1

Prioritizing Funding to Support Children’s Success in School and Life Testimony on IDHS budget before the Senate Appropriations I Committee

Submitted by Paula Corrigan-Halpern on behalf of Voices for Illinois Children April 10, 2013

Voices for Illinois Children is a nonpartisan, nonprofit, child advocacy organization that works to build better lives for children across the state. For 25 years, Voices has helped parents, community leaders, and policymakers understand and respond to the issues facing children and families. We conduct policy analysis, raise public awareness about crucial issues, build coalitions to initiate and pursue policy solutions, and mobilize individuals, groups, and communities to speak up for children. We are pleased to have the opportunity to present our testimony at today’s House Human Services Appropriations Committee on the Illinois Department of Human Services budget. The Illinois Department of Human Services (DHS) plays a vital role in strengthening families and supporting children so they fulfill their potential. Since FY09, critical initiatives that ensure children’s health, provide child care in enriching environments, build strong social and emotional skills in children and teens, treat the toxic effects of trauma, and offer academic support to youth have been cut repeatedly. For example, the Child Care Assistance Program, which provides low-income parents with access to affordable child care while they work or go to school, has been cut by 62 percent since FY09 — resulting in thousands of families being unable to provide quality child care for their children. The Illinois Children’s Mental Health Partnership — which saves the state approximately $19 million each year by reducing unnecessary psychiatric inpatient hospitalization for children — has been cut by $2.9 million in the DHS budget since FY09. These cuts are not good for children. They’re not good for families. And they threaten our efforts to ensure a bright future for everyone in our state. Today we encourage you, as you deliberate on the FY14 budgets, to prioritize the following cost-effective interventions and strategies funded by DHS that improve children’s lives and contribute to efforts to address the state’s short- and long-term fiscal stability:

the Illinois Children’s Mental Health Partnership; Home visiting programs, including Healthy Families Illinois and Parents Too Soon; Early Intervention services; Teen REACH; and Child Care Assistance.

2

Illinois Children’s Mental Health Partnership

With the economic and social stresses confronting children today, mental health is an important children’s issue. Recent research indicates that between 9 and 14 percent of children under the age of 6 experience social, emotional, and behavioral challenges1. The prevalence of these challenges is even higher in families experiencing economic instability, domestic violence, substance abuse, or other life stressors. The greater the number of risk factors, the greater the potential for poor mental health outcomes for both the caregivers and young children. Without intervention, these challenges have life-long impacts on healthy development and learning. In 2003, Illinois became a leader in addressing children’s mental health by passing the Children Mental Health Act. This Act created the Illinois Children’s Mental Health Partnership. The Partnership is building a coordinated and comprehensive system of care to reach and better serve children who would otherwise fall through the cracks of various agencies. In the last year, the Partnership, working with Caregiver Connections, a project administered by DHS, has provided training to a network of mental health consultants who work with home-based child care providers and child care centers serving children from birth to age5. This training, which reaches over 950 programs working with 48,000 families a year, helps reduce the number of children asked to leave a child care program due to behavioral challenges. In FY12, the Partnership also:

Expanded the Developmentally Oriented Primary Care program which trains nearly 1,000 primary care providers on screening for and responding to early childhood mental health issues;

Provided mental health consultation to nearly 2,000 primary care providers through the Doc Assist Program, expanding their capacity to recognize and address mental health concerns, particularly as part of well-baby visits;

Served 225 children without access to psychiatric services through telepsychiatry, reducing the need for expensive hospitalizations; and

Delivered support to more than 1,200 parents in the correction system and their children so that they could maintain positive relationships with each other during a time of separation and stress.

The Partnership is the primary funder of the Illinois Childhood Trauma Coalition, which promotes the prevention and treatment of childhood trauma. The approaches and programs delivered by the Partnership are inexpensive and result in savings to the state. Over the last seven years, the Partnership has helped the state avoid $136 million in costly inpatient mental health services.

1 Smith, S., Stagman, S., Blank, S., Ong, C., and McDow, K. (2011). Building Strong Systems of Support for Young Children’s Mental Health: Key

Strategies for States and a Planning Tool. National Center for Children in Poverty, Mailman School of Public Health, Columbia University.

3

However, DHS funding for the Partnership has decreased dramatically since FY09. In FY11, the DHS line item, once totaling $3 million, was eliminated. The Partnership is now funded solely by $3 million from the Health and Human Services Medicaid Trust Fund. We urge legislators to protect the Partnership’s funding from the Trust Fund and to consider restoring additional funding as the state’s fiscal crisis improves. Home Visiting Programs Home visiting programs, including Healthy Families Illinois and Parents Too Soon, provide coaching to parents so they are able to provide safe, nurturing environments for their young children. These programs promote positive interactions, encourage developmentally appropriate responses by parents to their children, and foster strong parent-child relationships for more than 5,000 Illinois children and their families each year. The voluntary home visiting programs also connect families to preventative health care and other services. Research shows that home visiting programs improve children’s literacy, increase high school graduation rates, and decrease rates of child abuse and neglect. In Illinois:

Teens in home visiting programs are 50 percent less likely than teens in the general population to have another baby within two years. Delaying subsequent birth improves many future outcomes, including health, well-being and self-sufficiency for both mom and baby.

