Monday, May 4, 2015
Posted by: John Meidl
1. Assure a strong Medicaid program that meets the unique needs of children.
2. Protect NC’s well-established minor’s consent law
3. Promote a biennium budget that fosters the physical, social and emotional well-being of children, including health policies and payment structures that work well for children
4. Revise the NC Juvenile Code to better reflect needs of children in the foster care system
5. Improve reporting, treatment and prevention of child sexual abuse by adopting the study group recommendations relating to Erin’s Law to be reported to the Human Trafficking Commission
The NC Pediatric Society was appointed to a study group to make recommendations relating to protecting children against sexual abuse. Recommendations focus on using existing NC infrastructure to improve prevention, screening, and treatment of child sexual abuse.
6. Improved package of services for children with autism
Research on the best ways to treat children with autism is evolving. While appropriate treatment is needed for all age groups, treatment in the early years of life seems to offer substantial long-term benefit. NCPeds supports enhancing the package of services covered by private health insurance to include a range of evidence-informed best practices while excluding ineffective treatments.
7. Child resistant packaging for e-cigs
According to the Centers for Disease Prevention and Control the number of calls across the United States to poison centers involving e-cigarettes rose from one per month in September 2010 to 215 per month in February 2014. The majority (51%) of e-cigarette related poisonings were young children ages 0-5.1 E-cigs come in fruit and candy flavors that may be appealing to young children. NC already bars the sale of e-cigs to minors. Child resistant packaging would offer greater protections for young children trying to mimic adult behavior or to enjoy what they might perceive to be candy. The American Academy of Pediatrics State Government Affairs Legislative Reports notes that all e-liquids should be required to be sold in child-proof packaging.
8. Continue strong smoke-free laws
NC smoke-free laws are associated with an 89% improvement of the quality of air in restaurants and bars, a 7% decline in visits to emergency departments for asthma, and continued decline of smoking among middle school and high school students.2 Children are especially vulnerable to tobacco exposure, including second hand smoke.
9. Restore funding for tobacco prevention
NC receives approximately $140 million in (Master Settlement) funds from tobacco companies every April in payment of an on-going lawsuit. For several years, approximately $17 million of these funds were dedicated to tobacco reduction and cessation strategies.3 Now, none of these funds are dedicated for this important purpose.
10. Improved access to healthy foods
About 30% of children aged 10 to 17 in NC are overweight or obese.4 According to the Centers for Disease Control and Prevention, only about 11% of food stores and restaurants offer healthy foods.5 Some areas – often called food deserts – have a very limited or no options for healthy foods. Corner stores that offer fruits and vegetables and other initiatives can help improve family access to health foods.
11. Limit children’s exposure to toxins (Toxic Free Kids Act S81)
Children, with their smaller body masses and developing systems, are especially vulnerable to the impact of toxins. The Toxic Free Kids Act pertains to BPA, Tris flame retardants, and phthalates. It first requires labeling of products containing substances of high concern and then later bans the sale of such products intended for use by children.
12. Promote road safety for children and teens
a. Restore funding for driver education
The NC Graduated Driver License system (GDL) is one of the most effective in the nation in terms of reducing crashes among 16 and 17 year olds.6 Many credit part of its effectiveness to the phase-in time to build the skill of driving. Teens who do not participate in GDL can get a full license at 18 with no time devoted to building skills. Early research suggests crashes for this group is higher than teens who go through the GDL process. The first step in obtaining a GDL is going through driver education. Driver education used to be no cost to students in NC public schools. When the law changed and NC allowed school districts to charge, analysis from Wake County showed a 20% decline in the number of teens taking driver education once the district started charging $45. 7 Restoring funding will increase the likelihood that more teens will take driver education, go through the GDL process and avoid injury due to motor vehicle crashes. AAP recommendations on teen driving closely mirror currently NC law which is supported by reducing barriers to driver education.
b. Promote use of cameras on school buses to catch and prosecute drivers who pass stopped school buses More than 3,100 vehicles pass a stopped school bus on a given day.8 Research repeatedly demonstrates that a higher certainty of being caught deters undesirable behaviors, including traffic behavior.9 NC recently passed laws to use evidence from cameras on school buses to prosecute drivers of this crime. Simultaneously increasing the number of cameras in use and the “publicity” around this strategy is an evidence-informed way to reduce the number of drivers who pass stopped school buses.
