Objective

To determine the extent of implementation of the five recommendations included in our initial audit report, Oversight of the Early Intervention Program (Report 2021-S-25).

About the Program

When a child has a developmental delay or disability, their early years provide a critical window of opportunity to intervene. Research shows that the earlier a developmental delay or disability is identified, and the sooner services begin, the less likely it is that the child will need more intensive and expensive special education services later. Young children missing these opportunities for early intervention services are potentially at greater risk of significant developmental and learning delays.

The mission of the Early Intervention Program (Program) is to identify and evaluate as early as possible those infants and toddlers whose healthy development is compromised and provide appropriate intervention to improve child and family developments. The Department of Health (DOH) oversees both the Program and its contracts with the 57 counties in the State and New York City (referred to as “municipalities”) that administer the Program at the local level.

The federal Individuals with Disabilities Education Act and State Public Health Law include specific requirements and time frames for the provision of Program services. One requirement is that DOH must develop a comprehensive Child Find system (Child Find) that ensures eligible children in the State are identified, located, and referred to the Program. Generally, after referral, children should be evaluated by qualified professionals through a multidisciplinary evaluation. If the evaluator determines a child has a disability or developmental delay, the municipality is responsible for convening a meeting to develop an initial Individualized Family Service Plan (IFSP) for therapeutic services and supports from a qualified service provider.

DOH uses a web-based system, New York State Early Intervention System (NYEIS), to manage the Program and exchange information among municipalities. According to NYEIS, for the period from February 2023 through June 2024, approximately 85,000 children were newly referred to the Program for a suspected or confirmed developmental delay or disability and about 10,000 new children were referred as at risk of developmental delay or disability. For the same period, there were almost 36,000 children enrolled in the Program with an active IFSP.

The objective of our initial audit, issued on February 28, 2023, was to determine whether DOH was effectively administering the Program in compliance with all applicable laws and regulations and ensuring equitable and timely access to services for children across the State. The audit covered the period from July 2018 through February 2022. Our initial audit found that many children who could benefit from the Program weren’t receiving services, and children who were receiving services weren’t always getting them in a timely manner. In addition, limited guidance and oversight from DOH resulted in significant differences in Child Find’s outreach and awareness activities across the State. Furthermore, the audit identified disparities across the State in the referral and inclusion of children into the Program as well as in the availability of providers and access to Program services. Equity was also an issue, with White children generally being referred at a younger age and Black children being less likely to receive services within the prescribed time frame. While DOH demonstrated that it recognized the importance of equity, more work needed to be done to identify and fully address barriers to equitable access to the Program. The audit also found that NYEIS did not have the functionality or accuracy municipalities need to administer the Program efficiently and effectively at the local level. While DOH was working with a contractor to implement a new web-based system, EI-HUB, progress had been delayed multiple times.

Key Findings

DOH made some progress in addressing the issues we identified in the initial audit; however, additional actions are needed. Of the initial report’s five audit recommendations, one was implemented and four were partially implemented.

Key Recommendation

DOH officials are requested, but not required, to provide information about any actions planned to address the unresolved issues discussed in this follow-up within 30 days of the report’s issuance.