Moving from Dependence to Independence

Long before welfare reform was approved at the federal level, the Edgar administration was taking action to move public aid recipients to self-sufficiency. It ended benefits to single, able-bodied adults and created the nationally recognized Earnfare program to provide them with work experience.

Welfare recipients were no longer penalized for holding part-time jobs. Families were no longer denied aid when the father remained in the home. Teenaged mothers were required to complete their high school education through the Teen Parent Initiative. As a result of these initiatives and others, Illinois outpaced the nation in moving people from dependence to independence.

These reforms resulted in more than 200,000 people moving from the welfare rolls to payrolls. At the end of Edgar’s term in office, Illinois ranked 1st among Midwestern states and 10th in the nation in improving the lives of poor families through welfare reform.

Impact by the Numbers


decrease in state mental hospital admissions

families moved from welfare to jobs

“The principle is simple but powerful. Public assistance should be a lifeline, not a lifestyle”– Jim Edgar

Edgar signed sweeping welfare reform legislation in 1997 at the United Airlines in Chicago to help thousands to move from welfare to work.

Created six decades ago as a Depression-driven plan for widows’ relief, the nation’s welfare system in the 1990s no longer made sense. The program did not require beneficiaries to work. It did not promote stable families. It often did not help those for whom it was intended. It fostered reliance on government for handouts. It was in need of change.

Under Governor Edgar’s leadership, Illinois took steps to bring “common sense where nonsense prevailed” and transformed the way welfare operated in the state long before Washington decided to reform welfare. The Governor saw welfare as a job ladder for public aid recipients to climb out of dependency and into work and self-sufficiency. “The principle is simple but powerful,” Edgar said. “Public assistance should be a lifeline, not a lifestyle.”

In a sweeping reversal of well-worn past practices, the Edgar administration introduced programs requiring recipients to work as a condition for aid. And while work was the ultimate goal, Edgar also realized there was no single approach to getting the job done. Some families might need income incentives, others education, training, substance abuse treatment or transportation. So Illinois developed varied experimental programs Earnfare, Work Pays, Opportunities, Teen Parent Initiative, Targeted Work Initiative, Get a Job, Unemployed Parents Work Experience, School Attendance Initiative, the Family Responsibility Project and Work First.

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The Governor also keenly understood that for many on welfare, finding a job might be the easy part. Keeping a job often presented more of a challenge, particularly for working moms. The need for reliable and affordable child care services was an especially crucial concern. Edgar boosted funding for child care from $54 million in 1991 to $392 million in fiscal 1999, and the number of children cared for jumped from just over 33,000 to 130,000. The state also invested in such work-related services as transportation and job placement programs to help participants keep more of their welfare benefits while collecting a paycheck.

Illinois’ groundbreaking efforts worked and, in doing so, received national attention. A study by Tufts University Center on Hunger and Poverty released in 1998 ranked Illinois first among Midwestern states and 10th in the nation in improving the lives of poor families through welfare reform.

“We were never interested in just dumping people off welfare,” Edgar said. “Welfare reform in Illinois isn’t about punishment. It’s about encouraging, stimulating and helping people who can become self-sufficient to turn away from dependence and government and toward the pride of a paycheck.”

One of Edgar’s first plans, called Earnfare, demonstrated the administration’s resolve not to follow the well-worn route of the past. There would be no more handouts whereby the state would neither ask — nor expect — anything in return from welfare recipients. Those old-style failures were well documented, and the Governor knew that to repeat them would compound failure.

Earnfare, launched in 1992, was an example of Edgar creatively responding to those unemployed, single, able-bodied adults who had grown dependent on government aid. Through its General Assistance program, Illinois for decades had provided monthly cash payments to those who qualified, but expected very little in return.

During the 1991 budget crisis, the General Assembly scaled back the General Assistance program to free up state dollars for programs with higher priorities. Available cash assistance dropped from 12 months to no more than nine months. On July 1, 1992, General Assistance for able-bodied, employed adults — about 100,000 persons at the time ended. Community advocates and social service activists predicted disaster.

But Earnfare, a voluntary work program, would help former General Assistance recipients find state subsidized jobs for six months, earn wages and, most important, prepare for regular jobs so that they could become self-supporting and free of government aid.

The program offered single adults a new opportunity to prove themselves as dependable, capable workers to their Earnfare employers and helped them acquire new skills and abilities, making them more employable. By 1998, more than 17,000 had gone on to regular, unsubsidized jobs with 3,700 persons volunteering monthly. Earnfare was cited with an innovation award by the National Council of State Governments for creative and nontraditional methods of solving traditional problems.

“I am happy that this public-private partnership is helping to give more Illinoisans independent lives rather than lives dependent on public assistance,” Edgar said in 1995 when he accepted the award. He credited the program’s success, in large part, to more than 800 employers who hired Earnfare volunteers and started them toward regular paying jobs.

