Ohio families are experiencing greater mental-health challenges coming out of the pandemic, and social services workers emphasized it makes it more difficult to place kids who need help in appropriate facilities.

According to a report published earlier this year by the Public Children Services Association of Ohio, 89% of counties experienced placements of youths whose needs were primarily behavioral health-related.

Deanna Nichols-Stika, executive director of Wayne County Children's Services, explained caseworkers had options for residential placement and could select the provider who best met the needs of a child a decade ago. Now, she noted, it is now rare to find basic long-term housing and care.

"It is not uncommon for us to make over 40 phone calls to different providers in the state of Ohio, just looking for an available bed," Nichols-Stika pointed out. "Not even having the opportunity to really look at available services matching the needs of the child."

According to an Ohio Council of Behavioral Health and Family Services Providers report, demand for behavioral-health treatment in the state spiked by 353% between 2013 and 2019, likely worsened by the pandemic. Agencies said the increased demand for youth mental-health services, in particular, is having a substantial impact on wait times.

Scott Boone, director of Knox County Job and Family Services, said families are struggling with increasingly complex, interconnecting issues compared to previous generations. As a result, kids are dealing with trauma and resulting behavioral and mental-health issues traditional foster homes and even therapeutic foster care, are not equipped to manage.

"We're finding that a lot of kids are developing these types of behaviors where they're self harming, and they're running away," Boone observed. "They've been exposed to every kind of abuse that you can think of."

Boone cited a recent example of trying to place a teenage girl who had been in a detention facility. He recalled staff worked desperately with the local probation department and contacts throughout the state for nearly three months trying to find placement.

"And we were turned down by over 100 providers until finally we found a location in Cincinnati," Boone recounted. "You can imagine that the cost of that is around $400 a day."

Nichols-Stika added despite the challenges, there is a collaborative spirit among people working to stabilize and care for children coming out of the worst circumstances.

"There is such a passion for this, of people in this profession, child welfare, behavioral health, mental health, to help people," Nichols-Stika explained. "That's why we got into this profession. We just need additional resources to help us do better."

More than 300,000 children have been dropped from Medicaid and Peach Care for kids since the pandemic ended.

A report from the Georgetown University Center for Children and Families pinpoints a nationwide trend: More than 4 million kids were left uninsured, soon after the COVID public-health emergency ended.

Georgia ranks third-highest for the number of children who have lost coverage.

Judy Fitzgerald, executive director of Voices for Georgia's Children, said many lost coverage because of procedural reasons rather than eligibility.

"They're not ineligible, but there was missing or incomplete paperwork, or what we know from families is, they felt like they didn't receive the notification, they didn't know," she said. "And so, there are a large number of children who are still eligible."

Fitzgerald said the repercussions of disenrollment can be dire, as when children can't get timely access to health-care services, they're more vulnerable to illnesses and developmental delays. The report also found parents with access to employer-sponsored health plans can't always afford the cost of adding their dependents.

While parents face higher income requirements for Medicaid, many children who lost coverage during the pandemic are still eligible. Fitzgerald said Voices for Georgia's Children is advocating for ways to increase enrollment for children, including a more simplified enrollment process and assistance from state agencies to expedite screening.

"So, we're asking the state to expand the kinds of organizations that could screen kids for eligibility, and enroll them in coverage temporarily while the state processes an official enrollment," she added, "and this is something called presumptive eligibility."

She said programs such as SNAP, and information through the Department of Labor, could be used to facilitate renewals. For families who don't qualify, she said, alternative coverage options are available through the insurance marketplace. Navigators through Georgians for a Healthy Future can help find them.

The Medicaid and Nevada Check Up programs had more than 13,000 fewer children enrolled last year than during the pandemic, according to new research from the Georgetown University Center for Children and Families.

States have been reexamining Medicaid benefits since the pandemic ended, and disenrolling families based on their head-of-household's eligibility. Carissa Pearce, health policy manager for the Children's Advocacy Alliance, said this means some children were also dropped from coverage who are still eligible.

As a result, she said, the Centers for Medicare and Medicaid Services told states to stop disenrolling and ensure they were looking at individual eligibility.

"Meaning that children would be screened separately from their parents, and that was a really important change," Pearce explained. "Specifically in Nevada, every person who had been disenrolled up to that point in August and September of 2023 were reinstated for their coverage, so that they could fix their system and then proceed with disenrollments."

Pearce said Nevada didn't start disenrolling children again until January of this year, giving families more time to check the requirements and submit the documentation to keep their coverage. But from January to February, about 1,500 Nevada children were dropped. She said it's important for families to see if their child is eligible for Nevada Check Up or consider a state marketplace insurance program at nevadahealthlink.com.

Tara Raines, deputy director of the Children's Advocacy Alliance, said her message to families is to not avoid medical appointments if they suspect their child may not be covered. She said there are other programs that families can be directed to, and thinks the state could do more to reach and inform families.

"I think a campaign that lets people know, 'Hey, you were disenrolled from Medicaid, here are your options,' would be incredibly helpful," she said, "and I don't know if that looks like partnering with school districts."

Raines said families' living conditions and circumstances vary in the Silver State. This could mean some may not have a permanent address, but should not mean they go without health coverage.


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More than one million children in Texas no longer have health insurance through Medicaid, despite being eligible for coverage, according to a new report from the Georgetown University Center for Children and Families.

During the COVID-19 pandemic, states were not allowed to cancel coverage - then last year, state health departments were tasked with rechecking the eligibility of Medicaid recipients.

Brittney Taylor-Ross, senior policy analyst with the advocacy group Every Texan, said despite the option to slowly complete the task, Texas chose to do it in one year's time.

"We didn't take up a lot of the flexibilities that were offered, so that was a state choice at the leadership level. We also chose to go through this unwinding process pretty quickly. Other states have paused their process when they've seen that things don't look right," Taylor-Ross said.

The report shows Texas has disenrolled more children than any other state. Anyone who lost coverage must reapply. Taylor-Ross said as of April, the median amount of time to process a new Medicaid application is 95 days. Federal law requires this number to be 45 days or less.

Most families don't realize they no longer have coverage until they go to the doctor's office.

Joan Alker, research professor, McCourt School of Public Policy, and executive director, Georgetown University Center for Children and Families, said the problem affects not only families, but the pediatricians and clinics that treat them.

"Kids are going to miss out on those well-child visits, they're going to miss out on getting the medications they need - be it an inhaler for their asthma or an ADHD medication. And that really sets them back, both in their health and their success in school," she said.

Because of the unwinding, more than 4 million fewer children are enrolled in Medicaid. One out of four of those children lives in Texas.