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

Helping Families. Supporting Communities. Empowering Individuals.

Overview of the Annual Performance Report Development: See Indicator 1.

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. (20 U.S.C. 1416(a)(3)(B) and 1442)
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 Measurable and Rigorous Target

FFY  Measurable and Rigorous Target
FFY09/SFY10 The percentage of all children in Illinois under age 1 served through an IFSP will be at least 1.33%, approximately 2,420 children.

Actual Target Data for FFY09/SFY10

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
FFY09/SFY10 Result Based on October 31, 2009 data (1,950/18,133) X 100= 1.08% Illinois ranks 22th out of all states and D.C.

Based on October 31, 2009 data, Illinois reported 1,950 children under 1 had active IFSPs, equal to a 1.08% participation rate. That is lower than the 1.13% for October 31, 2008, and falls short of the FFY09/SF10 target of 1.33%. Illinois does perform above the national percentage of 1.03%. Illinois has fallen from a ranking of 19 in FFY08/SFY09 to 22 among the 50 states and D.C.

The following chart provides statewide, regional, and CFC office participation rate histories. The participation rates are based upon June 30, 2010 data, with the census estimates used for the population of infants and toddlers birth to 1. For previous years, the participation rates were calculated using birth data rather than census estimates. Birth data for Illinois infants that are born in bordering states are no longer available to the program.

Participation Rate Under 1 History by CFC & Region

CFC # & Area End of:
SFY04
End of:
SFY05
End of:
SFY06
End of:
SFY07
End of: SFY08 End of: SFY09 End of: SFY10 Rank FY09 Change 6 Year Change
#1 - ROCKFORD 1.44% 1.15% 1.28% 1.46% 1.22% 1.25% 0.98% 16 -21.96% -32.25%
#2 - Lake County 0.66% 0.86% 1.00% 0.91% 0.75% 0.88% 0.61% 25 -30.45% -7.26%
#3 - FREEPORT 1.25% 1.59% 1.10% 1.50% 1.25% 1.68% 0.93% 18 -44.62% -25.57%
#4 - Kane & Kendall Co. 0.76% 1.19% 1.01% 1.20% 0.97% 1.02% 0.63% 24 -38.61% -17.61%
#5 - Du Page County 0.94% 0.97% 0.92% 0.99% 0.95% 0.96% 0.96% 17 0.30% 2.43%
#6 - N. Suburbs 0.93% 1.10% 1.28% 1.38% 1.43% 1.31% 1.37% 5 4.91% 47.77%
#7 - W. Suburbs 0.88% 0.93% 1.10% 1.25% 1.30% 1.30% 1.16% 11 -10.47% 32.26%
#8 - SW Chicago 1.33% 1.60% 1.40% 1.44% 1.42% 1.44% 1.38% 4 -4.47% 3.43%
#9 - Central Chicago 1.28% 1.20% 1.53% 2.05% 1.68% 1.60% 1.58% 3 -1.25% 23.43%
#10 - SE Chicago 1.54% 1.68% 1.67% 1.90% 1.42% 1.45% 1.20% 10 -17.23% -22.07%
#11 - N. Chicago 0.95% 1.00% 1.20% 1.33% 1.21% 1.20% 1.36% 6 13.61% 43.51%
#12 - S. Suburbs 1.37% 1.60% 1.45% 1.30% 1.22% 1.21% 1.01% 14 -16.22% -26.00%
#13 - MONMOUTH 0.63% 1.38% 1.01% 1.24% 1.16% 1.06% 1.01% 15 -5.15% 59.59%
#14 - PEORIA 0.63% 0.74% 0.98% 0.94% 1.13% 0.83% 0.72% 23 -12.66% 15.06%
#15 - Joliet 1.15% 1.26% 1.01% 0.96% 1.13% 1.04% 0.80% 22 -23.49% -30.81%
#16 - DANVILLE 0.69% 0.83% 0.95% 1.28% 1.31% 1.21% 1.24% 8 2.34% 79.46%
#17 - QUINCY 0.85% 1.28% 1.29% 1.84% 1.84% 1.94% 0.91% 19 -52.92% 7.46%
#18 - SPRINGFIELD 1.45% 1.22% 1.39% 1.49% 1.30% 1.13% 1.13% 12 -0.35% -22.35%
#19 - DECATUR 0.94% 1.41% 1.29% 1.60% 1.51% 1.92% 1.24% 9 -35.63% 31.48%
#20 - EFFINGHAM 1.29% 2.13% 1.61% 1.99% 1.99% 2.07% 1.85% 2 -10.45% 43.69%
#21 - BELLEVILLE 0.86% 1.03% 0.94% 0.78% 0.97% 1.31% 0.80% 21 -38.95% -7.01%
#22 - CENTRALIA 1.53% 1.61% 1.39% 1.60% 1.56% 1.28% 1.31% 7 2.38% -14.35%
#23 - NORRIS CITY 2.88% 3.35% 4.27% 2.65% 2.75% 4.51% 2.29% 1 -49.19% -20.43%
#24 - CARBONDALE 0.63% 1.14% 1.33% 1.28% 1.11% 1.25% 1.07% 13 -14.48% 69.67%
#25 - McHenry County 1.36% 1.02% 0.94% 0.99% 1.28% 1.13% 0.90% 20 -20.57% -34.00%
Statewide 1.06% 1.21% 1.20% 1.30% 1.25% 1.21% 1.08% -9.92% 2.83%
Cook (6-12) 1.14% 1.25% 1.35% 1.48% 1.36% 1.31% 1.31% 0.00% 14.91%
Collar Counties (2,4,5,15,25) 0.97% 1.09% 1.05% 1.07% 1.11% 1.07% 0.77% -28.04% -20.62%
Downstate (Others) 1.03% 1.26% 1.12% 1.24% 1.22% 1.19% 1.00% -15.97% -2.91%

