Appendix E - New York State Early Intervention Program
|E-1: EARLY INTERVENTION PROGRAM RELEVANT POLICY INFORMATION|
|In NYS, children with diagnosed conditions that are highly likely to affect development are eligible for early intervention services. Children with autism are eligible for the Early Intervention Program on this basis.||Guideline Reference (page 4)|
|EIP||The terms assessment, parents, and screening are also defined in regulations that apply to the Early Intervention Program in New York State. These definitions are included in Appendix E-3 .||Guideline Reference (page 7)|
|EIP 3||In New York State, the term used for professionals who are qualified to deliver early intervention services is "qualified personnel". Qualified personnel are those individuals who are approved to deliver services to the extent authorized by their licensure, certification or registration, to eligible children and have appropriate licensure, certification, or registration in the area in which they are providing services. See Appendix E-3 for the list of qualified personnel included in program regulations.||Guideline Reference (page 7)|
|EIP 4||In NYS, children with diagnosed conditions that are highly likely to affect development are eligible for early intervention services. Children with autism are eligible for the Early Intervention Program on this basis.||Guideline Reference (page 21)|
|EIP 5||All children referred to the Early Intervention Program must receive a multidisciplinary evaluation to determine if they are eligible for early intervention services. The multi-disciplinary evaluation must assess the child's developmental status and if possible, determine a diagnosis. Children under three with autism are eligible for the Early Intervention Program in New York State. Some children who are eventually diagnosed with autism are first found eligible for the Early Intervention Program because of developmental delays that meet the NYS definition of developmental delay (see Appendix E-3).||Guideline Reference (page 35)|
|EIP 6||Under the NYS Early Intervention Program, physicians and other professionals are considered "primary referral sources." When primary referral sources suspect possible autism or a developmental delay in cognitive, communication, physical, social-emotional, or adaptive development, they must refer the child to the Early Intervention Official in the child's county of residence - unless the parent objects to the referral (see Appendix E-3 ).||Guideline Reference (page 42)|
|EIP 7||Under the early intervention program, a multi-disciplinary evaluation must assess all five areas of development (cognitive, communication, physical, social-emotional, or adaptive development). The multidisciplinary evaluation team can use a combination of standardized instruments and procedures and informed clinical opinion to determine a child's eligibility for services. The multidisciplinary evaluation is provided at no cost to parents.||Guideline Reference (page 44)|
|EIP 8||An assessment of physical development, including a health assessment, is a required component of the multidisciplinary evaluation under the Early Intervention Program. Whenever possible, the health assessment should be completed by the child's primary health care provider.||Guideline Reference (page 46)|
|EIP 9||The child's multidisciplinary evaluation for the EIP must be conducted in the child's dominant language, whenever feasible.||Guideline Reference (page 48)|
|Under the EIP, the multidisciplinary evaluation team is responsible for informing the parent(s) about the results of the child's evaluation.||Guideline Reference (page 49)|
|EIP 11||Physicians and other primary referral sources who suspect a child may have autism or a developmental delay must refer the child to the Early Intervention Official, unless the parent objects.||Guideline Reference (page 55)|
|EIP 12||Primary referral sources, including physicians and other professionals, are required to inform parents about the Early Intervention Program and the benefits of early intervention services for children and their families.||Guideline Reference (page 56)|
|EIP 13||Parents can refer their children directly to the Early Intervention Official in their county of residence if they suspect possible autism or a developmental delay.||Guideline Reference (page 56)|
|EIP 14||If the CHAT is used by a physician or other professional before the child is referred to the Early Intervention Program, and autism is suspected, the physician or professional must inform the parents about the program and the benefits of early intervention services. If the CHAT is used by the multidisciplinary evaluation team after a child has been referred, and possible autism is suspected, the child's multidisciplinary evaluation should include an assessment for autism by professionals qualified to make a diagnosis.||Guideline Reference (page 62)|
|EIP 15||Under the NYS Early Intervention Program, the multidisciplinary evaluation team may use a combination of standardized instruments and procedures and informed clinical opinion to determine a child's eligibility for early intervention services.||Guideline Reference (page 64)|
|EIP 16||Under the NYS EIP, the multidisciplinary evaluation should include a parent interview. The interview may be a formal interview schedule or an informal discussion with the parent.||Guideline Reference (page 71)|
|EIP 17||Under the NYS EIP, the multidisciplinary evaluation includes an assessment of all five areas of development (cognitive, communication, physical, social-emotional, and adaptive development)||Guideline Reference (page 74)|
