HARRISBURG, Pa. -- As students gear up for getting back to school, Pennsylvania childrens' advocates are asking parents to ensure kids are up-to-date on routine immunizations and annual well-child visits.

Pennsylvania Partnerships For Children, with the state chapter of the American Academy of Pediatrics, has released guidance to keep kids safe and healthy this school year.

Kari King, president and CEO of Pennsylvania Partnerships for Children, said along with wearing face masks as recommended by the Centers for Disease Control and Prevention (CDC), a doctor's visit is the best way to ensure children are protected from contagious diseases, and to track developmental milestones.

"When you look at the overall benefit from ensuring that your child has that continuum of care, really, in getting those well-child visits, it really is critical to get in," King advised. "Just to make sure you're setting them on the path to continued healthy development moving forward."

According to state data, childhood immunizations fell significantly early on in the pandemic. More recent data show improvements by the end of 2020, but gaps remain, especially for kids ages four to ten. Some parents don't immunize children for religious reasons; others are concerned about potential health problems associated with some vaccines, although those risks are reported to be extremely small.

After the COVID-19 vaccine was authorized for children over age 12, the American Academy of Pediatrics and the CDC endorsed co-administering it with the routine booster shots often required for kids who play fall sports. King noted her organization also supported the recommendation.

"Which is really great because it doesn't put parents in the position of really having to choose, 'OK, one or the other, which am I going to do first?'" King explained. "And that in that one visit, you can really address the variety of needs for vaccinations and other services that are needed."

There are multiple options for parents without employer-based coverage to get health insurance for their children, including Medicaid and the Children's Health Insurance Program. The state's Vaccines for Children Program also provides free immunizations to kids who are uninsured.

A persistent child care worker shortage across New Hampshire is leaving families with few options.

The state is currently short more than 7,000 child care positions but low wages and burnout are driving workers from the field and forcing some centers to close.

Shannon Tremblay, director of the New Hampshire Child Care Advisory Council, said workers are struggling to care for their own families with wages barely above the federal poverty line.

"No one wants to come in for a low wage," Tremblay pointed out. "No one wants to come in making $15 an hour, working long hours in a stressful environment."

Tremblay argued greater state investment will create long-term benefits for both parents and children, some of whom may have disabilities or behavioral issues which could be identified earlier by trained child care staff.

Last year, state lawmakers invested more than $60 million in child care services, including $15 million for the creation of child care workforce grants and investments in the state's Family Resource Centers.

Tremblay emphasized the end of career and technical education programs in New Hampshire high schools broke the pipeline of workers entering the field, putting greater pressure on current staff to do it all.

"Our providers are the case manager, the cook, the plumber," Tremblay observed. "They want to provide that high-quality care and right now it's just, they can't do it."

Tremblay stressed pandemic-era funding to support the child care industry will run out in September, so state lawmakers need to act. She added the state could increase wages so the burden does not fall on New Hampshire families, who currently spend roughly $24,000 a year on care for two children under age five.

The child welfare system in Pennsylvania faces a staffing crisis affecting children and families throughout the system.

The Child Welfare Resource Center said about 30 counties report caseworker vacancy rates of 30% or higher

Terry Clark, president and CEO of the Pennsylvania Council of Children, Youth and Family Services, at a state Senate hearing on child welfare, challenged the Departments of Education and Human Services to work together to develop a STEM-focused model for human services. It could offer young people opportunities for training, apprenticeships and careers in child welfare, juvenile justice and behavioral health.

"We spend a lot of time focusing on colleges and universities," Clark noted. "But we believe we might want to back this up a little bit, and start looking at middle schools and high schools. Try to reinvigorate, get younger students motivated and trying to come into this field."

Clark pointed out some agencies have asked supervisors and even people from other departments to take on casework responsibilities. A recent Philadelphia study found Community Umbrella Agencies had an average 45% turnover rate, with vacancies ranging from 21-60 positions.

Clark observed private providers face workforce challenges similar to the county child welfare agencies. He emphasized counties are beginning to explore more contractual relationships with private providers for needed work.

"Counties are starting to put out RFPs, calls for private providers to help supplement their workforce," Clark stressed. "That means they're asking private providers to take on roles and functions that, in the past, were primarily done by counties themselves."

Clark argued competitive wages are seen as crucial to attract and retain child welfare workers, and county funding often falls short. He added student loan forgiveness and fellowship programs may be promising ways to bring new people into the field, but lawmakers would have to agree.

"There have been House bills and different Senate bills that have been introduced, or at least in draft form over the years," Clark acknowledged. "We hope that there's continued discussion about those, because if we can get some movement on those, we think those will really help."

He told legislators the turnover trends will not change significantly without increased investment in workers.

Despite a recent policy victory, Wisconsin labor leaders still express concern about the current environment for shielding young teens from unsafe work environments.

Gov. Tony Evers this month vetoed a bill which would have expanded the elimination of required work permits for those younger than 18. The bill's language applied to 14- and 15-year-olds, several years after the state did away with parental permission for 16- and 17-year-olds.

Stephanie Bloomingdale, president of the Wisconsin State AFL-CIO, said the recent debates are policy fights advocates thought they won decades ago when minors often worked in dangerous conditions. She cautioned there is a strong push to chip away at protections.

"We are seeing a growing movement from different, unscrupulous employers that want to put kids back in the workplace, and not have the kind of oversight that is needed," Bloomingdale contended.

The Economic Policy Institute said rollbacks have been approved in a dozen states in the past few years. While current efforts are thwarted in Wisconsin, Bloomingdale worries about similar debates in future sessions.

Meanwhile, violations are trending upward, with the U.S. Labor Department reporting an 83% increase in financial penalties. Backers of the Wisconsin bill said the goal was to reduce red tape for families.

Bloomingdale countered taking away another layer of protection does more to trample on the rights of parents and guardians. And with higher consumer prices placing more pressure on household budgets, she added some kids might feel the need to bring in additional income.

She emphasized the current law helps the whole family make an informed decision.

"It's important for kids to get a good work ethic," Bloomingdale acknowledged. "But at the same time, these kids need to make sure that they are getting enough sleep, that they are able to participate in their school, and really making sure that balance is there."

The Economic Policy Institute report showed amid the push in many states to weaken laws, several other states have advanced bills to strengthen protections. There have been bipartisan bills in Congress which, among other things, would crack down on violators.


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