A r c h i v e d  I n f o r m a t i o n

Other OSEP Programs and Projects Benefitting Young Children with Disabilities

The Early Education Program for Children with Disabilities

Demonstration Projects

EEPCD's demonstration projects address a variety of topics. They include the following:

• the unique needs of children with low incidence disabilities, such as deaf-blindness;

• the use of technology to enhance services for young children with disabilities;

• multidisciplinary intervention services for children and families;

• interagency collaboration in the provision of services;

• family and professional collaboration;

• an examination of differing service delivery models;

• coordination between public and private agencies;

• curriculum and materials development; and

• services for infants with special health needs, including HIV infection.

Outreach Projects

Outreach projects have two goals: to increase the availability of high-quality services to young children with disabilities and to promote replication of innovative models or components of models that were developed under the demonstration or inservice components of EEPCD or have been developed with other funding. All of the 45 projects receiving outreach funding have a multi-State or national focus and are funded for three years. Outreach efforts focus on improving training and services, as well as on interagency and inter-State collaboration. Allare required to coordinate their dissemination and replication activities with the State lead agencies under Part H and/or the Preschool Grants Program.

Inservice Training Projects

Projects in this priority area develop and evaluate inservice training models that will prepare professionals and paraprofessionals to provide, coordinate, or enhance early intervention, special education, and related services for infants and toddlers with disabilities and/or for preschool children with disabilities. Inservice training projects are funded for 3 years. During FY 1994, eight new projects were funded.

Experimental Projects

Non-directed experimental projects provide a comparative analysis among educational practices and intervention procedures related to early childhood services. During FY 1994, four projects addressed language instruction, intervention in inclusive versus segregated settings, bilingual/bicultural training for preschoolers who are deaf, and paraprofessional training systems.

Research Institutes

Six research institutes are supported. These institutes investigate:

• cost and effectiveness of early intervention;

• interventions for children affected by parental substance abuse;

• the challenges and barriers to preschool inclusive service delivery;

• developmental care and intervention in the neonatal intensive care unit;

• influences on service patterns and utilization in early intervention and preschool programs; and

• barriers to inclusion in educational, cultural, and community contexts.

Statewide Data Systems Projects

Statewide data systems projects expand States' capabilities for tracking and linking services for children with disabilities and those at-risk for disabilities. During FY 1994, five projects were funded.

NEC*TAS (National Early Childhood Technical Assistance System)

Personnel Preparation

Research Projects

In the feasibility study, applications from 18 States that had fully implemented the Part H program requirements were reviewed during FY 1991 and FY 1992, and 5 States were selected to participate. The five States were chosen because of their differing geographic locations, the population characteristics they represented, and the range of service provision models they had developed. The main purpose of the study was to collect information on the feasibility of determining the costs of providing early intervention services. The specific research questions addressed are listed below.

1. To what extent do State Part H grant applications describe the availability of data on the costs of early intervention services?

2. What information is available about children being served and the services being provided to them and their families?

3. What data are collected on the expenditures on early intervention services?

4. Where, how, and how often are the data collected and stored?

5. What data are available on the costs of administering the statewide system?

6. Are any data available that would permit projections of costs of early intervention services?

7. How comparable are the data across States and in what ways are the data not comparable?

Because of the small sample size and the nature of the questions asked, the analysis for this study was mainly qualitative.

The researchers found that data available from individual State records were insufficient to analyze Part H program costs and caseloads, for two reasons. One, some of the information collected by local providers was maintained at the local level and not available to State agencies. Two, the elements listed above in the specific research questions that were essential components to this evaluation were not contained in full in any one set of State records. In addition, each State had developed a unique system to comply with the Federal reporting requirements. Therefore, aggregate information from all 5 States was not obtained for any of the seven research questions.

Although counts of children served were available in all five States, the time periods covered, and the count accuracy, varied. The researchers received unduplicated counts from four of the five States. Two of those four were unduplicated counts of all children served during the year. The other two States provided unduplicated December 1 counts. In the fifth State, the researchers received only duplicated counts. The varying time periods and count accuracy are additional reasons why the data from these States could not be aggregated.

