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90_HB0230
New Act
Creates the Healthy Start Program Act. Establishes a
3-year demonstration project, administered by DCFS, to
prevent child abuse and neglect by providing various services
to families meeting specified criteria. Establishes the
Healthy Start Program Steering Committee to plan and
implement the Healthy Start Program. Effective immediately.
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1 AN ACT to create a Healthy Start Program.
2 Be it enacted by the People of the State of Illinois,
3 represented in the General Assembly:
4 Section 1. Short title. This Act may be cited as the
5 Healthy Start Program Act.
6 Section 5. Purpose. The legislature finds that
7 substance abuse, mental illness, and poverty are frequently
8 linked to child abuse and neglect.
9 In Illinois, in 1992, at least 75 children died as a
10 result of child abuse and neglect.
11 The U.S. Advisory Board on Child Abuse and Neglect
12 recommends that the first, most important step in responding
13 to the child abuse crisis is to focus on preventing it before
14 it occurs by implementing a universal, voluntary, neonatal
15 home visiting service for all new parents.
16 The Healthy Start Program, developed in the state of
17 Hawaii, has pilot-tested, evaluated, and put into place a
18 model home visitor program that currently reaches over 50% of
19 their at-risk new parents. Hawaii reports child physical
20 abuse or neglect in fewer than 1% of the families served by
21 the Healthy Start Program. The Healthy Start Program has
22 also been adopted in other states.
23 This demonstration project shall be phased in over a
24 period of 3 years.
25 Healthy Start Program services are to be provided by
26 hospitals participating in the project. Participating
27 hospitals will screen all new parents to identify those most
28 in need of home support and education. Families served by
29 the program will begin receiving home services once a week
30 from trained professionals. These home visits will be
31 reduced to one per month as family stability improves.
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1 Services may continue until the child enters school at age 5.
2 In addition to home visits, caseworkers will provide
3 access to community-based services including housing,
4 substance abuse treatment, and nutrition programs.
5 Caseworkers also will ensure that families are linked to a
6 health-care provider to ensure that their children are
7 immunized, are screened for developmental delays, and receive
8 other continuing health care.
9 The purpose of this Act is to establish an Illinois
10 Healthy Start Program demonstration project with services
11 provided in the largest county hospital located in each
12 service region of the Illinois Department of Children and
13 Family Services to demonstrate the effectiveness of this
14 community-based parent screening and service program over a
15 period of 3 years.
16 Section 10. Definitions. In this Act:
17 "Department" means the Department of Children and Family
18 Services.
19 "Hospital" means a hospital designated by the Department
20 located in the largest metropolitan area within each service
21 region of the Department, with the exception of the Cook
22 County service region, in which the Cook County Hospital
23 shall be the designated hospital.
24 "Parent" means a new parent who is deemed to be at high
25 risk for child abuse and neglect based upon a list of risk
26 indicators developed by the Hawaii Family Stress Center.
27 "Project" means the Illinois Healthy Start Program.
28 Section 15. Project.
29 (a) There is established, subject to available
30 appropriations, a 3-year demonstration project, known as the
31 Illinois Healthy Start Program. The Department shall be
32 responsible for the establishment of the project. The
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1 Department shall work with the Department of Public Health
2 and the Department of Human Services (as the successor agency
3 to the Department of Alcoholism and Substance Abuse), along
4 with the largest county hospital located in each service
5 region of the Department of Children and Family Services in
6 the planning and implementation of the project.
7 (b) To coordinate the planning and implementation of the
8 project, the Illinois Healthy Start Program Steering
9 Committee shall be established as provided in Section 20 of
10 this Act.
11 (c) The project shall begin with a comprehensive needs
12 assessment to identify the size of the target population, the
13 capacity of current services to address the needs of this
14 population, and the relevant actors and advocates needed to
15 create a fully operational and funded project.
16 (d) In order to prevent child abuse and neglect, the
17 project shall target "early identified" families at high risk
18 for child abuse and neglect based upon a list of risk
19 indicators developed by the Hawaii Family Stress Center.