Earnfare was just the beginning. Soon after came Fresh Start, a package of welfare reform initiatives that Edgar introduced in 1993 to remove barriers to employment and provide new incentives for persons to become independent.

The Governor’s plan banished bureaucratic road-blocks. One old federal rule held that if one parent in a two-parent family on public aid worked more than 100 hours a month, regardless of income, that family no longer would be eligible for cash assistance. This forced many fathers to leave home so their abandoned families could remain eligible for aid. The state’s Family Responsibility program encouraged two-parent families to stay together and provide the emotional and financial support their children deserved. Since elimination of the marriage penalty, the number of working two-parent families on public aid has increased from 10.6 percent in 1993 to nearly 60 percent in 1998. The number of two-parent families requiring welfare assistance dropped by more than a third.

“We found a system that literally told fathers to abandon their wives and children. Today in Illinois, we tell fathers that we want them to stay with their families. Today in Illinois, we want children to have a father in the home, someone they can look up to,” Edgar said in 1994.

At the core of Illinois’ welfare reform was a project called Work Pays. Instead of disincentives that kept people on welfare, it built escape routes. Simply put, Work Pays lets recipients keep more of their wages without losing eligibility for Medicaid, child care and food stamps. The program, considered the most generous in the country, reduced state cash grants by just $1 for every $3 earned until clients’ wages grew sufficiently to live on. Recipients quickly learned they could realize more over-all monthly income if they took jobs rather than subsisting on welfare alone.

Through Work Pays, the number of welfare recipients earning income has more than tripled. By 1994, Illinois was the only major state to achieve the federal goal of having 40 percent of the caseload employed. Work Pays received national recognition for innovation from the Council of State Governments.

To tackle the problem of teen parents dropping out of school and onto welfare rolls, the Governor pushed legislation that required 9,500 teen moms to attend school and earn a high school diploma or risk losing a portion of their cash assistance. Edgar budgeted $12.8 million to provide the necessary child care and transportation to help these teens complete their education while supporting a young family.

“We all know that education is key if those teenaged parents are to be successful in making the shift from welfare to work, ending long-term dependency and breaking the generation-upon-generation cycle of welfare,” Edgar told lawmakers in his 1994 State of the State speech.

Other programs called for welfare recipients with children ages 5 to 12 to complete a six-month job search as condition of eligibility, required mothers with no children under 13 to find work or to risk having their benefits reduced, installed a family cap that barred increased assistance for mothers who bore additional children after going on welfare, required welfare recipients with drug or alcohol problems to undergo treatment, stipulated that unemployed parents work or do community service to receive welfare checks, required welfare parents to address child immunizations and family well-being, and discontinued state assistance to parents if their children were excessively truant from elementary school.

By the time Congress got around to welfare reform and President Clinton signed federal legislation on Aug. 22, 1996, to “end welfare as we know it,” Illinois’ welfare system was already moving in a new direction. Since Edgar took office, 317,000 people have made the move from welfare to work, from dependence to independence.

The new Department of Human Services (DHS), which is responsible for continuing Illinois’ welfare reform initiatives, became effective on July 1, 1997, the same day Washington turned welfare over to Springfield and other state capitals.

Sweeping welfare reform legislation passed the General Assembly in 1997, accelerating Edgar’s changes and incorporating federal reform guidelines. The law imposed a federal mandate that public aid recipients find work within two years. It also put a five-year limit on most family benefits. The Aid to Families with Dependent Children (AFDC) program was renamed Temporary Assistance for Needy Families (TANF) to underscore new time limits and work rules.

“The Edgar plan — especially by comparison to other states and within the harsh parameters imposed by the federal government – is a reasonable and thoughtful one that I think can work,” said John Bouman, director of the Poverty Law Project for the National Clearinghouse for Legal Services.

Edgar signed the legislation at the United Airlines terminal at O’Hare International Airport in Chicago to herald the company’s hiring of dozens of welfare clients, and its commitment to hire up to 200 more. Another major employer, United Parcel Service, hired more than 200 former public aid recipients, giving them good-paying, entry-level jobs on the south side of Chicago.

To further business participation in hiring those on welfare, Edgar asked dozens of Illinois’ largest employers to join in a statewide effort. Several agreed enthusiastically, including AT&T, Sears, Spiegel, Commonwealth Edison, Helene Curtis, Marriott and Dominick’s Finer Foods Inc. The state also created the Employer Clearinghouse in September 1997, featuring a toll-free number businesses can call to find qualified workers from welfare rolls.

As the state trimmed the welfare rolls, those left behind often were individuals most challenged and most difficult to place. Edgar took some of the savings the state had earned from welfare reform and in 1997 put it into a $32 million job preparation and training program, and other initiatives. The money went to private agencies providing training in basic work skills, such as showing up for work despite bad weather, being on time and cooperating in the workplace. The program, which began in 12 inner-city Chicago neighborhoods, was later expanded to the outlying parts of Chicago and then downstate.

