BRIEF

Promoting Young Children’s

Health and Development
Taking Stock of State Policies

Will Schneider May 2010

Sheila Smith
Dionna Walters
Janice L. Cooper
 The National Center for Children in Poverty (NCCP) is the nation’s leading public
policy center dedicated to promoting the economic security, health, and well-being
of America’s low-income families and children. Using research to inform policy and
practice, NCCP seeks to advance family-oriented solutions and the strategic use of
public resources at the state and national levels to ensure positive outcomes for the next
generation. Founded in 1989 as a division of the Mailman School of Public Health at
Columbia University, NCCP is a nonpartisan, public interest research organization.

Promoting Young Children’s Health

Taking Stock of State Policies
Will Schneider, Sheila Smith, Dionna Walters, Janice L. Cooper

Authors Acknowledgements

Will Schneider is a policy analyst on the Improving the We gratefully acknowledge funding support from the Birth to
Odds for Young Children project at the National Center for Five Policy Alliance.
Children in Poverty.
We would like to thank Christel Brellochs, director of
Sheila Smith, PhD, is director of early childhood at NCCP. health and mental health at NCCP for her guidance in the
Dr. Smith directs the Improving the Odds for Young Children development of this brief. Special thanks to Morris Ardoin,
project. Her research focuses on the role of early childhood Telly Valdellon and Amy Palmisano for their support on the
programs and policies to promote the healthy development production of this brief.
and school readiness of young children.

Dionna Walters, MPH, MPA, is the project coordinator for

the Improving the Odds for Young Children project at the
National Center for Children in Poverty.

Janice L. Cooper, PhD, is interim director at NCCP and

assistant clinical professor, Health Policy and Management
at Columbia University Mailman School of Public Health.
Dr. Cooper directs Unclaimed Children Revisited, a series
of policy and impact analyses of mental health services
for children, adolescents, and their families. From 2005 to
2010, she led NCCP’s health and mental health team.

Copyright © 2010 by the National Center for Children in Poverty

2
Promoting Young Children’s Health and Development
Taking Stock of State Policies

Will Schneider | Sheila Smith | Dionna Walters | Janice L. Cooper May 2010

Young children’s health is essential to their overall

development, well-being, and school readiness.1 Improving the Odds for Young Children (ITO)
Untreated health problems and a lack of preventive provides printable profiles of states’ policy
care contribute to higher rates of serious illness, choices that affect the healthy development
absenteeism in preschool,2 physical and emotional
of young children. ITO also shows the preva-
distress3, and even long-term disability.4 At a
historic moment when the passage of federal health lence of young child family risk factors in
care reform promises significant improvements in each state, along with national trend data for
health care access for many Americans, it is impor- policies and risk factors.
tant to take stock of how well states are currently
meeting the health needs of young children in
low-income families. This brief presents informa-
tion from NCCP’s Improving the Odds for Young Relevant components of health care reform legisla-
Children project about state policy choices in the tion are considered in a set of recommendations for
following areas that affect the health and well-being meeting the short and long-term health care needs
of children, ages birth to 5:* of young, low-income children.
♦ access to health care and continuity of care;
♦ maternal health care; and
♦ preventive screening and assessment.

