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 2025, Virginia served 23,429 eligible infants, toddlers and families with early intervention services using $30,553,977 in state general funds from the budget. Total revenue and expenditures for the statewide early intervention system both exceeded $107 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 service coordination.

In FY 2025, reported expenses exceeded reported revenues by approximately $1.6 million for the Part C early intervention system. Looking ahead, the following indicate the need for revenue growth:

• Child count numbers were relatively unchanged from FY 2024 to FY 2025. However, estimates on the prevalence of developmental delay and disability among children in the United States range from 8.5 percent - 17 percent. Virginia is serving 4.35 percent of the birth-three population in early intervention.

• Early intervention reimbursement rates continue to fall short of covering the cost of providing services. A 12.5 percent rate increase in 2024 was the first and only rate increase since the early intervention rates were established with DMAS in 2009. As noted in this report, expenditure exceeded revenue in FY 2025 and local systems are reporting anticipated budget shortfalls for FY2026. In addition to impacting the need for additional funds, the discrepancy in cost versus reimbursement is contributing to provider shortages as attracting and retaining qualified personnel becomes increasingly challenging.

• When submitting their FY 2026 initial budgets, 10 local systems reported a projected combined deficit of approximately $3.61 million. Due to budget shortfalls, at least two LLAs have had internal discussions about ending their role in early intervention. Some LLAs have eliminated service provider positions and increased caseloads. While solving short-term budget shortfalls, these steps will ultimately result in infants, toddlers and families waiting for critical services and early intervention service coordinators and providers leaving the field due to burnout.

• In FY 2025, 21 of 40 local systems were out of compliance with federally mandated timelines because they lack the providers and/or funding necessary to serve the number of children being referred and found eligible for early intervention services. Failure to meet timelines puts Virginia’s ability to receive federal funding at risk; it also puts infants and toddlers at risk of further developmental delays and leaves families waiting for the support they need to help their children develop and learn.