To help rebuild poverty stricken inner cities and rural with responsible, affordable communities, Edgar promoted the federally funded caregivers, they can’t leave Empowerment Zones and Enterprise Communities Initiative. The Governor committed $50 million in state funds over 10 years to the 21 communities that submitted plans describing how they would offer jobs and opportunities for families living in poverty.

Because of the Edgar administration’s efforts, Illinois’ welfare caseloads declined by more than half to the lowest level in three decades from a high of 242,000 in 1994 to 109,000 in November 1998. In the first 12 months after Washington returned welfare to the state, 41,000 people found work and the welfare budget fell $100 million. The number of TANF families who were employed rose to 40 percent, compared to just 8 percent in 1990.

One of the state’s success stories was subsidized child care. Without it, Edgar understood that single moms who dominate welfare rolls simply would not and could not work.

“If mothers on welfare can’t leave their children with responsible, affordable caregivers, they can’t leave welfare. What’s more, we can’t let them,” Edgar said in his March 1997 budget address. “It does no good to steer moms off welfare if their babies and toddlers are going to suffer because of inadequate day care. Moreover, without adequate day care, we are going to force the working poor onto the welfare rolls because they can’t hold jobs and provide proper care to their children.”

In fiscal 1998 alone, Edgar boosted child care funding by more than $100 million, the second largest increase in the nation. Waiting lists for day care slots vanished and families made a co-payment based on a sliding scale that rose with incomes. Low-cost loans became available to those seeking to open child care facilities, and the state helped people cut red tape and get quick answers about licensing and standards. Through community colleges, welfare moms were trained as licensed child care providers, providing a double benefit of more child care and additional jobs.

For those working night shifts, the state funded child care during evenings, weekends and rotating shifts. And for those struggling to get off welfare, Edgar offered additional benefits. In 1998, subsidized day care for as many as 15,000 children was in jeopardy due to a change in income eligibility, but the Governor changed state policy, relaxing maximum income levels so these families could continue receiving the child care subsidy.

But subsidies were not enough. Edgar made sure child care was available, affordable and, more important, of high quality. The Governor increased grants from $2 million a year in 1990 to $18 million in 1998 to improve services in more than 350 licensed centers and homes.

The National Governors’ Association in 1997 recognized these innovations with its prestigious Building Block Award.

By putting Medicaid on sound financial footing, Edgar was able to bolster access to care for clients because more providers were willing to participate knowing they would get paid on time.

In early 1991, the state learned what the Governor had discovered shortly after his election. General Assembly in 1990 and previous years had deliberately underfunded the Medicaid program.

During Edgar’s first term, hallways in the Illinois Department of Public Aid were jam packed with boxes of unpaid Medicaid bills. Medical providers were waiting an average of 100 days to receive state payment for doctor visits, hospital stays and nursing home living, at rates they claimed did not meet the cost of the services. In some instances, providers faced going out of business and others, unable to extend the state credit, dropped out of the program, which serves more than 1.3 million low-income Illinoisans mostly children, young mothers, the disabled and the elderly.

The backlog of old bills peaked at $1.4 billion in 1994.

By the close of the Edgar administration, however, more than 42,000 Medicaid providers physicians, hospitals, nursing homes, pharmacies, laboratories and others were receiving their payments in seven to 30 days, the fastest in at least a dozen years. The hallways — and the providers — were finally free of overdue bills.

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“Illinois is no longer a deadbeat state,” Edgar told law-makers in his 1998 State of the State address. “We eliminated a mountain of Medicaid debt. And, yes, we have been paying and will continue to pay our bills on time.”

Putting Medicaid on a sound financial footing also bolstered access to care for the program’s clients. Medical providers became more willing to participate in the program with timely payments.

Medicaid historically has occupied a prominent place in Illinois’ budget. It is the single largest claim on the state’s budget, accounting for nearly one of every five dollars. As Edgar understood from the beginning, any budget discussion usually begins or ends with Medicaid.

When Edgar took office, the Medicaid budget story had played like a well-worn record. Medicaid money typically ran out before the end of the fiscal year, leaving medical bills unpaid until the next year’s appropriation became available after July 1. By the following spring, Medicaid would once again run short as the cycle repeated itself.

The national recession in the early 1990s, compounded by sky-rocketing healthcare costs and an underfunded program, worsened Medicaid’s financial problems. The Governor and Illinois withstood the severest blows the economic downturn could deliver and rebounded by rebuilding Medicaid into a program now characterized by its stability. It took tough choices, strict discipline and creative approaches to remedy not only the problems facing Medicaid, but state government generally.

The Governor understood there would be no quick or easy solutions. The situation demanded innovation, additional revenue and economic reforms. The Edgar administration achieved all three.

