Category: Health

Save Home Visiting

The early childhood community celebrates a huge win in the Arizona state budget! The final version of the budget invests $10 million dollars to fill the funding gap and expand the Healthy Families Arizona (HFAz) home visiting program.  HFAz is designed to help expectant and new parents get their children off to a healthy start. Program services are designed to strengthen families during the critical first years of a child’s life – the time when early brain development occurs, laying the foundation for a lifetime of memories, behaviors, and outcomes. Through its efforts to support and educate families, the program has shown to reduce incidences of child abuse and neglect, provide stability for at-risk families and has grown a new generation of healthy families in the state.1 Back in 2009, monies supporting HFAz were cut from the state general fund and have not been replaced since. We are thrilled to see that Arizona legislators recognize the essential value HFAz provides for Arizona families and applaud the new $10 million dollar investment.  

Now that we have secured this investment in home visiting for Arizona children, the next step is to advocate on behalf of children in every state! We are less than 100 days out from the Maternal, Infant, and Early Childhood Home Visiting Program (MIECHV) reauthorization deadline. The MIECHV Program supports families with the tools and resources they need to thrive. This program is bi-partisan and evidence based and builds upon decades of scientific research showing that home visits by a nurse, social worker, early childhood educator, or other early childhood professional during pregnancy and early childhood significantly improves life outcomes of children and families. Congress has a lot on their plates, but we want to make sure that MIECHV reauthorization is top of mind as we approach the expiration of the current funding on September 30th. We are asking early childhood advocates and stakeholders to do two things.   

First, contact your members of Congress by clicking HERE and then please use this 100 Days Social Media Tool Kit to create a sense of urgency on Capitol Hill. Now is the time to rally together and let our Senators and Representatives know that it’s time to take action on MIECHV!  

Abortion is More Than Health Care

Children’s Action Alliance envisions an Arizona where all children and families can thrive. We cannot stay silent about today’s decision by the Supreme Court of the United States to overturn Roe v. Wade.

Today’s decision will not stop abortion in our state – not for those with resources. But it will prevent Arizonans from exercising their right to make informed decisions about their health care, maintain autonomy over their bodies, and to choose when and how to start a family.

Abortion is health care – and it’s so much more. Abortion is financial security. It’s an education. It’s the ability to plan for a better future. Without that choice, Arizonans will continue to fall prey to a system that’s designed to benefit those with means by harming those without.

For over three decades, CAA has been advocating for children and families. For over three decades, our state lawmakers have systematically denied these families the tools to build a better future. There has rarely been anything “pro-life” or “pro-family” about how our state invests its resources.

Since our nation’s founding, Black, Indigenous, and People of Color have been forced to fight for the most basic of rights: control of their own bodies. From slavery and colonization to the Tuskeegee study and forced sterilization to today’s unacceptable maternal mortality rates for BIPOC individuals, the United States government and its institutions have maintained White supremacy through conscious restriction of reproductive rights.

The state of Arizona is equally complicit in this subjugation.

Each year Arizona receives millions in federal TANF dollars. Most states use these funds to provide flexible assistance to families struggling to afford rent, utilities, diapers, medicine. But only a tiny portion of Arizona’s TANF money is invested in keeping families clothed, fed, and housed. The lucky few who do receive assistance through the program are wound up in red tape and reporting requirements and lose access to aid after just two years.

It's no wonder, then, that Arizona families struggle to pay rent, put food on the table, and provide the essentials. And it’s no wonder that 92% of DCS referrals are not a result of physical or sexual abuse, but neglect – insufficient shelter, poor nutrition, inadequate childcare, unmet medical needs.

Seven in ten Black children in Maricopa County will experience a DCS investigation at some point in their childhood, and Black parents are four times as likely to have their parental rights severed by the state. Arizona’s standard TANF payment for a family of four is just $335 per month; by contrast, foster parents in the state are paid an average of $700 per child per month, which does not include additional costs assumed by the state when a child enters DCS care.

It should not come as a surprise that the vast majority of foster caregivers in the state are White.

It’s not just a lack of financial assistance that hinders Arizona families’ ability to be well and stay together. Inequity is baked into our health care systems. One in four American Indian children in Arizona is uninsured, despite being disproportionately likely to qualify for AHCCCS or KidsCare; though centuries of treaties are supposed to assure Tribal members access to health care, the US government has never adequately funded the Indian Health Service or other Tribal health programs. Unsurprisingly, Indigenous individuals in Arizona are nearly four times as likely to die during or in the year after pregnancy. Despite being more likely to work year-round, Latinx households are less likely to have access to employer-sponsored health coverage. Black and Latinx children are more likely to be impacted by chronic diseases like Asthma, but less likely to have access to preventive care to keep them out of the hospital and stave off medical debt.

