The higher the quality of care a child receives in his earliest years, the greater the chance for his later success. With that in mind, Gov. Paul Patton pushed for 25 percent of the tobacco settlement money to go toward an initiative to improve early chil

As the General Assembly wound down, his goal was accomplished. "This really is historic legislation," said Kim Townley, executive director of the Office of Early Childhood Development. "For young children, it's much on the level of KERA . . . Early childhood is an area that we can no longer ignore." The legislation focuses on areas of childhood wellness, prevention of disease, family support and improving the quality of childhood care. Funding for the initiative will come from the $206 billion tobacco settlement 46 states received from tobacco companies to cover smokers' ill health. Kentucky is slated to receive an estimated $3.45 billion over the next 25 years. The initiative calls for a push to add folic acid to the diet of Kentucky women of child-bearing age to prevent neural tube defects, which occur at 11/2 times the national average in the state, Townley said. Cost to provide folic acid would be $4 a year for each woman, compared to $500,000 in lifetime support of a person with neural tube defects. "It's one of those classic (situations), pay me now or pay me later," Townley said. "That is a preventable disability, and we ought to be ashamed we haven't done anything about that before now." Under the initiative, newborns will be screened for hearing problems, children will be checked for vision impairments before entering school and all Kentucky children will be immunized. Hearing problems are the most common birth defect with three per 1000 births, according to a summary of the Governor's Early Childhood Initiative. The average yearly cost to educate a child with a hearing impairment is $27,000, compared to $6,000 annually for the child who is diagnosed early, the summary states. The governor's plan also recommends voluntary home visitation to support and build stronger families. Children involved in programs such as these are healthier and develop better, said Lamone Mayfield, director of the Green River District Health Department. However, the idea of taking the clinic into clients' homes didn't fly as high with some legislators, who argued that the program would cost more than if the information were provided in a clinical setting, such as the health department. But Mayfield said some barriers can't be detected unless home visits are conducted. She testified before the House Health and Welfare Committee to educate legislators on the need. Visiting personnel can detect roaches and safety hazards such as insecticides, she said. Home services exist now through the health department, but the extra funds will help move some from the waiting list, Mayfield said. "That is our goal, to provide support and help them identify their own risk factors," Mayfield said. "The goal of the program is to do what public health has always done, to improve the health of families." Improving early child care also was targeted, since an estimated 103,000 Kentucky children are cared for by someone other than their parent, according to a study on the state's child care released by the Kentucky Long-Term Policy Research Center last year. The state will offer scholarships, administered through the Kentucky Higher Education Assistance Authority, to train child-care providers in hopes of attracting and retaining quality employees, Townley said. Taking care of the state's youngest residents is imperative for the future. A 1998 study by the Rand Corporation found that children in high quality child care do better in school and have fewer interactions with the juvenile system. Keith Sanders, executive director of the Hager Foundation, said research shows that a more capable staff will enhance the quality of child care. The foundation funds programs that improve the health and welfare of children. And more capable staff are more apt to stay at one facility for longer, another benefit for children, Sanders said. "We're really encouraged by this start," Sanders said. "It doesn't do everything, but it's a really good start."

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