To capture more federal dollars for Medicaid’s growing needs, Edgar launched the Medicaid Assessment Program in July 1991. This revenue-producing initiative pumped more than $4.2 billion into Medicaid by levying assessments on certain health care providers to capture additional federal dollars for Illinois.

Assessments paid by hospitals, nursing homes and of Medicaid debt. And, yes, facilities for the developmentally disabled helped pay Medicaid services delivered by the three provider groups. These assessment dollars then leveraged new matching federal dollars totaling more than $2 billion in eight years. The hospital portion of the assessment program ended March 31, 1997, while long-term care and developmentally disabled providers continue to pay an assessment, albeit smaller than originally imposed.

The assessment program fomented controversy, to say the least. But without it, the Illinois health care system faced chaos. When lawmakers considered scrapping the program in 1993, Edgar warned of “a billion dollar hole this budget cannot fill and an inexcusable loss of health care for millions of our most needy citizens.” The assessment remained.

Two years later, Medicaid funding was again the center of budget negotiations. Minus the assessment, Edgar asked whether lawmakers wanted to consider the draconian alternatives. Again the assessment survived.

But more and more money alone would not cure Medicaid’s ailments. Edgar made it a priority to “tame this budget basher” and overhaul the system

In June 1995, the Governor, chair of the Medicaid Task Force of the Republican Governors’ Association, appeared before the U.S. Senate Finance Committee and pleaded for more state control over the Medicaid program, freeing the state of micromanagement by bureaucrats in Washington.

At the time he testified, it had been about nine months since Illinois sought a federal waiver to implement a mandatory managed care program providing some cost control for about 1.1 million Medicaid clients. A frustrated Edgar was still awaiting this approval. It would not be until July 1996 that the waiver arrived.

“If we [governors] want to depart from the one-size-fits-all approach to Medicaid, we must go hat in hand to federal bureaucrats,” Edgar said. “They delay and delay on our waiver requests. And they are very reluctant, very reluctant to surrender control. You have given us the responsibility to manage Medicaid. Now give us the flexibility and freedom to do it well.”

Edgar told senators the federal government dictated benefits that were far more generous than those normally provided to working men and women through private insurance programs. At the same time, he bemoaned the state’s inability to negotiate the best possible rates from health providers.

The Illinois tab for federal mandates had grown to $480 million in fiscal 1995, Edgar said, and Medicaid spending between 1991 and 1993 had ballooned beyond the combined funding increases for education, child welfare, prisons, mental health and law enforcement.

While awaiting the federal waiver, the state introduced more voluntary managed care in Medicaid. In 1998, Edgar decided to suspend introduction of a complex mandatory program and focused on other efforts to cut Medicaid costs. The state Department of Public Aid began informing clients about options promoting primary and preventive care as opposed to costly emergency room visits for those not requiring urgent treatment.

While Washington resisted change in the 1990s, Edgar brokered other initiatives to quell a burgeoning Medicaid system. Included were short-term borrowing to pay old bills, eliminating some optional services for adults and freezing reimbursement rates for hospitals and long-term care facilities.

When Medicaid funding was stabilized and the Illinois and national economy improved, steps were taken to assist medical providers. Long-term care facilities serving Medicaid residents received a 6.8 percent across-the-board rate increase Jan. 1, 1997. The Governor proposed and the legislature approved a 3 percent cost of living increase for medical and human service providers effective July 1, 1998. About two months later, he provided a $54 million increase in reimbursements to physicians, dentists and health maintenance organizations and other providers serving enrollees in KidCare and Medicaid clients. And an additional $70 million grant went to children’s hospitals, out-patient hospital services and long-term care facilities to cope with rising costs.

In 1996, the state introduced an electric debit card to make it easier and safer to distribute benefits to welfare clients. The card cut administrative costs, fraud and food stamp misuse.

To fight welfare fraud, the Edgar administration turned to the latest electronic technology.

In 1996, the state began Illinois Link, an electronic debit card that distributes more than $125 million in benefits monthly to 450,000 welfare clients, who can withdraw cash assistance from automated teller machines or use food stamp allotments at grocery stores. The card makes it easier and safer for clients to retrieve benefits, while cutting administrative costs, fraud and food stamp misuse.

The Governor also supported pilot projects testing an electronic system using a scanner to record each client’s fingerprint. Another scanner makes electronic images of a person’s retina, the tissue lining the rear surface of the eye. In 1999, the state will determine which is more effective and efficient in combating fraud.

To strengthen the fiscal integrity of Medicaid and other social services programs as well, the Governor signed legislation creating the independent Office of Inspector General within the Department of Public Aid in 1994.

From July 1991 through February 1998, 9,303 allegations of recipient fraud and abuse were investigated and $24 million in overpayments were identified and pursued for collection.

Since 1995, Edgar’s programs for refugees and immigrants have helped more than 100,000 learn English, fill out citizenship papers and prepare for citizenship tests.

