A Bulletin for 

professionals

U.S. Department of Health and Human Services

Administration for Children and Families

Administration on Children, Youth and Families

Children’s Bureau

Child Welfare Information Gateway

Children’s Bureau/ACYF

1250 Maryland Avenue, SW

Eighth Floor

Washington, DC 20024

703.385.7565 or 800.394.3366

Email: info@childwelfare.gov

www.childwelfare.gov

What’s Inside:

Child welfare and early intervention

Promising strategies

Funding strategies

Resources

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May 2007

Addressing the 

Needs of Young 

Children in Child 

Welfare: Part C – 

Early Intervention 

Services

Enactment of the Part C referral provisions 

in the Child Abuse Prevention and 

Treatment Act (CAPTA) and the Individuals 

with Disabilities Education Improvement 

Act of 2004 (IDEA) opens the door to a 

powerful partnership with great potential 

benefits for children under age 3 involved in 

substantiated cases of abuse or neglect and 

their families. For child welfare administrators, 
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these provisions offer new tools to enhance 

policy and practice and ensure compliance 

with Federal child welfare requirements that 

focus on child well-being. The provisions also 

connect child welfare staff to early intervention 

service providers who can assist in assessment, 

service delivery, and permanency planning. 

This partnership can expand the array of 

supports and resources for children and their 

caregivers to promote safety, permanency, 

and well-being. 

This bulletin provides examples of State efforts 

to implement the new referral provisions and 

provides lessons learned to child welfare 

administrators and practitioners in accessing 

early intervention services for children and 

families identified by the child welfare system. 

While policies and practices vary from State 

to State, this bulletin explains the overall 

importance to child welfare of the Part C Early 

Intervention Program and offers potential 

strategies to address barriers. Contact 

information for State and local programs is 

provided at the end of this document. 

Child Welfare and 

Early Intervention

Despite some implementation challenges, 

the Part C referral provisions promise unique 

benefits for child welfare agencies and the 

children in their care. 

Special Needs of Children 

in Child Welfare 

Research shows that children who are abused 

or neglected often experience physical, 

developmental, and emotional problems, 

including attachment disorders, social and 

emotional disturbances, cognitive deficits, 

neurobiological changes in the brain, and 

failure to thrive (Jaudes & Shapiro, 1999). This 

risk is greatest for the very young. In 2005, 

children ages birth to 3 had the highest rates 

of victimization, at 16.5 per 1,000 children of 

the same age group. More than three-quarters 

(76.6%) of the estimated 1,460 children who 

died as a result of child abuse or neglect 

that year were younger than 4 years of age 

(U.S. Department of Health and Human 

Services, 2007). 

Many young children under the age of 3 who 

experience abuse and neglect are placed 

in foster care. Studies reveal one-quarter of 

these young children have significant delays 

in motor development, and almost one-half 

have significant delays in communication and 

cognitive development (Jaudes & Shapiro, 

1999; Spiker & Silver, 1999; U.S. GAO, 1995; 

Blatt, Saletsky, & Meguid, 1997; Hochstadt, 

Jaudes, Zimo, & Schachter, 1987).

Part C Referral Provisions and 

Early Intervention Programs 

In recognition of these risks, Congress’s 

reauthorization of CAPTA—with the enactment 

of the Keeping Children and Families Safe 

Act of 2003 (P.L. 108-36)—required States 

to develop “provisions and procedures 

for referral of a child under age 3 who is 

involved in a substantiated case of child 

abuse or neglect to early intervention services 

funded under Part C of the Individuals with 

Disabilities Education Improvement Act” (§ 

106(b)(2)(A)(xxi)). The 2004 reauthorization 
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of the IDEA contains language parallel 

to CAPTA.

The IDEA also details specific requirements 

for State early intervention programs (EIPs) 

that include services for children in foster care. 

EIPs are administered by lead agencies in 

each State (including departments of health, 

developmental disability, social services, 

children and families, or education). Among 

the Part C application requirements are 

the following:

Each lead agency must implement a 

comprehensive child find system to identify, 

locate, and evaluate children needing early 

intervention services—particularly young 

children in foster care.

When a child is identified as being 

potentially eligible for Part C, a formal 

referral must be made to Part C within 2 

working days of identification. 

EIPs must ensure timely, comprehensive, 

multidisciplinary evaluations to determine 

initial and continuing eligibility. 

For those children determined eligible, an 

Individual Family Services Plan (IFSP) must 

be developed within 45 days of referral. 

	 The IDEA requires States seeking grants to include in their

applications “a description of the State policies and procedures

that require the referral for early intervention services ... of a

child under the age of 3 who -- (A) is involved in a substantiated

case of child abuse or neglect; or (B) is identified as affected

by illegal substance abuse, or withdrawal symptoms resulting

from prenatal drug exposure.” CAPTA section 106 [42 U.S.C.

