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Birth to Three Early Intervention Study

Enrollment of Washington Children with Disabilities and Special Health Care Needs in Washington State Public Programs

Executive Summary

Total Enrolled: 4,324 children under three years of age were found to be enrolled in public early intervention services for disabilities and special health care needs as of December 1, 1993.

Enrollment Versus Estimated Prevalence Rates: The rate for children enrolled in these services in Washington (16.4 per 1000) is comparable to the rate found for children with limitations in some daily activity in the National Health Interview Survey (NHIS: 17.5 per 1000). The above enrollment rate is lower than the planning rate used by the Birth to Six State Planning Project (25.0 per 1000).

Lower Income: The enrollment rate is higher among children of Medicaid-eligible families (23.9 per 1000). This higher rate is comparable to the higher prevalence of reported limitations among lower income families surveyed nationally (NHIS: 23.8 per 1000).

Race/Ethnicity: There are large differences in enrollment rates by race/ethnicity within the Washington population, even among children of Medicaid Eligible Families. The general pattern of enrollment by race/ethnicity in Washington conforms to the general pattern of reported limitations found among race/ethnic groups in the national sample (NHIS).

Risk Factors: The pattern of enrollment includes a higher enrollment rate for low birth weight babies and for children of substance-abusing mothers than for the general population.

Rural-Urban: While there is high variability by Washington counties, rural counties have, on average, higher enrollment rates than do metropolitan and rural-urban counties; among children who are Medicaid-eligible, children in rural counties are far more likely to be enrolled than children in metropolitan and rural-urban counties.

Particular Barriers to Service: A qualitative study of barriers to service provides tentative explanations for the above quantitative findings regarding differences in enrollment by rural-urban location, by income level of families, by racial/ethnic groups, and by various risk factors.

The findings on enrollment are based on total statewide counts of enrolled children under three enrolled in service plans on December 1, 1993, from four provider surveys and two agency management information systems matched with Birth Certificate and Medicaid information in the First Steps Database (ORDA, DSHS). The qualitative findings emerge from one to four hour in-depth, structured, open-ended interviews conducted in April and May 1994 in seven counties with seventy respondents: parents, resources coordinators, private and public service providers.

Modified: Thursday November 17 2005

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