Today’s decision reminds us why it is so critical for Arizonans to select leaders at every level who will prioritize health care, economic supports, and reproductive justice.

Operation: Affordable Healthcare

Any toddler will tell you that a band-aid can fix most problems - but really big boo-boos need really big solutions. That’s why we’re launching Operation: Affordable Healthcare, a campaign to help heal the American healthcare system. The mission? Access to affordable, high-quality healthcare for all.

The Operation: Affordable Healthcare policy plan will expand access to care, empower consumers, and promote health equity in Arizona and beyond. By reinforcing the foundation laid by the Affordable Care Act, Families First Coronavirus Response Act, and American Rescue Plan Act, we can start to fix what’s broken in the U.S. healthcare system.

Will you join us?  

We’re calling on Arizona Senators Kelly and Sinema to take bold steps to promote access to affordable care. 

Operation: Affordable Healthcare policy priorities

  1. Close the family glitch to open Marketplace health coverage to families paying too much for dependent coverage through their employer-sponsored health plans.
  2. Extend the American Rescue Plan Act’s health care affordability provisions beyond 2022 to ensure everyone can get the care they need without breaking the bank.
  3. Require Medicaid to cover people for twelve months after pregnancy (Arizona is on its way to making this happen at the state level! Please take a minute to let your legislator know it’s important that this is funded in the state budget.)
  4. Cover Arizonans fully from toe to top – mental health, oral health, and all the rest. Medicaid and Medicare should cover the whole person at parity.
  5. When children qualify for Medicaid or CHIP they should be continuously covered for a full year – no more pesky paperwork for hardworking Arizona families.
  6. Save Arizona families money at the pharmacy by allowing Medicare to negotiate prescription drug prices.
  7. Play for keeps; make permanent funding for the Children’s Health Insurance Program (CHIP; KidsCare in Arizona).

AZ families could be dropped from health care (and don't even know it)

Early in the pandemic, the federal government issued a Public Health Emergency (PHE) declaration. This allowed the government access to funding and procedural flexibilities to help control the COVID-19 crisis. One of many such flexibilities was the decision to stop disenrolling people from Medicaid and the Children’s Health Insurance Program – known as AHCCCS and KidsCare in Arizona.

As cases continue to drop nationwide, it’s likely that the PHE will expire as soon as this summer, and AHCCCS and KidsCare will return to business as usual.

Over the past two years, youth enrollment in AHCCCS and KidsCare has grown by nearly 100,000 children. As of March 2022, 49% of children in Arizona have health coverage through Medicaid or CHIP. Compared to their uninsured peers, children covered by these programs are more likely to do well in school, graduate from high school, earn more as adults, live longer, and even give birth to healthier infants in the next generation.

In order to stay enrolled, families will need to respond swiftly to requests for information from AHCCCS. By AHCCCS’ own estimation, half a million Arizonans are at risk of losing coverage at the end of the PHE, either because they no longer qualify or because they have been unreachable by mail.

We’re working to get the word out about this change to families throughout Arizona. Will you help us?

We need all hands on deck to keep kids covered.

  1. Families with coverage through AHCCCS or KidsCare should verify that their contact information is up to date. They can do this by logging into Health-E Arizona Plus or by calling AHCCCS at 1-855-432-7587 or TTY 1-800-842-6520.
  2. Help with enrolling, re-enrolling, or identifying a new health coverage source is available throughout Arizona. Families can schedule a free appointment with an enrollment assister by calling 2-1-1 or visiting coveraz.org/connector.
  3. We’ve created social media materials in five languages, as well as talking points for educators and health care providers about the change. Please share widely. Print materials are also available by request.
  4. If you’re interested in scheduling a presentation on the change and what it means for Arizonans, please email Health Policy Director, Zaida Dedolph Piecoro.
  5. If you’d like to support this effort, please consider making a monthly gift to CAA. Your support will help us amplify this message.

AZ kids are at risk of losing health coverage

The Families First Coronavirus Response Act of 2020 temporarily increased the federal government’s share of Medicaid costs. In return, states are prohibited from disenrolling anyone from Medicaid or CHIP (AHCCCS or KidsCare in Arizona) unless they move, die, or request to be disenrolled. This has kept many children and families from losing coverage. As the pandemic begins to wane this temporary relief will end and our state leaders must act swiftly to #KeepAZKidsCovered.