5106a], subsection (b)(2)(A)(xxi) discusses specific elements

that must be included in a State’s plan, including “provisions

and procedures for referral of a child under the age of 3 who

is involved in a substantiated case of child abuse or neglect to

early intervention services funded under part C of the Individuals

with Disabilities Education Act.” Subsection (b)(2)(A)(iii) requires

“the development of a plan of safe care for the infant born

and identified as being affected by illegal substance abuse or

withdrawal symptoms.”

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EIPs must ensure that “appropriate early 

intervention services are available to all 

infants and toddlers with disabilities in the 

State and their families, including... infants 

and toddlers who are wards of the state” 

(§ 634).

The 2004 IDEA also requires the establishment 

of a State Interagency Coordinating Council 

that includes representatives from the 

State child welfare agency responsible for 

foster care. 

To locate the Interagency Coordinating 

Council Chair in your State, use the 

Contacts Finder on the National 

Early Childhood Technical Assistance 

Center website: www.nectac.org

Benefits of Part C for Child Welfare 

Research confirms that the early years present 

an unparalleled window of opportunity 

to support the positive development of 

children (Shonkoff & Phillips, 2000). Child 

welfare workers can help ensure that the 

developmental needs of children who are 

abused and neglected are addressed by 

attending trainings on child development, 

referring children to the EIP, and working 

closely with EIP staff. An EIP service 

coordinator can then help families (and child 

welfare professionals) navigate the eligibility 

process, design an IFSP, and ensure needed 

services are provided.

The IDEA encourages service providers to 

collaborate with families to be sure the IFSP 

or Individualized Education Program (for 

school-aged children) reflects the family’s 

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vision for the child. The IFSP can include any 

of the following: 

Occupational, physical, speech, and 

language therapies

Assessment and treatment of hearing and 

vision problems

Psychological services, assessment, and 

counseling 

Social work

Nursing services

Special instruction

Assistive devices such as hearing aids 

and wheelchairs

Nutrition counseling

Transportation 

The EIP also permits caregivers to consent 

to and participate in services that can help 

them enhance their child’s development. The 

stress of caring for a child with a disability or 

delay can strain family resources and threaten 

family stability. Child welfare professionals can 

refer caregivers to EIP services such as parent 

counseling and training, home visitation, and 

respite care that may help them manage the 

stress of parenting their children, encourage 

the recruitment and retention of foster and 

adoptive families, stabilize placements, and 

support reunification.

Referrals to the EIP support a State’s capacity 

to enhance the safety, permanency, and wellbeing of children and their families in the 

following ways:

Foster parents can be considered parents or serve as

surrogate parents under the EIP, and many States include foster

parents under the parent definition of the 2004 IDEA 20 U.S.C.

1401(23).

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Referral to the EIP enhances service 

availability and accessibility, enabling 

children to receive appropriate services 

to meet their educational, mental health, 

and physical needs and supporting 

families’ enhanced capacity to provide for 

those needs. 

By providing parent training and respite 

services to eligible children and their 

caregivers, referrals to the EIP enhance a 

State’s capacity to provide family-centered 

services that safely maintain children in their 

own homes, prevent removals, promote 

reunification, and stabilize placements.

CAPTA’s referral provisions help State 

child welfare administrators comply with 

Federal child welfare regulations to ensure 

that “families have enhanced capacity 

to provide for their children’s needs ... 

children receive appropriate services to 

meet their educational needs and children 

receive adequate services to meet their 

physical and mental health needs” 45 CFR 

1355.34(b)(1)(iii).

Implementation Challenges

Despite their documented need and 

eligibility for EIP services, many children 

who have experienced abuse or neglect do 

not receive them. States nationwide report 

underidentification and underenrollment of 

children involved with child welfare in early 

intervention services (Robinson & Rosenberg, 

2004). Some of the challenges include: 

Many of these children do not have a 

consistent caregiver in their lives who can 

observe their development over time.

It is difficult to understand the complexity 

of the early intervention system, Federal 

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laws, and State policies and effectively 

navigate the system on a child’s behalf. 

While pediatricians and primary care 

physicians are often referral agents for 

the EIP, Federal Child and Family Services 

Review (CFSR) data suggest that a lack of 

access to primary health care and limited 

contact with health-care professionals in 

general are problems for many children in 

the child welfare system.

