Kids Count 2016 ranks Florida 40th nationally in overall measures of child well-being that include economic well-being, education, health, family and community. This ranking reflects the effects of family poverty on Florida’s children.
Florida, ranks 40th among the fifty states in the Annie E. Casey Foundation’s Kids Count 2016 survey that analyzes factors that contribute to child well-being. This ranking demonstrates the need for greater investment in Florida’s children. Notably, Florida ranks above the midpoint of states on only two out of 16 variables.
In addition to an overall ranking, Kids Count provides a state ranking for each of four areas related to child welfare. Specifically, rankings are assigned for: economic well-being, education, health, and family and community. The rankings are based on the percentage of children within the state who may be affected negatively by factors within each area. State rankings are then assigned based on the comparative percentage of affected children.
The ranking in the four areas is summarized briefly below after which more detailed analysis is provided for each.
Kids Count notes that economic stability is crucial to children’s well-being. To the extent that parents have stable employment that offers wages and benefits to cover the necessities of life, parents have more money, time, and energy to invest in their children. Instability and substandard wages result in stress that renders the best-intentioned parents less able to be effective. In the worst case, parents who are unemployed or underemployed cannot meet the most basic needs of their children.
The four variables Kids Count considered in economic well-being are:
With 24 percent of children living in poverty (income below $24,000 for a family of four), Florida ranks 37th nationally. Moreover, the poverty rate for children in Florida has increased by 33 percent since 2008.
The parents of 1.3 million children (32 percent of children in Florida) lack secure employment, tying Florida with two other states for a ranking of 36th nationally. There are more children whose parents lack secure employment in 2014 than 2008. Kids Count describes “secure employment” as full-time employment with wages above the poverty level.
Almost 1.7 million children (41 percent) live in households that spend more than 30 percent of their income on housing. Accordingly, Florida ranks 46th nationally for children living in households with a high housing cost burden.
Florida ranks 36th for the 78,000 teenaged children (8 percent) who are neither enrolled in school nor working. These teenagers are building neither the skills nor workplace experience necessary to successfully enter the workforce and achieve economic independence.
Education provides a life-long social and academic foundation that starts with toddlers and, ideally, ends at death. Early learning is crucial for developing the skills needed for success in elementary school. Children who are prepared to enter kindergarten, then first grade, are significantly more likely to keep up with their peers at each grade level. Conversely, children who start school with an academic deficit are likely to experience increasing academic disparity with each successive grade. The K-12 curriculum is designed to instill the knowledge and skills that prepare students for success in higher education or the workforce. Their future economic well-being, and by extension, our well-being as a state, rides on their academic success as students.
The four variables Kids Count considered in education are:
Half of three- and four-year-old Florida children are not enrolled in school programs, ranking Florida 12th in that measure. Prekindergarten programs provide a variety of stimuli that foster learning and interpersonal engagement. For economically disadvantaged children, access to this stimulus-rich environment helps bridge resource gaps at home.
61 percent of fourth graders in Florida are not proficient in reading on the National Assessment of Educational Progress, which ranks Florida 17th in this measurement. Reading proficiency is fundamental for mastering subjects covered in the curriculum. Reading for understanding is also a fundamental skill for an informed citizenry.
74 percent of eighth graders are not proficient in math on the National Assessment of Educational Progress, which places Florida 41st in this category. Math proficiency has grown increasingly important in a technology-based workforce. The higher-level Florida Standards for math should substantially increase the proficiency of eighth graders within the next five years.
24 percent of Florida students do not graduate on time, placing Florida 43rd of all states in this category. A high school diploma is a critical credential for entering postsecondary vocational or academic programs necessary for the jobs associated with a knowledge economy. Moreover, earnings are significantly different based on educational attainment. The U.S. Census Bureau reports that the 2014 median annual earnings for bachelor’s graduates was $50,500, compared with $27,800 for high school graduates and $20,500 for those who do not have a diploma.
Good health is fundamental to child development, starting at birth. Poverty, and attendant issues related to nutrition, routine and preventive health care and mental health, impedes parents’ ability to provide the conditions for a healthy childhood.
The four variables Kids Count considered in health are:
Florida ranks 37th for low-birthweight babies at 8.7 percent. Kids Count defines low birthweight as babies weighing 5.5 pounds or less at birth. Low-birthweight babies are more likely to suffer from short- and long-term disabilities, as well as developmental problems.
Florida ranks 45th for the 378,000 children (nine percent) who have no health insurance. These children are unlikely to have their routine childhood checkups. Of greater importance, they are less likely to receive timely medical care when they are sick, resulting in a higher likelihood of subsequent hospitalization.