Discussion of Improvement Activities Completed and Explanation of Progress or Slippage that occurred for FFY09/SFY10:

Progress/Slippage for Indicator 5: The October 31, 2009 under 1 participation rate of 1.08% is lower than the October 31, 2008 participation rate of 1.13%, and falls short of the FFY09/SF10 target of 1.33%. Illinois has fallen from a ranking of 19 in FFY08/SFY09 to 22 among the 50 states and D.C. Illinois performed above the national percentage of 1.03%. In addition, 13 CFC offices have participation rates above the national percentage. Five CFC offices have increased under 1 participation rates from the previous year.

In the six years between the end of FFY03/SFY04 and the end of FFY09/SFY10, the under 1 participation rate increased statewide and for 13 CFC offices. The Cook County CFC offices, as a group, achieved an increase. Regional data for Collar County CFC offices and the remaining CFC offices outside of Cook County show a downward trend.

Data provided in Indicator 6 demonstrate a decrease in under 3 participation rate (from 3.43% on October 31, 2008 to 3.38 on October 31, 2009). It is not clear why Illinois has experienced a proportionally larger decline in its under 1 participation rate. The following rationales identify several important factors.

  • Of the 10 CFC offices with the greatest drop in under 1 participation rates, all but one office borders on another state. For these CFC offices, the change in the use of census estimates for the population of infants and toddlers birth to 1, rather than birth data, may have contributed to these decreases.
  • 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.
  • Economic stressors on families may result in fewer families accessing program services.
  • During FFY08/SFY09, the Early Intervention program initiated the Program Integrity Project to accomplish statewide program equality; fidelity to program principles and state and federal laws; and long-term program stability. As a result of the Program Integrity Project, the program anticipated a reduced growth rate or a decline in overall enrollment in the program in FFY09/SFY10. Initial efforts focused on eligibility determination to make sure that process was being conducted according to policy and procedure, so that appropriate determinations will be made.

CFC managers provided their perspective on why under 1 participation rates have fallen or remained stable. They described insurance/HMO influences on physicians' decisions to retain child in system services, rather than referring them to the EI Program, until insurance benefits have been exhausted. In addition, acting as good stewards of program funds, CFC offices evaluate premature infants for EI eligibility, but do not keep the case open if the infant does not need services at the time and the family chooses not to remain in the program. These families are periodically contacted regarding participation.

Improvement Activities Completed:

Improvement Activity Status/Timeline/Resource
The improvement activities described above are ongoing efforts. The Early Intervention Program coordinated efforts with the Illinois Department of Public Health to ensure that all infants who are registered in the Illinois Adverse Pregnancy Outcomes Reporting System (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 continues to work with APORS to help ensure that evaluations are completed and service plans are in place for eligible children.
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.