A new report by the Georgetown Center for Children and Families (CCF) shows that 851,574 children - nearly half (49%) of all children in Arizona - were enrolled in AHCCCS or KidsCare in 2021.* Between February of 2020 and June of 2021, enrollment in these programs increased by nearly 100,000 children.

We’ll be hosting a Facebook Live discussion to explore how advocates can help minimize coverage loss in their communities, as well as steps our state policymakers can take to #CoverAZKids and #KeepAZKidsCovered.

The federal public health emergency could expire in the next few months, at which point AHCCCS will resume their standard renewal practices and disenroll people who fail to respond or who no longer qualify. By AHCCCS’ own estimates, 500,000 people are likely to be disenrolled after the public health emergency ends. Many of these individuals are likely still eligible for coverage, but have fallen through the administrative cracks.

What can our leaders do to #KeepAZKidsCovered? Here are a few ideas to start:

  1. Invest in health care outreach and enrollment support (CoverAZ.org and 2-1-1 can help families find coverage year-round!)
  2. Boost AHCCCS funding to ensure the agency is fully equipped to assist applicants and process renewals.
  3. Increase income eligibility for KidsCare to ensure kids have access to quality health care while their families build a solid financial foundation.
  4. Provide continuous enrollment for children enrolled in AHCCCS and KidsCare, so children who that qualify at any point in the year can stay connected to care even if their household income fluctuates.
  5. Offer transparent access to state disenrollment data, so advocates can engage in targeted outreach to families who lose coverage.

*Arizona does not provide detailed data on children’s AHCCCS or CHIP enrollment to the federal government. CCF relied on administrative reports to make this estimation. See “Methodology.”

2022 Governor's Budget Hits & Misses

Each year, Arizona’s legislative session begins with the Governor’s State of the State speech and the unveiling of his or her annual priorities and proposed budget. This session presents Governor Ducey a rare opportunity in his final year in office to provide much-needed help to children and families in Arizona. Despite the lingering pandemic, Arizona’s revenues have reached historic highs in large part due to the multiple federal economic rescue packages and temporary unemployment insurance expansion. Arizona currently has $1 billion in ongoing and $2.1 billion in one-time revenues. This is in addition to billions of dollars in unspent federal COVID relief dollars.

Also at the beginning of each year, Children’s Action Alliance publishes its list of legislative priorities. It is our hope each year that the Governor's priorities align with ours. This year, while we did see a few bright spots that address longstanding needs, that largely did not happen. Take a look at a comparison of where the Governors priorities and ours find common ground, and where opportunities missed the mark or weren’t addressed.

On mobile? View our printable PDF.

Early Childhood

Secure state general fund investment in child care assistance  

Not addressed in the Governor’s budget or State of the State.

Increase Arizona Early Intervention Program provider rates  

Nearly 11,000 children under the age of 3 who have disabilities or developmental delays receive therapies and other support from the Arizona Early Intervention Program.  Current rates paid to providers are significantly below comparable rates paid by the program that provides services to children over age 3. The Governor’s budget proposal adds $18.6 million per year starting in fiscal year 2024 to bring the rates in line with rates paid by other programs.  A temporary rate increase will be funded in fiscal year 2023 using federal dollars.

Secure state investment in Healthy Families home visitation program  

The Governor’s budget provides $10 million, of which $7.5 million is new funding and $2.5 million replaces funds that will no longer be available. Healthy Families currently serves 4,000 families. The Governor’s budget would add an additional 1,500 families. The Governor’s budget also includes a total $15 million for fiscal years 24 and 25 which would increase the program’s ability to serve 8,000 families.

Fight any use of state funds appropriated for online early education  

Not addressed in the Governor’s budget or State of the State.

Education

Prevent a $1.2 billion cut to public schools by authorizing an annual exemption to the K-12 expenditure cap for this school year by March 1 

If the legislature does not override the education spending limit by March 1, 2022, Arizona’s district schools will be required to cut their current year budgets by $1.2 billion.  This issue is not addressed in the Governor’s budget or State of the State.

Refer a measure to the ballot to update or eliminate the outdated K-12 expenditure authority.  

Not addressed in the Governor’s budget or State of the State.

Expand access to affordable higher education and prevent increases in student debt 

The Governor’s budget proposal increases the Promise Grant funding by $12.5 million for a total $20 million.  These additional dollars will serve an additional 3,300 students.  The Promise Grant program covers the balance of tuition that remains for students who are fully eligible for Pell grants.  

The Governor’s budget, however, continues to suspend $10 million of the statutorily required deposit into the Student Financial Aid Trust Fund. This issue is not addressed preventing tuition increases.