|EIP 18||Under the NYS EIP, if the core component of the child's multidisciplinary evaluation suggests possible autism, a supplemental evaluation by personnel qualified to diagnose autism may be conducted to confirm or rule out the diagnosis.||Guideline Reference (page 77)|
|EIP 19||An assessment of cognitive development is a required component of the multidisciplinary evaluation under the NYS EIP.||Guideline Reference (page 78)|
|EIP 20||An assessment of communication development is a required component of the multidisciplinary evaluation under the NYS EIP.||Guideline Reference (page 83)|
|EIP 21||A family assessment is an optional part of the multidisciplinary evaluation for the Early Intervention Program.||Guideline Reference (page 90)|
|EIP 22||An assessment of physical development, including a health assessment, is a required component of the multidisciplinary evaluation under the Early Intervention Program. Whenever possible, the health assessment should be completed by the child's primary health care provider.||Guideline Reference (page 91)|
|EIP 23||Although a health assessment is a required component of the multidisciplinary evaluation, medical tests (such as MRIs, metabolic, and genetic tests) are not reimbursable under the NYS Early Intervention Program. The service coordinator can and should assist the family in accessing these and other health care services through their primary health care providers. Supplemental physician evaluations may be accessed if appropriate and necessary to establish a child's eligibility for the Early Intervention Program.||Guideline Reference (page 98)|
|EIP 24||Medical tests (including genetic tests, MRIs, SPECTs, evaluation of immune systems, and allergy, diet assessments) are not considered early intervention evaluations or services under the NYS EIP. The service coordinator should help families in accessing services, if needed and appropriate, through the child's primary health care provider.||Guideline Reference (page 98)|
|EIP 25||Audiological services are covered under the NYS Early Intervention Program.||Guideline Reference
|EIP 26||Under the NYS EIP, early intervention services must be included in a child and family's Individualized Family Service Plan (IFSP) and provided: at no cost to parents, under the public supervision of Early Intervention Officials and State Department of Health, and by qualified personnel as defined in State regulation (see Appendix E-3 and E-4 ).||Guideline Reference (page 119)|
|EIP 27||Under the NYS EIP, an IFSP must be in place for children within 45 days of referral to the Early Intervention Official. The IFSP must include a statement of the major outcomes expected for the child and family and the services needed by the child and family. The IFSP must be reviewed every six months, and evaluated annually. Information from ongoing assessments should be used in IFSP reviews and annual evaluations.||Guideline Reference (page 122)|
|EIP 28||An IFSP may be amended any time the parent(s) and the Early Intervention Official agree that a change is needed to better meet the needs of the child and family.||Guideline Reference (page 123)|
|EIP 29||Under the NYS Early Intervention Program, early intervention services can be delivered in a wide variety of home- and community-based settings. Early intervention services can be provided to an individual child, to a child and parent or other family member or caregiver, to parents and children in groups, and to groups of eligible children (these groups can also include typically-developing peers). Family support groups are also available.||Guideline Reference (page 139)|
|EIP 30||The type, intensity, frequency, and duration of early intervention services provided to a child and family under the NYS EIP are determined through the Individualized Family Service Planning process. All services in the IFSP must be agreed to by the parent and the Early Intervention Official. When disagreements about what should be included in the IFSP occur, parents can seek due process through mediation and/or an impartial hearing.||Guideline Reference (page 139)|
|EIP 31||Music therapy is not an early intervention service under the NYS EIP.||Guideline Reference (page 161)|
|EIP 32||Medications, hormone therapies, immunological therapies, vitamin therapies, and medical treatments are not included in the definition of early intervention services in New York State law or regulation pertaining to the Early Intervention Program. Service coordinators may assist families in accessing primary and specialty health care services outside of the scope of the Early Intervention Program.||Guideline Reference (page 163)|
|EIP 33||Nutrition services are considered early intervention services under the NYS EIP. However, the program does not cover or reimbursement for special foods or dietary supplements.||Guideline Reference (page 163)|
|E-2||EARLY INTERVENTION PROGRAM DESCRIPTION|
The Early Intervention Program is a statewide program that provides many different types of early intervention services to infants and toddlers with disabilities and their families. In New York State, the Department of Health is the lead state agency responsible for the Early Intervention Program.
Early Intervention services can help families:
- Learn the best ways to care for their child.
- Support and promote their child's development.
- Include their child in family and community life.
Early Intervention services can be provided anywhere in the community, including:
- A child's home.
- A child care center or family day care home.
- Recreational centers, play groups, playgrounds, libraries, or any place parents and children go for fun and support.
- Early childhood programs and centers.
Parents help decide:
- What are appropriate early intervention services for their child and family.
- The outcomes of early intervention that are important for their child and family.
