Restricting state part C eligibility policy is associated with lower early intervention utilization

Area of Science:

• Pediatric Health
• Public Health Policy
• Developmental Pediatrics

Background:

• Early intervention (EI) services are crucial for children with developmental delays or disabilities.
• Significant state-level variations exist in EI utilization rates among eligible children.
• Recent policy changes may influence access to and utilization of EI services.

Purpose of the Study:

• To investigate whether state-specific eligibility policies explain variations in early intervention (EI) utilization.
• To determine the association between the restrictiveness of state EI eligibility criteria and service use.
• To identify factors influencing EI utilization among children with special healthcare needs (CSHCN).

Main Methods:

• Analysis of data from the 2009/10 National Survey of Children with Special Health Care Needs (n=923).
• Inclusion of CSHCN aged 0-3 with functional impairments due to developmental delay or disability.
• Application of multi-level logistic modeling to assess state differences and policy impacts on EI utilization.

Main Results:

• EI utilization varied widely across states (6% to 87%).
• Severe conditions and a usual source of care were linked to higher EI utilization odds.
• Narrower state eligibility policies were significantly associated with lower EI utilization, particularly for severely impaired children.

Conclusions:

• State eligibility criteria play a significant role in explaining variations in early intervention service utilization.
• Children with severe functional impairments are disproportionately affected by restrictive state eligibility policies.
• Policy reforms aimed at expanding eligibility may improve EI access for vulnerable populations.