Reduces inequities in school funding  

The Governor’s proposal increases results-based funding for excelling schools by $60.8 million for a total $129 million.  The Governor’s proposal also includes moving this funding into the Basic State Aid appropriation where it will lose its separate identity.  Schools continue to receive results-based funding as long as they meet the criteria.  For struggling schools the Governor’s proposal includes $58 million to create the Operation Excellence program which provides $150 per student for three years.  

Family Health

Extend postpartum Medicaid coverage to 12 months (currently 60 days) 

Approximately 15,000 to 18,000 pregnant adults could benefit from extended AHCCCS coverage. This issue is not addressed in the Governor’s budget or State of the State. 

Comprehensive adult dental coverage through Medicaid

Currently only a maximum of $1,000 annually of emergency services are available for most adult populations.  This issue is not addressed in the Governor’ budget or the State of the State.

Streamline Young Adult Transitional Insurance (YATI) re-enrollment for former foster youth 

Young adults who “age out” of foster care at age 18 are automatically eligible for enrollment in AHCCCS, the state’s Medicaid program.  If they do not respond to redetermination notices or requests for additional information, often because AHCCCS does not have an accurate address, they are disenrolled.  More than 5,200 young adults are currently enrolled through YATI.  This issue is not addressed in the Governor’s budget or State of the State.

Children's Health

Waive the Medicaid five-year residency requirement for otherwise eligible pregnant people and kids who are lawfully present immigrants 

Between 7,000 and 11,000 Arizona children are ineligibility for the state’s health insurance program because they have not been in the US for at least five years.  This issue is not addressed in the Governor’s budget or State of the State. Adopting the Immigrant Children’s Health Improvement Act (ICHIA) option would allow the state to provide high-quality health coverage to these children and to receive a higher federal reimbursement for their care. 

Provide 12-month continuous enrollment for children participating in AHCCCS or KidsCare 

More than 850,000 Arizona children are enrolled in Arizona’s Medicaid or CHIP programs. Though children who qualify are eligible for 12 months, families who experience income volatility may lose coverage due to a temporary or one-time increase. This has a negative impact on children’s health outcomes and presents an administrative burden to both AHCCCS and the families who lose coverage. This issue is not addressed in the Governor’s budget or State of the State.

Eliminate three-month wait period for KidsCare enrollment  

Arizona’s KidsCare program requires a child cannot be covered by any health insurance for three months prior to enrollment.  This presents a barrier to enrollment.  Even short lapses in health insurance coverage have a negative impact on children’s health outcomes.  This issue is not addressed in the Governor’s budget or State of the State.

Child Welfare & Juvenile Justice

Increase kinship foster care stipend

The Governor’s proposal quadruples the unlicensed rate from $75 to $300 per month and also increases the daily allowance that pays for clothing, school supplies, etc. This increase adds $19.8 million for a total $24.8 million for kinship placements. 

Reduced barriers to licensure for foster care and kinship care providers

Licensed foster care providers receive more than $600 a month compared to the current $75 for unlicensed kinship providers.  The Governor’s budget proposes removing barriers to licensure for kinship caregivers while maintaining home life and safety standards.

Increase the independent living subsidy provided for youth in extended foster care  

Currently, 651 former foster youth between ages 18 and 21 receive the independent living subsidy.  Currently the maximum subsidy is $715 and is reduced by $50 every six months. Neither the Governor’s budget nor the State of the State address this issue.

Reduce or eliminate juvenile court fines and fees  

This issue is not addressed in the Governor’s budget or State of the State.

Click twice to save a life!

ICYMI: Arizona’s Medicaid program guarantees health coverage to birthing parents for just 60 days after pregnancy. For too many new parents in our state, the care they need to form a healthy bond simply isn’t there.

Parents without access to quality, affordable health coverage are likely to delay or decline treatment for their medical and emotional needs. Even minor conditions can become life-threatening or fatal without intervention – a reality reflected in Arizona’s high rate of preventable mortality and morbidity for pregnant and postpartum individuals. For Black, Indigenous, and People of Color who give birth in Arizona, the risks associated with pregnancy are even greater.

We’re urging lawmakers to prioritize a full year of postpartum Medicaid coverage in the state budget.** We need your help to amplify the message.

P.S. Have you checked our full list of 2022 legislative priorities?

