out of the school system and prevent those that do gain access from traveling from school to school. "Kentucky teachers receive training on sexual harassment but has no requirement that they undergo training on sexual abuse or appropriate boundaries between teachers and students," Musgrave and Spears report. "33 states and the District of Columbia mandate that training."

Kentucky is not alone. Many states that struggle to prevent the hiring or discipline of teachers who act inappropriately with students. In Cabell County, W.Va., a gym teacher faced charges for sexually abusing multiple students. "The alleged incidents happened from August 2019 through January of 2022, according to the criminal complaint," says Eric Fossell for WSAZ-TV. "It also states that an administrator with Cabell County Schools told investigators that Miles had been reprimanded before for similar allegations. That administrator asked Miles in a letter to refrain from 'jovial touching of students' or the matter would be referred to the superintendent."

A Montana school district was sued in 2020, "over its hiring of a teacher and coach who was accused of sending sexual messages to the student," reports The Associated Press. The suit said the teacher "had a pattern of inappropriate behavior toward underaged girls and that the school district was negligent in hiring him. . . . Botsford had been fired from a different high school in 1999 after two girls reported him for inappropriate contact. . . . Centerville Supt. Jan Cahill investigated the reports and found Botsford had 'unethical and immoral relationships' with at least three students, the lawsuit said."

While laws can be passed, it's up to school boards and administrators to set policies and stop abuse. For instance, the Montana legislature passed the "Creating a student safety accountability act" in May of 2019, but it did it keep the teacher from continuing his pattern of abuse.

Pandemic roundup: Publix won't vaccinate kids under 5; even asymptomatic coronavirus infection can hurt a fetus

Here's a roundup of recent news stories about the pandemic and vaccination efforts:

Coronavirus vaccines saved nearly 20 million lives worldwide over the first year they were available to the public, according to a newly published study. Read more here.

Use of at-home coronavirus tests has been difficult or impossible for blind and visually impaired people, especially those who live alone. The Biden administration announced Thursday it's rolling out free at-home tests that are designed to be more accessible. Read more here.

Rapid tests are more prone to false negatives, but those who get such results might be less contagious, because the tests seem to be more accurate if viral loads are higher. Read more here.

Publix, a big grocery chain in the South, says it won't administer coronavirus vaccines to children younger than 5, The Associated Press reports. The Florida-based chain offers other federally approved vaccinations to babies as young as 6 months. Last week Gov. Ron DeSantis said the state isn't pre-ordering doses of the under-5 vaccine, making Florida the only state not to do so. Publix has donated $150,000 to DeSantis since Nov. 2019 but hasn't donated any more since a "60 Minutes" report in April 2021 about it.

Covid-19 can harm a developing fetus even if the infected mother shows few or no symptoms of the virus, according to University of Kentucky researchers. Read more here.

Covid-19 patients who have taken the antiviral treatment Paxlovid may experience a rebound of the virus and test positive again two to eight days after their initial recovery, the Centers for Disease Control and Prevention warned. The CDC continues to recommend Paxlovid for patients at high risk of serious complications from Covid-19. Those who take the treatment and then test positive again or see a resurgence in symptoms should isolate again for at least five days and wear a mask for 10 days after the onset of rebound symptoms. Read more here.

Appeals court: EPA didn't have enough proof to conclude Roundup doesn't cause cancer, needs new risk assessment

The Environmental Protection Agency didn't have enough facts in 2020 to rule that glyphosate, the key ingredient in the weedkiller Roundup, doesn't cause cancer, the U.S. Court of Appeals for the 9th Circuit ruled last week. "The three-judge panel also said the EPA violated federal law by failing to consult with wildlife agencies on how to limit the impact of the herbicide on threatened and endangered species," Chuck Abbott reports for the Food & Environment Reporting Network.

In the decision, Judge Michelle Friedland ordered the EPA to review its conclusion that glyphosate doesn't pose "any unreasonable risk to man or the environment" and issue a new ecological risk assessment by Oct. 1. The opinion said EPA's conclusion was inconsistent with previous agency analyses: "EPA could not reasonably treat its inability to reach a conclusion about NHL (non-Hodgkin’s lymphoma) risk as consistent with a conclusion that glyphosate is not likely to cause cancer within the meanings of its Cancer Guidelines." Roundup manufacturer Bayer AG announced in 2020 that it would pay more than $10 billion to settle tens of thousands of lawsuits about the product, many of which claimed it caused cancer.