Child welfare professionals, foster parents, 

and court personnel who are responsible 

for the well-being of these children are not 

always trained to identify developmental 

needs of children in foster care and may 

have limited knowledge about Part C 

services. One study found that children 

had more problems than were identified 

by caseworkers and foster parents. Only 

one-third of the problems later identified by 

EIP professionals in this study were initially 

reported by caseworkers and foster parents 

(Halfon, Mendonca, & Berkowitz, 1995). 

At every stage of the EIP beyond referral, 

Federal legislation under the IDEA requires 

parental consent and participation. Yet, the 

parents of children who have substantiated 

reports of abuse and neglect are sometimes 

unknown or cannot be found to provide 

consent for services.

EIP professionals may be unfamiliar with 

child welfare policies and procedures, with 

strategies for engaging families who are 

Common challenges States cited in meeting the well-being

indicator related to physical health include finding doctors

willing to accept Medicaid, providing timely health assessments,

and providing adequate preventive health care. For more

information, see www.acf.hhs.gov/programs/cb/cwmonitoring/

results/genfindings04/ch1.htm

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involuntarily involved in a referral to child 

welfare services, or both. 

Promising Strategies

Many States are developing policies and 

procedures to implement the Part C referral 

provisions of CAPTA and the IDEA more 

effectively. Additionally, many localities and 

individual provider agencies have developed 

initiatives to ensure that children who are 

abused and neglected are linked to the EIP. 

All of these strategies address existing barriers 

to identifying, evaluating, engaging, and 

serving maltreated children and their families. 

This section will describe many strategies that 

have been tried and provide specific State and 

local examples.

Collaboration 

States have found that successful Part C 

implementation requires extensive interagency 

collaboration, not just between child welfare 

and EIP but among all relevant agencies and 

stakeholders. This includes Medicaid, mental 

health, public health, maternal and child 

health, developmental disabilities, Early Head 

Start/Head Start, education, and the courts.

In South Carolina, for example, an 

extensive collaborative group has signed 

a memorandum of agreement to ensure 

the coordination of BabyNet, a statewide, 

comprehensive interagency system of early 

intervention services for all eligible children 

in accordance with Federal and State laws. 

Participating agencies include the State’s 

Department of Disabilities and Special Needs, 

the Department of Health and Environmental 

Control, the Department of Health and 
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Human Services, the Department of Mental 

Health, the Department of Social Services, the 

Department of Education, and the School for 

the Deaf and the Blind.

www.scdhec.net/health/mch/cshcn/programs/

babynet/

Collaborative efforts have been found to 

help child welfare and EIP administrators do 

the following:

Clarify and share information about each 

system’s procedures

Identify and convene leaders to facilitate 

implementation of the referral provisions 

and ensure compliance with all Federal 

and State laws and regulations (e.g., ASFA, 

CAPTA, IDEA)

Identify and tap available funding streams

Develop written interagency agreements 

that establish workable referral and 

information-sharing procedures and 

ongoing communication mechanisms

Promote clearer understanding of staff roles 

in each agency

Develop consistent guidelines for 

processes such as obtaining consent, 

conducting evaluations, and appointing 

surrogate parents

Create opportunities for cross-disciplinary 

training 

At the practice level, collaboration between 

child welfare and the EIP staff can help:

Spotlight the safety and well-being needs 

of individual children and families

Integrate child welfare and early 

intervention service goals and services

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Ease child welfare workload burdens by 

engaging the EIP service coordinator as 

a partner

Identify new resources for consultation and 

technical assistance

As the examples on the next several pages 

will demonstrate, comprehensive and creative 

collaborations between State child welfare and 

the EIP systems have overcome many of the 

barriers to identifying, referring, and serving 

abused and neglected children under the EIP.

Since 1996, Delaware child welfare and 

EIP agencies have had policies and 

agreements in place to refer children 

involved in substantiated abuse and 

neglect cases to the EIP and to share 

resources. An Operations Agreement 

between the two agencies defines staff 

roles for each step in the EIP process, 

clarifies expectations for information 

sharing between child welfare workers 

and EIP staff, and outstations child welfare 

staff at the EIP to serve as liaisons. These 

staff use a developmental checklist 

created by the EIP and built in to the child 

welfare computerized tracking system to 

conduct preliminary screenings of children 

for referral to the EIP. They also monitor 

the status of all referred children. The 

liaisons, funded by Part C, provide case 

management on individual cases and offer 

training and technical assistance to staff in 

both systems. 

Delaware

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Identification and Referral

The 2004 reauthorization of the IDEA requires 

States to develop a comprehensive Child 

Find system that ensures eligible children, 

including infants and toddlers in foster care 

or those with substantiated abuse or neglect, 

are identified, located, and referred to the 

EIP. Child Find efforts usually include outreach 

to child protection and preventive services 

agencies, as well as to hospitals and clinics 

that are likely to see infants and toddlers who 

have been abused or neglected. 

