The most efficient investment NC can make is in children

July 1, 2013 

As legislators enter the final phase of closed-door state budget negotiations, young children could wind up being the biggest losers. Services for infants and toddlers with disabilities, Medicaid for pregnant women and even the task force created to prevent child deaths are on the chopping block. Budget-writers would be wise to preserve these investments in our youngest children.

We know from decades of neurological research that a child’s basic brain architecture – the actual physical structure of the brain – is shaped by experiences during the first few years of life. While children are obviously capable of learning and changing behavioral patterns later, it is difficult and costly to rebuild the foundation that is created in a child’s infant and toddler years. For this reason, investing in young children is the most efficient strategy for ensuring our future success.

Unfortunately, legislators are considering eliminating fundamental pieces of infrastructure that support the healthy development of our young children.

Here’s what’s at stake:

•  Services for young children with disabilities: The state’s Early Intervention program provides services such as developmental therapy and speech therapy to children up to age 3 with developmental delays or disabilities. These services are administered at one of the 16 Children’s Developmental Service Agencies across the state. The most recent version of the state budget would close four Children’s Developmental Service Agencies and cut $10 million in annual funding for Early Intervention services. As a result, young children with special needs will lose services that they need to learn and succeed.

•  Early care and education: North Carolina has a model system for early childhood care with Smart Start as the foundation. The Senate budget proposal would prevent Smart Start from administering child care subsidies, which would devastate the statewide network of local Smart Start agencies that address the local needs of children birth-to-5. Furthermore, the Senate budget would result in the loss of 10,000 NC Pre-K slots over the course of two years. The House budget, while better in some respects, would restrict eligibility for NC Pre-K, leaving thousands of families ineligible and unable to afford private pre-kindergarten.

Cutting funding and eligibility for early education is pennywise and pound-foolish. Longitudinal studies of early childhood programs across the country have shown that children in high-quality early care are more likely to be successful adults and less likely to commit crimes or receive public benefits. The benefit-to-cost ratio in these studies ranges from 4:1 to 16:1. It doesn’t take a Ph.D. in economics to recognize that early education is a good investment.

•  Medicaid for pregnant women: A healthy gestation and birth are critical not only to an infant’s survival but also to her future development. That’s why in 1991, the state expanded Medicaid to include all pregnant women under 185 percent of the federal poverty line. Since then, we’ve seen a dramatic decrease in preterm births and infant mortality, especially since the implementation of Medicaid’s pregnancy home program.

Despite the success of this initiative, Senate budget-writers have proposed moving all pregnant women above 133 percent of the federal poverty line into the private market. While the Senate budget purports to provide premium assistance to these women, many won’t qualify for the vouchers, and even those who do could face significant costs that will be a barrier to accessing quality prenatal care.

•  Child Fatality Task Force: Inexplicably, the House budget eliminates the Child Fatality Task Force, which is composed of lawmakers and issue experts who develop common-sense solutions to prevent child deaths. Over the years, the task force has recommended funding and policies that protect the health of young children, including appropriations for a host of infant-mortality prevention programs and mandatory car seats. Its success is well-documented: The child death rate has decreased 46 percent since the task force’s inception, translating to an estimated 9,000 more children living to adulthood.

None of these cuts occurs in isolation. When local Smart Start chapters and Children’s Developmental Service Agencies shut down, it puts pressure on the schools, health departments and other providers to take up the slack. Quite often, these providers don’t have the expertise or capacity to provide the necessary services, leading to poor outcomes for children and for society.

Fortunately, lawmakers have an opportunity to correct these problems. Here’s hoping that young children don’t get lost in final budget.

Rob Thompson is executive director of the Covenant with North Carolina’s Children.

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