Investing in a Healthy Start for Children

July 2009

Children in poor health generally do less well in school, complete fewer years of school, have poorer adult health and earn less as adults.  According to the New England Journal of Medicine, only 41 percent of children receive recommended health screenings and services to prevent disease, reduce complications, and achieve optimal health and development, including those enrolled in Medicaid and SCHIP.  States cover millions of children in their Medicaid and SCHIP programs, where children should be getting the recommended screenings and services.  However, most states do not achieve the recommended levels of screening for their enrolled children.

In response to legislator interest in these issues, the National Conference of State Legislatures researches policy and provides technical assistance to state legislatures about early childhood health and development.   State legislatures can play important roles in improving child health and development by considering evidenced-based and cost-effective pediatric practices, particularly around preventive, well-child care.  Possible options for action include:

• Assess the status of the state's child health screening rates under Medicaid and CHIP, including the recommended screening for developmental disabilities;

• Assess the availability of treatment services and referrals;

• Influence state planning and use of evidence-based best practices and cross-agency coordination;

• Finance specific initiatives and innovations to develop best practices as well as reimbursement within public health insurance programs;

• Set and regulate standards relating to insurance;

• Identify appropriate stakeholders who can collaborate with policymakers to create more effective child health and development policy.

NCSL Meeting Materials

Investing in a Healthy Start for Children: Are States Getting Their Money's Worth?
Spring Forum Preconference, April 2008

• Overview:  Children's Health As An Economic Investment
  Edward Schor, M.D., Program Officer, The Commonwealth Fund

• Medicaid and SCHIP:  Is Your State Getting Its Money’s Worth?
  Charles Bruner, Executive Director, Child and Family Policy Center

• Improving Child Development:  Lessons Learned and Promising Practices
  Neva Kaye, Senior Program Director for Assuring Better Child Health and Development (ABCD) Program, National Academy for State Health Policy

• Investing in a Healthy Start for Children, April 2009
  This NCSL brief summarizes the key points addressed at the meeting.

Resources

• Preventive Care for Children Postcard
  NCSL Postcard, July 2009

• Child Health Screenings Postcard
  NCSL Postcard, December 2008 

• NCSL Children's Early Care and Education Legislation Database
  From NCSL's Children and Families Program, issues include child care and child care financing, early childhood services, prekindergarten, professional development, home visiting, infants and toddlers, and financing early education.  

• Improving Children's Healthy Development Through Federal Policy Change Webinar
  The Commonwealth Fund, November 2008 

• U.S. Variations in Child Health System Performance: A State Scorecard
  The Commonwealth Fund, May 2008

• Maternal and Child Health Overview
  National Conference of State Legislatures webpage

• Newborn Genetic and Metabolic Screening
  National Conference of State Legislatures webpage

• Child Care and Early Education
  National Conference of State Legislatures webpage

• State Policy Options to Improve Delivery of Child Development Services: Strategies from the Eight ABCD States
  National Academy for State Health Policy, December 2006

• The Role of States in Improving Health and Health Care for Young Children
  The Commonwealth Fund, July 2005

• Improving the Delivery of Health Care that Supports Young Children's Healthy Mental Development: Early Accomplishments and Lessons Learned from a Five-State Consortium
  National Academy for State Health Policy, April 2006

• Screening for Behavioral Developmental Problems: Issues, Obstacles, and Opportunities for Change
  National Academy for State Health Policy, November 2006

• Using Medicaid to Support Young Children's Healthy Mental Development
  The Commonwealth Fund and National Academy for State Health Policy, January 2004

• Early Childhood Health Problems and Prevention Strategies: Costs and Benefits Studies Show Lasting Societal Benefits from Investments in the Health of Young Children
  Partnership for America's Economic Success

• Early Childhood Development: The Building Blocks of Health and Well-being
  Grant Makers in Health, August 2007

• From Neurons to Neighborhoods: The Science of Early Childhood Development
  Institute of Medicine, October 2000

National Organizations and Programs

• The Commonwealth Fund: Child Health/Development

• National Academy for State Health Policy: Early Childhood Health and Development 

• State Early Childhood Policy Technical Assistance Network

This project is made possible by a grant from The Commonwealth Fund.