Overview of the Annual Performance Report Development:

Monitoring Priority:

Effective General Supervision Part C / Child Find

Indicator 5: Percent of infants and toddlers birth to 1 with IFSPs compared to national data.

Measurement:

Percent = [(# of infants and toddlers birth to 1 with IFSPs) divided by the (population of infants and toddlers birth to 1)] times 100 compared to national data.

FFY FFY08/SFY09

Measurable and Rigorous Target The percentage of all children in Illinois under age 1 served through an IFSP will be at least 1.32% on June 30, 2009, approximately 2,421 children.

Actual Target Data for FFY08/SFY09:

Indicator 5

Percent = [(# of infants and toddlers birth to 1 with IFSPs) divided by the (population of infants and toddlers birth to 1)] times 100

FFY08/SFY09 Result: Based on October 31, 2008 data) (2,097/185,298) X 100= 1.13% Illinois ranks 19th out of all states.

Percent = [(# of infants and toddlers birth to 1 with IFSPs) divided by the (population of infants and toddlers birth to 1)] X 100

FFY08/SRY09 Result (based on June 30, 2009 data): (2,194/185,218) X 100= 1.18% FFY08/SRY09 Target = 1.32%

On October 31, 2008, Illinois reported 2,097 children under 1 had active IFSPs, equal to a 1.13% participation rate. [(2,097/185,298) X 100= 1.13%] That is lower than the 1.20% for the FFY 07 federal report. Illinois has retained its FFY07/SFY08 ranking of 19 among all states. Illinois ranks 5th out of the 14 states with moderately restrictive eligibility.

2003 - 2008 Participation Rate Comparisons National & Similar Eligibility States

2003 2007 2008 1-Year
% Change
5-Year
% Change
STATE % of
Pop.
Rank % of
Pop.
Rank % of
Pop.
Rank
States with Moderately Restrictive Eligibility Criteria
RHODE ISLAND 1.85 5 2.29 5 2.2 4 -3.90% 19.00%
LOUISIANA 0.67 37 1.27 15 1.46 12 15.00% 116.50%
INDIANA 1.57 7 1.25 16 1.25 16 0.00% -20.60%
NEW YORK 1.06 17 1.04 24 1.15 18 10.60% 8.90%
ILLINOIS 0.93 25 1.2 19 1.13 19 -5.80% 22.10%
ALASKA 0.93 24 1.14 22 1.02 24 -10.50% 10.00%
NORTH CAROLINA 0.42 51 0.89 32 0.95 28 6.70% 124.40%
DELAWARE 1.78 6 1.03 25 0.93 29 -9.70% -47.80%
COLORADO 0.61 39 0.71 36 0.89 30 25.40% 44.90%
SOUTH DAKOTA 0.67 38 1.15 21 0.87 31 -24.30% 29.10%
MINNESOTA 0.72 32 0.62 44 0.79 33 27.40% 9.50%
KENTUCKY 0.58 43 0.65 40 0.74 35 13.80% 26.90%
NEW JERSEY 0.6 41 0.65 41 0.57 44 -12.30% -5.50%
PUERTO RICO 0.32 55 0.63 43 0.55 47 -12.70% 70.70%
MODERATE STATES# 0.93 0.97 1.01 4.10% 9.20%
NATIONWIDE ^ 0.91 1.06 1.04 -2.30% 13.60%

# For states with moderately restrictive eligibility rules in that year.
^ Totals excluding children classified as eligible because they are at-risk

The comparisons, provided in the chart above, use October data, which represent a traditionally low point for the caseload. The Indicator target is set using data from June 30, which is both the end of the fiscal year and the traditional high point for the caseload. There were 2,194 open cases of children under 1 on June 30, 2009, representing a participation rate of 1.18% [(2,194/541,091)*100=1.18%], which falls short of the target goal of 1.32%.

The following chart provides statewide, regional, and CFC office participation rate histories. The participation rate has increased statewide.

NOTE: Although the statewide participation rate of 1.18% is based upon census data, the participation rates in the following chart are calculated based on births, instead of population estimates because population estimates are not available to the necessary level.

