Connecticut's Early Intervention Services and Support Programs

Birth23.org

Connecticuts Birth to Three System Supporting families to enhance the development of their child and connect to their communities.

EIS = Early Intervention Services (DSS and IDEA) Part C (of the IDEA) Birth to Three (in CT) It s all the same thing

Birth to Three A View From 10,000 Feet OEC

CT B23 System Timeline and ASD 2007 Autism Specific Programs 1998 2003 2017-18 Converted to FFS Began Family Cost Participation 1st Autism Guidelines 1993 ICD10 2016 Change in Lead Agency 2011 Three State-wide RFPs 2002 2005 Hearing Requiring ABA 2020 One 1996 Change in Lead Agency 36.2 Hours Mediation Agreement State-wide RFP Deficits Every Year

From Bundled Rates to Fee for Service Before After Commercial Insurance Medicaid Much less Medicaid Different rates by type of program Different contracts More Medicaid revenue Same rates for all EIS More skin in the game Better productivity OEC Payments to Programs

FY21 Direct Service Budget Projections by Revenue Source IDEA Part B $0.8 2% OEC $23.4 43% Commercial $2.8 5% IDEA Part C $1.3 2% Parent Fee Receipts $0.0 0% Medicaid $25.8 48%

FY19-20 RFP Before After 27 6 3 16 Programs x Type Autism Specific DHH Specific General 19 11 2 6 EIS Programs in Total Specialize in ASD Specialize in DHH No specialty (yet) 3 of the agencies that ran autism specific programs also ran general programs The agencies that used to run two programs only run one Comprehensive EIS program

Exits from Part C at Age 3 with F84.* on the IFSP 822 No ADOS ~ F84 Decrease ? Remote EI? 762 740 639 559 2016 2017 2018 2019 2020

2017 Birth Cohort 1/1/17 12/31/17 Turned 3 by 12/31/20

IFSP ICD = Autism 675 2014 2014 Birth Cohort Census Estimate 36,326 1.86% 1:54

IFSP ICD = Autism 859 2017 2017 Birth Cohort Census Estimate 35,560 2.42% 1:41

Monthly Averages from August 2019 - January 2020 Number of Children Number of Hours ($) F84 787 13% F84 20,369 42% No F84 28,027 58% No F84 5447 87%

2014 Average Hours pm on 1st IFSP with F84.* Mean = 38.4 Median = 36.1

2017 Average Hours pm on 1st IFSP with F84.* Mean = 29.8 Median = 24.6

2014 Racial /Ethnic Percentages Hsp nHsp WHsp WnHsp nWHsp nWnHsp 15% 19% 20% 50% 43% 54% 32% 29% 21% 65% 67% 74% 35% 33% 26% Census IFSPs Autism

Average Age when 1St IFSP Includes an Autism ICD 2014 2017 All 26.6

Remote EI AND In-person Visits https://toddlerglasses.files.wordpress.com/2010/05/caleb.jpg

Early Intervention Supports Provided Each Month by R/E and Method* Counts of All Children Percent in Month January In-Person Remote In-Person Remote In-Person Remote 13% 87% 16% 12% 88% 15% 13% 87% 14% 15% 85% 17% 10% 90% 14% January 2021 In-Person Remote Total In-Person Remote Total In-Person Remote Total 816 5272 6088 1013 5343 261 1828 2089 316 1836 95 636 731 109 426 2488 2914 531 2524 34 320 354 57 February 2021 March 2021 February March R/E group All Hispanic Black Non-Hispanic White Non-Hispanic Other Non-Hispanic R/E group All Hispanic Black Non-Hispanic White Non-Hispanic Other Non-Hispanic 6356 2152 755 3055 394 1584 490 169 834 91 5506 1888 681 2591 346 7090 2378 850 3425 437 84% 85% 86% 83% 86% 22% 21% 20% 24% 21% 78% 79% 80% 76% 79% 646 337 Counts of Children with an Autism Spectrum Disorder January 2021 In-Person Remote Total In-Person Remote Total In-Person Remote Total 167 685 852 183 71 285 356 76 27 95 122 20 58 256 314 72 11 49 60 15 *Children whose families received both methods in the month are counted in both columns. Percent in Month January In-Person Remote In-Person Remote In-Person Remote 20% 80% 22% 20% 80% 22% 22% 78% 17% 18% 82% 23% 18% 82% 25% February 2021 March 2021 February March R/E group All Hispanic Black Non-Hispanic White Non-Hispanic Other Non-Hispanic R/E group All Hispanic Black Non-Hispanic White Non-Hispanic Other Non-Hispanic 653 271 99 237 46 836 347 119 309 61 237 84 32 99 22 615 264 88 218 45 852 348 120 317 67 78% 78% 83% 77% 75% 28% 24% 27% 31% 33% 72% 76% 73% 69% 67% ALL ASD DPH 2017 25% 13% 54% 8% Percent of Totals Hispanic Black Non-Hispanic White Non-Hispanic Other Non-Hispanic Jan 34% 12% 48% 6% Feb 34% 12% 48% 6% Mar 34% 12% 48% 6% Jan 42% 14% 37% 7% Feb 42% 14% 37% 7% Mar 41% 14% 37% 8% Births Hispanic Black Non-Hispanic White Non-Hispanic Other Non-Hispanic 2016 24% 13% 55% 8% 2018 25% 14% 54% 7%

Transition Out of Part C Part C - Birth to Three Part B - Preschool Special Education Natural Learning Environments Naturalistic Interventions Least Restrictive Environment Family is the Focus for Coaching Education of the Child Home and Community Settings Peers in an Early Childhood Classroom OEC Birth to Three Autism Community of Practice Meeting every other month Referring families to Beacon before age 3 Sharing options with families about supports beyond what LEAs offer State Interagency Coordinating Council public comment Upcoming joint Early Childhood Intervention (ECI) convening with leaders in CT about the fluidity of a DSM diagnosis during preschool years

Questions? Koleen.Kerski@ct.gov (Alice.Ridgway@ct.gov)