Supporting Texas’ Early Childhood Intervention Program Interim Charge Recommendation
Texas Early Childhood Intervention (ECI) is a vital statewide program that provides home-based therapies and support to more than 50,000 babies and toddlers with developmental delays and disabilities. Created under Part C of the Individuals with Disabilities Education Act, or IDEA, ECI’s purpose is to ensure children develop the skills necessary to meet their goals and thrive in preschool and throughout their education. To administer the program, Texas HHSC contracts with community organizations that provide targeted therapies, skills training, parent coaching, and other tailored services. ECI organizations work with families to help their children learn to swallow, learn to walk, communicate with their families, and be ready for school. By intervening early and working with families to replicate needed services at home, ECI is effective for children and saves taxpayer money, such as reducing the need for costly special education services.
The current ECI system is in crisis, with providers terminating contracts at an alarming rate and huge enrollment drops since 2011. A combination of state cuts to ECI funding since 2011, program changes, and more recent state cuts to Medicaid reimbursement rates for children’s therapies has contributed to an overall decrease in the number of children served, ECI contractors leaving the program, and financial strain on community organizations providing ECI services. From FY 2010 to FY 2017, Texas reduced spending on ECI by 11 percent. Due in large part to the state funding cuts, the number of children receiving ECI services fell 10 percent statewide between 2011 and 2016, even though the population of children under age three grew four percent across the state. In some parts of the state, ECI enrollment dropped more than 35 percent. Enrollment declines have hit all demographic groups, but the largest decline is among Black children.
Currently, only 45 organizations provide ECI services across the state, down from 58 contractors just seven years ago. Three agencies ended their ECI in 2016 and three announced in 2017 that they would not renew their contracts. Program closures are devastating to families, children who rely on these services, and ECI providers that have shouldered increased responsibilities, adjusted to many funding changes, and sustained losses to serve children with developmental delays.
Furthermore, the devastation brought by Hurricane Harvey has displaced countless families, including children with disabilities who rely on ECI. In some cases, there is a disruption in care as families look for a replacement provider to offer early intervention services in their area.
ECI Interim Charge Recommendation
The interim provides lawmakers an opportunity to focus on the complex issues and challenges affecting Texas ECI. In order to forge a sustainable future for ECI and ensure children have access to these critical services, we recommend the following topics be included in an interim charge related to ECI:
- Identify strategies to ensure Texas children age birth to three with disabilities or developmental delays have access to Early Childhood Intervention (ECI) services in their communities.
Investigate the impact of Hurricane Harvey and family displacement on ECI contractors and children’s access to ECI services.
Review the decline in the number of ECI contractors and examine reasons for their decisions to exit the program, including the effects of state ECI policy changes and Medicaid reimbursement levels. Develop recommendations for continued sustainability of Texas ECI, including assessing the family cost share system and creating parity between Medicaid and private insurer coverage of early intervention services.
Examine opportunities to strengthen Child Find outreach and improve identification and referral of children eligible for ECI services. Identify strategies to increase awareness of ECI and bolster referral practices and linkages among programs serving young Texas children, including Medicaid and CHIP Managed Care Organizations, private health insurers, primary care providers, Head Start programs, and early childhood education programs.
Review best practices in other states for ECI financing, Child Find, coordination regarding developmental screenings and referrals, and effective transition of children to pre-k programs.
Thank you for your commitment to the mission of ECI and the transformative effect ECI services have on the children and families of Texas. If you have any further questions, please contact Stephanie Rubin, CEO at Texans Care for Children at firstname.lastname@example.org.
Center for Public Policy Priorities
Children’s Defense Fund Texas
Coalition of Texans with Disabilities
Disability Rights Texas
First 3 Years
Texas Association for the Education of Young Children
Texans Care for Children
Texas Council for Developmental Disabilities
Texas Council of Community Centers
Texas Parent to Parent
Texas Pediatric Society