Florida ranks 31st for its 26 deaths per 100,000 children. Kids Counts recognizes a variety of factors that affect this rate, such as access to health care, community safety, environmental safety, and sufficient adult supervision.
The state-by-state variation for teens who abuse alcohol or drugs is too small for ranking purposes. With rates ranging from four to six percent for all states, Florida’s rate was six percent.
Children are significantly more likely to thrive when they have nurturing families and supportive communities. Many of the factors associated with child well-being are a function of their parents’ capacity to parent effectively. The family and community variables represent significant inputs to parental capacity.
The four variables Kids Count considered in family and community are:
40 percent of Florida children live in single-parent homes, ranking the state 45th. Single-parent households have a higher likelihood for for limited economic and emotional resources. To the extent that a constructive community supports the parent, children are better served.
Florida ranks 30th for the 12 percent of children who live in a household whose head lacks a high school diploma. Median income increases with educational attainment; parental lack of a diploma typically places children at an economic disadvantage.
Florida ranks 36th for the almost 600,000 children (15 percent) who live in high-poverty areas. These children may be subject to health hazards, as well as increased crime and violence. Lack of opportunity also affects the caretaking ability of parents and communities.
Florida ranks 23rd for having a birth rate of 23 per 1,000 teens. Teen pregnancies pose a higher risk for prenatal and neonatal difficulties. Moreover, to the extent that parenting prevents teens from completing or advancing their education, the pregnancy has a lifelong economic impact for both parent and, potentially, children.
In order to improve its national rankings in analyses such as Kids Count and, more importantly, to improve the lives and prospects of many of Florida’s children, policymakers at the state and local levels must consider an array of policies, programs, and corresponding funding to foster children’s physical, emotional, and intellectual development.
 Annie E Casey Foundation (2016). Kids Count Data Book: State Trends in Child Well-Being. Retrieved from http://www.aecf.org/resources/the-2016-kids-count-data-book/#state-rankings
American Rescue Plan Act Changes. The American Rescue Plan Act of 2021 extended PEUC and PUA benefits through the week ending September 6, 2021. It also increased the maximum duration of PEUC benefits ($300 a week) to 53 weeks and the maximum duration of PUA to 79 weeks. Although PEUC and PUA did not end until September 6, 2021, Florida withdrew from the Federal Pandemic Unemployment Compensation Program (FPUC) effective June 26, 2021. FPUC provided persons who were out of work due to COVID-19 with an additional $300 a week in unemployment insurance.
Reemployment Assistance weeks reverted to 12 effective January 1, 2022. DEO determines the maximum number of weeks available to RA claimants based on a statutory formula that looks at the average unemployment rate for the most recent third calendar year quarter (i.e., July, August, and September). Based on the downturn in unemployment, the maximum number of weeks for RA reverted to 12 effective January 1, 2022.
RA work-search and work registration requirements reinstated on May 30, 2021. Persons filing an application for RA benefits beginning March 15, 2020, are not required to complete work registration in Employ Florida through May 29, 2021. In addition, work search requirements for individuals requesting benefits for the weeks beginning March 15, 2020, were also reinstated on May 30, 2021.
Mobile app deployed. DEO has deployed a mobile app for RA applications.
DEO announces extended benefits. DEO announced implementation of Extended Benefits (EB).
Resources and guidance. For a list of resources and guidance from the United States Department of Labor on unemployment insurance and COVID-19, go here.
For DEO’s “Reemployment Assistance Frequently Asked Questions and Additional Resources,” updated 12/30/2020, go here.
For DEO’s latest claims data, go here.
DCF opens offices. DCF has reopened its brick-and-mortar storefronts, which were previously closed due to coronavirus.
DCF adds call center numbers. DCF has added a call center number for Monday through Friday, from 7 a.m. to 6 p.m. Call center numbers now include 850-300-4323, 866-762-2237, or TTY 1-800-955-8771.
Certification periods extended by 6 months only through August 2020. Certification periods for cash, food and medical assistance were extended by 6 months for individuals and families scheduled to recertify in April through August 2020. FNS’ approval of the SNAP extension for August is here. However, effective September 1, 2020, SNAP, TANF and Medicaid recertifications have been reinstated, although DCF says that no one will lose Medicaid due to recertification.
DCF allows phone interviews. Phone interviews are now being used for TANF cash and SNAP food assistance.