The findings described below were derived from the data.

• Eligibility criteria were found to be an important determinant of the costs of providing early intervention services. Providing services only for children with significant disabilities costs more per child than providing services to children with mild disabilities. In contrast, limiting services to children with significant disabilities keeps the number of children served low and lowers the total cost of the program.

• States collected data largely for billing and administrative purposes. None of the States had designed data collection systems to track the various costs of providing early intervention services.

• Only one State was able to provide the total expenditures from Federal, State, local, and private sources that funded its Part H services. Additionally, when States did have access to funding data such as Medicaid records, the data systems were generally not set up to identify early intervention services or Part H-eligible children.

• One State had an integrated data system that cross-referenced individual records. All of the States were working to better integrate the various funding source data.

• Three States administered their statewide early intervention systems themselves. In two States, this function was performed by contractors. All of the States were able to provide high quality data on the costs of administering their Part H system.

The companion study entitled "The Use of Family Payment Systems in the Part H Program" collected information about the decision to either implement or not implement fee payments and sliding fee scales in selected States. Twenty-three States were surveyed. Nine of the 10 States that had family payment systems, and the 13 States that did not, responded. The study addressed the three questions below.

1. Why have some States chosen to implement family payment systems, whereas others have not?

2. How do family payment systems contribute to the provision of early intervention services?

3. What are the common characteristics of these service systems and what are their advantages and disadvantages?

All quantifiable responses were tabulated and frequencies developed, as appropriate. Open-ended qualitative responses were reviewed and analyzed to identify the key dimensions of the response to the relevant study question.

The Part H statute provides that "`early intervention services' must be provided at no cost except where Federal or State law provides for a system of payments by families, including a schedule of sliding fees" [20 U. S. C. 1472(2)(B)]. However, States may not charge parents for (1) child find; (2) evaluation and assessment; (3) service coordination; (4) administrative and coordinating activities related to the development, review, and evaluations of IFSPs; and (5) implementation of procedural safeguards. Additionally, if the State guarantees the provision of FAPE, then the State may not charge parents for any services that are provided as part of a FAPE.

Distinct viewpoints emerged between States that chose to implement family payment systems and those who chose not to charge families for services. Of the nine States with family payment systems, five had such systems in place before the Part H program began. The other four States have instituted them since 1991. Three administrative structures were used by the nine States to manage the payment systems--locally controlled, State-controlled, and jointly (local and State) controlled family payment systems. In eight of the States, the method of determining fees varied by locality. In most of the States, the calculations of ability to pay also differed by locality.

Six States reported that they generated revenue from family payment systems. However, only two States were able to estimate the amount of revenue generated. The study reported that the inability to estimate revenues was probably related to local level control of family payment services. The study also reported that service providers bear the costs of administration in most States.

States that use family payment systems reported that they do so not only to generate revenue, but for other reasons. For example, a common feeling among proponents of family payment systems was that "families that can pay should pay."

Of the 13 States surveyed that do not have family payment systems for early intervention services, two stated that they had not considered them because they were aware of the poor experiences of other States that had implemented such programs. The other 11 States actively considered adopting family payment systems at one time or another. Informal discussions in the lead agency or State ICC were the most common method used to arrive at the decision not to use a family payment system. Three States conducted a cost-benefit analysis and found that they would lose money by adopting payment scales. Eleven States provided responses describing deterrents that led them to decide not to adopt a family payment system. In nine States, administrative costs and other administrative difficulties were reported as the main reasons for not adopting payment systems. In six States, barriers created by fees and potential reduction in services were reported as key factors in the decision.

In five States, a philosophical opposition to family payment systems was given as the main reason for not using them. These States reported that some families would refuse to seek services if they were charged any fees, even if the fees were based on sliding scales. Also cited as reasons for not charging families were the fact that historically, private nonprofit organizations have not charged families for early intervention services, and the State agencies belief that FAPE should be extended to children with disabilities from birth to age 2.
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[Implementation of the Preschool Grants Program]

[Summary and Implications]