RD492 - Report on Virginia’s Part C Early Intervention System (July 1, 2016 – June 30, 2017) – November 15, 2017

Executive Summary:

Congress enacted early intervention legislation in 1986 as an amendment to the Education of Handicapped Children’s Act (1975) to ensure that all children with disabilities from birth to the age of three would receive appropriate early intervention services. This amendment formed Part H of the Act, which was re-authorized in 1991 and renamed the Individuals with Disabilities Education Act (IDEA). When the IDEA was re-authorized in 1998, Part H became Part C of the Act. IDEA was reauthorized most recently in December 2004. Virginia has participated in the federal early intervention program, under IDEA, since its inception.

In 1992, the Virginia General Assembly passed state legislation that codified an infrastructure for the early intervention system that supports shared responsibility for the development and implementation of the system among various agencies at the state and local levels. The Department of Behavioral Health and Developmental Services (DBHDS), was designated and continues to serve as the State Lead Agency. The broad parameters for the Part C system are established at the state level to ensure implementation of federal Part C regulations. Within the context of these broad parameters, 40 local lead agencies manage services across Virginia.

In 2012, the General Assembly appropriated the state funds necessary to increase the Medicaid reimbursement rate for early intervention targeted case management from $120 per month to $132 per month for FY 2013. In order to address a $8.5 million deficit in funding for early intervention due to significant increases in the number of children served and static federal funding, the General Assembly provided critical support for Virginia’s early intervention system in 2013 by allocating an additional $2.3 million in state general fund dollars in FY 2013 and another $6 million for FY 2014. A total of $13.2 million was allocated for early intervention in FY 2015, $14.8 million in FY 2016, and $15.5 million in FY 2017.

In FY2017, reported revenue kept pace with reported expenses in the Part C early intervention system. However, the completeness and accuracy of expense and revenue data is of concern since local lead agencies and private providers collect their data separately and there is no central mechanism to ensure reporting by all private providers or to ensure non-duplication. The following factors underscore the importance of continued revenue growth to support the system:

• The number of children served in the Part C early intervention system increased by 7 percent from FY 2016 to FY 2017. At the same time, revenue from private insurance and TRICARE decreased by 12 percent, and federal Part C funding remained stagnant.

• Increases in the number of substance exposed infants, earlier identification of autism spectrum disorders and improved statewide collaboration with Neonatal Intensive Care Units (NICUs) is expected to result in even higher annual increases in the number of children referred to and served in Virginia’s early intervention system.

• Nine local systems requested additional funds in FY 2017. The funds were needed to support the expenses of the local system, including the cost of providing services. DBHDS was able to provide the local systems with 84 percent of their requests. The additional funds were from savings at the state level and from retained funds from four local systems who volunteered to return funds to assist local systems with a fiscal need.

To the maximum extent possible, the following narrative, charts and other graphics respond to the legislative requirements as delineated in Item 315.H2. The following data is based on revenue and expenditure reports received from the 40 local lead agencies and includes data from the private providers with which the local lead agencies contract.