The New York State Early Intervention Program (EIP) is part of the nationwide EIP.  Infants and Toddlers under the ages of 3 years old, who reside in New York State, that have a diagnosed disability with a high probability of developmental delays, or an established developmental delay are eligible.

A disability means that a child has a diagnosed physical or mental condition that has a high chance of resulting in a delay. These include, but are not limited to, Autism, Down syndrome, motor disorders, or vision and hearing problems. 

A developmental delay means that the child is behind in at least one area of development.  The delay as measured by tests must be at least a 33% or 12-month delay or a score of 2 standard deviations below the mean in one area of development, or a 25% delay or score of 1.5 standard deviations below the mean in at least 2 areas of development.

The developmental areas that are tested include:

Cognitive:  thinking, reasoning, learning

Physical:  fine motor, gross motor, vision, hearing, sensory and oral motor feeding and swallowing disorders

Communication: talking and understanding what others are saying

Social-Emotional: relating to others

Adaptive (self-help skills): sleeping, feeding, toileting, dressing

 

For children who have been found to have a delay only in the communication domain, delay shall be defined as a score of 2.0 standard deviations below the mean in the area of communication; or, if no standardized test is available or appropriate for the child, or the tests are inadequate to accurately represent the child's developmental level in the informed clinical opinion of the evaluator, a delay in the area of communication shall be a severe delay or marked regression in communication development as determined by specific qualitative evidence-based criteria articulated in clinical practice guidelines issued by the Department.

A child can be referred to the Early Intervention Program by various health professionals or by his/her parent(s). All children referred with a suspected disability are entitled to receive a multidisciplinary evaluation to determine their eligibility for early intervention services. Children with a diagnosed condition will still need an evaluation to help plan early intervention services.

Please see the Checklist for Growing Children at http://www.health.ny.gov/publications/0527.pdf  or in Spanish at http://www.health.ny.gov/publications/0528.pdf.  

An optional family assessment would include a review of several areas:

• A family's resources—the strengths, abilities, and support that a family can use to improve the child's development.
• A family's priorities—the outcomes the family most want from early intervention services.
• Family concerns—the problems or needs a family want to work on.
  

,One of the first persons you will meet in the EIP is your Initial Service Coordinator (ISC). Your ISC will talk with you about your concerns for your child's development. She or he will answer any questions you have about the EIP. 

The ISC will also: 

• Review your family's rights and make sure you understand them, 

• Talk with you about your child's evaluation for the EIP, and how this evaluation will determine if your child is eligible to receive services through the EIP, 

• Give you the list of evaluators in your county and help you pick one that will meet your child's and family's needs, 

• With your permission, help arrange for your child's evaluation, 

• Help you arrange for transportation to your child's evaluation, if you need it, 

• Attend your child's evaluation if you wish, 

• Inform you that, in NYS, EI services must be provided at no cost to your family. However, NYS's system of payment for the EIP includes the use of public insurance (such as Medicaid and Child Health Plus) and private insurance (such as United Healthcare and others) for reimbursement of EI services, 

• Provide parent(s) with a copy of the Parent Notice Regarding Insurance and review the information.

• Collect information and documentation about your child's insurance coverage, including public and private insurance. This information includes: the type of insurance policy or health benefits plan, the name of the insurer or plan administrator, the policy or plan identification number, the type of coverage in the policy and any other information needed to bill your insurance, 

• Explain your rights and responsibilities regarding your family's health insurance, and answer your questions about the protections the law provides for family insurance benefits.
  

• Obtain information in the extent of benefits available to your child under your family's insurance policy.  If your family's health insurance plan is not regulated by New York State Insurance Law, the plan will not be billed unless you give informed written consent.

• If your child is uninsured, the ISC is responsible for assisting you in identifying and applying for benefit programs for which your family may be eligible, including Medicaid, Child Health Plus, and Social Security Disability Income, however, you are not required to enroll in order for EIP services to be provided,

• All EIP services in your child's IFSP, including service coordination and evaluations, must be provided, if your child is uninsured.  If your child is uninsured, your service coordinator is responsible for assisting you in identifying and applying for benefit programs for which your family may be eligible, including Medicaid, Child Health Plus, and Social Security Disability Income, however, you are not required to enroll in order for EIP services to be provided. You must complete and sign the Parent Attestation of No Insurance Form if your child does not have health insurance coverage.