Under Age 1 Participation Rate History By CFC & Region

CFC & Number End of
SFY 03
End of
SFY 04
End of
SFY 05
End of
SFY 06
End of
SFY 07
End of
SFY 08
End of
SFY 09
Rank FY 09
% Change
6 Year
Change
By CFC
#1 - ROCKFORD 1.23% 1.44% 1.15% 1.28% 1.46% 1.22% 1.25% 13 2.5% 77.8%
#2 - LAKE CO. 0.66% 0.86% 1.00% 0.91% 0.75% 0.88% 0.87% 24 -1.1% 70.1%
#3 - FREEPORT 1.07% 1.25% 1.59% 1.10% 1.50% 1.25% 1.68% 5 34.4% 66.9%
#4 - KANE-KENDALL 0.82% 0.76% 1.19% 1.01% 1.20% 0.97% 1.02% 22 5.2% 36.4%
#5 - DUPAGE 0.66% 0.94% 0.97% 0.92% 0.99% 0.95% 0.96% 23 1.1% 92.2%
#6 - N. SUBURBS 0.67% 0.93% 1.10% 1.28% 1.38% 1.43% 1.31% 9 -8.4% 180.8%
#7 - W. SUBURBS 0.75% 0.88% 0.93% 1.10% 1.25% 1.30% 1.30% 11 0.0% 82.8%
#8 - SW CHICAGO 1.08% 1.33% 1.60% 1.40% 1.44% 1.42% 1.44% 8 1.4% 34.8%
#9 - CENTRAL CHICAGO 1.27% 1.28% 1.20% 1.53% 2.05% 1.68% 1.60% 6 -4.8% 88.3%
#10 - SE CHICAGO 0.93% 1.54% 1.68% 1.67% 1.90% 1.42% 1.45% 7 2.1% 102.8%
#11 - N. CHICAGO 0.72% 0.95% 1.00% 1.20% 1.33% 1.21% 1.20% 17 -0.8% 112.0%
#12 - S. SUBURBS 0.98% 1.37% 1.60% 1.45% 1.30% 1.22% 1.21% 15 -0.8% 49.6%
#13 - MACOMB 0.83% 0.63% 1.38% 1.01% 1.24% 1.16% 1.06% 20 -8.6% 224.9%
#14 - PEORIA 0.65% 0.63% 0.74% 0.98% 0.94% 1.13% 0.83% 25 -26.5% 67.4%
#15 - JOLIET 0.78% 1.15% 1.26% 1.01% 0.96% 1.13% 1.04% 21 -8.0% 29.0%
#16 - BLOOMINGTON 0.72% 0.69% 0.83% 0.95% 1.28% 1.31% 1.21% 15 -7.6% 158.8%
#17 - QUINCY 0.76% 0.85% 1.28% 1.29% 1.84% 1.84% 1.94% 3 5.4% 127.5%
#18 - SPRINGFIELD 1.09% 1.45% 1.22% 1.39% 1.49% 1.30% 1.13% 18 -13.1% 85.2%
#19 - DECATUR 0.78% 0.94% 1.41% 1.29% 1.60% 1.51% 1.92% 4 27.2% 73.0%
#20 - EFFINGHAM 1.76% 1.29% 2.13% 1.61% 1.99% 1.99% 2.07% 2 4.0% 126.3%
#21 - BELLEVILLE 0.79% 0.86% 1.03% 0.94% 0.78% 0.97% 1.31% 9 35.1% 147.7%
#22 - CENTRALIA 1.72% 1.53% 1.61% 1.39% 1.60% 1.56% 1.28% 12 -17.9% 3.1%
#23 - NORRIS CITY 2.51% 2.88% 3.35% 4.27% 2.65% 2.75% 4.51% 1 64.0% 46.9%
#24 - CARBONDALE 0.57% 0.63% 1.14% 1.33% 1.28% 1.11% 1.25% 13 12.6% 28.5%
#25 - MCHENRY CO. 0.69% 1.36% 1.02% 0.94% 0.99% 1.28% 1.13% 18 -11.7% 15.8%
By Location
STATEWIDE 0.87% 1.06% 1.21% 1.20% 1.30% 1.25% 1.21% -3.20% 72.0%
COOK (6-12) 0.88% 1.14% 1.25% 1.35% 1.48% 1.36% 1.31% -3.59% 87.5%
COLLAR (2, 4, 5, 15, 25) 0.72% 0.97% 1.09% 1.05% 1.07% 1.11% 1.07% -3.54% 61.1%
DOWNSTATE (OTHERS) 1.00% 1.03% 1.26% 1.12% 1.24% 1.22% 1.19% -2.38% 59.4%

Discussion of Improvement Activities Completed and Explanation of Progress or Slippage that occurred for FFY08/SFY09:

Progress/Slippage for Indicator 5: Illinois' ranking of 19 when compared to all states remained stable from FFY07/SFY08 to FFY08/SFY09. Although Illinois slipped one place (from 4th to 5th) out of the 14 states with moderately restrictive eligibility, its under 1 participation rate remains above the national baseline of 1.04%.