Meanwhile, Bayer "has asked the Supreme Court to overturn a $25 million award to Edwin Hardeman, diagnosed with cancer after using Roundup on his San Francisco Bay area property for years. It says the EPA label for containers of glyphosate, which doesn’t mention of cancer, pre-empted claims that it should have warned purchasers of the risk. The Supreme Court could decide as soon as this week whether to hear the case," Abbott reports. "The appeal to the Supreme Court was part of Bayer’s five-point plan, announced in May 2021, to resolve thousands of lawsuits against Roundup. Bayer has set aside $4.5 billion for litigation and settlement expenses for more than 30,000 cases. The plan also calls for ending sale of glyphosate for lawn and garden use, beginning in 2023."

Amy van Saun of the Center for Food Safety said in a statement that the ruling was "a major victory for farmworkers and others exposed to glyphosate ... Imperiled wildlife also won today, as the court agreed that EPA needed to ensure the safety of endangered species before greenlighting glyphosate." CFS led a coalition of groups in filing the lawsuit in May 2020. Several studies have found that glyphosate can hurt endangered species and habitats. Another study linked fetal glyphosate exposure to shorter pregnancies, which is strongly correlated with lifelong adverse health effects.

Southern Baptist Convention publishes full sex-abuse report, including a database of alleged abusers

In a bid for greater transparency, the Southern Baptist Conference's Sexual Abuse Task Force has published online an independent report detailing how its leaders protected pastors and local church staff accused of sexual abuse while ignoring, pressuring and trying to discredit sexual-abuse survivors.

The report includes the database of alleged abusers, along with links to news articles and other details. However, a note at the top cautions that the list is incomplete, has not been proofed or adequately researched, and is not always specific to Southern Baptists. Some names and other details have been censored, possibly to preserve the privacy of minors.

In a press release accompanying the report, the task force called on other Southern Baptists to heed the report's findings and care for abuse victims as well as "provide a culture of accountability, transparency, and safety as we move forward."

The task force called for specific reforms:

• The next SBC president should create a task force to ensure reforms are implemented.
• The Executive Committee should hire experts to work with victims and train state conventions on how to respond to abuse allegations.
• All SBC boards and committees should undergo background checks as part of the selection process, and should and receive training on sexual abuse prevention and survivor care.
• All SBC-affiliated seminaries should teach staff and students about sexual abuse prevention and survivor care.
• The Executive Committee should budget for and hire a salaried staffer for the SBC's Credentials Committee, which assesses whether churches are operating within SBC standards of faith and practice.

Fact Check explains why and how infant formula is being sent to children of undocumented immigrants at the border

"The baby formula shortage has caused a raft of misleading and false claims, but here's one that is true: The federal government feeds babies detained in immigration facilities at the southwest border," FactCheck.org reports in its latest newsletter. Some Republican politicians have claimed that the government is sending formula at the expense of American consumers and that the action is a result of Biden administration policies. This is not so, Saranac Hale Spencer reports.

A framework of federal laws and regulations, some of which FactCheck details, governs the treatment of detained immigrant minors. Essentially, U.S. Customs and Border Protection is required to give children and babies food and water, access to bathrooms, emergency medical services, and accommodations that are well-ventilated and temperature-controlled. CBP facilities also must have diapers, wipes, unexpired formula, and one to five safe bassinets for infants to sleep in. Every administration for the past quarter-century has followed those legal requirements, including the Trump administration.

FactCheck also notes that detainees aren't supposed to be held for more than 72 hours. "That 72-hour limit isn’t always followed. But to the extent that CBP is providing formula to detained infants, it’s likely not for an extended period of time, which suggests that the amount of formula at the facilities wouldn’t have a measurable impact on the national supply," Spencer reports.

Formula roundup: House passes bills to help FDA, expand WIC choices; Biden invokes Defense powers; plant could reopen soon; some infants and children hospitalized

Here are some significant new developments in the baby formula shortage:

Abbott Laboratories reached an agreement Monday to reopen its Sturgis, Michigan plant in the next few weeks, pending federal inspectors' approval. Today Food and Drug Administration commissioner Robert M. Califf told a House appropriations subcommittee that he expects the plant to be open again within two weeks, and begged for more funding so the agency can cope with its workload, Laura Reiley reports for The Washington Post.

"President Biden took urgent action on Wednesday to address the nationwide baby formula shortage, invoking the Defense Production Act to increase production and creating 'Operation Fly Formula' to deploy Defense Department planes and speed formula shipments into the United States from overseas," Annie Karni and Emily Cochrane report for The New York Times. "The White House announced its plan only hours before the House took action of its own, approving an emergency infusion of $28 million for the Food and Drug Administration and a bill to loosen restrictions on what kind of formula can be purchased through the federal food aid program for women and babies."

The $28 million is meant to help the FDA "beef up inspections of formula made at foreign plants and to guard against any future shortages by ensuring the agency is prepared for supply chain disruptions," Nathaniel Weixel and Mychael Schnell report for The Hill. The bill passed on a mainly party-line vote, though 12 Republicans supported the bill in defiance of party leadership.