_____
* Birth to age 5 is inclusive through the fifth year.

National Center for Children in Poverty Promoting Young Children’s Health 3

Access to Health Care and Continuity of Care

Eligibility for Medicaid and the Child 2009 Poverty Guidelines

Health Insurance Program (CHIP) U.S. Department of Health and Human Services
Persons in Family or Household
As a result of the CHIP expansion signed into law by 1 $ 10,830
President Obama in early 2009, children in house- 2 14,570
holds with income at or above 200 percent of the fed- 3 18,310
eral poverty line (FPL) have access to public health 4 22,050
insurance (Medicaid/CHIP) in all but five states. 5 25,790
♦ Currently, 46 states have set the income eligibility 6 29,530
for Medicaid/CHIP at or above 200 percent of 7 33,270
FPL for young children. In 2009, four states – 8 37,010
Montana, Nebraska, Oregon and South Carolina For each additional person, add 3,740
– raised their eligibility thresholds to at least 200
percent of FPL. Ten states with previous levels
already at 200 percent of FPL increased eligi- States can also provide public health insurance to
bility above 200 percent in 2009, ranging from immigrant children through a Medicaid option
205 percent of FPL for children birth to age 5 (for legal documented children only) and through
in Colorado, to 400 percent of FPL for children separate state funds (for undocumented children).
birth to age 5 in New York.5 Arizona recently The relatively high rates of health problems among
suspended its CHIP program that previously immigrant children age 5 and younger highlight
served children up to 200 percent of FPL.6 their need for access to health care.8 In one study
♦ Alaska, Idaho, North Dakota, and Oklahoma have comparing the health status of poor immigrant and
income eligibility ranging from 160 percent to non-immigrant children, more than twice as many
185 percent of FPL. Following the recent elimina- immigrant children were reported by parents to
tion of its CHIP program, Arizona now covers be in poor or fair health.9 While some states offer
young children in families with incomes up to coverage to young immigrant children, this vulner-
140 percent of FPL (birth to age 1), and up to 133 able group has much less access to health care than
percent of FPL (age 1 to 5) through Medicaid.7 other low-income children.

Medicaid/CHIP Eligibility Levels at or Above 200% of Federal Poverty Level for Children Birth to Age 5

DC

Medicaid and CHIP: AR, DE, DC, FL, HI, IL,

IA, ME, MD, NE NH, NC, OH, RI, VT, WI

CHIP only: AL, AZ, CA, CO, CT, GA, IN, KS,
KY, LA, MA, MI, MS, MO, MT, NV, NJ, NY, OR,
PA, SC, SD, TN, TX, UT, VA, WA, WV, WY

Medicaid only: MN, NM

Does not cover above 200%: ID, ND, AK, OK

4
Medicaid/CHIP Eligibility Levels at or Above 200% of Federal Poverty Level for Immigrant Children Birth to Age 5

At or above 200%: IL, MD, WA, MN, DC, HI

DC
At or above 200% (birth to age 1 only):
CA, DE, ME, MA, NJ, NY

Below 200%: VA, CT, NE, PA

No coverage offered – AL, AK, AZ, AR, CO,

FL, GA, ID, IN, IA, KS, KY, LA, MI, MS, MO,
NV, NH, NM, NC, ND, OH, OK, OR, RI, SC,
TN, TX, UT, VT, WV, WI, WY

Provides coverage to undocumented immigrant

children: IL, NY, WA, DC

♦ Twelve states offer coverage to all or most legal Medical home data released in 2009 suggest that
documented immigrant children birth to age 1 young children in low-income households who have
with household incomes at or above 200 percent public insurance coverage are more likely to have
FPL. Four of the 12 states – Illinois, New York, a medical home.15 However, even among children
Washington, and the District of Columbia – also covered by public insurance, too few have a medical
extend coverage to undocumented immigrant home that can help ensure effective health care.
children birth to age 1.10 ♦ Sixty-two percent of young children with public
♦ Six of the 12 states provide coverage to all or most insurance have a medical home.16
legal immigrant children age 1 to 5 with house- ♦ Thirty-one percent of young children with private
hold incomes at or above 200 percent FPL. Three insurance have a medical home.17
of the six states – New York, Washington, and the
District of Columbia – also extend coverage to ♦ Seven percent of young children with no insur-
most undocumented immigrant children age 1 to ance have a medical home.18
5 with household incomes at or above 200 percent
FPL.11 States’ policies regarding continuity of public health
care coverage may support or impede families’ ability
to maintain a medical home for young children.
Medical Homes for Young Children