Mandatory work requirements suspended only through May 2021. Under a directive from Governor DeSantis to waive work requirements for safety net programs, DCF waived work requirements for individuals participating in the Supplemental Nutrition Assistance Program (SNAP) and Temporary Assistance for Needy Families (TANF) through May 2021. To do this, DCF explains that it partnered with the Department of Economic Opportunity to apply “good cause” statewide for TANF and SNAP recipients who would otherwise be subject to participation in mandatory work requirements as a condition of receiving those benefits. Through May 2021, persons who were sanctioned in the past due to work requirements will be able to reapply and participate in SNAP or TANF again.
Work requirements were reinstated effective June 1, 2021.
Emergency allotments (EA) ended. DCF automatically supplemented SNAP allotments of current recipients up to the maximum for a household’s size for July 2021. However, EA was discontinued beginning August 1, 2021.
The SNAP benefits increase by 15 percent ended in October 2021. Floridians who participate in SNAP to put food on the table will receive a temporary 15 percent supplement to SNAP under COVID relief passed by Congress and extended by the American Rescue Plan Act through September 2021.
FNS permanently increases SNAP through revamp of the Thrifty Food Plan. Effective October 2021, FNS has mandated a permanent increase to SNAP through a revamp of the Thrifty Food Plan. DCF says that the increase amounts to about 6% for Floridians.
Time limits suspended. SNAP time limits are suspended during the COVID-19 public health emergency. No one in Florida should be barred from SNAP due to time limits, even if they exhausted their time limit in the past.
Florida granted waiver to allow families to purchase groceries online. DCF has been granted a federal waiver to permit the State of Florida to launch a pilot project statewide effective April 21, 2020, that allows families to purchase groceries online with their Electronic Benefit Transfer (EBT) card instead of going into stores.
No Medicaid terminations from March 2020 through the end of the federal public health emergency. The national public health emergency has existed since January 27, 2020 and has been renewed by the Secretary of the U.S. Department of Health & Human Services in 90-day increments since that time. The most recent renewal is effective January 16, 2022.
Redetermination/recertification times are reinstated. As of October 1, 2020 AHCA's website is alerting recipients that the Department of Children and Families is now mailing letters for case reviews to check if a household is still eligible for Medicaid and/or Medically Needy. AHCA is urging people receiving these letters to take steps now to re-apply. But note, Medicaid coverage will not end during the COVID-19 Public Health Emergency. In January 2021 DCF conducted one-year “automated renewals” for people whose sole income is social security and SSI and are enrolled in an SSI-related Medicaid program (e.g., MEDS/AD, Medically Needy and Medicare Savings Programs). People getting VA income were not included in the automated renewal.
Extended application time. Effective with applications filed in February 2020, the time for submitting documentation required to process an application is extended for 120 days from the date of the application and eligibility will still be effective the first day of the month the application was received. Effective July 1, 2021, this policy has been rescinded. Medicaid applications submitted on or after July 1, 2021 may be denied on the 30th day after application or the day after verification information is due. Applications filed prior to July 1, will be allowed 120 days to provide requested verification to establish Medicaid eligibility.
Exclusion of additional unemployment payments in determining eligibility. The $600/week of additional unemployment insurance payments under the CARES Act will not be counted as income in determining Medicaid eligibility. (However, these payments will be counted as income in determining marketplace subsidy calculations.)
Coverage of Medicaid services during the state of emergency
COVID-19 Vaccines for Medicaid Enrollees. In an executive order published March 16, 2021 Governor DeSantis revised the vaccine distribution plan, which applies to the general public including Medicaid enrollees, to lower the age requirement to 40 effective March 29, 2021 and then effective April 5, 2021 all Floridians are eligible to receive any COVID-19 vaccination approved by the Food and Drug Administration.
Medicaid enrollees eligible to receive the vaccine may visit myvaccine.fl.gov to find a location distributing the vaccine and to schedule an appointment.
On March 12, 2021, AHCA published instructions for Medicaid enrollees on how to obtain Medicaid transportation once they have scheduled an appointment for a vaccine. AHCA states: "Florida Medicaid will take you to get the COVID-19 vaccine at no cost. All you need to do is set up a time to get your vaccine. Next, let your Medicaid plan know you need a ride and they will take care of the rest. If you are not enrolled in a plan, call the Medicaid Helpline at 1-877-254-1055 to find out the name and phone number for a transportation service."
The state has also recently launched a new email system to help bring COVID-19 vaccines to homebound seniors. Seniors will be able to sign up to have the vaccine come to them by emailing a request to HomeboundVaccine@em.myflorida.com.
AHCA has posted Medicaid Alerts and FAQs providing more detail on Medicaid service changes in response to COVID-19. They address a wide range of topics including, but not limited to: telemedicine guidance for medical, behavioral health, and early intervention services providers; long-term care provider network flexibilities allowing more types of providers to deliver specified long term care services; and continuity of care for adult day care center enrollees during the time these centers are closed.