- When and where their child and family will get early intervention services.
- Who will provide services to their child and family.
In New York State, all counties and the City of New York are required by public health law to appoint a public official as their Early Intervention Official.
The EIO is the person in the county responsible for:
- Finding eligible children.
- Making sure eligible children have a multidisciplinary evaluation.
- Appointing an initial service coordinator to help families with their child's multidisciplinary evaluation and Individualized Family Service Plan (IFSP).
- Making sure children and families get the early intervention services in their IFSPs.
- Safeguarding child and family rights under the Program.
The EIO is the "single point of entry" for children into the Program. This means that all children under three years of age who may need early intervention services must be referred to the EIO. In practice, Early Intervention Officials have staff who are assigned to take child referrals.
Parents are usually the first to notice a problem. Parents can refer their own children to the Early Intervention Official (see Step 1 of Early Intervention Steps). Sometimes, someone else will be the first to raise a concern about a child's development. New York State public health law requires certain professionals, primary referral sources, to refer infants and toddlers to the Early Intervention Official if a problem with development is suspected. However, no professional can refer a child to the EIO if the child's parent says no to the referral.
There are two types of service coordinators in New York State - an initial service coordinator and an ongoing service coordinator. The initial service coordinator is appointed by the Early Intervention Official. The initial service coordinator helps with all the steps necessary to get services - from the child's multidisciplinary evaluation to the first Individualized Family Service Plan (IFSP).
Parents are asked to choose an ongoing service coordinator as part of the first IFSP. The main job of the ongoing service coordinator is to make sure the child and family get the services in the IFSP. The ongoing service coordinator will also help change the IFSP when necessary and make sure the IFSP is reviewed on a regular basis. Parents may choose to keep the initial service coordinator - or can choose a new person to be the ongoing service coordinator.
Children are eligible for the Early Intervention Program if they are under three years old AND have a disability OR developmental delay. A disability means that a child has a diagnosed physical or mental condition that often leads to problems in development (such as Down syndrome, autism, cerebral palsy, vision impairment, hearing impairment).
A developmental delay means that a child is behind in at least one area of development, including:
- Physical development (growth, gross and fine motor abilities).
- Cognitive development (learning and thinking).
- Communication (understanding and using words).
- Social-emotional development (relating to others).
- Adaptive development (self-help skills, such as feeding).
A child does not need to be a U.S. citizen to be eligible for services. And, there is no income "test" for the Program. The child and family do have to be residents of New York State to participate in the Early Intervention Program.
All children referred to the Early Intervention Official have the right to a free multidisciplinary evaluation to determine if they are eligible for services. The multidisciplinary evaluation also helps parents to better understand their child's strengths and needs and how early intervention can help.
A child who is referred because of a diagnosed condition that often leads to developmental delay - like Down syndrome - will always be eligible for early intervention services. If a child has a diagnosed condition, he or she will still need a multidisciplinary evaluation to help plan for services. If a child has a delay in development - and no diagnosed condition - the multidisciplinary evaluation is needed to find out if the child is eligible for the Program. A child's development will be measured according to the "definition of developmental delay" set by New York State.
The Early Intervention Program offers many types of services. Early intervention services are:
- Aimed at meeting children's developmental needs and helping parents take care of their children.
- Included in an Individualized Family Service Plan (IFSP) agreed to by the parent and the Early Intervention Official.
Early intervention services include:
- Assistive technology services and devices
- Family training, counseling, home visits, and parent support groups
- Medical services only for diagnostic or evaluation purposes
- Nursing services
- Nutrition services
- Occupational therapy
- Physical therapy
- Psychological services
- Respite services
- Service coordination services
- Social work services
- Special instruction
- Speech-language pathology
- Vision services
- Health services needed for children to benefit from other early intervention services
- Transportation to and from early intervention services
Click for Early Intervention Steps
Only qualified professionalsindividuals who are licensed, certified, or registered in their discipline and approved by New York Statecan deliver early intervention services. All services can be provided using any of the following service models:
- Home- and community-based visits.
In this model, services are given to a child and/or parent or other
family member or caregiver at home or in the community (such as a
relative's home, child care center, family day care home, play
group, library story hour, or other places parents go with their
- Facility or center-based visits. In
this model, services are given to a child and/or parent or other
family member or caregiver where the service provider works (such
as an office, a hospital, a clinic, or early intervention
- Parent-child groups. In this model, parents and children get services together in a group led by a service provider. A parent-child group can happen anywhere in the community.
- Family support groups. In this model, parents, grandparents, siblings, or other relatives of the child get together in a group led by a service provider for help and support and to share concerns and information.
