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Medicaid Provides Early Intervention for Infants and Toddlers with Disabilities and Developmental Delays

Medicaid is a Key Source of Funding for the Part C Infants and Toddlers with Disabilities Program of the Individuals with Disabilities Education Act (IDEA) or Early Intervention

The two programs work together to provide effective early intervention services for infants and toddlers with disabilities and developmental delays. 

Medicaid covers more than 40% of births and infants and toddlers in the nation.1 Many infants and toddlers face developmental risks due to preterm birth, congenital conditions, or other factors. A number of studies have documented the positive effects of IDEA Part C early intervention for infants born preterm, children with hearing losss, children with Down syndrome and other diagnoses or developmental delays.2 States have the responsibility under both Medicaid and IDEA Part C to identify and help finance services for infants or toddlers with developmental delays and disabilities.3 State early intervention services support optimal development, help families care for their children, and reduce disabilities.

Early Intervention Services are Cost-Effective and Help to Prevent or Reduce Developmental Delays that May Affect School Readiness4

Part C early intervention services result in short- and long-term savings by avoiding the costs associated with children entering special education services. Reports on outcomes show that infants and toddlers with disabilities who participate in Part C demonstrate improved social-emotional skills, knowledge, and behaviors—with two thirds substantially improving and about one half catching up to a level appropriate for their age.5 The National Early Intervention Longitudinal Study (NEILS) found that 42% of young children served did not need special education by the time they reached kindergarten as a result of early intervention services.6 In addition, the program reduces disabilities, improves nutrition, and increases the potential for independent living when they become adults. 

INFANTS & TODDLERS WITH DISABILITIES ENROLLED IN MEDICAID AND PART C:

  • Show improvements in early development
  • Show reduced need for school special education
  • Grow up with better health
  • Have less severe disabilities as adults

Part C early intervention (IDEA, P.L. 108-446)7provides grants to states to assist them in making early intervention services available for infants and toddlers—from birth to their third birthday—with developmental delays or a diagnosed condition that has a high probability of resulting in developmental delay.8

In 2023, approximately 540,000 infants and toddlers received early intervention services under Part C.9 Nationally, about 7% percent of US children under age 3 receive services. On average, in recent years, 15% were referred, 11% were evaluated, and 8% were found eligible for Part C services.10 The percentage of children from birth to age 3 served varies substantially across states, in part because of differences in state eligibility policies11 and enrollment efforts.12

States define Part C early intervention eligibility conditions and criteria within broad federal parameters to develop and implement “a statewide, comprehensive, coordinated, multidisciplinary, interagency system that provides early intervention services...”13 Services needed for each child and their family are defined in an Individualized Family Service Plan (IFSP). Services are provided, to the maximum extent feasible, in “natural environments;” for most families, services are provided in their homes.

Part C Funds to States do not Cover the Full Cost of Services for Infants and Toddlers Served, Emphasizing the Need for Medicaid Support

The full cost of early intervention for each child varies by state. In 2023, seven states spent more than $4,000 per child (AK, DE, FL, KY, MO, VA,  VT) while others spent less than $2,000.14 On average, federal Part C dollars contributed $1,200 per child in 2023, a figure that has decreased in recent years due to increased enrollment.15 The per-child decrease in federal funding means states must make up for the additional costs as they identify and serve more children. According to state early intervention leaders, ensuring adequate funding for early intervention services remains one of the most critical challenges for the program.16

Nearly All States Use Medicaid to Finance Part C Early Intervention Services for Infant and Toddlers Who Qualify for Both Programs

While states vary in how they use federal, state and/or local dollars use federal, state, and/or local funding to finance Part C programs, most use Medicaid to finance services for infants and toddlers with developmental delays and disabilities.17 On average, states report about half of children served in Part C are enrolled in Medicaid.18 As shown in the graph, federal Medicaid, as well as state investments, are among the largest sources of funding for Part C programs according to surveys of state early intervention directors.19 Federal law  includes important protections to help ensure every infant and toddler has access to medically necessary services under both Medicaid and IDEA Part C. Part C services financed by Medicaid vary by state, but typically include (but are not limited to): audiology, occupational and physical therapy, mental health,20 social work,21 and medical care. 

Medicaid is vital to supporting infants and toddlers with disabilities and helps to reduce state and local costs for Part C Early Intervention services. Families depend on early intervention services to help access tools to most effectively support their children’s development. States depend on Medicaid as federal funds for Part C remain flat. Together, Medicaid and IDEA Part C help states identify and address early childhood delays that benefit from early intervention to help more children thrive in school and life.  