If your child's evaluation shows that she or he is eligible for the EIP, your ISC will: 

• Answer your questions about the EIP,

• Set up a meeting to work on your Individualized Family Service Plan (IFSP), 

• Help you understand what this meeting will be like, who else must be there, and who can be invited, 

• Help you resolve any problems that might come up - including disagreements about the service(s) you and your child might need, 

• Give you information on other programs and services which can help your family, including, the NYS Office for People with Developmental Disabilities (OPWDD) eligibility and available programs and services, 

• Discuss with you and your child's evaluators whether your child is potentially eligible for programs and services under the OPWDD. With your consent, notify the appropriate OPWDD contact person of the potential eligibility of your child for OPWDD programs and services. If you are interested, your service coordinator will help you make a referral to OPWDD.
  
• If the EIP evaluation shows that your child is not eligible for the EIP, your ISC will tell you about other services that may help.
  
• If you disagree with the evaluation findings, you can appeal the decision.
  

See the Early Intervention Steps: A Parent's Basic Guide to the Early Intervention Program for more information.

It is very important for your service coordinator to obtain your family's most recent and accurate health insurance information. Your service coordinator will explore with you the type of health insurance plan your family has and help identify if your plan operates under New York State Insurance Law ("regulated"), or is not regulated by New York State Insurance Law ("non-regulated"). Your service coordinator also will obtain information on the extent of benefits available to your child under your family's insurance policy. If your family's health insurance plan is not regulated by New York State Insurance Law, the plan will not be billed unless you give informed written consent.

Types of Health Insurance Coverage

Medicaid and Medicaid Managed Care plans are managed by a number of health plans throughout the state. Services are billed directly to Medicaid.

Child Health Plus (CHP) is managed by a number of health care plans throughout the state. CHP is subject to NYS Insurance Law with regard to the EIP.

Health Insurance plans that are issued/written outside of New York State are not regulated (e.g., Blue Cross/Blue Shield plans that are issued in another state are not regulated).

Health Spending Accounts/Health Savings Accounts (HSAs) are medical savings accounts and are not considered insurance; information about these accounts should not be collected by your service coordinator.

Your ISC will also discuss with you the requirements in New York State Public Health and Insurance Law, including:

• Under New York State Public Health Law, EI services must be provided at no cost to parents.

• Private insurance and Medicaid are part of NYS' system of payments for EI services. These private payors are important resources for the EIP.

• Health insurance will only be used for payment of EI services if your child's/ family's policy is regulated, or with your informed written consent, if the policy is non-regulated.

• All EIP services in your child's IFSP, including service coordination and evaluations, must be provided, if your child is uninsured. If your child is uninsured, your service coordinator is responsible for assisting you in identifying and applying for benefit programs for which your family may be eligible, including Medicaid, Child Health Plus, and Social Security Disability Income, however, you are not required to enroll in order for EIP services to be provided.

Protections for Use of Regulated Insurance

Parents do not pay any out-of-pocket costs, such as deductibles or co-payments for EI services.

Insurers are not allowed to charge any benefits paid for EI services against any maximum annual or lifetime policy limits.

EI visits reimbursed by the insurer cannot reduce the number of visits otherwise available to the child and family for health care.

Insurers cannot discontinue or fail to renew a family's insurance coverage solely because a child is receiving EI services.

Insurers cannot increase health insurance premiums solely because a child is receiving EI services.

Use of Non-Regulated Insurance

If a family's insurance plan is not regulated by NYS Insurance Law, the plan will not be billed unless you give informed written consent. If you give written consent to use non-regulated insurance for payment of EIP services, this consent will need to be signed again at every IFSP meeting.

If your family's insurance is not regulated by NYS Insurance Law, your insurance benefits may not be protected if billed for EIP services. In this case, the insurance can only be used if you are fully informed and choose to give written consent.