Many States have developed policies to 

address this requirement. For example: 

Massachusetts, Ohio, Nebraska, Vermont, 

and West Virginia now require automatic 

referral of child abuse and neglect cases by 

child welfare workers to the EIP. 

In Idaho, New Hampshire, New Mexico, 

and North Dakota, all children under age 

3 with substantiated cases of abuse and 

neglect are automatically referred to the EIP 

and receive a multidisciplinary evaluation 

conducted and funded under the State EIP. 

Any EI service, including State-initiated 

screening, must be performed by a qualified 

professional as defined under the IDEA. Some 

States provide training for child welfare staff 

in screening for developmental issues. In 

Utah, trained child welfare workers use a valid 

and reliable screening tool (normed for the 

purpose of screening children referred to child 

welfare), undergo a rigorous training utilizing 

a field-tested curriculum, and receive ongoing 

supervision from a clinical supervisor. Other 

States have child welfare staff rely on EI staff, 

who have had extensive training to conduct 

these screens. In Philadelphia, all children, 

including all children with substantiated cases 

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of abuse and neglect ages birth to 4.9 years, 

receive developmental screening by the EIP.

The Massachusetts Early Childhood 

Linkage Initiative (MECLI) was established 

in 2002 to create a formal link between 

the child protection system and the EIP. 

The project brings together Brandeis 

University, the EIP, and the Departments 

of Public Health and Social Services 

in a partnership to maximize early 

identification and intervention for young 

children who are at heightened risk for 

serious developmental problems. As an 

initial step, MECLI seeks to have the child 

protection system refer all children under 

3 years of age with a newly opened case 

to the Part C system. MECLI tracks the 

number of children referred, evaluated, 

determined eligible, and enrolled. 

A large percentage (51%) of MECLIreferred children have developmental 

delays rendering them eligible for 

Early Intervention. 

Massachusetts

Parental Consent

Once referred to the EIP, children involved 

in substantiated cases of abuse and neglect 

often face barriers to obtaining an assessment 

for needed services. Parents of children 

who have substantiated reports of abuse 

and neglect may be unknown or unable to 

be found to consent to EIP assessment and 

services. Parents also may be unwilling to 

participate, fearing intrusion by another State 

agency. EIP professionals may be unfamiliar 

with child welfare procedures or strategies 
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for engaging parents who are involuntarily 

referred to the child welfare system. 

Potential strategies to address these 

challenges include:

Involve court personnel. A parent’s 

approval to have a child evaluated for EI 

services may demonstrate to the court 

that the parent is willing and able to act 

in the child’s best interest. A discussion 

along these lines may be more effective 

if initiated by the parent’s lawyer or the 

child’s attorney or court appointed special 

advocate (CASA). 

Involve public health nurses. Some 

States and localities have successfully 

used public health nurses to work with 

families. In Delaware, a Memorandum 

of Understanding between child welfare 

and the Division of Public Health allows 

child welfare staff to refer a child to 

a public health nurse if the family is 

reluctant to consent to a formal EIP 

multidisciplinary assessment. 

Appoint surrogate parents. The Early 

Intervention law defines “parent” broadly 

to include biological and adoptive parents, 

a relative with whom the child is living, a 

legal guardian, and in some instances, a 

foster parent. The law specifically excludes 

State officials from acting as a parent. It 

also provides for the appointment of a 

surrogate parent if the child has no parent 

as defined under the Early Intervention law. 

Under the 2004 IDEA, courts are authorized 

to order a surrogate parent to represent the 

child (§614(D)(iii)(II)(cc); §615 (b)(209A)(i)). 

The role of the surrogate parent is limited 

to representing the child in all matters 

related to the EIP. Nothing in the Federal 

law prohibits a foster parent from serving as 

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the surrogate parent; however, States may 

have laws that limit foster parents serving as 

surrogates or otherwise acting as parents. 

At both the child welfare and EIP agencies, 

States have found that formal written 

agreements and easy-to-use forms that 

describe interagency policy and operations 

for seeking parental consent and appointing 

surrogate parents are helpful.

In Suffolk County, New York, the 

Departments of Health Services and Social 

Services provide home visits by public 

health nurses to all high-risk children, 

including those in the child welfare 

system, once every 6 months for basic 

health assessments and monitoring. For 

children under age 6, the nurse conducts 

a developmental screening and refers 

eligible children to Part C. Children who 

are ineligible for the EIP receive follow-up 

developmental assessment and tracking. 

Where appropriate, reports of the visits 

are sent to the foster care division of the 

Department of Social Services. The nurses 

also provide valuable health education 

to foster families. The home visits and 

developmental screens are funded by the 

EIP as part of Child Find.

