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Enrollment in early childhood education programs can be an important stepping stone to higher educational achievement, particularly for low-income children. However, children cannot succeed in these programs unless they are present. The Early Childhood Education Division (ECED) in the District of Columbia Public Schools (DCPS) has identified school attendance patterns and absenteeism as areas in need of improvement for meeting school-readiness goals. This focus is consistent with the overall goal, outlined in the DCPS Capital Commitment Strategic Plan for 2017, of increasing investments that will improve in-seat attendance and reduce tardiness and truancy throughout the school system. In the past, the DCPS has contracted with the Urban Institute to identify patterns of absenteeism across DCPS's Title I school-based Head Start programs. This information has been used to inform DCPS's efforts to reduce absenteeism in early childhood programs and to achieve its school-readiness goals. This report examines the extent to which attendance patterns in DCPS's Title I school-based Head Start programs predict attendance in kindergarten through second grade. In addition, the report identifies the characteristics of children who are most likely to remain chronically absent or become chronically absent over time. The results from this report should inform the ECED and DCPS about the risk factors for staying chronically absent over time and identify potential areas to target interventions. A supplementary table is appended.

The Children's Health Insurance Program Reauthorization Act (CHIPRA) of 2009 gave states additional resources and tools aimed at improving participation in Medicaid and the Children's Health Insurance Program (CHIP). In 2007, five million uninsured children were eligible for Medicaid or CHIP, constituting 64 percent of all uninsured children. Nationwide, over 80 percent of eligible children participated in Medicaid/CHIP, but participation rates, as well as the characteristics of uninsured eligible children, vary dramatically across areas. Efforts to streamline application and retention processes offer tremendous potential for increasing enrollment among the eligible children who are uninsured. Over 90 percent of low-income parents say they would enroll their uninsured child if he or she was eligible, but around half do not know that their child is eligible, do not know how to apply, or find the application processes difficult. In order to close coverage gaps, states may also need to undertake targeted outreach efforts aimed at teenagers, Hispanics, and other groups of children with lower than average participation rates, provide additional support for community-based application assistance, broaden their outreach strategies to include parents, and address existing barriers in their Medicaid and CHIP application and retention processes. Since almost all uninsured low-income children live in families that participate in other government programs or file taxes, states have a number of promising vehicles for covering more eligible children. States can take advantage of new express lane provisions in CHIPRA to make use of more data-driven enrollment and retention processes in order to minimize burdens on families. This analysis indicates that states will likely succeed in further increasing participation and reducing uninsurance among children if they take steps to improve their enrollment and retention processes, and tailor their outreach strategies to the particular needs of the uninsured children who are eligible for coverage in their state. States will be aided in designing their outreach approaches by newly available data that provide detailed information about health insurance coverage at the state and local level. However, uncertainty about the future role of Medicaid and CHIP in covering children combined with ongoing state budget difficulties may make states reluctant to move aggressively to cover more children in the near term. An extension of higher federal matching rates in Medicaid could mitigate this latter problem. Current health care reform proposals include a mandate requiring individuals to obtain health insurance coverage and expansions of Medicaid to cover more parents, both of which would likely increase participation among eligible children. These findings suggest that expanding Medicaid as a part of health care reform will be a successful strategy for reducing uninsurance, but that careful attention must be given to enrollment and retention processes so as to minimize gaps in coverage. (Contains 6 exhibits and 26 notes.)

This brief presents highlights from rigorous, independent evaluations of the Healthy Kids programs in three California counties: Los Angeles, San Mateo, and Santa Clara. Launched by Children's Health Initiatives (CHIs) in these counties between 2001 and 2003, the three Healthy Kids programs provide children with comprehensive health insurance coverage, including a broad range of medical, dental, and vision care; prescription drugs; and mental health services. Children are eligible for Healthy Kids if they are ineligible for California's two major state insurance programs, Medi-Cal and Healthy Families, and live in families with incomes up to 300 percent of the federal poverty level (FPL) in Los Angeles and Santa Clara counties, and 400 percent of the FPL in San Mateo County. Most of the children enrolled in Healthy Kids have family incomes at or below the poverty level. This brief describes some of the many positive impacts that Healthy Kids programs have had on children's access and use of dental services. (Contains 4 figures.)

This report focuses on Medicaid and the State Children's Health Insurance Program (SCHIP) for low-income, uninsured children. It presents data from the 1999 National Survey of America's Families (NSAF), which indicated that 72 percent of eligible children without any other coverage were covered by Medicaid in 1999, leaving over 4 million Medicaid-eligible children uninsured. Children with greater health services needs participated in Medicaid/SCHIP at higher rates than other children. There was variation in Medicaid and SCHIP participation among children in different racial/ethnic subgroups. Children were less likely to participate when their families had not previously been enrolled in welfare. (Contains 12 references.) (SM)

This report focuses on Medicaid and the State Children's Health Insurance Program (SCHIP) for low-income, uninsured children. It examines the 2000 National Survey of American Families data, concluding that in 2000, over half of all children and about 90 percent of low-income children were eligible for Medicaid or SCHIP coverage. Nearly 70 percent of uninsured children who qualified for public coverage were actually eligible for Medicaid, not SCHIP. Although many states had implemented policies to facilitate enrollment and increase retention, states were more willing to do so under SCHIP than Medicaid. (Contains 15 references.) (SM)