- Group developmental intervention. In this model, children receive services in a group setting led by a service provider or providers without parents or caregivers. A group means two or more children who are eligible for early intervention services. The group can include children without disabilities and can happen anywhere in the community.
All services are at no cost to families. Funding sources to cover the cost of services include Medicaid and private health insurance, supplemented by county and state funds.
For more information about the New York State laws and regulations that apply to Early Intervention services, contact the state Early Intervention Program.
New York State Department of Health
Early Intervention Program
Corning Tower Building, Room 208
Albany, NY 12237-0618
|E-3||OFFICIAL EARLY INTERVENTION PROGRAM DEFINITIONS|
These definitions are excerpted from the New York Code of Rules and Regulations, § 69-4.1 and § 69-4.10. For a complete set of the regulations governing the Early Intervention Program, contact the New York State Department of Health Early Intervention Program at (518) 473-7016 or visit the department's website: www.health.state.ny.us.
Sec. 69-4.10 Service Model Options
(a) The Department of Health, state early intervention service agencies, and early intervention officials shall make reasonable efforts to ensure the full range of early intervention service options are available to eligible children and their families.
(1) The following models of early intervention service delivery shall be available:
(i) home and community based individual/collateral visits: the provision by appropriate qualified personnel of early intervention services to the child and/or parent or other designated caregiver at the child's home or any other natural environment in which children under three years of age are typically found (including day care centers and family day care homes);
(ii) facility-based individual/collateral visits: the provision by appropriate qualified personnel of early intervention services to the child and/or parent or other designated caregiver at an approved early intervention provider's site;
(iii) parent-child groups: a group comprised of parents or caregivers, children, and a minimum of one appropriate qualified provider of early intervention services at an early intervention provider's site or a community-based site (e.g. day care center, family day care, or other community settings);
(iv) group developmental intervention: the provision of early intervention services by appropriate qualified personnel to a group of eligible children at an approved early intervention provider's site or in a community-based setting where children under three years of age are typically found (this group may also include children without disabilities); and
(v) family/caregiver support group: the provision of early intervention services to a group of parents, caregivers (foster parents, day care staff, etc.) and/or siblings of eligible children for the purposes of:
(a) enhancing their capacity to care for and/or enhance the development of the eligible child; and
(b) providing support, education, and guidance to such individuals relative to the child's unique developmental needs.
(b) < Assessment means ongoing procedures used to identify:
- the child's unique needs and strengths and the services appropriate to meet those needs; and
- the resources, priorities and concerns of the family and the supports and services necessary to enhance the family's capacity to meet the developmental needs of their infant or toddler with a disability.
(g) <Developmental delay means that a child has not attained developmental milestones expected for the child's chronological age adjusted for prematurity in one or more of the following areas of development: cognitive, physical (including vision and hearing), communication, social/emotional, or adaptive development.
- A developmental delay for purposes of the Early Intervention Program is a developmental delay that has been measured by qualified personnel using informed clinical opinion, appropriate diagnostic procedures and/or instruments and documented as:
(i) a twelve month delay in one functional area; or
(ii) a 33% delay in one functional area or a 25% delay in each of two areas; or
(iii) if appropriate standardized instruments are individually administered in the evaluation process, a score of at least 2.0 standard deviations below the mean in one functional area or score of at least 1.5 standard deviation below the mean in each of two functional areas.
(gg) <Parent means a parent by birth or adoption, or person in parental relation to the child. With respect to a child who is a ward of the state, or a child who is not a ward of the state but whose parents by birth or adoption are unknown or unavailable and the child has no person in parental relation, the term "parent" means a person who has been appointed as a surrogate parent for the child in accordance with Section 69-4.16 of this subpart. This term does not include the state if the child is a ward of the state.
- certifies occupational therapy assistants;
- licensed practical nurses, registered nurses and nurse practitioners;
- certified low vision specialists;
- occupational therapists;
- orientation and mobility specialists;
- physical therapists;
- physical therapy assistants;
- pediatricians and other physicians;
- physician assistants;
- registered dieticians;
- school psychologists;
- social workers;
- special education teachers;
- speech and language pathologists and audiologists;
- teachers of the blind and partially sighted;
- teachers of the deaf and hearing handicapped;
- teachers of the speech and hearing handicapped;
- other categories of personnel as designated by the Commissioner.
ll. < Screening means a process involving those instruments, procedures, family Information and observations, and clinical observations used by an approved evaluator to assess a child's developmental status to indicate what type of evaluation, if any, is warranted.
LOCAL NUMBERS FOR COUNTY|
EARLY INTERVENTION PROGRAMS