Young children benefit from having a “medical Young children in low-income households who
have public insurance coverage are more
home,” described by the American Academy of likely to have a medical home.
Pediatrics (AAP) as health care that is “accessible,
continuous, comprehensive, family-centered,
7% 62%
coordinated, compassionate, and culturally no insurance with public insurance
effective.”12 Research shows that public health
insurance programs improve the physical health
and development of children through the receipt of 31%
consistent and continuous health care.13 Children with private insurance

enrolled in public health insurance programs are

also more likely to receive regular dental care and
visit emergency rooms less often.14

National Center for Children in Poverty Promoting Young Children’s Health 5

 Continuity of Care ♦ Only 14 states have policies known as “presump-
tive eligibility,” which provides temporary
State policy choices affect the extent to which health coverage for young children while their initial
care for young children and pregnant women is applications are being reviewed for approval. Nine
timely – available when most needed – and uninter- of these states have implemented “presumptive
rupted. In most states, the enrollment process for eligibility” policies for both Medicaid and CHIP,
Medicaid and CHIP can be time consuming. The while the remaining five states do so only for
required, periodic re-enrollment process can result Medicaid.22
in eligible families losing coverage due to adminis- ♦ Three states – Alabama, Louisiana, and New
trative lapses and paperwork errors. Jersey – have established formal Express Lane
♦ Forty-seven states require that children’s eligibility Eligibility initiatives to automatically enroll
for Medicaid/CHIP be reviewed every 12 months.19 children in Medicaid/CHIP when they qualify for
Thirty-one of these states have formal 12-month other government programs. New York, Vermont,
continuous eligibility policies, while six states and Wisconsin have programs similar to Express
employ policies similar to continuous eligibility but Lane Eligibility but which do not meet all of the
which do not meet all aspects of the formal policy.20 requirements.23
♦ Four states – Georgia, Minnesota, Pennsylvania,
and Texas – require review every six months for
Medicaid.21

Young Children’s Health and Well-being is Linked to Maternal Health

The health and well-being of infants and young chil- increased risk for preterm births, low birth weight,
dren is closely tied to the health of pregnant women. preeclampsia, miscarriage,24 and poor physical and
It is especially important for pregnant women to socio-emotional development of infants.25 Despite
receive prenatal care that includes screening for increased Medicaid/CHIP eligibility for low-income
conditions such as periodontal disease, obesity children, pregnant women in many states continue
and depression. These conditions are linked to to lack access to public health insurance.26

Medicaid/CHIP Eligibility Levels at or Above 200% of Federal Poverty Level for Pregnant Women

DC

At or above 200%: AR, CA, CO, CT, DE, DC,

GA, IL, IN, IA, LA, ME, MD, MA, MN, NY,
NM, NY, OH, RI, TN, VT, VA WI

Below 200%: AL, AK, AZ, FL, HI, ID, KS, KY,
MI, MS, MO, MT, NE, NV, NH, NC, ND, OK,
OR, PA, SC, SD, TX, UT, WA WV WY

6
 Medicaid/CHIP Eligibility Levels at or Above 200% of Federal Poverty Level for Pregnant Immigrant Women

DC

At or above 200%: AR, DE, DC, IL, LA, ME, NJ,

NY, PA, TX, WA, MD, RI, TN, MN, CA, MA, WI

Below 200%: CO, CT, HI, MI, NE, OK, OR

No coverage offered: AL, AK, AZ, FL, GA, ID,

IA, KS, KY, MS, MO, NV, NH, NM, NC, ND,
OH, SC, SD, UT, VT, VA, WV, WY

♦ Twenty-four states cover pregnant women at 200 ♦ Eighteen states cover pregnant immigrant women
percent of FPL or higher – an increase of four with incomes up to 200 percent of FPL.31
states.27
♦ Ten states set the income eligibility at or below Despite low eligibility levels in many states, preg-
150 percent of FPL for pregnant women.28 nant women can be enrolled immediately in
Medicaid through “presumptive eligibility” policies
♦ Seventeen states set the income eligibility between in 30 states. An additional five states have poli-
175 percent and 185 percent of FPL for pregnant cies that are very similar to presumptive eligibility,
women.29 allowing pregnant women to receive prenatal health
♦ Currently, 25 states offer public health insurance care and screening before their applications are
to pregnant immigrant women: 17 of these states formally approved.32
offer coverage to all legal and undocumented
immigrants, while eight states offer coverage to all
or most legal immigrants.30