Teens who are enrolled in school when they begin home visiting are much more likely to be in school through the year following their child’s birth. And 38 percent of those who had dropped out before receiving services re-enrolled in school. High school graduates earn an average of about $9,000 more per year than non-graduates. One study states, “If the students who dropped out of the class of 2007 had graduated, the nation’s economy would have benefited from an additional $329 billion in income over their lifetimes.”

Mothers receiving home visiting services have higher rates of breastfeeding initiation. For example, African-American teens enrolled in Parents Too Soon programs are 70 percent more likely to initiate breastfeeding than African American teens in general. The nutritional benefits of breastfeeding result in reduced health care costs for children, according to the American Academy of Pediatrics.

Over 80 percent of infants and over 95 percent of toddlers in the Parents Too Soon programs are read to by their parents, with the majority being read to at least three times a week.

95 percent of children enrolled in Parents Too Soon programs received all required immunizations in FY11. An average of 96 percent of children enrolled received all recommended well-child visits. This is well above state and national averages.

Illinois is receiving funding from the federal government to expand home visiting services and reach a greater number of pregnant women, their infants, toddlers, and families

4

through this voluntary program. In order to remain eligible for these funds, Illinois must maintain its funding for home visiting services in the Health Families Illinois and Parents Too Soon budget lines. Erosion in the state’s commitment to these home visiting programs will place the state at risk of repayment of $23 million already awarded in federal funds to Illinois and jeopardize future funding. Voices urges you to maintain level funding for home visiting programs to ensure continued federal investment. Early Intervention Illinois’ Early Intervention program provides services for families with children under age 3 who may have or who are at risk for developmental delays. Providing these services helps ensure the best long-term outcomes for children. Research shows that children who receive Early Intervention services are less likely to have language and learning difficulties, have higher reading and math scores, and have lower dropout rates compared to their peers with comparable developmental delays who did not receive Early Intervention.2 The Governor’s budget includes a $7.7 million increase for Early Intervention. We urge you to support this increase. Teen REACH Afterschool Programs Teen REACH is Illinois’ primary vehicle for engaging at-risk youth in school and developing positive behaviors. Teen REACH has been shown to boost participants’ academic success, build critical thinking skills, and improve the decisions that kids make. As a result of programs like Teen REACH, fewer teens drop out of school, abuse drugs, and become pregnant. Funding for Teen REACH has been cut by 53 percent over the last four years. We urge the General Assembly to maintain the current level of $8.2 million for Teen REACH. Child Care Assistance Too many Illinois families are struggling to make ends meet. Most parents simply do not have the option of choosing not to work to take care of their children, making child care a necessity. The Child Care Assistance Program (CCAP) is a cornerstone of Illinois’ early childhood system, providing low-income parents with access to affordable child care while they work or go to school. Over the past few years, the Illinois Department of Human Services has increased parent co-payments by an average of 112 percent and reduced the income eligibility threshold for the program from 200 percent to 185 percent of the federal poverty level. These changes force many parents to make difficult decisions about the quality of care their children receive. We urge the General Assembly to restore eligibility to 200 percent of the federal poverty level and to ensure that co-pays do not exceed 10 percent of a family’s income.

2 Ceglowshi, D. and Bacigalupa, C., “Childcare as early intervention,” Early Childhood Research and Practice,

2002.

5

Additional Revenue is Critical to Providing Vital Services As an advocacy organization for children, it is extremely difficult for us to advocate for more funding for one priority if it comes at the expense of another. The truth is that our state continues to fail our kids, as the ongoing fiscal crisis erodes our ability to give them the opportunity that they require to be successful students, skilled employees, taxpayers, and productive citizens. To repair the damage we have done to the programs that help kids thrive, we must dig out of our state’s enormous fiscal hole. This means not only dealing with the pension funding crisis, but also maintaining current income tax rates beyond the end of 2014. The January projection from the Governor’s Office of Management and Budget estimated revenue losses of $2.2 billion in FY15 (which is just over 15 months away) and $4.7 billion in FY16. Voices encourages the General Assembly to explore additional sources of revenue, including accessing surplus revenue outside the General Funds (see attached), to protect our children’s education, healthy development, and well-being. The General Assembly and Governor also must enact meaningful pension legislation and maintain current income tax rates beyond 2014. If we do both, we will be able to pay back all the unpaid bills and reinvest in a brighter future for our children and our state. For more information, contact Paula Corrigan-Halpern at paula@voices4kids.org or 312-516-5566.