Is What You Need in Early Intervention What You Get

"Fulfilling the Promise. " is a paper that contributes to the field of early intervention. It describes a population database that includes all authorized and delivered services for children and families enrolled in Part C in Indiana. Indiana's database is used by the state and localities to identify shortfalls in the early intervention system and make needed improvements. Neither the Indiana database nor the paper includes concurrent descriptions of the quality of services or outcomes for children and families. The paper does not describe the accomplishments of the central finance model underlying the IFSP service authorization process. Such accomplishments might be necessary for the reader to understand the Indiana model's tradeoffs between maximizing funding streams for services and the discrepancy between the level of planned and delivered services. Nor is it possible to conclude whether the discrepancy that is observed between authorized and delivered rates of service is intrinsic to components of the Part C law, such as the IFSP process, or the Indiana model. The paper does provide the first comprehensive description of an important policy variable—the amount and type of services authorized and delivered to children and families and their relationship to child, family, and service characteristics. A major accomplishment of the paper and Indiana's data system is that it describes the type and amount of early intervention services provided to all families and children who were enrolled in early intervention in Indiana. Early intervention studies often conduct time-consuming interviews with samples of families and service providers to get a picture of the amount and type of services that may or may not be generalizable to early intervention in the rest of the state. Many resources are spent for the development, piloting, and administration of surveys. The surveys are often completed based on the recall of families and providers. Early intervention providers are often reluctant to spend time completing such surveys because it reduces the amount of time they have for direct service. Few early intervention studies have undertaken more accurate time diary studies because of the high resource costs associated with such work (Barnett & Boyce, 1995), and these are typically for a limited period that may or may not be representative. One reliability check for the Indiana services data is a statement sent to providers and families describing the amount, date, and cost of provided services. Thus, Indiana's data are an improvement over other state data systems in that they describe the full range of type and amount of services for the complete population of children and families served by early intervention in Indiana. In a recently completed 2-year evaluation in Indiana (Goetze, Akers, & Broadhead, 2001; Goetze, Akers, Judd, & Narasimhan, 1999), I gained a more comprehensive picture of Indiana's new service and finance model and its underlying database. States are challenged by federal Part C requirements to use Part C funds last and use other funds, such as Medicaid and the Children's Special Health Care Needs program, before Part C. Indiana's Central Reimbursement Office (CRO) was designed to be more effective in implementing