Well-child Visits and Preventive Screening

Even when young, low-income children have health AAP recommends that children receive a set
insurance, they do not always receive the health, number of well-child medical visits per year: seven
developmental and dental screenings that are con- visits in the baby’s first year, four visits between the
sistent with pediatric practice recommendations, ages of 1 and 2 years, and three visits between the
and key to preventing or reducing the severity of ages of 3 and 5 years. During these visits, parents
future problems. The Early and Periodic Screening, receive important guidance about how to support
Diagnosis and Treatment (EPSDT) program is their child’s health and development. EPSDT
Medicaid’s comprehensive child health benefits screens are also conducted in well-child visits. Many
package. EPSDT requires health care providers to states are falling short of these guidelines, requiring
periodically screen children for good health, diag- fewer than the number of recommended visits.33
nose any medical problems or delays, and provide
treatment for identified conditions.

National Center for Children in Poverty Promoting Young Children’s Health 7

 ♦ Only five states – Georgia, Indiana, North Dakota, States Where EPSDT Screening Rates Exceeded 80%
Vermont, and West Virginia – met or exceeded Ages
AAP recommendations for seven well-child visits State
0 to 1 1 to 2 3 to 5
for a child birth to age 1.34 ALABAMA 
ALASKA
♦ Thirty-nine states met AAP recommendations for 
ARIZONA
four well-child visits for a child between the ages   
ARKANSAS
of 1 and 2. Two of these states – Nebraska and
CALIFORNIA  
Kansas – exceeded the AAP recommendations
COLORADO  
by requiring five visits.35
CONNECTICUT   
♦ Forty-eight states met AAP recommendations for DELAWARE   
three well-child visits for a child between the ages DISTRICT OF COLUMBIA   
of 3 and 5. Three states – Arkansas, California FLORIDA   
and Delaware – require only two visits for these GEORGIA  

children.36 HAWAII  
IDAHO  

The federal government set a benchmark for 80 ILLINOIS  

percent of Medicaid-enrolled children to receive at INDIANA 

IOWA
least one developmentally-appropriate health screen   
KANSAS
each year during a well-child visit.37 In 2008:   
KENTUCKY  
♦ 40 states reported that they completed the screens LOUISIANA   
of more than 80 percent of children less than 1 MAINE  
year old;38 MARYLAND   
MASSACHUSETTS
♦ 44 states reported that they completed the screens   
MICHIGAN
of more than 80 percent of children ages  
MINNESOTA
1 to 2 years;39 and  
MISSISSIPPI  
♦ 20 states reported that they completed the screens MISSOURI   
of more than 80 percent of children ages 3 to 5.40 MONTANA  
NEBRASKA  

Newborn Screening NEVADA  

NEW HAMPSHIRE  
NEW JERSEY
Universal newborn screening for hearing and meta-   
NEW MEXICO 
bolic deficiencies and disorders are recommended
NEW YORK  
for all children in order to identify and treat condi-
NORTH CAROLINA  
tions that can cause life-long disabilities. The March NORTH DAKOTA 
of Dimes and American Academy of Pediatrics OHIO  
recommend newborn screens for hearing and 28 OKLAHOMA  
metabolic conditions.41 Currently, some states are OREGON  
still failing to perform all of these recommended PENNSYLVANIA 
screens. RHODE ISLAND  