20 Risk indicators include marital status, partner employment
21 status, inadequate income, unstable housing, no telephone,
22 education under 12 years, inadequate emergency contacts,
23 history of substance abuse, late or no prenatal care, history
24 of abortions, history of psychiatric care, abortion
25 unsuccessfully sought or attempted, relinquishment of a child
26 for adoption, marital or family problems, and history of or
27 current depression. Project services shall be provided by
28 hospitals participating in the project. Participating
29 hospitals shall screen all new parents to identify those
30 most in need of home support and education. Families served
31 by the project shall begin receiving home services once each
32 week from trained professionals. These home visits shall
33 reduced to one each month as family stability improves.
34 Services may continue until the child enters school at age 5.
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1 Service criteria shall include the following:
2 (1) Initiation of services prenatally or at birth.
3 (2) Universal intake service for all new parents
4 initially from a defined geographic target area (for
5 example, the area served by a participating hospital).
6 (3) Universal needs assessment using a standardized
7 protocol to systematically identify those new parents
8 most in need of services due to the presence of various
9 factors associated with increased risk for child
10 maltreatment and other poor childhood outcomes.
11 (4) Offering of all high risk services in a
12 positive, voluntary way.
13 (5) Home visitation as the core service offered.
14 (6) Creative outreach (for example, persistent,
15 positive outreach for at least 3 months) to build client
16 trust in accepting services.
17 (7) Intense offering of services (for example, at
18 least once each week) with well-defined criteria for
19 increasing or decreasing the intensity of services.
20 (8) Offering of services over the long term (for
21 example, 3 to 5 years).
22 (9) Provision of services that are family-centered,
23 addressing the needs of the child within the context of
24 the family and recognizing that the adults in the family
25 are the primary decision makers.
26 (10) Provision of services that focus on supporting
27 the parent as well as on supporting parent-child
28 interaction and child development.
29 (11) Provision of services that include a focus on
30 child health and linkages to a health care system.
31 (12) Provision of services that include a focus on
32 school readiness, either directly or by offering linkages
33 to other school readiness services.
34 (13) Tailoring of service plans to the needs of the
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1 individual family.
2 (14) Selection of staff who are culturally
3 competent, who like the materials and approaches used,
4 and who reflect the cultural, linguistic, racial, and
5 ethnic diversity of the population served.
6 (15) Selection of early identification and home
7 visitation workers because of their personal
8 characteristics.
9 (16) Completion by all workers of an intensive,
10 standardized initial training program and periodic
11 in-service training.
12 (17) Receipt by all workers of ongoing, intense
13 professional supervision to assure quality of services
14 (for example, 2 hours of supervision weekly for home
15 visitors; 5 or 6 home visitors per supervisor).
16 (18) Limitation of worker caseloads (15 families in
17 the first year of the project, 20 families in the second
18 year).
19 (19) Overall focus of service delivery on
20 integration with other services in the area.
21 To the extent possible, the project shall utilize
22 existing home visiting services and other support programs
23 already operating at or in conjunction with the designated
24 project hospital located in each service region of the
25 Department.
26 Section 20. Illinois Healthy Start Program Steering
27 Committee.
28 (a) There is established the Illinois Healthy Start
29 Program Steering Committee for the purpose of planning and
30 implementing the establishment and development of the
31 project. The Committee shall be appointed by the Governor
32 and shall consist of representatives from the public and
33 private sectors of the community including the following: one
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1 representative from each of the Illinois Departments of
2 Children and Family Services, Public Health, and Human
3 Services (as the successor agency to the Department of
4 Alcoholism and Substance Abuse) and each of the participating
5 hospitals; a person who has earned a doctor of social work
6 degree and who has at least 5 years of direct work experience
7 in child abuse or neglect; a person who has earned a master
8 of public health degree and who has at least 5 years of
9 direct work experience with maternal and child health
10 programs; a person who has earned a doctor of education
11 degree and who has at least 5 years of direct work experience
12 with pre-school aged children; and a pediatrician who has at
13 least 5 years of direct work experience in emergency room or
14 child protective services.
