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

A Comparison of Enrollment Counts on December 1, 1993, May 1, 1995, December 1, 1995 and May 1, 1996

An estimated 2.5% of children under the age of three in the state of Washington have delaying or disabling conditions. Infants and toddlers with disabilities and their families are eligible to receive an array of public early intervention services although all may not seek enrollment in state programs. State agencies, families, and local communities share a common vision for developing a system of coordinated, comprehensive, family-centered and culturally relevant early intervention services for these children with developmental disabilities and their families.

This report presents information on infants and toddlers, birth to three with delaying or disabling conditions who were enrolled in Washington State public services at four timepoints: December 1, l993; May 1, l995; December 1, l995; and May 1, l996. A child was defined as enrolled if the child 1) was determined to be eligible for services and/or 2) had an individualized service plan.

Summary of Findings

• The Washington State enrollment rate has been generally stable from December 1, l993, to May 1, l996, with a slight increase from a rate of 1.65% at the first count to 1.79% at the fourth count.

• Over 70% of the children who were enrolled on December 1, l993, and were less than three years old on May 1, l996, were still enrolled on May 1, 1996.

• The national prevalence rate estimated from the National Health Interview Survey (NHIS) (1.8% – 2.1%), whether adjusted for Washington State poverty levels or not, has been consistently higher than the Washington State enrollment rate. Not all eligible children are enrolled in publicly funded early intervention programs. Children may receive early intervention services funded through private pay, private insurance, military programs, or charitable grants.

• The enrollment rate (2.4% – 3.1%) for Medicaid eligible children, with family incomes up to 200% of the Federal Poverty Level (FPL), was consistently higher than that for Non-Medicaid children (0.8% – 1.1%) over the four counts. Similarly, the national prevalence rate of reported limitations for children in lower income families (2.3% – 2.9%) was higher than for children in families with incomes greater than 200% of the FPL (1.4% – 1.5%).

• The proportion of enrolled children who were Medicaid eligible (70%) remained stable over time and was significantly greater than that for all children in Washington (42% – 45%). Similarly, the proportion of NHIS children with reported limitations who are at or below 200% of the FPL (55% – 64%) was significantly greater than for all children under three (44% – 47%).

• For all Washington births, rural counties as a group have moderately higher enrollment rates (2.3% – 2.7%) than small urban counties (1.6% – 2.2%) and substantially higher enrollment rates than metropolitan counties (1.2% – 1.8%).

• Very low birthweight and extreme prematurity were the risk factors associated with the highest enrollment rates, 21.8% and 19.3%, respectively.

• Enrollment rates between 5% and 10% were found for medium low birthweight infants, moderately preterm infants, infants with Apgar scores of less than 8, and infants born to mothers who received no prenatal care, who had been identified as substance abusers, or who were less than 15 years old.

• Among children who were Medicaid eligible, enrollment rates were highest for children with Down Syndrome (87.7%) and cerebral palsy (65.3%) compared to other children with specific medical conditions.

• Medicaid eligible children who were diagnosed with other conditions associated with developmental delay also had high enrollment rates: cleft lip and/or palate (62.6%), developmental speech and language disorder (42.4%), and other developmental disorder or delay (41.1%). 

The analyses and results presented in this report provide baseline data for planning and discussion at the state and local levels, and facilitate decision making and priority setting for Washington's early intervention programs for infants and toddlers with delaying or disabling conditions.

Modified: Thursday November 17 2005

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