13. Provide $100,000 to promote safe sleep strategies for infants
Approximately 15% of infant deaths occur in sleep-related settings. These may be classified as SIDS or asphyxiation or undetermined. Regardless, education about the best safe sleep practices (in a cool room, with the baby on his/her back on an appropriate surface, etc.) is continually needed. Funding is needed to continue to education each generation of new parents and the caregivers (grandparents, aunts/uncles, etc.) in each child’s life.
14. Require LRC to review and recommend youth suicide prevention strategies (Suicide Prevention Resolution – H83)
Suicide is one of the leading causes of teen death in NC. Deaths among 10-14 year olds in particular have increased substantially over the past three years.10 A survey of NC high schoolers found that in 2013 17% of students had seriously considered attempting suicide. 11 Study is needed to determine what evidence-informed strategies will work best for North Carolina.
15. Earmark funding for school-based health centers
School based health centers provide an important venue of care for many children. Funding has been dwindling recent years making it more challenging to assure quality care.
16. Raise the age of juvenile jurisdiction
NC is one of only two states in the nation that automatically treats a child as young as 16 as an adult in the criminal justice system regardless of crime. For teens, the juvenile justice system generally offers more services, requires greater involvement of parents and produces better outcomes, including less recidivism than Adult Corrections. 12
17. Ban youth from using tanning beds (Jim Fulghum Teen Skin Cancer Prevention Act S125; H158)
Tanning bed use by youth is associated with higher skin cancer rates, both earlier and later in life. Data suggests that youth are less likely to use tanning beds in states with bans for minors than states with parental consent requirements.13 The American Academy of Pediatrics State Government Affairs Legislative Reports recommends that youth younger than age 18 should be prohibited from using tanning beds.
1 Electronic Nicotine Delivery Devices: CDC Letter of Evidence, May 2014: http://www.tobaccopreventionandcontrol.ncdhhs.gov/
2 The Top Five Things the Smoke Free Law Has Done for NC: http://www.tobaccopreventionandcontrol.ncdhhs.gov/
33 Presentation to the Child Fatality Task Force by Sally Herndon, Branch Head for Tobacco Control and Prevention, October 2012: http://www.ncleg.net/gascripts/DocumentSites/browseDocSite.asp?nID=116&sFolderName=\Presentations\2012-2013
4 2013 NC Child Health Report Card http://www.nciom.org/nc-health-data/child-health-report-cards/,
5 NC Department of Health and Human Services, http://www.ncdhhs.gov/pressrel/2011/2011-05-05-corner_stores.htm
6 See for example, Masten, S.V., Foss, R.D., Long-term effect of the North Carolina graduated driver licensing system on licensed driver crash incidence: A 5-year survival analysis. Accid. Anal. Prev. (2010), doi:10.1016/j.aap.2010.04.00
7 Child Fatality Task Force, Teen Road Safety Report, December 2012 http://www.ncleg.net/gascripts/DocumentSites/browseDocSite.asp?nID=116&sFolderName=\Reports and Data
8 NC Department of Public Instruction, www.ncbussafety.org/stoparm/documents/StopArmStats2014.pdf
9 See, for example, Teen Road Safety Report from the Child Fatality Task Force, http://www.ncleg.net/gascripts/DocumentSites/browseDocSite.asp?nID=116&sFolderName=\Reports and Data
10 Child Fatality Task Force. See for example Hudgins 8-2014 presentation or 20th anniversary annual report. http://www.ncleg.net/DocumentSites/Committees/NCCFTF/Homepage/index.html
11 2013 Youth Behavioral Risk Survey (High School): http://www.nchealthyschools.org/data/yrbs/
12 NC Child, http://www.ncchild.org/what-children-need/juvenile-justice/
13 NC Child Fatality Task Force, 2014 Fact Sheet – Tanning Beds: http://www.ncleg.net/gascripts/DocumentSites/browseDocSite.asp?nID=116&sFolderName=\Past Information