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Endnotes

  1. Kaiser Family Foundation, Births Financed by Medicaid, 2023. Available here and Georgetown University Center for Children and Families analysis of U.S. Census Bureau 2023 American Community Survey (ACS) Public Use Microdata Sample (PUMS). ↩︎
  2. B. Elbaum and S. Celimli-Aksoy, (2022), Developmental outcomes of children served in a Part C early intervention program. Infants & Young Children, 35(1), 3-19. Available here. ↩︎
  3. Early Childhood Technical Assistance Center (ECTA), (2024), Part C of IDEA, available here. ↩︎
  4. B. Elbaum and S. Celimli-Aksoy, (2022), Developmental outcomes of children served in a Part C early intervention program. Infants & Young Children, 35(1), 3-19. Available here. ↩︎
  5. Early Childhood Technical Assistance Center (ECTA), (2022), PART C FFY 2020 [State Performance Plan/Annual Performance Report] SPP/APR Indicator Analysis Booklet. Available here and also see: https://sites.ed.gov/idea/part-c-spp-apr-indicator-3/ ↩︎
  6. K. Hebbeler, et al (2007). Early intervention for Infants and Toddlers with Disabilities and their Families: Participants, Services, and Outcomes. SRI International: Menlo Park, CA, available here. ↩︎
  7. Early Childhood Technical Assistance Center (ECTA), (2024), Part C of IDEA, available here. ↩︎
  8. K.E. Dragoo, (2019), The Individuals with Disabilities Education Act (IDEA), Part C: Early Intervention for Infants and Toddlers with Disabilities, (CRS Report No. R43631, Version 11), Congressional Research Service, Updated February 26, 2024. Available here. ↩︎
  9. Early Childhood Technical Assistance Center (ECTA), Part C (Website. 2025), Frank Porter Graham Child Development Institute, University of North Carolina.  Available here. ↩︎
  10. Prenatal-to-3 Policy Clearinghouse Evidence Review, Early Intervention Services.  (ER11b.0821), Prenatal-to-3 Policy Impact Center, 2021. Available here. ↩︎
  11. Early Childhood Technical Assistance Center (ECTA), State and Jurisdictional Eligibility Definitions for Infants and Toddlers with Disabilities Under IDEA Part C, Frank Porter Graham Child Development Institute, University of North Carolina, 2025. Available here.  ↩︎
  12. U.S. Government Accountability Office, Special Education: Additional Data Could Help Early Intervention Programs Reach More Eligible Infants and Toddlers, (Report No. GAO-24-106019) October 2023. Available here. ↩︎
  13. Code of Federal Regulations, Part C.  Available here. ↩︎
  14. Communications with Maureen Greer, Infant-Toddler Coordinators Association, December 2024. ↩︎
  15. Early Childhood Technical Assistance Center (ECTA), Part C Infant and Toddler Program Federal Appropriations and National Child Count 1987–2023 (updated September 9, 2024), Frank Porter Graham Child Development Institute. University of North Carolina. Available here. ↩︎
  16. C.O. Vail, R.G. Lieberman-Betz, and L.S. McCorkle, (2018), The Impact of Funding on Part C Systems: Is the Tail Wagging the Dog? Journal of Early Intervention, 40(3), 229-245. Available here. ↩︎
  17. Infant and Toddler Coordinators Association (ITCA), 2023 ITCA Finance Survey Report, 2023. Available here. ↩︎
  18. Infant and Toddler Coordinators Association (ITCA), 2023 ITCA Finance Survey Report, 2023. Available here. ↩︎
  19. Infant and Toddler Coordinators Association (ITCA), 2023 ITCA Finance Survey Report, 2023. Available here. ↩︎
  20. S. Smith, D. Ferguson, E.W. Burak, M.R. Granja, and C. Ortuzar. Supporting Social-Emotional and Mental Health Needs of Young Children Through Part C Early Intervention: Results of a 50-State Survey.  National Center for Children in Poverty and Georgetown University Center for Children and Families, November 2020. Available here. ↩︎
  21. Early Childhood Technical Assistance Center (ECTA), Briefing Paper: Infant and Early Childhood Mental Health and Early Intervention (Part C), Frank Porter Graham Child Development Institute, University of North Carolina, May 2022. Available here. ↩︎

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