Suffolk County, New York

Interagency Training

Cross system training on the Federal law 

provisions, operations of each other’s systems, 

and relevant procedures help ensure that all 

stakeholders share the same knowledge and 

understand one another’s language. Cross 
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training can also help identify and address 

systemic barriers to accessing services from 

the EIP. It can provide ongoing opportunities 

for discourse and relationship-building among 

the leadership and staff in each agency, 

improving their ability to shape clinical 

recommendations and resolve difficult cases. 

Since the court is a central decision maker 

in all child protective cases, interdisciplinary 

training on infant development and EIP 

involving judges and court staff has been 

found to be helpful.

To assist child welfare staff in meeting the 

Federal mandate to refer children under 

age 3 involved in cases of substantiated 

abuse and neglect to the EIP, Nebraska 

has developed several interdisciplinary, 

collaborative opportunities for 

information-sharing and training. These 

include joint video conferences, a child 

welfare representative on the Early 

Childhood Interagency Coordinating 

Council, and stakeholder meetings. 

Nebraska

Tracking and Oversight 

Referral alone will not necessarily ensure 

enrollment and services. Several States have 

developed policies and programs to track 

both individual children and aggregate case 

data. In Delaware, for example, child welfare 

staff use a computerized tracking system to 

monitor the status of all children referred to 

the EIP on a monthly basis. In Massachusetts, 

MECLI (see Identification and Consent section) 

captures the number of children referred, 

evaluated, determined eligible, and enrolled 

in the EIP.

The Philadelphia Child Welfare Early 

Intervention Initiative is a collaborative 

effort between the Philadelphia 

Department of Human Services’ Office 

of Behavioral Health and the Early 

Intervention (ChildLink) and Preschool 

Special Education (Elwyn) programs to 

ensure identification, facilitate referral, 

and track all children birth to age 5 in the 

child welfare system. 

A panel that includes representatives 

from each agency plans, implements, 

and monitors the initiative. The panel 

developed policy and procedures for 

accessing early intervention services. 

A shared database tracks movement 

of children into the early intervention 

system, including identification of children 

under age 3 for referral, monitoring 

of developmental screenings and 

assessments, and development of IFSPs. 

An advisory group composed of child 

welfare and EIP representatives guides the 

project, and an implementation evaluation 

is being conducted to determine how 

well program objectives are achieved. To 

date, monthly reports suggest that the 

number of referrals is steadily growing, 

and provider program managers are 

aware of the new policy to monitor 

the participation of eligible children 

and refer all children under age 6 for 

developmental screening. 

Philadelphia, Pennsylvania 

Some States use the courts to help ensure 

referral to and enrollment in the EIP. Under 

Federal child welfare laws, every child in foster 
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care has hearings to review case status and 

assess permanency goals. These hearings 

present opportunities to inquire into the wellbeing of young children.

In some States, formal mechanisms have been 

developed to share information with those 

decision-makers responsible for advocating 

on behalf of abused and neglected children, 

including judges, attorneys for children and 

parents, guardians ad litem, and CASAs. 

Courts have the opportunity to inquire as to 

whether infants and toddlers are referred to 

and enrolled in the EIP and ensure relevant 

information is shared (see box next column). 

Funding Strategies

Early Intervention funds typically cover the 

costs of administration, evaluation, and 

service coordination. However, lead agencies 

in each State determine how services for 

eligible children will be funded. Because many 

children involved in substantiated child abuse 

and neglect cases have historically not been 

identified for referral to the EIP, State EIPs 

may have concerns about increased caseloads 

and gaps in funding as a result of the new 

requirements. 

In many States, child welfare and EIP 

collaborations have identified and creatively 

harnessed multiple funding streams to 

implement the referral provisions. Some 

States, such as Massachusetts and New 

Mexico (see box on p. 11), tap insurance or 

require sliding scale fees.

The New York State Permanent Judicial 

Commission on Justice for Children has 

developed the Healthy Development 

Checklist and the Infant Checklist. These 

checklists contain key questions that 

spotlight children’s needs (including 

referral to the EIP) and help ensure 

that at least one person involved in 

every child welfare case—a judge, a 

lawyer, a caseworker, or a CASA—asks 

critical questions about a child’s health 

and development. 

The Commission’s Babies Can’t Wait 

Initiative promotes a steady focus on the 

needs of infants in foster care to ensure 

court-based leadership and oversight. 

Additionally, CASAs throughout New York 

State are specifically assigned to cases 

of children in foster care under age 5, 

working alongside the judge, attorneys, 

and social workers to identify health and 

developmental needs and, for those 

under age 3, to facilitate and track referral 

to the EIP. 

