JONESBORO, Ark. (AP) — Dr. Mitzi Scotten typically sees babies at least six times in their first year of life.

"Most families come in regularly when we ask them to, and we give pretty strict guidelines as to when we should see patients in the first five to six years of life," said Scotten, a pediatrician with the Children's Clinic. "For the most part, patients keep those appointments because they are interested in knowing how their babies are growing and how healthy they are.

"Of course, we do find people who don't show up regularly," she admits. "I think, for the most part, those are people who do not understand the significance of what we do in these wellness exams."

The Jonesboro Sun reports that improving access to care in Arkansas and getting children the early care they need was the subject of a recent report released by Arkansas Advocates for Children and Families (AACF).

That report stated Medicaid and the Children's Health Insurance Program (CHIP) ensure that nearly half of the state's children — more than 400,000 — have access to health care coverage.

"I think the key takeaway that we were trying to drive home with this report is the importance of young children having access to screenings and the necessary preventative services early in life," Marquita Little, AACF's health policy director, said. "Having access to health coverage is really the first step or precursor to ensuring that kids can get those early screenings and preventative care."

The report comes as CHIP's future is uncertain. Fresh funding for the $14 billion program that serves 9 million low-income kids ran out Oct. 1, causing states to rely on unspent funds until it is renewed.

The Associated Press reports Congress approved a temporary fix in late December to ensure states facing shortfalls from CHIP won't have to purge children from the program. However, a long-term extension is still needed.

Arkansas gets a set amount for CHIP each year. Before the temporary fix was announced, Amy Webb, communications director for the Arkansas Department of Human Services, said the state is allowed to carry over unused funds so funding is available to carry coverage through early 2018.

Little is hopeful that Congress will approve a long-term extension, but she said the broader concern is whether there will be future cuts to health care funding, especially Medicaid.

"That will certainly have a huge impact in the state of Arkansas where about half of the kids depend on our ARKids First program that is funded through those Medicaid and CHIP dollars," she said. "Sixty percent of rural kids in our state depend on that program."

Arkansas ranks 46th in child health, according to the annual Kids Count report.

Scotten believes the problem of getting children the health care they need stems from a lack of education on why it is needed and from a lack of resources.

"I think we really underestimate how difficult it is for some people to get here and how much it costs for people to drive in, to take the day off work," she said. "We really need to address that."

Jonesboro is the hub of Northeast Arkansas. Scotten said people drive over an hour to see her and other physicians from remote, rural areas, and many are hourly-wage employees who struggle to get time off and/or may have a single vehicle per household meaning the vehicle is not available to make that hour or more drive.

Already faced with a financial hardship, Scotten said families may not understand why they should bring a healthy child to the doctor each year.

She works hard to inform families why wellness exams, immunizations and checking children's growth and development are important to helping them go on to be productive and healthy.

One important factor about children's Medicaid is that it provides for and requires regular, comprehensive screenings that are designed to catch health conditions for early treatment.

The Kaiser Family Foundation found 85 percent of children enrolled in Medicaid and other public coverage have a wellness checks compared to only 53 percent of uninsured children.

While more children in Arkansas have gotten health care coverage in the past 20 years — 95 percent currently have coverage in Arkansas, Little said the percentage of kids being screened is still low.

There has been progress to raise that percentage. Little said steps in the right direction include ARKids First program, a home visiting program for low-income and at-risk children to ensure they receive screenings and improved mental health services for really young children.

"But, we still have a long ways to go," she said. "The first step is making sure kids have consistent access to comprehensive coverage then the next step is putting the work and effort into actually ensuring they are getting the care they need."


Information from: The Jonesboro Sun,