Under Part C of the federal Individuals with Disabilities Education Act (IDEA), early intervention services must be provided to all eligible infants and toddlers with disabilities, birth to the age of three, and their families, with parental consent. In Virginia, the Department of Behavioral Health and Developmental Services (DBHDS) is the State Lead Agency for early intervention.

In FY 2024, Virginia served 23,660 eligible infants, toddlers and families with early intervention services using $26,556,453 in state general funds from the budget. Total revenue and expenditures for the statewide early intervention system both exceeded $106 million. Medicaid, state general funds for Part C and local funds were the top three revenue sources. The most common early intervention services provided were physical therapy, occupational therapy, speech-language pathology and developmental services. All eligible children and families receive services coordination.

In FY 2024, reported revenue covered the reported expenses for the Part C early intervention system. However, looking ahead, the following indicates the need for revenue growth:

• Child count numbers continue to increase. The one-day child count grew by over 5.3 percent between December 1, 2022, and December 1, 2023.

• The State budget for FY 2024 included a 12.5 percent Medicaid rate increase beginning January 1, 2024, for early intervention services other than service coordination. Although helpful in increasing revenue and narrowing the gap between the reimbursement rate and costs, this rate increase did not cover the full cost of providing services nor does it completely close the gap in overall funding for early intervention. In addition to impacting the need for additional funds, the discrepancy in cost versus reimbursement is contributing to provider shortages. Staff vacancies were the contributed to some local systems not having a budget deficit in FY 2024.

• When submitting their FY 2025 initial budgets, eight local systems reported a projected deficit for this year. The total projected shortfall is approximately $3.6 million. The FY 2025 projected deficit is triple what was reported in FY 2024 initial budgets.

• Impacts of personnel shortages continue to impact infants, toddlers and their families. In FY 2024, eight LLAs were found to be out of compliance with federally mandated timelines because they lack the providers necessary to serve the number of children being referred and found eligible for early intervention services.