1. Why is the NC Infant-Toddler Program eligibility definition change necessary?
Due to the continued very high number of referrals (annualizing to more than 17,000 for 2005-2006), and lack of adequate resources to meet the needs of all children and families, the NC Infant-Toddler Program proposed a change in its eligibility definition. Public comment processes for both state (Administrative Rules) and federal (Office of Special Education Programs) approvals were completed. The new eligibility definition includes a more restricted level of developmental delay and lists specific established conditions. Potential high risk and atypical development categories were redefined or eliminated as appropriate in the new categories. State and federal approvals of the new eligibility definition were received as of April 2006, and the changes will be implemented for new children referred to the program as of July 1, 2006.
2. Who does the new eligibility definition change affect?
This change in eligibility definition means that eligibility for children referred on or after July 1, 2006 will be determined under the new definition. The new eligibility definition will not affect children who are currently enrolled in the Infant Toddler Program at the time of the definition change (July 1). These children will continue to be enrolled in the program as long they have a need for early intervention services (based on the “old” eligibility definition that was in place prior to July 1); until they age out of the program at age three years; or until the family chooses to withdraw their child from the program prior to the age of three years.
3. Who can receive services from the Infant-Toddler Program under the new eligibility definition?
A child and family may receive Infant-Toddler Program supports and services if a child is younger than age 3 and the child meets criteria for one of the two eligibility categories described below.
A. Developmental Delay
The Infant-Toddler Program considers a child to have a developmental delay if he or she is considerably behind other children of the same age in one or more of the following areas:
Developmental Delay is document by:
B. Established Conditions
A child is considered to have an established condition if the child has a diagnosed physical or mental condition which has a high probability of resulting in developmental delay. Examples include genetic disorders, vision impairment, hearing loss or autism.
(The above descriptions are summaries and not the complete definitions of the new eligibility categories. A complete definition can be found at www.ncei.org or by contacting your local CDSA.)
4. Who will not be eligible for Infant Toddler Program under the new eligibility definition?
A child who does not have a specific delay or established condition as described above, but who has other risk factors, is likely not eligible, but only the Children’s Developmental Services Agency (CDSA) can determine this for sure. Examples of risk factors that may be ineligible include premature birth (gestational age of 27 weeks or more or birth weight of 1000 grams or more), children of very young mothers, and children in high risk family environments. There are other community programs such as the Child Service Coordination Programs with the Health Departments that will continue to provide support and developmental monitoring for many of these children and families. The Infant-Toddler Program is committed to helping families meet their children’s needs. If a child is found to be not eligible for the Infant Toddler Program, the CDSA staff will, with parental consent, make a referral to the Child Service Coordination Program, and ensure that families are linked with other appropriate community resources that may address the needs of the family.
5. How will eligibility be determined?
The eligibility determination process will continue as currently defined under the Infant-Toddler Program. Only the Children’s Developmental Services Agency (CDSA) can determine eligibility for the Infant-Toddler Program. The CDSA will base eligibility determination on documented evidence and informed clinical opinion. The CDSA must use a variety of methods and procedures (e.g., the use of standardized measures of child health and development; interviews and discussions with families; observations of the child in natural settings) in order to adequately determine a child’s eligibility for the program.
Eligibility for the Infant-Toddler Program can be determined, by the CDSA, prior to an initial evaluation if, at the point of referral, written and defendable evidence exists that a child meets the criteria for Established Conditions or Developmental Delay. Having a documented condition that is listed in the Established Conditions category distinguishes a child’s need for the Infant-Toddler Program. The CDSA would use this existing information for determination of the child’s eligibility. In these situations, following the eligibility decision, the Early Intervention Service Coordinator will make arrangements for an initial evaluation to gather additional information for intervention planning and IFSP development.
Please refer to the North Carolina Policy and Procedure Manual Bulletin #18 Eligibility Categories and Bulletin #20 Eligibility Determination for additional information.
6. What if a parent disagrees with the eligibility decision?
It is important that parents first try to settle differences by talking with their Early Intervention Service Coordinator and with staff of the CDSA. If parents continue to disagree with the CDSA on eligibility decisions, they have the right to timely resolution of their concerns through mediation and/or an impartial due process. Parents may initiate a complaint by notifying the Director of the local CDSA and requesting an Individual Child Complaint form.
7. If a child is determined eligible under the new categories, will they remain eligible until they age out of the program?
As has always been the case, eligibility determination continues to be reassessed throughout a child’s enrollment in the program. Children will continue to be enrolled in the program as long they have a need for early intervention services. Eligibility determination is based upon the unique strengths and needs of each individual child and family. A child’s IFSP (Individualized Family Service Plan) team, including the parent, must ensure that ongoing discussions and assessments occur as a means of monitoring the child’s developmental progression and skills acquisition. If at some point there are questions related to a child’s continued eligibility in the Infant Toddler Program, the CDSA should review existing information (such as results of current assessments and evaluations, current IFSP including status toward achievement of outcomes), and/or request new evaluations to determine continued eligibility. The Early Intervention Service Coordinator would discuss termination of eligibility from the Infant Toddler Program if needed, with the family and assist with linkages to community resources.
8. Who can make referrals to the Infant-Toddler Program?
Referral sources include: hospitals, physicians, the parent, child care programs, public schools, public health facilities, other social service agencies, other health care providers, and any other public or private agency receiving public funds. Written authorization by the parent is not required before the referral source notifies the Children’s Developmental Services Agency of the child, but referral sources are encouraged to notify the family that a referral has been made. NC Child Find requirements allow the person or agency making the referral to share the child’s name, date of birth, address, telephone number, parent’s name, and the general fact that the child may be eligible for the Infant-Toddler Program. Parental permission is needed to proceed with the eligibility determination process and for evaluations to be completed. CDSA staff will work with parents on these permissions.
9. What if a referral source is not sure if the child meets the new eligibility criteria?
If a child is thought to be eligible for the Infant Toddler Program, a referral should be made to the CDSA. The CDSA is responsible for responding to referrals, designating an Early Intervention Service Coordinator, determining eligibility, and making arrangements for the initial Infant-Toddler Program evaluation. In certain circumstances (e.g., under the Child Abuse Prevention and Treatment Act or CAPTA), referrals are mandated.
10. What if the referral to the CDSA is determined to be inappropriate?
The CDSA, referral source, or parent may decide that a referral to the Infant-Toddler Program is inappropriate prior to completing an initial Infant-Toddler Program eligibility evaluation. Referral sources may conclude that a child’s identified conditions are not associated with developmental concerns and that early intervention services may not be needed. CDSA staff will discuss options with parents if a referral is not warranted. CDSA staff should discuss the need for other service coordination with the parent and, with parental consent, make a referral to the Child Service Coordination Program or another community provider, as appropriate. Parents may contact the following resources for linkages with the appropriate resources available in their respective communities.
The Family Support Network Central Directory of Resources
1-800-852-0040
The Exceptional Children’s Assistance Center
1-800-962-6817