New York’s 2005 Permanency Act builds 

upon the Babies Can’t Wait Initiative by 

requiring courts to inquire into children’s 

well-being, including referral to the EIP. 

A key component of the project is a 

statewide interdisciplinary training effort 

on the most critical guideposts for infant 

health, including infant development 

and the EIP, for judges, courts, and child 

welfare staff.

New York State
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reimbursement, including early intervention 

services and developmental screening (see 

42 U.S.C. 1396d(a)). These services must be 

listed in the State plan. At least 27 States have 

plans covering EI services, including physical 

therapy and other rehabilitative therapies 

such as speech and occupational therapies, 

screenings, and developmental assessments. 

States should consult with the U.S. 

Department of Health and Human Services 

Centers for Medicare and Medicaid Services 

(CMS) to determine the extent to which 

the EIP services below may be billable 

to Medicaid:

Assessment of the child and the child’s 

home life 

Physical, occupational, and speech therapy 

Vision and hearing testing, diagnosis, 

and treatment, such as eyeglasses and 

hearing aids

Nutritional assessment and intervention

Basic living and social skills development

Parent skills training

Case management

Home visiting programs, including visits by 

public health nurses to provide screening 

and referral of children to the EIP

Transportation costs for the child to 

receive services, as well as the cost of an 

attendant to accompany the child where 

the attendant is not a family member

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New Mexico saw 100 percent growth in 

children and families served by the EIP 

between 2000 and 2005, with a future 

expected annual growth of 16 percent. 

Fixed Federal Part C funding resulted in 

the need to access State general funds 

to keep up with the growth. In 2004, the 

New Mexico legislature requested a study 

to examine the feasibility of billing private 

health insurance to address program 

costs. A measure was passed to bill 

private providers up to the $3,500 annual 

cap for early intervention services. After 

the cap, the Department of Health picks 

up all EIP costs. 

New Mexico

Medicaid 

Medicaid’s Early and Periodic Screening, 

Diagnosis and Treatment Program (EPSDT) 

reimbursement can be used to maximize 

State resources for early intervention services. 

The EPSDT program is a health care program 

for Medicaid-eligible children ages birth to 

21. It is designed to detect and treat health 

problems early through regular medical, 

dental, vision, and developmental screenings. 

Many abused and neglected children not 

placed in foster care, and nearly all children 

in out-of-home placement, will meet income 

eligibility guidelines for Medicaid.

EPSDT permits States to use Medicaid 

to finance an array of services that might 

otherwise be ineligible for Medicaid 

All States cover most foster children for Medicaid. For more

information: www.cms.hhs.gov/MedicaidGenInfo/
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arrange or obtain further diagnostic 

testing, examination, and treatment for 

children with a suspected disability or 

developmental delay. It also requires 

grantees to establish partnerships with Part 

C and child protective services.

CAPTA. The Basic State Grant program 

under CAPTA requires States to develop 

a process to ensure the referral of eligible 

children for early intervention services. 

This grant funding may be used to fulfill 

this requirement. 

Temporary Assistance for Needy Families 

(TANF). Many States have used TANF to 

fund preventive programs that reduce outof-home placement, including assessment, 

case management, and family instruction 

(Dicker, Gordon, & Knitzer, 2001).

The Ohio Department of Job and 

Family Services (ODJFS) and the Ohio 

Department of Health (ODH) developed 

an interagency agreement that requires 

referrals for all substantiated cases of 

abuse and neglect and allows ODH to 

receive reimbursement from ODJFS for 

developmental evaluations conducted 

as a part of the CAPTA requirements. 

ODH then sends the reimbursement to 

the local early intervention provider using 

TANF funds. 

Ohio

Additional funding streams that might be 

explored include title IV-B child welfare 

services program and IV-B Subpart 2 funds 

under the Promoting Safe and Stable Families 

•

•

Vermont’s Success by Six program, funded 

through Medicaid and local grants, 

provides developmental screening for 

all children ages birth to 3. Families at 

risk receive extra support. Through this 

program, the child protection agency 

makes computerized, automatic referrals 

to the EIP. Interagency training is provided 

for both social services and EIP staff.

Vermont

Other Federal Funds

Some State agencies have utilized other 

Federal funds and programs to support EIP 

referral, evaluation, and services for abused 

and neglected children, as well as child 

development training for professionals. 

States have found it helpful to seek additional 

guidance from the funding source regarding 

allowable activities. 

Maternal and Child Health Program 

(MCH) (title V of the Social Security Act). 