Only qualified professionals who are licensed, certified, or registered in their field and approved by NYS can provide early intervention services. Qualified professionals include speech-language pathologists, physical therapists, occupational therapists, nutritionists, and others. A list of qualified professionals can be found in the Early Intervention regulations, Section 69-4.1(aj) (1)-(20), at the following link on the Department's Web site:

 Subpart 69-4 Early Intervention Program

The Individualized Family Service Plan, or IFSP, is a written plan that will be specially designed for you, your child, and your family that outlines and explains the EI services your child and family will receive. If the MDE shows that your child is eligible for the EIP, your ISC will set up an IFSP meeting to sit down and write your IFSP. The IFSP is a very important document and you are an important member of the team that develops it. If you need extra time to think about the plan, ask for it. You may want to discuss the plan with other family members or review it to make sure it meets the needs of your child and family. You will be asked to sign your IFSP when the plan is finished. When you sign the IFSP, you show that you were at the IFSP meeting and that you agree to the services in the plan. You are also giving your consent to start EI services.

If you and the IFSP team do not agree on the IFSP you do not have to sign the IFSP. You can give your written consent to start the services that you agree with, and exercise your due process rights to resolve the disagreement.

Your ISC will tell you about what happens at the IFSP meeting and help you prepare. Some important things you need to know about your IFSP meeting include:

• The IFSP meeting must be held at a time and place that is good for you and your family,
• You, your ISC, the Early Intervention Official (EIO) in your county, and evaluation team, or selected member of the team must take part in the meeting,
• You can invite others to attend the IFSP meeting, such as, family, friends, your babysitter, or child care providers,
• Your ISC can invite others to take part in the meeting, with your consent,
• You can ask an advocate to take part in the meeting,
• You, your ISC, your child's evaluators, and your EIO will review the information that has been collected about your child's development and will decide together how the EIP will help your child and family,
• Your family's resources, priorities and concerns related to your child's development will be discussed,
• You will help to identify outcomes (improvements you would like to see in your child's development) for your child and family,
• Strategies, activities, and services that will lead to the outcomes you hope to reach will be developed and written on the plan,
• Your need for respite services will be discussed, as appropriate, and determined based on the individual needs of your child and family. Respite services can be used for temporary relief of caregiving responsibilities that may be necessary for your child. Respite may be provided in the home or another appropriate location,
• To include a service in your IFSP, you and all members of the IFSP team must agree to the service,
• You may accept or decline any EI service without jeopardizing your child's right to receive any of the other EI services identified in the IFSP.

Your family's IFSP will include the following information:

• A statement of your child's current level of functioning,
• With your permission, a statement of your family's resources, priorities, and concerns related to your child's development,
• A statement of the major outcomes expected from EI services. IFSP outcomes must be meaningful and based on your child and family's needs and priorities,
• A statement of the EI services, including transportation, needed to meet your child's and family's needs,
• A plan for when your child is in day care, and when needed, for EI service providers to train the day care staff to meet the needs of your child,
• A physician's, physician's assistant's or nurse practitioner's order or prescription for EI services that require an order/prescription from specific medical professionals,
• A statement about other services, including medical services that are needed by your child and family that are not provided or paid for by the EIP,
• The dates that services are expected to begin as soon as possible after the IFSP meeting, once you have signed the plan and given your permission,
• The name of the ongoing service coordinator who will help you to put the plan into action,
• The steps to help your child and family change to other services, including preschool special education services. In the EIP, this is called transition planning,
• A statement of the natural environments where EI services will be provided. "Natural environment" means settings where infants and toddlers are typically found in the community. This can be your home or another community location, such as day care or at a playground.

Services should begin as soon as possible after you have given your consent for the EI services listed in the IFSP. Your EIO must convene a meeting at least annually to evaluate and, as necessary, revise the IFSP for your child and family. The EIO is also responsible for making sure the IFSP is reviewed every six months or more frequently if you request a review.

Please review the NYS Early Intervention program's flyer Working with Your IFSP Team for more information.

Services listed in the IFSP that are provided by nurses, occupational therapists, or physical therapists require a prescription before early intervention services can be provided. A written recommendation from a physician, nurse practitioner, or speech-language pathologist is needed for speech-language therapy.

