LOUISVILLE — Advocates of a program designed to help the state's youngest children say it must not be targeted for further budget cuts.

        Kids Now, a $56 million state effort to improve the health and welfare of pregnant women, infants and young children, was launched during the 2000 General Assembly.

        In its second year, Kids Now is rapidly expanding and starting to show results, its backers say.

        Gov. Paul Patton's administration started KIDS NOW amid growing concern about young children and because research shows that a crucial period of a child's mental and emotional development occurs before age 3.

        The Louisville Courier-Journal reported in 1999 that thousands of Kentucky's children live in extreme poverty, the quality of the state's day cares often was poor or mediocre, and many pregnant women and young children suffered from inadequate health care and poor living conditions.

        Kids Now gave $10 million in unspent money to the administration in its first year to help with the state budget deficit.

        Rep. Tom Burch, D-Louisville, sponsor of the bill that created Kids Now, said that was a one-time cut and the program will need all its money to provide services as it grows.

        But because Kids Now is funded through Kentucky's $360 million share of the federal tobacco settlement, advocates fear some lawmakers may be eyeing it as state revenue shrinks.

        “I think there are going to be raids on everything,” said Debra Miller, executive director of Kentucky Youth Advocates, a lobbying group.

        Mr. Burch said he will fight attempts to cut money from the program.

        “It will be over my dead body,” he said. “It's the best investment Kentucky has made in children in a long time.”

        Under state law, Kids Now gets 25 percent of the state's share of the tobacco money, or an estimated $31 million annually for the next two years. A plan to provide insurance to chronically ill people gets 25 percent and the rest goes to agriculture.

        Kids Now nearly foundered late in the 2000 session when some Republican leaders proposed taking $20 million out of the program to pay for grade-school literacy programs, but they backed off after Mr. Patton said they were “playing politics with our children.”

        Meanwhile, those involved with Kids Now say it is beginning to show positive results.

        Family support workers are visiting pregnant women and new parents in 102 counties and expect to expand to all counties by next year.

        The visitation program is aimed at families considered at risk because of low education or low income. The goal is to promote better health for mothers and babies and ensure that young children live in safe homes, said Dr. Steve Davis, director of the division of adult and child health.

        Workers, most through the local health departments, visit pregnant women at home to help make sure they are receiving prenatal care and to encourage them to avoid smoking, alcohol and drugs.

        After the baby is born, the workers continue to visit through the child's second birthday to try to encourage cuddling, reading and playing with the child and help the family with any problems. Workers are encouraged to assist with job training or education, if necessary, and help families find assistance if they run short of food or money to pay bills.

        Kids Now has also been able to give folic acid to more than 40,000 women and counseled them about its effectiveness in reducing a serious birth defects, provided hearing screening to more than 30,000 infants before they left the hospital, mandated eye exams for children entering school for the first time, sought to achieve 100 percent immunization of children without adequate health insurance by age 3.

        In the child-care ratings, the program awards stars for centers that exceed minimum requirements by providing more training for workers, better child-staff ratios and more enrichment activities for children. The goal is to help parents assess a center's quality and to provide incentives to day-care centers, such as cash bonuses and increased child-care subsidies.

        About 16 centers have received star ratings, and hundreds have applications pending. Awards range from one to four stars. A four-star rating also requires accreditation from a national accrediting body.

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