In April 2026, the NCIOM joined NC Child to co-host the third annual State of the Child Summit. This event, which grew out of the organizations’ co-published Child Health Report Card, offers an opportunity for parents, leaders, elected officials, and public health professionals to learn about the current state of children’s health and well-being.1, 2 At this year’s event, speakers discussed improving rural education systems, mental health, cannabis and high-nicotine vapes, healthy food and nutrition, rural health, and more.
Throughout the day, one message surfaced again and again: childhood outcomes are interconnected, and North Carolina will require coordinated policies, practices, and investments across health care, education, and community systems to help children thrive.
After PBS NC’s David Crabtree kicked off the morning, Dr. Eric Cunningham, the superintendent of Halifax County Schools, took the stage to talk about progress made in his county since 2016. He highlighted how the county school system moved from a state takeover due to poor performance to achieving its highest graduation rate ever recorded, over 87%, last year.
NC Child Executive Director Erica Palmer Smith followed Dr. Cunningham to deliver the “State of the Child,” discussing data, policy, and ongoing priorities for youth across North Carolina. Her speech covered:
In addition to the data, she gave an overview of policy opportunities tied to each point, including:
To close out the morning session, three members of NC Child’s Youth Advocacy Council joined North Carolina State University’s senior associate athletic director, Raymond Harrison Jr., to discuss youth mental health. The three high school students talked about their own experiences and the experiences of their peers, misconceptions adults often have about youth needs, and their advocacy council’s policy proposal to provide 30-minute, structured and guided peer conversations around mental health topics in schools.
During lunch, Harvard Center on the Developing Child Co-Executive Director and Chief Strategy Officer Tassy Warren gave a keynote address on the science behind brain development and the data and research that underscores public policy. She spoke about the architecture of a child’s brain, how toxic stress can build over time and have long-lasting negative effects, and how positive interactions between children and caring adults can build strong foundations for healthy lives.
Tassy Warren also discussed the impact that social drivers of health, from safe housing to sidewalks to exposure to hot weather, can have, both directly on childhood development and indirectly on caregivers’ ability to support that development.
In between keynotes, Colleen Briggs, President of the Blue Cross NC Foundation, and Josh Dobson, President and CEO of the North Carolina Healthcare Association, provided back-to-back updates on rural health. Colleen Briggs discussed pediatric gaps, telling a story about a child who lives in a county with no pediatricians and whose mom struggles to juggle a job with no time off and a 40-minute one-way drive to the closest doctor’s office. She spoke about philanthropy’s role in the health care system and a need for more dollars allocated to rural communities, while underscoring that philanthropic support can’t offset federal funding cuts that are expected to disproportionately impact rural children.
Josh Dobson also spoke about federal cuts after outlining NC Medicaid stats and how Medicaid expansion has impacted rural communities. He warned that the federal cuts will exacerbate existing problems in rural communities in ways that could be “catastrophic.”
To round out the lunch session, US Health and Human Services Administration for Children, Youth, and Families Associate Commissioner Ryan Hanlon gave a keynote address on the Administration’s priorities and efforts to improve foster care. He shared information about the Home for Every Child Initiative, a new pilot program aimed at improving state performance while reducing administrative burden, and a 2018 law reforming federal funding to prioritize family-based care in the foster system.6-8
In morning and afternoon panel breakouts, speakers representing state agencies, community-based organizations, youth voices, and care providers discussed data and priorities around a variety of topics, including:
At the end of the day, NC Health News Founder and Editor Rose Hoban moderated a plenary panel featuring Senator Gale Adcock, Representative Allen Buansi, Senator Jim Burgin, and Representative Donnie Loftis. While the panelists covered a variety of legislative priorities, the bulk of the conversation centered around how North Carolina is preparing for the impact of federal Medicaid and Supplemental Nutrition Assistance Program (SNAP) cuts and North Carolina’s ongoing budget stalemate.
During the conversation, the elected official panelists talked about the administrative burden of work requirements, how SNAP funding changes will impact county budgets, and the funding the North Carolina Department of Health and Human Services has requested to meet new requirements.
Regarding the state budget, the elected officials announced some details around a Medicaid-specific bill, which was introduced the week after the State of the Child Summit and signed into law on April 30, 2026.9
To close out the event, NCIOM President and CEO Michelle Ries gave remarks recapping the event and outlining NCIOM work related to children’s health. She outlined the ways in which Veterans’ needs are connected to child and family systems, announced ongoing work with the Essentials for Childhood initiative, and announced details about the 2026 NCIOM Annual Meeting, which will take place on October 21, 2026.10-12
Throughout the 2026 State of the Child Summit, speakers emphasized that improving outcomes for North Carolina’s children will require more than just isolated policy solutions. Discussions repeatedly returned to the interconnected nature of children’s well-being, from stable housing and access to pediatric care to mental health support, quality education systems, and family stability. As state leaders navigate ongoing budget negotiations and prepare for the impact of federal funding changes, the conversations at this year’s State of the Child Summit underscored both the challenges facing children and families and the importance of sustained collaboration across sectors to address them.
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Written by
Brady Blackburn
Communications Director, NCIOM
Managing Editor, NCMJ
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