While Illinois sought to move people off welfare, the state always stood ready to help those who needed assistance. Such was the case in 1998 when Congress stripped benefits from needy legal immigrants. The Governor stepped in to provide $6 million in state benefits for about 15,000 elderly and disabled immigrants and immigrant children eliminated from the federal foodstamp program.

Edgar also went to bat for refugees and immigrants wanting to become U.S. citizens. As the nation’s first state- sponsored program of its kind, the Refugee and Immigration Citizenship Initiative was singled out as a model by the U.S. Immigration and Naturalization Service. Since 1995, the state has helped more than 100,000 individuals from 94 countries to learn English, to fill out citizenship papers and to prepare for citizenship tests. The program became even more relevant in 1997 when a new law decreed that naturalized citizens can qualify for federal benefits in their transition to independent lives.

Illinois established the Refugee Resettlement Program to coordinate community-based services to promote economic self-sufficiency and social self-reliance. Bilingual mental health services, the Bosnian Refugee Center and help for elderly refugees all joined Illinois’ resettlement efforts. When federal funding waned, Edgar committed state funds so refugees would not suffer. In the last three years of his administration, state funding grew to $1.2 million.

In 1996, the Governor awarded nearly $7 million in grants to resettle more than 10,000 legal immigrants in Illinois from 30 different countries. The refugees received English language instruction, job search and placement assistance, mental health services, plus an overview of state services, taxes, public transportation, and their legal rights and responsibilities.

Besides welcoming these immigrants to Illinois, programs to find them jobs obviated their ending up on welfare. In 1997 alone, nearly 4,000 immigrants came to Illinois — about 2,500 found jobs through state programs. Their employment saved the state $7.7 million in potential welfare costs.

While admissions to state mental hospitals declined, the number of forensic patients in state facilities grew. This necessitated construction of new treatment building at Alton and at Elgin (left), which is to accept its first patients here in late 1998

In the early days of the Edgar administration, the Governor set out to reform and improve the mental way health services were delivered in Illinois. No longer would the state rely on warehousing patients in state facilities. Instead, the mentally ill would be cared for in the family home, homelike residences or small community settings, rather than prison-like hospitals. Only those requiring intensive care would be hospitalized.

By 1996, state spending on private community-based medical services exceeded that spent on state institutions for the mentally ill and developmentally disabled. A year later, for the first time, community treatment beds out-numbered state hospital beds. During Edgar’s eight years, funding nearly doubled to $312 million and the number of mentally ill persons in residential settings rose from 100,000 to nearly 150,000. At the same time, state mental hospital admissions dropped by more than half to 9,500 patients. Staff-to-patient ratios at state hospitals increased reform reflects the approach by more than 30 percent during Edgar’s tenure.

“We have transformed the system from one that relied heavily on state hospitals and institutions, to one where most who need our help are cared for in community-based facilities. Near their loved ones. In settings where they often can work, can be productive, can be self-sufficient as possible,” Edgar told lawmakers in his 1998 State of the State address.

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Edgar began his mental health reforms shortly after assuming office in 1991. Noting newspaper reports of unsuitable conditions in state mental health facilities in pushing for reform, the Governor announced a policy of “zero tolerance” towards abuse and neglect. People in state hospitals should be given the same care that he would expect for himself and his loved ones, he said. To make sure his policy was enforced, Edgar named C.J.Dombrowski, executive director of the Alliance for the Mentally Ill and a leading advocate for mental health reform, as the inspector general of the Department of Mental Health and Developmental Disabilities and significantly expanded the responsibilities of that office. The new inspector general not only responded to allegations, but also worked to improve the quality of care in state hospitals.

Meanwhile, Edgar worked with mental health experts to reform the state’s mental health system, providing better care at state hospitals and expanding community services. Often, mental illness could better be addressed at home, near families, with only a minimum disruption in patients’ lives.

As downpayment on the plan, Edgar added $36 million for mental health reform in the 1994 budget, bringing its funding to $1 billion. The money paid for more community agencies and for the Assertive Community Treatment (ACT) approach, which proved to reduce long-term hospitalization for seriously ill patients with a history of frequent admissions. During ACT’s first year, a demonstration project in Chicago reduced the average bed days per patient from 80 to 28. Edgar made it a priority that each patient be evaluated before referral to a hospital to eliminate unnecessary institutional care. Alternatives to hospital care were provided when clinically appropriate treatment.

Other reforms followed. Connect ’97 became the largest new spending initiative for mental health in a decade. Begun in 1996, Connect ’97 provided $7.2 million to more than 100 community providers statewide to ensure each person discharged from a state mental hospital was linked with appropriate care. Case managers helped each patient adjust to community living and avoid a return to the hospital.

