The Connecticut Birth to Three System

Report
IDEA Part C:
The Connecticut
Birth to Three System
Early Childhood Education Cabinet
October, 2011
What IS IDEA Part C?
Individuals with Disabilities Education Act
Part A – General Provisions
Part B – Special Education ages 3-21
Part C – Infants and Toddlers with Disabilities
Part D – National Activities to Improve Education of
Children with Disabilities (includes Parent
Training and Information Centers)
IDEA Part C encourages, but does not
require, states to participate. All 50
states do currently.
Annual federal funding based on state
population ($4M for CT) requires an
annual application explaining how the
state meets each required component
of the law and assuring the U.S. Dept.
of Education that the state’s policies
are in full compliance with the IDEA.
Required Components
•Designate a lead agency
•Have an Interagency Coordinating Council
•Assign financial responsibility, pay for
services
•Describe the system and services
(including services in natural environments)
•Policy on use of funds
•Referral and eligibility policies
•Transition policies
•Public Participation in policies
•Coordinate with Head Start, Early HS,
other ECE programs
State Assurances
•Equitable access
•Expenditure of funds
•Payor of last resort
•Control of funds and property
•Reports and records
•Prohibition against supplanting
•Restricted indirect rate
•Fiscal controls
•Traditionally underserved groups
The core mission of the
Connecticut Birth to Three
System is:
to strengthen the capacity of
families to meet the
developmental and health-related
needs of their infants and
toddlers with disabilities or
delays
AND
The core mission of the
Connecticut Birth to Three
System is:
to ensure equal access to a
coordinated program of
comprehensive services and
supports.
What We Do
 Referrals
 Eligible
Children
 Early Intervention
Services
Referrals
FY11 referrals – 8,603
10000
8000
6000
4000
2000
0
1996
1999
2002
2005
2008
2011
The Connecticut birthrate has
decreased since 1995
2010 – 37,446
Provisional data from DPH
46000
44000
42000
40000
38000
36000
34000
32000
1995
1997
1999
2001
2003
Births
2005
2007
2009
The majority of referrals
are directly from families
FY11Referrals
State Agencies
Health Care
Providers
Families
More children are referred
after age two
Age at Referral
Birth – 12 months
12 – 24 months
24-35 months
Percentage
22%
38%
40%
65% of all referrals are boys
Which children are eligible?
IDEA Part C requires serving:
1. children with medical conditions
expected to lead to a developmental
delay and
2. children who have a developmental
delay.
The definition of developmental delay and the
choice of conditions is at the state’s discretion.
Which children are eligible?
The IDEA also says that:
Children at environmental risk for delay MAY
be eligible if the state wants to include that
population in its policies and application.
Connecticut has never served children who
are at environmental risk for developmental
delay in Part C.
Which children are eligible?
Connecticut adopted a narrow definition of
developmental delay in 1993:
A child must demonstrate a delay of 2
standard deviations below the mean in at
least one area of development or 1.5 SD
below the mean in two or more areas
Which children are eligible?
Today, about 60% of the children evaluated
each year are eligible.
10% due to diagnosed conditions (including
extremely low birth weight below 1000g or
gestational ages of 28 weeks or less).
90% due to developmental delay
Birth Cohort Data
Birth Year
Referred
%
Eligible
%
2000
6147
14%
4293
10%
2001
6681
16%
4580
11%
2002
6634
16%
4453
11%
2003
6826
16%
4238
10%
2004
7146
17%
4169
10%
2005
7543
18%
4293
10%
2006
7759
19%
4599
11%
2007
7645
19%
4276
10%
Who provides the services?
44 local programs
•32 general
• 9 autism-specific
• 3 deaf/hard-of-hearing specific
At least two general programs serve
each town. At least one autismspecific program serves each town.
All three deaf/hard-of-hearing
programs are statewide
Who provides the services?
Programs are operated by a variety
of host agencies:
1 state-operated by DDS
2 LEAs
5 RESCs
For profits
Not-for-profits
Who provides the services?
In early October, three RFPs were
issued for the three types of
programs. All current contracts end
6/30/12 and new contractors will be
selected from among the proposals
received.
DDS is phasing out its state-operated
program.
Who provides the services?
Discipline
# and % receiving
Speech and Language Pathologist
Special Educator
Occupational Therapist
Physical Therapist
Early Intervention Associate or Assistant
Social Worker
Board Certified Behavior Analyst or
Associate Analyst
Audiologist
Nutritionist
Occupational Therapy Assistant (COTA)
Nurse
Psychologist
Physical Therapy Assistant
Family Therapist/Professional Counselor
5,676 65%
4,337 49%
2,952 34%
2,823 32%
2,805 32%
665 8%
502 6%
401 5%
175 2%
149 2%
73 1%
68 >1%
65 >1%
24 >1%
How much does it cost?
FY11 Expenditures: $50M
State
Federal
Insurance
Fees
$41M
Reduced by $9.7M in
Medicaid reimbursements
to General Fund
How much does it cost?


Per child gross cost in a general program
is $8356 per year for most children.
Average hours of direct services delivered
per month is 4.2.
For children with autism, the gross cost
per year averages $30,000. Average
hours of direct services delivered per
month is 46.
How Well Do We Do It?

99.9% of children are evaluated and
service plans are written within 45 days of
referral

99% of services are delivered in natural
environments (home or child care)

98% of transition conferences are timely

CT Part C has been determined to “meet
requirements” of IDEA five years in a row
Is Anyone Better Off?

Families are surveyed annually to determine
whether Birth to Three helped them:

Know their rights, 88%

Effectively communicate their
children’s needs, 86%
and, most importantly,

Help their children develop and learn 95%
Is Anyone Better Off?

9% of children exiting (about 450 each
year) are no longer in need of services

2100 children transition to preschool
special education services (44% of all
children exiting and 81% of those
referred to their school districts)

By Kindergarten age, only 50% of
children who ever received Birth to Three
services are enrolled in special education.
Tracked by SASID from B-3 to SDE data.
Is Anyone Better Off?

We assess children entering and exiting the
program to determine progress in:
 Positive social/emotional skills;
 Acquiring and using knowledge and skills
(includes communication); and
 Using appropriate behaviors to meet
their needs
Is Anyone Better Off?
Skill Area
Caught Up
Reduced the gap
Social/emotional
51%
83%
Knowledge and
skills
55%
83%
Appropriate behaviors 63%
89%
We can’t do this without our
partners
DCF – agreement on CAPTA referrals
 DSS – co-fund Child Development Infoline
Office with the Children’s Trust Fund;
Bill Medicaid
 SDE – notification to districts, data
sharing, co-fund training and newsletter
 DPH – finding preemies and children with
hearing loss, home visiting advisory

Next Up




Legislative proposal to combine DPH home
visiting advisory council, Nurturing Families
Network advisory council, and Birth to Three
Interagency Coordinating Council
November monitoring visit by OSEP
Monitor FY12/13 budget since budget was
reduced in anticipation of more insurance
revenue
May need to write a Medicaid 1915i waiver

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