In the six years between the end of FFY02/SFY03 and the end of FFY08/SFY09, the under 1 participation rate increased for all CFC offices. Eight of the 25 CFC areas at least doubled. Statewide, the FFY08/SFY 09 reported caseload represents a 22.1% increase over five years, compared to just 13.6% nationwide. In FFY08/SFY09, 21 CFC offices have participation rates above the national baseline of 1.04%, the same number as the preceding fiscal year. Although 11 CFC offices saw an increase in the under 1 participation rate and several others either demonstrated no or minimal decrease, all three geographic areas noted in the attached chart experienced a drop in the participation rate.

Although the overall growth in caseload has slowed, it is not clear why Illinois has experienced a decline in under 1 participation rate. System stresses aggravated by the State's fiscal situation and the resulting delays in payments to providers may have diverted CFC office from efforts to target the under 1 population. System efforts including improved physician referrals and follow-up to referrals from the Illinois Adverse Pregnancy Outcomes Reporting System (APORS), a registry of Illinois infants born with adverse pregnancy outcomes, may help offset the loss. Discussions with the IICEI workgroups have led the program to believe that family stress triggered by economic factors is causing some families who might have taken their children in for screening before to pass on taking that step as they deal with what, for them, are more pressing concerns. In addition, direct cuts to other social service and health service programs and payment delays to these programs have resulted in reductions in the amount of programs being offered by partner agencies as they focus on maintaining their core services. These indirect changes are having a negative impact on child find efforts in general and a more significant impact on the programs success in reaching infants.

Improvement Activities

  • The Illinois Interagency Council on Early Intervention (IICEI) has made reaching eligible children at younger ages a priority for a number of years. Performance is reported to them regularly and age related factors are one of the areas of discussion with CFC Managers at their periodic meetings.
  • The under 1 participation rate and the percentage of IFSPs initiated before the child's first birthday are reported for each CFC each month. These are two of the measures that carry performance contacting incentive funding. Another performance contracting measure is the average age of children at initial IFSP.
  • The monthly reporting system also includes the following additional measures intended to emphasize the importance of reaching more children earlier: percent of caseload under 1, percent of initial IFSPs started under age 1, the average age of all open cases and average age at initial IFSP. In addition, the program tracks the percentage of the caseload over 30 months old, both because those cases should be in the transition process and as a counter-weight to the under 1 caseload. The emphasis is on reducing the age of the caseload.
  • As part of designation of determinations, the score of a CFC office is negatively impacted if it is in the bottom 5 CFC offices for all 10 measures that carry incentive funding, including those listed above.
  • The Early Intervention Program coordinated efforts with the Illinois Department of Public Health to ensure that all infants who are registered in APORS have been referred to Early Intervention. Referral information is being sent to the Bureau of Early Intervention and is then forwarded to the appropriate CFC office. The CFC office contacts the family if the infant is not already enrolled in the program. The Bureau is working with APORS to determine a process to provide feedback on the outcomes of referrals, to help ensure that evaluations are completed and service plans are in place for eligible children.
  • Early Intervention is participating in advisory groups and pilot activities as part of an Assuring Better Child Health and Development (ABCD) III project and in the development of an early childhood community referral pilot system in select communities. The goals of these projects include building on existing community referral systems to enhance coordination and referral strategies across programs, including Early Intervention. Physician, medical clinic staff, and CFC office staff education is a key component.
  • Early Intervention is working with partners from the Illinois Chapter, American Academy of Pediatrics (ICAAP), Advocate Health Care, and the Illinois Academy of Family Physicians (IAFP), in an effort to increase primary care providers' use of validated tools to implement developmental, social emotional, autism and maternal depression screening during pediatric visits with the 0-3 population. This should increase the number of infants under age 1 who are referred to EI. The overall goal of the EI/Medical Home project is to improve child health outcomes by improving the coordination of care between EI and primary care. The project will achieve this goal through the development of training and technical assistance interventions for EI and primary care in pilot sites in Illinois; the spread of the training in Illinois; and promotion of lessons learned and available tools to EI agencies and professional medical societies nationwide to more broadly spread the intervention.
  • The Program Integrity Project efforts, initiated in FFY08/SFY09 and described in Indictors 1 and 6, will continue.

Revisions, with Justification, to Proposed Targets / Improvement Activities / Timelines / Resources for FFY09/SFY10:

  • The improvement activities described above are ongoing efforts. As a result of the Program Integrity Project, the program anticipates a reduced growth rate or a decline in overall enrollment in the program in FFY09/SFY10. A new improvement activity includes the following:
  • Participate in advisory groups and pilot activities to promote the referral of infants to the Early Intervention Program, such as the Assuring Better Child Health and Development (ABCD) III project, the EI/Medical Home project, and the development of an early childhood community referral pilot system in select communities.