Edgar traveled to Peoria in 1997 to highlight comprehensive reforms in Illinois’ mental health system, which resulted in more effective and efficient services. The city’s Human Services Center, funded 50 percent by the state, features a team of psychiatrists, physicians and social workers who help those from mental hospitals with problems of inadequate housing, family difficulties, hunger, chemical dependency and other physical difficulties associated with mental illness. Patients suffering from mild illnesses can work in the community and live at home or on their own. As a result, there was a 38 percent decline over three years in admissions to the Zeller Mental Health Center in Peoria.

“The approach we have taken in mental health reform reflects the approach this administration has taken in overhauling the way we provide services to all the needy in Illinois,” Edgar said. “It is a team approach. It is a one-stop approach. It is an approach that recognizes we can do a better job of marshaling services to more effectively meet the needs of the truly needy.”

Edgar also made sure Illinois received its fair share of federal dollars. When several mental health services were added to the costs reimbursed by Medicaid, state billings rose from just $96,000 in 1990 to $75 million in 1998.

Hanging as a dark cloud over Edgar’s reform efforts was a lawsuit filed in August 1992 by the American Civil Liberties Union (ACLU). The suit challenged conditions, management and care of mentally ill patients in state institutions. Even though the lawsuit came after the Governor launched reforms, it triggered a contentious five-year legal battle, consuming precious state time and resources. Finally, in 1997, the ACLU dropped its action, and the state agreed to improve training for its 4,500 mental health employees, to update hospital buildings and to change behavioral control practices at some downstate facilities.

Edgar believed the lawsuit had been unnecessary. After all, he had detected problems with the mental health system, independent of litigation, and he had moved the state toward community-based care. Under Edgar’s leadership, the state earmarked $150 million a year in new money for mental health and no one challenged that dramatic improvements had been made before the lawsuit was settled.

During the Edgar years, capital improvements for mental health facilities commanded $168 million, including construction of new forensic treatment buildings at Alton and Elgin mental health centers. These ultra-modern facilities, built at a cost of $43 million, increased capacity and replaced old, unsafe buildings originally designed for other purposes. Another 23 beds were added at Chester Mental Health Center to manage forensic referrals. Although state hospital admissions were declining, the population of forensic patients, those ordered held by the criminal courts as unfit to stand trial or not guilty by reason of insanity, increased. Edgar also budgeted $5 million in fiscal 1999 for sexually violent persons to be housed at the Sheridan Correctional Center.

Other capital improvements included a 120-bed adult psychiatric residence and treatment building at Elgin. In addition, millions of dollars went for renovations and improvements to the state’s other mental health centers.

As the need for institutional beds declined, Edgar moved to consolidate in-patient services and closed Decatur’s Meyer Mental Health Center. To ease the economic loss to Decatur, the Governor allocated $24 million to convert the center into a 500-bed prison for women.

Each year, Edgar saw to it that more than 200,000 people with disabilities were provided assistance so they could be included in all aspects of community life.

Much like the mental health reforms, Edgar sought to change the state’s method of caring for persons with developmental disabilities from one relying on state-operated institutional centers to one based on family and smaller community options.

Funding for community-based services increased from $190 million to $383 million during the Edgar years, and the number of persons living in the state’s 11 developmental centers dropped by more than 25 percent. Private intermediate care facilities for the developmentally disabled also recorded a 25 percent decrease to about 7,600 clients, and those cared for in nursing homes dropped by more than 50 percent to about 1,800.

A key to Edgar’s initiatives was community-integrated living arrangements (CILAS), providing needed support and services in an individual’s own home or in a home serving no more than eight persons. Since 1990, more than 2,000 persons with developmental disabilities have moved to such settings and by 1998 more people lived in CILAS than in state developmental centers.

Innovative programs also were created to assist individuals living at home. One provided a monthly stipend for families caring for a child with severe mental disabilities. Another allocated money so that adults with severe mental disabilities and their families can choose the help they need to become more independent.

Edgar aggressively pursued federal Medicaid money to expand the community service system. Through this effort, federal funding grew from less than $8 million in 1990 to more than $61 million in 1998.

Although the Governor placed greater emphasis on community living, he did not ignore the state’s developmental centers, which provide residential support for about 3,400 persons with multiple developmental and physical impairments. Significant improvements were made. All 11 centers are licensed, certified and professionally accredited, compared to just six in 1990. Staff-per-resident ratios were greatly increased and improvements made in clinical and medical expertise. The centers are partners with community organizations in efforts to return residents to their communities when appropriate and to prevent unnecessary admissions to state centers or nursing homes.

State funding linked businesses and job-ready employees with disabilities, helping more than 48,000 disabled people a year to get jobs.

Each year, Illinois serves more than 200,000 people who are visually or hearing impaired, disabled by AIDS or HIV infection, or suffering from other physical or mental disabilities. They receive assistance to live as independently as possible and to enter the competitive work force.