Click here to send a digital note to your lawmakers

3 steps Arizona’s lawmakers should take to improve access to health care in 2022

Having access to affordable, high-quality health care can make all the difference for a child. Kids with health insurance miss fewer days of school, get better grades, and are more likely to graduate from high school. Pregnant people who were covered by Medicaid and CHIP in their own childhood give birth to healthier infants than their peers who did not have health insurance.

In short, investing in access to health care can help families build a healthy economic future for generations to come.

The 2021 American Rescue Plan Act (ARPA) made critical investments in health care affordability, which we’ve detailed in a new report entitled “Acting on Affordable Care: The American Rescue Plan’s Role in Arizona’s Path to Pandemic Recovery.” But, as we note in the report - it’s up to Arizona’s Congressional delegation to solidify these changes, and up to state lawmakers to take full advantage of the flexibilities offered under the ARPA.

Please write Senators Sinema and Kelly and urge them to pass the Build Back Better package before the new year.

We need our state legislature to make sure that Arizona families can access the health care they need in 2022 and beyond.

  1. Extend postpartum AHCCCS coverage to a full twelve months after pregnancy. This is a low-cost intervention that will help save lives and prevent severe illness, particularly among people of color.CLICK HERE to send a postcard to your state lawmaker stressing the importance of this issue.
  2. Make KidsCare more accessible to more families.
    1. By increasing the income eligibility threshold for KidsCare to reflect the increased cost of living, thousands of uninsured children in Arizona will have access to high quality health coverage. Learn more.
    2. Cut the wait period and keep kids enrolled year-round.
  3. Allow green card holders to access health coverage. Arizona should adopt the Immigrant Children’s Health Improvement Act (ICHIA) so children and pregnant people with green cards won’t have to wait five years to enroll in AHCCCS or KidsCare.
  4. Keep former foster youth enrolled until age 26. The Affordable Care Act ensured children who age out of foster care at 18 can stay covered by Medicaid, regardless of their income but that doesn’t always happen. We’ll be advancing legislation to ensure that young people who age out can stay connected to the care they need.
  5. Cover oral health care through Medicaid. AHCCCS is one of the largest sources of health coverage in Arizona, but does not provide routine, preventive oral health care services to adults. As a result, too many Arizonans are forced to wait until a situation becomes dire to seek care in the emergency room for preventable oral health concerns. We can change that by adopting comprehensive oral health coverage for adults enrolled in AHCCCS.

Postpartum health coverage saves lives

When someone enrolled in AHCCCS gives birth, their coverage may expire just sixty days after their pregnancy ends.* Sixty days is not much time to recover from childbirth. And it means many people are forced to forego necessary postpartum health care due to the expense. For people with physical or mental health complications after pregnancy, having reliable health coverage can mean the difference between life and death. In fact, a report requested by the Arizona state legislature found that having health insurance reduces the likelihood of death during or in the year after pregnancy.

Changes in federal Medicaid policy mean it’s now easier than ever for states to expand postpartum coverage to a full year after pregnancy.** CAA and our partners are working now to ensure our state policymakers act on this opportunity.

CAA has launched a “Post-partum Post Card” campaign to help raise awareness of the need for postpartum AHCCCS coverage. We want to make it quick and easy for you to take action.

We’re collecting messages to share with our lawmakers. Our goal is to collect as many messages as possible. We’ll print the message on a postcard, then deliver a joyful advocacy bundle when the 2022 legislative session begins.

If you’d like to participate, here are three easy steps:

  1. Peruse our brief fact sheet to learn more about this issue
  2. Pick a postcard – images are available at this link.
  3. Fill out your home address and home zip code on the form linked above (we will never sell or share your information, we just want to make sure your postcard makes it to your representatives.)
  4. Write a short note to your state lawmakers. Tip: share why postpartum coverage is important to you and/or what it would mean to your community.
  5. Spread the word far and wide: Medicaid coverage saves lives.

Visit the postpartum postcard message collection form to choose a message and add your comment. Please submit comments no later than December 10th, 2021.

Thank you for your advocacy!

*Racial and ethnic disparities in pregnancy-related morbidity and mortality persist, and are driven by systemic inequities in access to care and culturally-responsive treatment. CAA wishes to note that for individuals who do not qualify for full Medicaid coverage due to their immigration or citizenship status, only delivery is covered. For these individuals, access to affordable, comprehensive pregnancy care begins and ends with delivery. CAA is committed to finding policy solutions that will promote access to prenatal and postpartum care for all Arizonans, regardless of immigration status.

**The Build Back Better package passed by the U.S. House of Representatives would mandate a year of postpartum Medicaid care. If enacted by the Senate with this provision, Arizona’s legislature will need to grant AHCCCS statutory authority to enact this change.