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Washington's Infant Toddler Early Intervention Program Study

December 1, 1998

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

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

This report presents information on infants and toddlers, ages birth to three, with developmental delays or disabilities, who were enrolled in Washington State public services. A child was defined as enrolled if the child 1) was determined to be eligible for services, 2) was receiving services, and/or 3) had a completed service plan.

• In Washington State, 5,332 infants and toddlers under three years of age were found to be enrolled in public early intervention services for developmental delays or disabilities as of December 1, 1998. Over the last five years the number of children served has increased by 31% from 4,055 to 5,332, and the proportion of children enrolled has risen from 1.6% to 2.3%.

• The 1998 rate of enrollment in services in Washington (2.3%) was similar to the rate found in the National Health Interview Survey (NHIS) for children with limitations in some daily activity (2.3%).

• The enrollment rate (3.4%) for Medicaid-eligible children, with family incomes up to 200% of the FPL, was greater than that for non-Medicaid children (1.3%). The proportion of enrolled children who were Medicaid-eligible (71%) was significantly greater than that for all children in Washington (47%). These patterns are similar among children in the NHIS with reported limitations.

• The enrollment rate for children of mothers with no prenatal care (6.6%) was over three times higher than that for children of mothers who received first trimester prenatal care (2.1%).

• Characteristics of infants at birth that were associated with high enrollment rates include low birthweight (11.0%), preterm birth (6.2%), and Apgar score less than 8 (10.2%). Male children had a higher enrollment rate than female children (2.6% versus 2.0%).

• Among children who were Medicaid-eligible with diagnosed medical conditions, enrollment rates were highest for those with cerebral palsy (91.3%), Down syndrome (91.0%), cleft lip and/or palate (69.6%), developmental speech and language disorder (57.1%), and other developmental disorders or delays (40.8%).

• Children of mothers with diagnosed substance abuse had an enrollment rate of more than three times that for all other Medicaid children in Washington (11.6% versus 3.0%).

Summary of Findings: Expanded Characteristics of Enrolled Children

• The proportion of children enrolled in publicly-funded early intervention who receive other publicly-funded services is much higher than that for all other children.

• Rates of Supplemental Security Income (SSI) eligibility for children enrolled in early intervention services were more than 100 times greater than for all other children.

• Rates of out-of-home placement, children affected by drugs and alcohol, and mortality between ages one and three for early intervention enrolled children were generally around ten times greater than those for all other children.

• The proportion of children eligible for medical assistance during the first year of life has shown continuing increases from 1992 to 1997; however, the rate of increase has been smaller for enrolled children than for all other children. The proportion of enrolled children who were Medicaid-eligible during the first year of life has increased from 42.0% for children born in 1992 to 55.4% for children born in 1995. This represents an increase of 32%. For all other children, the Medicaid-eligible proportion increased from 22.2% in 1992 to 33.3% in 1995. This represents an increase of 50%.

• Managed care enrollment rates among Medicaid-eligible children in early intervention programs resembled those for other low-income children over time. Most low-income children born after 1993 were enrolled in a Medicaid managed care plan at some point before their second birthday. Approximately nine of every 10 low-income children born in 1996 enrolled in a Medicaid managed care plan before their first birthday.

Modified: Thursday November 17 2005

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