A premier effort was the $138 million Home Services Program, which allowed 18,500 Illinoisans

with severe disabilities to remain at home rather than in less desirable and more costly institutions. The program offers services such as home-maker assistance, personal assistant care, electronic home response, home-delivered meals, home modification and respite care. Its cost is one-third what the state would pay for institutional care and is eligible for Medicaid reimbursement. The state also provides similar in-home help for a growing population of Illinoisans with AIDS or HIV.

Vocational rehabilitation assists disabled people to obtain or maintain employment. Funding supports skills evaluation, guidance, job development, assistive devices, medical services and educational assistance, as well as a state link between businesses and job-ready employees who are disabled. More than 48,000 disabled people a year get help finding a job.

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A community-based program for the blind and visually impaired assists those coping with vision loss and learning to adapt. Services can be delivered to the individual’s home or, in Chicago, through an intensive residential program. The program also trains the visually impaired to operate vending stands in public or private buildings or at roadside rest areas statewide.

While supporting the full return to society by disabled persons, the state realizes that many school districts, especially in rural areas, lack resources for the specialized training sought by children with visual, hearing or severe physical disabilities. To fill this need, Illinois operates three residential schools —  the Illinois School for the Deaf and the Illinois School for the Visually Impaired, both in Jacksonville, and the Illinois Center for Rehabilitation and Education-Roosevelt in Chicago. Each year, 500 students receive an accredited education and their families are offered outreach programs. Regarding capital improvements for these schools, Edgar budgeted $3.7 million to renovate the main building at the Illinois School for the Deaf. Built in 1846, it is the oldest state building still used for its original purpose.

To assist the hearing impaired who travel the state’s roadways, Illinois became the nation’s first state to install teletypewriters at interstate rest stops.

When it came to substance abuse, protecting children was Edgar’s primary focus.

In the battle against alcohol and drug abuse, Edgar deemed children’s interests as a priority. The Governor sought to prevent the problems of substance abuse — crime in the streets, gangs, domestic violence and child abuse. He also began programs to discourage children from experimenting with drugs and alcohol and to help those already addicted.

Intent on high visibility for these efforts, he appointed Lt. Gov. Bob Kustra to head the Partnership for a Drug Free Illinois. Kustra worked to raise awareness about the pitfalls of alcohol and drug use: school dropouts, suicides, crime, motor vehicle crashes, general health problems and AIDS. To be effective, the prevention programs coordinated with those affected most by the problem teens, their families and their communities.

Edgar also directed the Illinois State Police to work with local law enforcement agencies in focusing community policing efforts on parks, swimming pools, recreational centers and other areas where children gather.

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“I want those areas to be safe havens — drug free, violence free, gang free,” Edgar told the Governor’s Conference on Drug Prevention in 1996. “We can’t tolerate older drug dealers hanging around these areas and using kids to do their dirty work. In fact, we can’t tolerate that anywhere.” He successfully pushed for legislation to toughen penalties for dealing drugs, particularly for those who peddle on school property and for those age 18 or older who use younger boys and girls to further their drug trade.

Spending on treatment services nearly doubled during the Edgar administration to more than $180 million, while those admitted for care increased from about 82,000 in 1990 to more than 116,000 in 1998.

Knowing how drug and alcohol abuse often are linked to child abuse, Edgar targeted funds to expand treatment for parents investigated by the Illinois Department of Children and Family Services. Spending for child care, transportation and case managers was increased to help those needing treatment. Admissions to the program went from 4,200 to more than 17,000.

Specialized services were developed for women and their children, allowing nearly 40,000 mothers a year to remain with their children during treatment, tackling not only alcohol and drug problems, but also parenting skills and job training. When federal funds for this program dried up, Edgar allocated state funds in the fiscal 1999 budget to keep it going. Treating pregnant women for alcohol and drugs helped to ensure thousands of babies a healthy birth.

As part of the prevention program, Edgar extended grants to community-based efforts that reflect his view that problem solving is best done at the local level. His grants bolstered mentoring programs, drop-in centers and special programs with community policing.

“We don’t have all the answers in Springfield,” Edgar told community activists at the 1996 Governor’s Conference on Drug Prevention. “There is no single approach that will work in each and every community in the state. For too long, drug strategy has been dictated almost exclusively from state capitals and the nation’s capital. We need your help to shape, as well as wage, the war on drugs.”

Edgar, with Dr. John R. Lumpkin, state public health director, joined others in November 1991 in signing a card pledging to help prevent new AIDS cases, which dropped for the first time in 1995.

Prevention was the linchpin in Edgar’s efforts to combat disease, whether they were new scourges such as HIV/AIDS and E. coli 0157:H7 or century-old ones like tuberculosis and measles.

“I talked about the importance of prevention on my first day as governor,” Edgar said in his 1998 State of the State address. “Every dollar we spend on prevention means dollar after dollar we don’t have to spend tomorrow correcting our failure to act.”