AHCA is loosening coverage restrictions for behavioral health services. Effective May 5, 2020, all prior authorization requirements for mental health or substance use disorder treatment are waived and service limitations (frequency and duration) are lifted. For behavioral analysis services, current authorizations will be extended through an "administrative approval process" which does not require providers to reassess beneficiaries currently getting services. Effective July 1, 2021 service limits will be reinstated for behavioral health services and effective July 15, 2021 Medicaid prior authorization requirements will be reinstated for behavioral health services.
Per a May 29, 2020 provider alert, during the state of emergency AHCA will be reimbursing providers for telemedicine well-child visits provided to children older than 24 months through age 20. Providers are directed to actively work to schedule follow-up in-person visits to administer immunizations and other physical components of the exam which cannot be accomplished through telemedicine.
Coverage of home and community-based waiver services (HCBS) - In response to the public emergency, Florida obtained approval from the federal government to make changes in HCBS waiver programs, including the Long Term Care and Developmental Disabilities programs. The changes are effective retroactively from January 27, 2020 to January 26, 2021. Details can be found here. They include, but are not limited to:
Note on COVID-19 testing, treatment, and vaccines for the uninsured. Florida has not opted to receive 100 percent federal Medicaid funding for COVID-19 testing of people without health insurance. Under the 2021 American Rescue Plan Act this option has been expanded to cover COVID-19 treatment and vaccines for the uninsured as well. Since the state has not taken up this option Floridians must look to an uneven patchwork of free testing, treatment, and vaccine resources scattered around the state. AHCA advises that uninsured people may receive free testing from their county health department or a federally qualified health center and that “many communities provide testing for free for individuals who do not have insurance. Please [click here] to find a test site in your area. Uninsured individuals should ask before the test whether testing is free of charge." There are no state agency instructions on where uninsured people can receive free treatment. However, more information on possible sources for free treatment is available here.
Residency proof no longer required at some vaccine sites, “paving the way for migrants.” - On April 29, 2021 Surgeon General Rivkees issued a new public health advisory specifying that COVID-19 vaccines are available to “a Florida resident” or someone “who is present in Florida for the purpose of providing goods or services for the benefits of residents and visitors of the State of Florida.” This new policy applies to all state-run and federally supported vaccination sites. It rescinds an advisory issued in January that had restricted vaccinations to people who could show proof of Florida residency
2021 unemployment compensation claimants can access free or reduced cost health insurance through the ACA marketplace. The Affordable Care Act (ACA) Marketplace was re-opened in February 2021 to give people who need health insurance a new “special enrollment" opportunity to get covered. The 2021 American Rescue Plan eliminated or vastly reduced premiums for many people with low or moderate incomes.
Starting July 1, 2021, people who received or have been approved for unemployment compensation for any week beginning in 2021 can access free or reduced cost comprehensive health insurance plans through the ACA marketplace. This benefit is available regardless of someone's current income. To get this benefit, people must enroll in the marketplace no later than August 15, 2021. For help with enrollment, contact Covering Florida at 877-813-9115.
School children in distance learning still eligible for free or reduced cost meals. Students in distance learning for 2020-21 can still receive school meals through the National School Lunch Program if they are eligible. The student or parent/guardian may pick up meals at the school but should contact their school for more information.
For a list of current child nutrition program waivers for Florida from USDA, go here.
Congress allows increased fruit and vegetable benefits. At present, WIC provides $9 for children and $11 for women monthly for fruits and vegetables. The American Rescue Plan Act makes funding available for a four-month increase in the benefit of up to $35 monthly, if a state chooses to do so.
DOH attains waiver allowing remote issuance: Department of Health (DOH) obtained a waiver of the requirement that participants pick up their EBT cards in person at recertification or during nutritional education appointments.
WIC participants allowed to substitute certain food. Under a waiver from USDA, WIC participants in Florida are allowed to substitute milk of any available fat content and whole wheat or whole grain bread in package sizes up to 24 oz. when 16 oz. packages are unavailable.
USDA waived physical presence requirements: Although the scope and logistics are unclear at this time, USDA has given DOH permission to waive the requirement that persons be physically present at each certification or recertification determination in order to determine eligibility under the program through May 31, 2020.
USDA extends certification periods through May 31, 2020, for some participants.
For a list of current WIC waivers for Florida from USDA, go here.
HHS provides guidance. HHS has issued guidance on the flexibilities in TANF to respond to COVID-19.