♦ Forty-one states require universal newborn screen- SOUTH CAROLINA  

ing for the 28 metabolic deficiencies/disorders as SOUTH DAKOTA  

TENNESSEE
defined by the March of Dimes; an increase of 21   
TEXAS
states since 2007.42  
UTAH
♦ Thirty-six states require universal newborn VERMONT 
screening for hearing deficiencies, with two addi- VIRGINIA  
tional states – Michigan and South Carolina – WASHINGTON 
requiring the screening since 2007.43 WEST VIRGINIA   
WISCONSIN  
WYOMING  

8
Part C Early Intervention Services with a narrow definition. Data released in 2008 (the
most current available) show that:47
Children who exhibit or show risk of developmental ♦ twenty-two states use a broad definition of eligibility
delays in the first three years of life are at higher risk that includes children “at-risk” of serious delays and
of school failure, mental health problems, and other disabilities, 13 states use a moderate definition, and
conditions that limit their life opportunities.44 Part 16 states have narrow definitions; and
C of the Individuals with Disabilities Education Act
(IDEA) requires states to provide early interven- ♦ among states with a broad definition, 59 percent
tion services to children from birth to age 3 who (13 states) serve more children than the national
have an identified disability or serious delay. Some average; among states with moderate definitions,
states also extend eligibility to infants and toddlers 54 percent (seven states) serve more children than
who are at risk of a serious delay due to individual the national average; and among states using a
or family risk factors, such as low birth weight, narrow definition, 19 percent (three states) serve
parent mental illness and high exposure to lead in more than the national average.
the home. These risk factors are more commonly
experienced by low-income children than their States’ Part C early intervention programs are
more advantaged peers. Recent research suggests increasingly focused on identifying the mental
that both a child’s poverty status and a state’s use of health needs of very young children. However,
narrow eligibility criteria increase the chance that a efforts to identify mental health needs appear
child with a parent-reported delay or disability will stronger in the screening process than in evalua-
not receive early intervention.45 tions to determine eligibility for EI services.
♦ More than half (58 percent) of the 48 states whose
The Department of Education classifies states as Part C coordinators responded to a recent survey
using narrow, moderate or broad eligibility criteria reported that their state recommended the use of
for early intervention (EI) services. In general, states an instrument that screens for social-emotional
with broad and moderate criteria extend eligibility to problems.48
include children who have less serious delays or who ♦ More than half of the responding states (56 per-
show risk factors for delays or disabilities. Nationally, cent) also reported that they do not require the
an average of 2.5 percent of children birth through age participation of a professional with expertise in
2 receives Part C early intervention services.46 States young children’s social-emotional development in
with broad and moderate eligibility criteria are more the multi-disciplinary evaluation that is conducted
likely to be above the national average in the numbers to determine eligibility for EI services.49
of children who receive EI services compared to states

Scope of Eligibility Criteria for Part C

DC
Broad eligibility criteria: MS, AL, FL, WA, VA,
TX, AR, CA, MI, WI, IA, KS, OH, MD, NH, PA,
VT, NM, WY, WV, MA, HI

Moderate eligibility criteria: RI, NY, IN, IL, SD,

NJ, KY, DE, NC, AK, CO, MN, LA

Narrow eligibility criteria: DC, GA, MO, NV, NE,

MT, OR, TN, AZ, OK, UT, SC, ME, ID, ND, CT

Meets or exceeds the national participation average:

WI, IA, KS, OH, MD, NH, PA, VT, NM, WY, WV,
MA, HI, RI, NY, IN, IL, SD, NJ, KY, ID, ND, CT

National Center for Children in Poverty Promoting Young Children’s Health 9

What States Can Do

Full implementation of national health care reform ♦ State policy initiatives designed to strengthen
under the Patient Protection and Affordable Care supports for young children’s healthy develop-
Act (PPACA) will occur in stages over the next ment and school readiness should establish new
several years. Some provisions, such as federal guidelines, training for pediatric settings and
subsidies for families to help them buy health monitoring procedures to ensure that all recom-
insurance, and the creation of health insurance mended well-child visits and developmental
exchanges designed to provide affordable options screenings are provided for children birth to
to families who do not qualify for public insurance, age 5. The Early Childhood Comprehensive
will not be fully in place until 2014.50 Meanwhile, Systems initiatives funded by the federal Maternal
states should consider the following steps to ensure and Child Health Bureau and the State Early
that low-income young children receive the health Childhood Advisory Councils, required under the
care they need for positive health, developmental, Improving Head Start for School Readiness Act of
and educational outcomes. 2007, provide opportunities for developing these
♦ PPACA requires that states maintain their supports for young children’s well-being.
Medicaid and CHIP programs through at least ♦ States that currently do not conduct the recom-
2019. While states cannot lower income eligi- mended universal newborn screens for 28 meta-
bility thresholds during this period, they can bolic deficiencies/disorders and hearing problems
and should extend coverage to young children in should join the majority of states that currently
families with incomes below 200 percent of the require these screens.
federal poverty line, regardless of immigration ♦ States that use narrow eligibility criteria in their
status. Coverage for undocumented children will Part C Early Intervention Programs should
require the use of separate state funds even after consider broadening their eligibility criteria to
full implementation of PPACA.51 include children at-risk of serious delays and
♦ By 2014, the PPACA will require that states disabilities. Early interventions with at-risk chil-
provide Medicaid coverage to all adults with dren can reduce the chance of costly long-term
incomes up to 133 percent of FPL.52 Low-income conditions that limit children’s prospects for good
pregnant women with income between 133 health and educational outcomes.
percent and 200 percent of FPL will still be left ♦ States’ Part C programs should strengthen their
without coverage under PPACA, along with capacity to respond to young children’s mental
low-income, pregnant, undocumented immi- health needs by requiring the participation of
grant women. To ensure rising rates of healthy a professional with expertise in infant-toddler
births and infants who start life without disabili- social-emotional development during the multi-
ties, states should extend Medicaid coverage disciplinary evaluation that determines eligibility
to all pregnant women, regardless of immigra- for EI services.
tion status, with incomes up to 200 percent of
FPL. Separate state funding should be used for
coverage of undocumented immigrant women.
♦ States should consider several actions to ensure
that pregnant women and children have the
timely and continuous care they need for posi-
tive child health and developmental outcomes:
(1) provide 12-month continuous eligibility for
both Medicaid and CHIP for children; (2) provide
presumptive eligibility for public insurance
coverage for both children and pregnant women;
and (3) keep co-pays low so that families are not
deterred from seeking care.