The federal law that created the Early Intervention Program (EIP) says that EI services must be provided in natural environments as much as possible. Natural environments are settings where infants and toddlers, with and without special needs, and their families participate in everyday routines and activities that are important to them, and serve as important learning opportunities. Natural environments can include your home, places where child care is provided, playgrounds, restaurants, public transportation, libraries, supermarkets, places of worship, and other community settings. Natural environments are not just about places or locations, they are also about family routines and activities including family meals, bathing, bed time, family celebrations, household chores, and visiting family and friends. There may be some services that are provided at an agency or a school that specializes in EI services if this is the setting that is best for your child. Since natural environments are where children with or without special needs live, learn, play, and participate in community/neighborhood activities and events, this gives all children the chance to learn from one another.

Yes, children can receive services in a center-based program if agreed to by the parent and the Early Intervention Official/Designee, and if specified in the IFSP.

As part of your child's Multidisciplinary Evaluation (MDE), you will be given the chance to take part in a voluntary family assessment; it is not required. The family assessment is family-directed and used to help you in determining the resources, priorities, and concerns of your family related to caring for and enhancing your child's development; it is not a test of your parenting skills. The family assessment is based on information provided by you and your family in a personal one-to-one discussion with a member of your child's evaluation team. The family assessment can help you to think about what you need most from Early Intervention services and other community services or supports. It can also help you prepare for your Individualized Family Service Plan  (IFSP) meeting. 

 A family assessment includes a review of several areas:

• A family's resources—the strengths, abilities, and supports that a family can use to improve the child's development.
• A family's priorities—the outcomes the family most wants from early intervention services.
• Family concerns—the problems or needs a family wants to work on.

The family assessment is voluntary. All of the information that you share is kept private. You decide what information from the assessment should be included in the evaluation report, and discussed at your IFSP meeting.

There are two types of service coordinators. An Initial Service Coordinator (ISC) is assigned by your EIO to help guide you through the first steps of EIP enrollment. These include referral and through the development of an IFSP. The ISC will explain each step to you and help set up the necessary evaluations to see if your child is eligible. The Ongoing Service Coordinator (OSC) makes sure that you and your child receive the services that are listed in your IFSP. The OSC also helps you make changes to your IFSP when needed and makes sure your IFSP is reviewed on a regular basis. You will be asked to choose your OSC at your initial IFSP meeting.

 No, a service coordinator must meet certain qualifications and be approved by NYSDOH as an EIP service coordinator. Even if a family member had the qualifications, it would be a conflict of interest for a family member to be your service coordinator.

As a parent,you have many rights. These include the right to say yes or no to having your child participate in the EIP. You have the right to take part in all decisions. Meetings are held at times and in places convenient for you. All information about your child and family is confidential. You have the right to have your opinions heard and considered if you disagree with others. 

It is the responsibility of your service coordinator and service providers to explain your rights to you and make sure you understand them, and help you carry them out. For example, you have the right to prior written notice. Prior written notice must be given by the EIO to you within 10 working days before the EIO intends to or refuses to start or change the identification, evaluation, service setting, or the provision of appropriate EI services to your child and family.

You also have the right to use due process procedures to settle disagreements or complaints about your child's eligibility for the EIP, or complaints about your child's EI services. Your right to use due process procedures to settle disagreements or complaints includes your right to access mediation, impartial hearing, and systems complaint procedures.

See Early Intervention Steps: A Parent's Basic Guide to the Early Intervention Program for more information. 

Mediation is a voluntary and confidential way to work out disagreements and complaints you may have about your child's early intervention services. Mediation is used to help you and your EIO reach an agreement as easily and quickly as possible. This is done through a mediator. Mediators are trained, certified, and assigned by the Community Dispute Resolution Center in your county. They are skilled in listening to all sides of a problem and in being fair. Mediators are not experts in early intervention. They are expert mediators who know about and understand the EIP.

Your mediator will meet with you and your EIO to discuss the issues involved and help you find answers. Both of you will have the chance to share your concerns about the early intervention services that need to be settled. The mediation process must be finished in 30 days of the time the Community Dispute Center receives the written request for mediation. Once mediation is finished, a written agreement is prepared describing what was agreed to and any outstanding issues. Your service coordinator will make sure this agreement is added to your IFSP. If the disagreement cannot be settled, your EIO should discuss with you another right you have, an impartial hearing. 