House Minority Whip Steve Scalise (R-La.) urged House Republicans to oppose the bill, saying it was reckless spending that would provide political cover for the Biden administration while failing to hold the FDA accountable. "House Republicans knocked Democrats for giving money to the FDA without guardrails and without forcing the agency to develop a concrete plan to solve the shortage. At least two House committees are investigating manufacturers and the FDA," Weixel and Schnell report. However, "Democrats argued the FDA does not have enough resources to adequately inspect foreign manufacturers and make sure they meet agency safety standards. The $28 million in emergency funding would make sure the agency can handle those inspections quickly."

A recent Politico investigation found several reasons for the FDA's failure to quickly catch problems at the Abbott plant. The FDA has been underfunded for years, its leaders tend to have far more experience with regulating medications than food, and Trump-era changes in leadership left the agency adrift and—in some cases—caught up in turf wars between feuding officials. All of this happened as the agency was under unprecedented pressure to examine coronavirus vaccines, tests, and treatments.

Meanwhile, some babies and children have already been hurt by the shortage. Doctors in East Texas say they've treated infants who had had seizures after their parents fed them watered-down formula in an effort to stretch their supply. Watered-down formula (or homemade recipes) can endanger babies. And at least two children with intestinal conditions have been treated in a Tennessee hospital because their parents couldn't find the special formula they needed. The formula shortage affects children and even adults with medical conditions that leave them unable to digest regular food. It also disproportionately affects low-wage and other disadvantaged families, Mariel Padilla reports for The 19th. Rutgers University assistant history professor Carla Cevasco spoke with Padilla about the long-standing structural issues that have left low-income families more vulnerable to formula shortages.

Abbott reaches agreement with FDA to reopen formula plant

Abbott Laboratories "reached an agreement with the Food and Drug Administration on Monday to reopen the company’s manufacturing plant in Michigan to help ease a nationwide shortage of baby formula, after the facility was closed due to bacterial contamination," reports Spencer Kimball of CNBC. According to the consent decree, Abbott can resume production at its plant in Sturgis, Michigan, within two weeks once the FDA signs off on it, but it will take six to eight weeks after production resumes for formula to hit store shelves.

The FDA ordered the Abbott plant to shut down in February after four infants were sickened from contaminated formula and two died. 

"Under the consent decree to reopen the plant, Abbott has agreed to bring in outside experts to help the facility come into compliance with food safety regulations, according to the Justice Department," Kimball reports. "The outside experts will design a plan for Abbott to reduce the risk of bacterial contamination at the plant and conduct periodic evaluations to make sure the company is in compliance. The process will be under FDA supervision."

In the meantime, the FDA will allow some imported formula meant for foreign markets to enter the U.S., but only after the agency has evaluated whether each manufacturer that applies has a safe and nutritious product. The FDA has been allowing more formula imports meant for the U.S. since February, Kimball reports.

Report documents abuse and deaths of Native American children at government boarding schools from 1819 to 1969

The Sherman Indian School Cemetary in Riverside, Calif. (Riverside Press-Enterprise photo by Cindy Yamanaka)

"An initial investigation commissioned by Interior Secretary Deb Haaland cataloged some of the brutal conditions that Native American children endured at more than 400 boarding schools that the federal government forced them to attend between 1819 and 1969," Mark Walker reports for The New York Times. "The inquiry was an initial step, Haaland said, toward addressing the 'intergenerational trauma' that the policy left behind. The report, released today, found that more than 500 indigenous children had died at about 19 federal boarding schools, and said that number is expected to grow to thousands."

Haaland called for the report last June after the unmarked graves of nearly a thousand children were discovered at similar boarding schools in Canada. She vowed that Bureau of Indian Affairs officials would search the grounds of former schools in the U.S. and identify any remains.

It's not an abstract issue for Haaland, a Laguna Pueblo member whose grandparents attended such schools. She said, "I came from ancestors who endured the horrors of the Indian boarding school assimilation policies carried out by the same department that I now lead," Axios reports.

The government forcibly took hundreds of thousands of children from their families to attend the schools. "In attempts to assimilate Native American children, the schools gave them English names, cut their hair and forbade them from speaking their languages and practicing their religions or cultural traditions," Walker reports. The government's other major goal with the schools was to claim Native American land by forcing the removal and relocation of their children.

While at the schools, children "suffered whippings, sexual abuse, manual labor and severe malnourishment," Chen reports. "Many children tried to escape but were found, brought back and punished, according to the report. The damage had long-term health effects."

"Haaland also announced plans for a yearlong, cross-country tour called The Road to Healing, during which survivors of the boarding school system could share their stories," Walker reports. The U.S. government has never before provided a forum for boarding-school survivors or their descendants to talk about their experiences at the schools.