Significant progress was made during the Edgar years to reduce the incidence of diseases. In 1996, the number of reported tuberculosis cases dropped below 1,000 for the first time in more than 100 years and TB deaths dropped to an all-time low of 974. Measles cases fell from 1,356 in 1990 to just two in 1995. And, for the first time since AIDS emerged as an epidemic in 1981, the annual number of reported cases and the number of deaths declined.

To deal with such public health problems, the Governor budgeted millions of dollars to buy vaccines against childhood diseases, including hepatitis B, which was added as a school admission requirement in 1997. He nearly quadrupled state AIDS education and prevention funding and he boosted spending on TB control and treatment.

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Once a disease breaks out, a key component of prevention is to identify the cause quickly and to then stop its spread and reduce human suffering. This involves disease sleuths and dispensing of medical treatment.

During the Edgar years, the state investigated and helped to control numerous outbreaks of bacterial infections such as salmonellosis, E. coli, leptospirosis, group A streptococcus, Cyclospora and meningococcal disease.

In 1991-92, an outbreak of meningococcal disease on the campus of the University of Illinois at Urbana-Champaign caused the death of three students and at least six others fell seriously ill. Acting on a state recommendation, 18,000 university students were vaccinated against the bug, later traced by a team of federal, state and local investigators to a student bar. The bacteria, which are spread through contact with nose and throat secretions, also were found among children in several cities, including Dixon, Jacksonville and Springfield, leading to mass vaccinations.

An estimated 1.2 million people in Illinois become ill annually from consuming food contaminated by organisms from animal and human waste. To safeguard restaurant customers, the Governor pushed through new regulations for more thorough cooking of meat, fish and poultry, better food storage and handling techniques, and he created a task force to study the efficiency and effectiveness of the state’s food distribution system.

Prevention helped reduce new HIV/AIDS cases. The state, however, saw a tremendous demand for a new class of AIDS-fighting drugs known as protease inhibitors that prolong and enhance the lives of those infected. A state program for HIV-infected people who are not poor enough to qualify for Medicaid and who are unable to afford the purchase of AIDS fighting drugs themselves was budgeted at $2.4 million in 1995 before protease inhibitors became available. To cover reimbursements for the new drugs, Edgar doubled funding the next year and, by fiscal 1999, the cost of the drug reimbursement program had reached $16 million. Illinois’ program rates among the most comprehensive in the nation.

When another prevention program faced a funding crisis in 1997, the Governor intervened to save the state-designated poison control center at Rush-Presbyterian- St. Luke’s Hospital in Chicago. Since 1953, the hospital had voluntarily operated a 24-hour-a-day, toll-free hotline for consumers and hospitals about poisons and their intake, but rising costs threatened its existence. Edgar came up with $250,000 the first year to keep the hotline in service and budgeted $1.25 million a year to continue the center. The hotline saves lives and reduces health care expenditures by eliminating costly emergency treatment. For every dollar spent on hotline services, up to $9 is saved on medical care. More than 60 percent of the center’s calls involve children under 6 years old who have swallowed a poison.

Governor Edgar believed the cultural diversity of Illinois is one of the state’s greatest strengths. He often attended ethnic festivals, here a 1994 Mexican celebration in Chicago’s Little Village neighborhood.

In 1980, the Illinois Human Rights Act created the Department of Human Rights to investigate charges of civil rights violations in housing, employment, public accommodation, and financial credit and of illegal discrimination against persons based on race, minority, sex or disability. The act also created the Human Rights Commission to adjudicate complaints.

When Edgar took office, the human rights system was overwhelmed. A backlog of 7,000 complaints posed a three-year wait to assign a case for investigation. There were delays up to 24 months for hearing cases ready to be adjudicated. In 1995, Edgar announced a $1.2 million, three-year plan to expedite current charges, to eliminate the backlog and to provide for a more efficient hearing of cases. Staff investigators were doubled and commission staff increased. By 1998, for the first time in the agency’s dollar we don’t have to spend history, all cases had been assigned for investigation and those on both sides of the charges could finally expect cases to be concluded within a year.

Besides clearing backlogs, the agency introduced an outreach program to educate businesses about their responsibilities under the Human Rights Act, particularly in the area of sexual harassment. Recognizing that sexual harassment in the workplace was not just a problem common to larger businesses, in 1991 Edgar extended the act’s jurisdiction to employers who only have one worker. Previously, an employer had to employ 15 or more workers to be covered by the act. Seminars were conducted with local chambers of commerce spread throughout the state. Due to their success, they were also offered to local governmental bodies. The topics expanded to include compliance with the American with Disabilities Act and cultural diversity.

During his first year in office, the Governor also signed legislation extending the Human Rights Act to include protection against job discrimination based on a person’s citizenship. This was especially important to the 130,000 immigrants who were citizens or had work authority but were denied employment.