Restricting state part C eligibility policy is associated with lower early intervention utilization.
To examine if state differences in early intervention (EI) utilization can be explained by recent restrictions on EI state eligibility policy. The sample (n = 923), derived from the 2009/10 National Survey of Children with Special Health Care Needs, included CSHCN who were ages 0-3 with a developmental delay or disability that affected their function. Multi-level logistic modeling was used to describe state differences in EI utilization and to determine if narrower state eligibility policy explained these differences. EI utilization ranged from 6 to 87 % across states. Having a severe condition (β = 0.99, SE = 0.28) and a usual source of care (β = 0.01, SE = 0.001) was associated with higher odds of utilizing EI. Compared to a diagnosed disability, having a developmental delay (β = -0.61, SE = 0.20) was associated with lower odds of utilizing EI. Living in a state with narrow and narrower state eligibility policy (β = -0.18, SE = 0.06) was significantly associated with lower odds of EI utilization, and this effect was strongest for children with the most severe functional impairments. Significant state variation in EI rates exists that can be explained, in part, by the restrictiveness of state eligibility criteria. Children with the most severe functional impairments appear to be least likely to utilize EI in states with the most restrictive eligibility policies.
Department of Health Systems, Management and Policy, Colorado School of Public Health, Children's Outcomes Research Group, Children's Hospital Colorado, 13001 E. 17th Place, MS B117, Aurora, CO, 80045, USA, beth.mcmanus@ucdenver.edu.
Beth M
BM
McManus
Dawn
D
Magnusson
Steven
S
Rosenberg
D000293:Adolescent; D000367:Age Factors; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D002658:Developmental Disabilities / Q000175:diagnosis / Q000191:economics / Q000628:therapy*; D004185:Disability Evaluation; D019988:Children with Disabilities / Q000534:rehabilitation* / Q000706:statistics & numerical data; D018479:Early Intervention, Educational / Q000331:legislation & jurisprudence / Q000706:statistics & numerical data*; D004608:Eligibility Determination / Q000331:legislation & jurisprudence*; D005260:Female; D018166:Health Care Reform; D006291:Health Policy; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008484:Medicaid / Q000191:economics / Q000331:legislation & jurisprudence*; D011050:Policy Making; D011379:Prognosis; D018570:Risk Assessment; D012737:Sex Factors; D014481:United States