10
Endnotes
1. Fomby, Paula; Cherlin, Andrew J. 2007. Family Instability 11. Ibid.
and Child Well-being. American Sociological Review 72(2):
12. Szilagyi, Peter G.; Cheng, Tina; Simpson, Lisa; Berkelhamer,
181-204(24).
Jay E.; Sectish, Theodore C. 2008. Health Insurance for All
Rouse, Heather; Fantuzzo, John W. 2009. Multiple Risks and Children and Youth in the United States: A Position Statement
Educational Well Being: A Population-Based Investigation of the Federation of Pediatric Organizations. The Journal of
of Threats to Early School Success. Early Childhood Research Pediatrics 153(3): 301-302.
Quarterly 24(1): 1-14.
13. Allred, Norma J.; Wooten, Karen G.; Kong, Yuan. 2007.
Thompson, Ross; Raikes, H. Abigail. From Knitzer, Jane; The Association of Health Insurance and Continuous Primary
Kauffman, R.; Perry, D. (eds). Early Childhood Mental Health. Care in the Medical Home on Vaccination Coverage for 19- to
Baltimore,MD: Paul H. Brookes Publishing Co. 35-Month-Old Children. Pediatrics 119: S4-S11.
2. Currie, Janet. 2005. Health Disparities and Gaps in School American Academy of Pediatrics, Committee on Child Health
Readiness. The Future of Children,15(1): 117-138. Financing. 2002. Policy Statement: Organizational Principles
3. McLaughlin, Andrea E.; Campbell, Frances A..; Pungello, to Guide and Define the Child Health Care System and/or
Elizabeth P.; Skinner, Martie. 2007. Depressive Symptoms in Improve the Health of All Children. Pediatrics 110(1): 132-135.
Young Adults: The Influences of the Early Home Environment Levine, Phillip B.; Schanzenbach, Diane. 2009. The Impact of
and Early Educational Child Care. Child Development 78(3): Children’s Public Health Insurance Expansions on Educational
746-756. Outcomes. Forum for Health Economics & Policy, 12(1).
4. Sanchez, Katherine; Gomez, Rebecca; King, Davis. 2010. Perry, Cynthia D.; Kenney, Genevieve M. 2007. Preventive Care
Fostering Connections and Medical Homes: Addressing Health for Children in Low-income Families: How Well Do Medicaid
Disparities Among Children in Substitute Care. Children and and States’ Children Health Insurance Programs Do? Pediatrics
Youth Services Review 32(2): 286-291. 120(6):1393-1401.
Silver, Ellen Johnson; Heneghan, Amy M.; Bauman, Laurie J.; 14. Kenney, Genevieve. 2007. The Impacts of the State Chil-
Stein, Ruth E. 2006. The Relationship of Depressive Symptoms dren’s Health Insurance Program on Children Who Enroll:
to Parenting Competence and Social Support in Inner-city Findings from Ten States. Health Services Research 42(4):
Mothers of Young Children. Journal of Maternal and Child 1520–1543.
Health 10(1): 105-112.
15. NCCP Calculations of Child and Adolescent Health
5. Ross, Donna Cohen; Marks, Caryn. 2009. A Foundation for Measurement Initiative (CAHMI). 2007 National Survey of
Health Reform: Findings of a 50 State Survey of Eligibility Rules, Children’s Health Indicator Dataset. Data Resource Center for
Enrollment and Renewal Procedures, and Cost-Sharing Practices Child and Adolescent Health.
in Medicaid and CHIP during 2009. Kaiser Commission on
16. Ibid.
Medicaid and the Uninsured, The Henry J. Kaiser Family Foun-
dation. [Link] (accessed Feb. 28, 2010). 17. Ibid.
6. [Link] 18. Ibid.
policy/[Link] (accessed: April 1, 2010) 19. See endote 5.
7. See endnote 5. 20. Ibid.
8. Hamilton, Erin; Hummer, Robert; You, Xiuhong; Padilla, 21. Ibid.
Yolanda. 2006. Health Insurance and Health-care Utilization of
U.S.-Born Mexican-American Children. Social Science Quar- 22. Ibid.
terly 87(5): 1280-1294. 23. Marrow, Beth. Express Lane Activities: States On The
Padilla, Yolanda; Hamilton, Erin; Hummer, Robert. 2009. Move.” February 2010. The Children’s Partnership. [Link]
Beyond the Epidemiological Paradox: The Health of Mexican- [Link]/AM/[Link]?Section=State_
American Children at Age Five. Social Science Quarterly 90(5): Activity_Report&TEMPLATE=/CM/ContentDisplay.
1072-1088. cfm&CONTENTID=13347 (accessed April 2010)
Zhihuan, Jennifer Huang; Yu, Stella M.; Ledsky, Rebecca. 2006. 24. Sibai, Baha; Dekker, Gus; Kupferminc, Michael. 2005. Pre-
Health Status and Health Service Access and Use Among Chil- eclampsia. The Lancet 365(9461, 26): 785-799.
dren in U.S. Immigrant Families. American Journal of Public 25. Roberts, G.; Bellinger, D.; McCormick, M. C. 2007. A
Health April 96(4): 1-8. Cumulative Risk Factor Model for Early Identification of
9. Reardon-Anderson, Jane; Capps, Randy; Fix, Michael. The Academic Difficulties in Premature and Low Birth Weight
Health and Well-Being of Children in Immigrant Families. Infants. Maternal and Child Health Journal 11(2): 161-72.
2002. New Federalism, The Urban Institute, Series B, No. B-52. Stein, Ruth E. K..; Siegel, Michele J.; Bauman, Laurie J. 2006.
10. The Henry J. Kaiser Family Foundation. 2009. New Option Are Children of Moderately Low Birth Weight at Increased Risk
for States to Provide Federally Funded Medicaid and CHIP for Poor Health? A New Look at an Old Question. Pediatrics
Coverage to Additional Immigrant Children and Pregnant (1): 217-223.
Women. Kaiser Commission on Key Facts. [Link] 26. See endnote 5.
(accessed Nov. 11, 2009).