 See  Early Intervention Steps: A Parent's Basic Guide to the Early Intervention Program for more information.

Transition includes steps that help a child who is receiving early intervention services move on to the preschool special education program. Some children may continue on with other programs or services. Or it may be decided that a child may no longer need services. These steps happen as your child gets close to his or her third birthday.

A transition plan must be developed for all children leaving the EIP, including going to Preschool Special Education or other services, on or close to their third birthday. The transition plan should include any help, support, and services that you and your child might need to adjust to the change in services and make a smooth transition. Discussions of the transition plan should start with your child's first IFSP. Some children will no longer need any services. Other children and families may go on to early childhood programs or to other services in their community.

If you or someone else thinks that your child is eligible for preschool special education services, your service coordinator will notify the Committee on Preschool Special Education (CPSE) in your school district. You will have the opportunity to "opt-out" of the CPSE notification. The OSC cannot take this step if you object. 

Additional steps to transition include: 

• Your OSC must offer you a chance to have a transition conference. A transition conference is a meeting that is held with the chairperson of the CPSE (or his/her designee) to decide whether your child should be referred for preschool special education services. This meeting is called a transition conference. You may decide if you would like to have a transition conference or not have one. You will be asked to give your consent to your OSC for this conference to take place, 

• If you decline to have a transition conference, your OSC will provide you with written transition information, 

• If you consent to the transition conference, your OSC will arrange for the transition conference with you, the CPSE chairperson/designee, and other members of the IFSP team as invited. The transition conference should be held at least 90 days before your child is first eligible for services through the CPSE. Your OSC will provide you with information on when your child is first eligible for services through the CPSE, 

• Whether or not you choose to have a transition conference, you can decide to refer your child to the school district CPSE. Your OSC can help you to make this referral. You will need to refer your child in enough time for your child to be evaluated by the CPSE, and for the CPSE to make a decision about your child's eligibility for preschool special education before your child's third birthday. Otherwise, eligibility for EI services will end on the day before your child's third birthday.

You should notify your Ongoing Service Coordinator (OSC) that you will be moving. With your permission, your OSC will contact the EIP in the state or NYS county that you are moving to. The OSC will help you get services in that state or county.

An order form for EIP publications is available at the following link on NYSDOH's Web site: Early Intervention Publication Order Form. Publications are free if you live in NYS.

Local numbers for your county Early Intervention Program or EIO can be found at the following link on NYSDOH's Web site: Municipal/County Contacts for the Early Intervention Program.

Some counties list provider names on their Web sites.  Also, you can request a copy of the NYS Central Directory for your area from the New York State Department of Health (NYSDOH). This directory lists everyone who can provide early intervention services in NYS.  You can request a copy at the following link on NYSDOH's Web site: Early Intervention Publication Order Form.

Please see  https://www.health.ny.gov/community/infants_children/early_intervention/service_providers/  for more information.

In addition to mediation or an impartial hearing, another option for parents who are having problems with how the EIP is working is to file a system complaint. Some examples of problems include:

• Not having an IFSP completed within 45 days of a child's referral to the Early Intervention Official,

• Not having services delivered on time,

• Not getting the services listed in your IFSP,

• Providing services to a child when a parent hasn't given permission,

• Receiving services in places where there are health or safety concerns.

A system complaint can be filed if you believe that your EIO, service coordinator, evaluator or service provider is not doing his or her job under the law. To file a system complaint, you must write to the New York State Department of Health, Director of the Bureau of Early Intervention. You must also forward a copy of your complaint to your service coordinator, county Early Intervention Official, and any early intervention provider(s) who is the subject of the complaint. The Department of Health must investigate your complaint.

If you make a complaint to the Department of Health you will be contacted by Department of Health staff. You will be told how your complaint will be investigated. This may include interviewing you, any person named in the complaint, and others who may have helpful information about the complaint.

The Department of Health must finish its investigation within 60 days from the time it receives the complaint. You will receive a written response to your complaint upon completion of the investigation. This response will provide findings of the investigation, and specify any actions that must be taken. The Department of Health is responsible for making sure that all steps to correct the problem are taken.