15 (b) The Committee shall confer with the Director of the
16 Department, who may do all of the following:
17 (1) Enter into agreements with other State
18 departments and agencies and with counties.
19 (2) Enter into assistance agreements with private
20 persons, groups, institutions, or corporations.
21 (3) Purchase services required or appropriate under
22 this Act from any private persons, groups, institutions,
23 or corporations.
24 (4) Allocate and spend any resources available for
25 the purposes of this Act.
26 (5) Enter into inter-agency agreements. All
27 agreements entered into for the accomplishment of the
28 purposes of this Act shall place a duty upon each
29 affected agency to cooperate fully with the project in
30 making every effort to enter into the agreement.
31 (6) All things necessary to accomplish the purposes
32 and provisions of this Act.
33 (c) The Committee shall complete an evaluation that
34 includes, but is not limited to, descriptive data on client
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1 status, project utilization data, profiles of participants,
2 intervention plans, participant and community satisfaction
3 ratings, and a detailed accounting of how the project
4 established its goals, selected its staff, and developed the
5 project content and focus.
6 The evaluation of project services shall provide for the
7 following:
8 (1) A formal control or comparison group of clients
9 participating in the project.
10 (2) A wide range of outcome measures for the
11 following:
12 (A) Home visitor services for parents
13 (including consideration of: subsequent reports of
14 child abuse; use of formal and informal social
15 supports, particularly health care systems;
16 knowledge of parenting and child development;
17 attitudes toward and use of corporal punishment;
18 parental stress; quality of parent-child
19 interaction; subsequent pregnancies; and employment
20 or educational achievement rates).
21 (B) Home visitor services for children
22 (including consideration of infant mortality,
23 physical development, cognitive development, and
24 social functioning).
25 Project evaluations shall include multiple methods of
26 data collection as well as, to the possible, standardized
27 measures of outcomes such as the Child Abuse Potential
28 Inventory, the HOME Observation Measurement Environment
29 Scale, the Parenting Stress Index, the Adult Adolescent
30 Parenting Inventory, the Nursing Child Assessment Satellite
31 Training, the Michigan Screening Profile of Parenting, and
32 the Maternal Social Support Index. Quarterly service
33 evaluations should be made during the first year of the
34 child's life and every 6 months thereafter until evaluation
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1 concludes or the family terminates services. Post-project
2 interviews shall be obtained for all participating parents.
3 Section 25. Funding. The Department, before
4 establishing the project, shall seek funding from public and
5 private sources. Funding received from private foundations
6 or from other sources may be used by the Department to
7 establish the project.
8 Section 30. Reporting. The Department shall monitor and
9 evaluate the project and shall submit a status report on its
10 findings to the General Assembly on February 1 in 1998 and
11 1999 and a final report on its findings to the General
12 Assembly on February 1, 2000. The status and final reports
13 shall include, but not be limited to, the following:
14 (1) A descriptive summary of the operation of the
15 project, including the services provided and a copy of
16 the service plan developed at each participating
17 hospital, the number of recipients served by the project,
18 the outcome of services provided, the allocation of
19 funds, and staffing information.
20 (2) An assessment of the impact of the project on
21 each of the regions served by the project.
22 (3) The composition and role of the staff and
23 steering committee for the project.
24 (4) Recommendations regarding the continuance of
25 the project at each of the hospitals participating in the
26 project, and the inclusion of other sites in the project.
27 (5) Recommendations regarding funding allocations
28 to support the project.
29 (6) A project budget for the expenditures required
30 to continue or expand the project in intervals of 1, 2,
31 and 3 years.
32 (7) Proposals for legislation necessary to
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1 facilitate the continuation or expansion of the project
2 and to fully implement the project statewide within 5
3 years.
4 Section 99. Effective date. This Act takes effect upon
5 becoming law.