MCH provides a health-services safety 

net for women and children to ensure 

basic health care; it can be used for 

screening, assessments, and follow-up 

medical care. States also can use these 

funds for special projects of regional and 

national significance, including training for 

professional staff. In Suffolk County, NY, 

basic health assessments and monitoring 

provided by public health nurses are 

funded through MCH dollars in addition to 

EIP Child Find funds and Medicaid.

Head Start/Early Head Start. Head 

Start requires grantees to perform or 

obtain developmental screenings and 

•

•
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program, Abandoned Infant Assistance 

Act funds, and funding streams that 

support substance abuse treatment and jail 

diversion programs. 

Conclusion

The new Part C referral provisions support 

access to early intervention services for 

abused and neglected children. The strategies 

discussed in this bulletin may help States 

consider options for fully implementing the 

CAPTA and IDEA directives. By providing 

access to early intervention services, child 

welfare administrators can better promote the 

healthy development of vulnerable children 

and their families.

Resources 

For More Information

National Early Childhood Technical 

Assistance Center (NECTAC)

www.nectac.org

The National Early Childhood Technical 

Assistance Center supports the 

implementation of the early childhood 

provisions of the Individuals with Disabilities 

Education Improvement Act (IDEA). They work 

with administrators from all States and other 

U.S. jurisdictions responsible for planning 

and implementing services under the IDEA to 

strengthen service systems and ensure that 

children with disabilities (birth through 5) and 

their families receive and benefit from high 

quality, culturally appropriate, family-centered 

supports and services.

New York State’s Permanent Judicial 

Commission on Justice for Children

www.nycourts.gov/ip/justiceforchildren/

The Commission addresses the problems of 

children whose lives are touched by the court 

system. The Commission’s website highlights 

its key reforms and initiatives, including the 

Children’s Centers, NYS Court Improvement 

Project, Healthy Development of Children in 

Foster Care Project, and the Babies Can’t Wait 

Initiative. The website also provides links to 

articles written by Commission staff related to 

child welfare, court reform, Early Intervention, 

healthy development of foster children, and 

the needs of infants in foster care, as well as 

links to resources for advocates, providers, 

and policymakers. 

State and Local Resources

Delaware

Rosanne Griff-Cabelli, Part C Coordinator

Division of Management Services

Dept. of Health and Social Services

Phone: 302.255.9135

Email: rosanne.griff-cabelli@state.de.us

Web: www.dhss.delaware.gov/dhss/dms/

epqc/birth3/directry.html

Gail Womble, Child Development 

Watch Liaison

Division of Family Services

Phone: 302.892.9135

Idaho

Mary Jones, Program Manager

Children’s Developmental Services

Dept. of Health and Welfare

Phone: 208.334.5523, 800.926.2588

Email: jonesm@idhw.state.id.us

Web: www.idahochild.org
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Massachusetts

John Lippitt, Program Manager

MECLI

Institute for Children, Youth and Family Policy

Heller School, Brandeis University

Phone: 781.736.3843

Email: lippitt@brandeis.edu

Nebraska

Todd Reckling

Office of Protection and Safety

Phone: 402.471.9625, 402.471.8404 

Email: todd.reckling@hhss.ne.gov

Joan Luebbers, Part C Co-Coordinator

Special Education Office

Dept. of Education

Phone: 402.471.2463 

Email: luebbers@nde.state.ne.us

Web: www.nde.state.ne.us/edn/

Micaela Swigle, Part C Co-Coordinator

Special Services for Children and Adults 

(Early Intervention)

Dept. of Health and Human Services

Phone: 402.471.9329

Email: micaela.swigle@hhss.ne.gov

Web: www.nde.state.ne.us/edn/

New Hampshire 

Carolyn Stiles, Part C Coordinator/

Program Specialist

Family Centered Early Supports and Services

Division of Developmental Services

Dept. of Health and Human Services

Phone: 603.271.5122

Email: cstiles@dhhs.state.nh.us

Web: www.dhhs.state.nh.us/DHHS/BDS/

family-early-support.htm

New Mexico

Andy Gomm

New Mexico Family Infant Toddler Program

Dept. of Health

Phone: 505.827.2578

Email: andrew.gomm@state.nm.us 

New York

Sheryl Dicker, Executive Director

NYS Permanent Judicial Commission on 

Justice for Children

Phone: 914.824.5665

Email: sdicker@courts.state.ny.us

Jane Corrarino, Director of Nursing

Suffolk County Dept. of Health Services

Phone: 631.853.3000

Email: Jane.Corrarino@suffolkcountyny.gov 

Ohio

Debbie Cheatham, Part C Coordinator

Bureau of EI Services

Dept. of Health

Phone: 614.644.9164, 800.755.4769

Email: dcheatha@odh.ohio.gov

Web: www.ohiohelpmegrow.org/

Pennsylvania

Julia Alexander, DHS Program Manager

Child Welfare Early Intervention Initiative

Phone: 215.683.0962

Email: Julia.Alexander@phila.gov
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Judith Silver, Ph.D., Director