In its first year, the ABCD III, Illinois Healthy Beginnings II (IHB2) project focused on: facilitating stakeholder input, surveying the 25 CFC offices about their current technical and staffing capacity to participate as a pilot project; reviewing draft materials for use in the pilot projects, including a universal referral and follow-up form and IFSP summary form; and reviewing barriers, policy and protocol for stakeholders.

Bureau of Early Intervention staff, in response to an invitation from the IL Department of Healthcare and Family Services (HFS), participate on Workgroups of the Children's Health Insurance Program Reauthorization Act (CHIPRA) child Health Quality Demonstration Grant. One goal of the grant project is to improve perinatal and early childhood health outcomes, including assuring that existing systems, such as Early Intervention, are linked to the medical home and developing a mechanism to link the NICU to the medical home and to EI to promote better care and coordination and earlier entry into EI.

Another improvement activity includes the following:

  • In addition to the projects identified above, EI has participated in the Enhancing Developmentally Oriented Primary Care (EDOPC) initiative. This collaborative project began in 2005 with the goals to improve delivery and financing of preventive health and developmental services for children birth to three and build on existing programs to develop a range of strategies for primary care settings. The initiative has provided training and implemented strategies to promote developmental screening and referral to EI, including facilitating communication between primary care providers and EI.

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

The State Performance Plan (SPP) has been revised to specify, for each indicator, annual targets and improvement activities for each year through FFY2012 (July1, 2012 through June 30, 2013).

FFY Measurable and Rigorous Target

FFY Measurable & Rigorous Target
2010 - (2010-2011) On October 31, 2010, the percentage of all children in Illinois under age 1 served through an IFSP will be at least 1.08%.
2011 - (2011-2012) On October 31, 2011, the percentage of all children in Illinois under age 1 served through an IFSP will be at least 1.08%.
2012 - (2012-2013) On October 31, 2012, the percentage of all children in Illinois under age 1 served through an IFSP will be at least 1.08%.

The proposed performance targets for FFY10, FFY11 and FFY12 have been set at the FFY09/SFY10 performance level due to the factors facing the EI Program, as discussed above. With several of these factors out of the control of the program, Illinois is not confident that improvement in terms of increases in stated percentages should be expected.

The improvement activities described in the SPP are ongoing efforts. The following are new improvement activities to be implemented through FFY12/SFY13.

New Improvement Activity Timelines & Resources

New Imporvement Timelines & Resources
The APORS referral process will be reviewed to ensure that it has been successfully implemented.

By December 2010, the CFC offices will be surveyed to determine if the process is being implemented appropriately and is responsive to the needs of CFC offices and families identified through the APORS. Information from the survey will be discussed with CFC offices.

Resources include APORS, the Bureau of Early Intervention, and the CFC offices.

Continue participation in ABCD III, IHB2 project, including CFC office participation in pilot project activities and data sharing between the HFS and the IL Department of Humans Services/EI.

Selection of pilot sites will be completed by January 2011. Pilot activities and the development and implementation of data sharing activities will be an ongoing activity.

Resources include HFS and its IHB2 Project Management Committee and subcommittees, Bureau of Early Intervention, and CFC offices.

Continued participation in CHIPRA Child Health Quality Demonstration Grant.  Bureau staff will continue participation in Workgroups and assist in the development and implementation of strategies throughout the grant period (i.e., 2015). Resources include HFS and its CHIPRA Child Health Quality Demonstration Grant Workgroups, Bureau of Early Intervention, and CFC offices.
Continue participation in EDOPC. Bureau and EI Training Program staff will continue participation in the EDOPC advisory group and CFC offices will participate in pilot project activities. Resources include the Advocate Health Care Steps Program, Illinois Chapter, American Academy of Pediatrics, Bureau of Early Intervention, EI Training Program, and CFC offices.
Utilize Program Integrity pilot project efforts to identify barriers to participation of infants in the program and develop strategies that can be shared with other CFC offices. A CFC office with low under 1 participation rate will be chosen as a pilot project in FFY10/SFY11. Identification of barriers, implementation of strategies, and sharing strategies with other CFC offices will be an ongoing effort. Resources include the Bureau of Early Intervention, the EI Training Program, EI System Ombudsman, and the EI Monitoring Program.