The overall state of children’s health in Rhode Island has shown marked improvement over the last several years. However, further improvement is required. After reviewing the eighteen criteria associated with health in the 2016 Rhode Island Kids Count Factbook, we settled on five key indicators to assess progress on the topic: evidence-based family home visiting, health insurance, immunizations, mental health, and special needs/behavioral health.
First, we assessed the number of families participating in evidence-based family home visiting programs. Children who participate in evidence-based family home visiting programs have improved language, cognitive, and social-emotional development, and are less likely to experience abuse and neglect. As of October 2015, there were 823 families participating, up from 500 the prior year. To further emphasize the importance of good parenting and promote the use of these effective programs, the General Assembly recently passed the Rhode Island Family Home Visiting Act, sponsored by Senate President M. Teresa Paiva Weed and Rep. Joseph McNamara. We need to ensure we continually monitor outcomes of the legislation to determine what else is needed and ensure the program is appropriately utilized.
Next we analyzed Health Insurance which measures the percent of children 19 years of age and younger who have health insurance. As of 2014, 96.7 percent of Rhode Island children have health insurance, placing the state 7th nationally. The percentage of children without health insurance has decreased significantly, from 5.2 percent in 2008 to 3.3 percent in 2014. This success rate is attributable to the RIte Care Program.
RIte Care is Rhode Island’s Medicaid managed care program for children, pregnant women and parents. The program has been so successful that the Centers for Medicare and Medicaid Services recognized it as the best in the nation in 2015, a credit to its many services, such as prenatal care, access to primary care and immunization status.
Immunization status is next criteria analyzed. Thanks to the Affordable Care Act, children enrolled in new health insurance plans now have access to all recommended vaccines. In 2014, Rhode Island came close to Healthy People 2020’s target of having at least 80 percent of children ages 19 to 35 months completing their recommended series of vaccines. We reached 76 percent. With additional effort, the state can and will achieve the 80 percent target. Sustaining health insurance and increasing health literacy is critical to ensuring sound individual personal health.
Our next criteria is children with special needs, defined as those who have a chronic disease or disability that requires educational services, health care, and/or related services of a type or amount beyond that typically required. Although for the past two decades Rhode Island has been striving to build a preventive and treatment system of care for children with mental health disorders, more progress is needed, and it is an area that needs to be elevated in priority. In 2014, there were 2,744 hospitalizations of children in Rhode Island with a primary diagnosis of mental health disorder, an alarming increase from 2005, when there were 1,797 hospitalizations of children with a primary diagnosis of mental health disorder.
RIte Care also plays a significant role within children’s mental health. Of the hospitalizations of children in 2014, 50 percent were covered by Medicaid/RIte Care coverage. In 2015, 22 percent of the children under age 19 enrolled in Medicaid/RIte Care had a mental health diagnosis, and 2 percent of those children were hospitalized due to a mental health condition.
In Rhode Island, 21 percent of children have at least one special health care need. Thanks to the Katie Beckett eligibility provision, many of these children are able to receive Medicaid coverage. Children with special needs that receive Medicaid have shown significant gains in access to necessary health care services and reductions in emergency care and hospitalizations.
Children’s health in Rhode Island continues to improve. While improvement has been realized, more work remains. With the right policy and an appropriate investment we can and will realize the needed results to improve the state of children’s well-being in Rhode Island.
Louis P. DiPalma is the Democratic state senator representing District 12, Middletown, Little Compton, Newport and Tiverton. Melissa Bann, a senior at the University of Rhode Island, is a Senate intern. She is from Oakland, N.J.