Child Welfare Early Childhood Initiative

Children’s Hospital of Philadelphia

Phone: 215.590.7723

Email: SilverJ@email.chop.edu

South Carolina

Cheryl Waller, Director

Division of Children with Special Health 

Care Needs

Maternal and Child Health Bureau

Dept. of Health and Environmental Control 

Phone: 803.898.0789 

Utah

Elizabeth Kuhlman

Division of Child and Family Services

Phone: 801.538.3993

Email: ekuhlman@utah.gov

Vermont 

Helen Keith, Part C Coordinator

Family, Infant and Toddler Program

Phone: 802.241.3622

Email: hkeith@vdh.state.vt.us

Web: www.dcf.state.vt.us/cdd/programs/

prevention/fitp/

West Virginia

Laura Sperry, Child Protection Services 

Program Specialist

Pamela Roush, Director

West Virginia Birth to Three

Office of Maternal, Child and Family Health

Bureau of Public Health

Phone: 304.558.2997; 304.558.5388; 

800.642.9704

Email: pamroush@wvdhhr.org

Web: www.wvdhhr.org/birth23

References

Adoption and Safe Families Act, Pub. L. No. 105-89, Statute 2115-2135 (1997) (codified as 

amended in scattered sections of 42 U.S.C.).

Blatt, S., Saletsky, R., & Meguid, V. (1997). A comprehensive, multidisciplinary approach to 

providing health care for children in out-of-home care. Child Welfare, 76, 331-349.

Dicker, S., Gordon, E., & Knitzer, J. (2001). Improving the odds for the healthy development of 

young children in foster care. New York: National Center for Children in Poverty.

Halfon, N., Mendonca, A., & Berkowitz, G. (1995). Health status of children in foster care. Archives 

of Pediatric and Adolescent Medicine, 149, 386-392. 

Hochstadt, N. J., Jaudes, P. K., Zimo, D. A., & Schachter, J. (1987). The medical and psychosocial 

needs of children entering foster care. Child Abuse & Neglect, 11, 53-62.

Individuals With Disabilities Education Improvement Act (IDEA) of 2004 U.S.C. §§ 1400 et seq.; 34 

C.F. R. § 303.19, § 406 (2004).
Addressing the Needs of Young Children in Child Welfare: Part C – Early Intervention Services www.childwelfare.gov

16 This material may be freely reproduced and distributed. However, when doing so, please credit 

Child Welfare Information Gateway. Available online at www.childwelfare.gov/pubs/partc.cfm

Jaudes, P. K., & Shapiro, L. D. (1999). Child abuse and developmental disabilities. In J. Silver, B. J. 

Amster, & T. Haecker (Eds.), Young children and foster care: A guide for professionals (pp. 213-

234). Baltimore, MD: Paul H. Brookes Publishing Co.

Robinson, C., & Rosenberg, S. (2004). Child welfare referrals to Part C. Journal of Early 

Intervention, 26, 284-291. 

Shonkoff, J. P., & Phillips, D. A. (Eds.). (2000). From neurons to neighborhoods: The science of early 

childhood development. Washington, DC: National Academy Press.

Spiker, D., & Silver, J. (1999). Early intervention and services for infants and preschoolers in foster 

care. In J. Silver, B. J. Amster, & T. Haecker (Eds.), Young children and foster care: A guide for 

professionals (pp. 347-372). Baltimore, MD: Paul H. Brookes Publishing Co.

U.S. Department of Health and Human Services. (2007). Child Maltreatment 2005. Washington, 

DC: Author. Retrieved May 2007 from www.acf.hhs.gov/programs/cb/pubs/cm05/index.htm

Acknowledgment: This bulletin was developed by Child Welfare Information Gateway, in 

partnership with Sheryl Dicker, J.D., Executive Director, and Elysa Gordon, M.S.W., J.D., Senior 

Policy Analyst, of New York State’s Permanent Judicial Commission on Justice for Children. This 

document is made possible by the Children’s Bureau, Administration on Children, Youth and 

Families, Administration for Children and Families, U.S. Department of Health and Human Services. 

The conclusions discussed here are solely the responsibility of the authors and do not represent 

official Children’s Bureau views or policies.

Suggested Citation: Child Welfare Information Gateway. (2007). Addressing the needs of young 

children in child welfare: Part C – Early intervention services. Washington, DC: U.S. Department of 

Health and Human Services.