National Center for Children in Poverty Promoting Young Children’s Health 11

27. Ibid. Wolke, Dieter; Schmid, Gabriele; Schreier, Andrea; Meyer,
28. Ibid. Renate. 2009. Dipl-Psych Crying and Feeding Problems in
Infancy and Cognitive Outcome in Preschool Children Born at
29. Ibid. Risk: A Prospective Population Study. Journal of Developmental
30. See endnote 10 & Behavioral Pediatrics 30(3):226-238.
31. Ibid. Feldman, Maurice A.; Hancock, Christie L.; Rielly, Nicole;
Minnes, Patricia; Cairns, Colleen. 2000. Behavior Problems
32. See endnote 5. in Young Children With or At Risk for Developmental Delay.
33. Recommendations for Preventive Pediatric Healthcare. Journal of Child and Family Studies 9(2):247-261.
2008. American Academy of Pediatrics ([Link] 45. McManus, Beth; McCormick, Marie C.; Acevedo-Garcia,
[Link]/cgi/data/120/6/1376/DC1/1 (accessed Dolores; Ganz, Michael; Hauser-Cram, Penny. 2009. The Effect
March 29, 2010). of State Early Intervention Eligibility Policy on Participation
34. U.S. Department of Health and Human Services, Centers Among a Cohort of Young CSHCN. Pediatrics 124(4): 368-374.
for Medicare and Medicaid Services. 2009. The Annual EPSDT 46. U.S. Department of Education, Office of Special Education
Report (Form CMS-416). [Link]/MedicaidEarlyPe- Programs, Data Analysis System (DANS). 2008. Infants and
riodicScrn/03_StateAgencyResponsibilities.asp (accessed Nov. Toddlers Receiving Early Intervention Services in Accordance
18, 2009) with Part C.
35. Ibid. 47. Ibid.
36. Ibid. 48. Cooper, Janice; Vick, Jessica. 2009. Promoting Social-
37. Health Care Financing Administration (HCFA), July 1990. emotional Well-being in Early Intervention Services. New York,
[Link] (accessed NY: National Center for Children in Poverty, Columbia Univer-
March 29, 2010). sity Mailman School of Public Health.
38. Ibid. 49. Ibid.
39. Ibid. 50. Schwartz, Karen. “Kaiser Commission on Medicaid and the
Uninsured: COBRA Subsidy for the Uninsured.” April 2010.
40. National Newborn Screening and Genetics Resource Center.
The Henry J. Kaiser Family Foundation. [Link]
2009. National Newborn Screening Status Report. [Link]
uninsured/upload/[Link] (accessed April 20, 2010)
[Link] (accessed Oct. 23, 2009).
51. “Summary of Medicaid, CHIP, and Low-Income Provisions
41. Ibid.
in Health Care Reform.” April 2010. Center for Children and
42. Ibid. Families, Georgetown University Health Policy Institute.
43. Ibid. 52. “Focus on Health Reform: Health Reform Implementa-
44. McLeod, Jane D.; Fettes, Danielle L. 2007. Trajectories of tion Timeline.” March 31, 2010. The Henry J. Kaiser Family
Failure: The Educational Careers of Children with Mental Foundation.
Health Problems The American Journal of Sociology 113(3):
653-701.

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