First steps down a bad path

JEFFERSON CITY - Missouri's Democratic state auditor charged Tuesday that a state program to provide health care for young children was inadequate because of criteria imposed as part of the Republican administration's budget cuts.

"What we have found in regards to this audit is that we really could use more service to the children in need," State Auditor Susan Montee said. "The way that the First Steps program is set up right now is we're giving services to too few children."

The First Steps program is designed to address health problems of special-needs children before they enter school. As part of the 2005 budget cut package, the governor first proposed eliminating the program entirely, but then agreed to imposition of stricter standards.

The program now requires a 50 percent delay in a child's expected development. Development delay occurs when a child does not go through changes in skill development at a predicted time, such as learning to walk around 9 months.

Missouri is one of three states that requires a 50% development delay along with Arizona and Alaska.

"If you do not fit into this program then you don't receive any kind of extra help until you are into the special education program," Montee said.

Montee said the delay percentage was set at 50 to limit the number of children in the program.

The audit states program eligibility is established by the Department of Secondary and Elementary Education. "According to department officials, the eligibility criteria has remained restrictive for budgetary reasons," the audit states.

"The reason we're so restrictive is just because we don't have the money," Montee said.

In 2005 Gov. Matt Blunt proposed in his yearly budget to destroy the First Steps program. Instead of being cut the program was altered so parents of enrolled children paid a co-pay and the program was funded out of general revenues.

"This audit shows he's (Blunt) still not a strong supporter of the First Steps program," said Rep. Jeff Harris D-Columbia.

Harris said the governor's attitude toward the program will be apparent in the budget released Wednesday.

Following Blunt's announcement in 2005, Harris said constituents from Columbia and all over the state contacted Harris's office in outrage over the plan. He said that a parent's group formed following the governor's announcement.

MU Special Eduction Dept. Chairman Michael Pullis was surprised that the cut off number was so high without being federally set.

"I hate to see people get their hands tied by very rigid criteria," Pullis said. "I kind of lean toward if kids are obviously going toward special needs intervene."

The special education program starts at age three and is less restrictive then the First Steps program. According to the audit, the First Steps program served 3,400 of the 11,000 children enrolled in the First Steps program.

Pullis said this causes a problem because if a special needs child is identified early the effect their disability has on their life can be minimized.

"If you look at research any kind of early identification is not just for the child but for the family who are adapting to it," Pullis said.

Montee said all of the shortcomings found in the audit are finance related.

"We're unable to get enough providers, we're not able to get people to do the evaluations because we're not paying enough," Montee said.

The Department of Education agrees with the audit's findings, having previously recommended higher pay but Montee said there just isn't funds available.

"The overall theme of the audit is that if we were able to put more money into this we would have a better program," Montee said.

The First Steps program is funded on the state and federal levels.

"Overall out findings are if we're able to fund this program a little better, either through cost allocations or maybe in the future taking some of these dollars back or just the legislature giving more dollars to the First Steps program that all the children would be better off," Montee said.