08102-Determination of Eligibility for Early Start
SCOPE:
This procedure applies to all Services and Supports staff of Tri-Counties Regional Center.
Any child, birth to 36 months of age, may be considered for Early Start eligibility under three categories: high risk for developmental delay, established risk, or developmental delay.
No single factor necessarily determines eligibility. The regional center multidisciplinary team determines eligibility based on standardized developmental assessments, parent report, observation, medical reports, and clinical assessment.
Initial Intake Inquiry
The On Duty Service Coordinator or designated person will complete the Early Start Inquiry Form when a referral to Early Start is made. The referral may be made by a parent, medical office, day care provider etc. The form must be completed with as much information as possible and must include parent address and contact information. Once the inquiry is received, a service coordinator is then assigned to each child.
A potentially eligible child may meet eligibility for TCRC as well as the respective school district. If the school district has not yet reached its funded capacity and it is determined that the child may be dually served, the service coordinator and/or the infant specialist from the school district will contact the family for the initial meeting. If the child is served solely by TCRC, the service coordinator will contact the family to schedule the intake meeting. All referrals that are solely low incidence (SLI) i.e., hearing, vision, or orthopedic impairment only, will be directly referred to the school district.
Once a service coordinator is assigned, he/she will contact the family to schedule the initial intake meeting which will usually occur at the family’s home. At the intake meeting, the service coordinator observes the child and obtains family history, family concerns, medical information and consent to evaluate. A developmental assessment may be scheduled at the initial meeting with prior written consent or scheduled at a later date and administered with the child to determine areas of family strengths and concerns, age equivalents in the developmental domains, and level of overall functioning. The initial intake interview, developmental assessment, eligibility determination and the development of the IFSP shall be completed within 45 days from the initial inquiry date.
Information from the intake visit, parental observation, health records, and the assessment are all used to determine eligibility. That information is then presented at the Eligibility Staffing meeting.
A child may be eligible under any of three categories: High Risk, Established Risk, or Developmental Delay.
If a child is determined to be eligible a letter is sent to the family and an initial IFSP is completed by the Service coordinator with the family.
If a child is determined ineligible a letter is sent to the family along with information on the appeal process.
Categories for Early Start Eligibility
High Risk for a developmental disability exists when the team determines that an infant or toddler has a combination of two or more of the following factors that requires early intervention services based on evaluation and assessment:
- Prematurity, less than or equal to 32-week gestation, or low birth weight, less than or equal to 1500 grams;
- Significantly small for gestational age (SGA), below the third percentile for estimated gestational age;
- Severe respiratory distress requiring assisted ventilation for 48 hours or longer during the first 28 days of life;
- Asphyxia neonatorum associated with five-minute Apgar of 5 or less;
- Hyperbilirubinemia requiring exchange transfusion;
- Severe and persistent metabolic abnormality;
- Neonatal seizures or non-febrile seizures during the first three years of life;
- Central nervous system lesion or abnormality;
- Central nervous system infection;
- Serious biomedical insult which may affect developmental outcomes;
- Multiple congenital anomalies or genetic disorders which may affect developmental outcomes;
- Prenatal exposure to known teratogen which may affect developmental outcomes.
- Child who is born to a parent with a developmental disability.
Established Risk exists when an infant or toddler has a condition of known etiology which has a high probability of resulting in developmental delay. For example, Down Syndrome, Fetal Alcohol Syndrome or Fragile X Syndrome.
Developmental Delay
A developmental delay exists if there is a significant difference (age equivalent score falls 25% below age expectation) between the infant’s or toddler’s current level of functioning and the expected level of development for his or her age in one or more of the following developmental areas: cognitive, physical, expressive communication, receptive communication, social/emotional or, adaptive, on a standardized, normed or criterion referenced instrument.
PROCEDURE:
- The Early Start On Duty Service Coordinator records the information on the Initial Inquiry Form.
- The date from the Initial Inquiry Form is entered in the SANDIS Inquiry Screen.
- Each intake is assigned to a service coordinator within 48 hours/2 business days.
- The assigned service coordinator will contact the family as soon as possible to schedule the intake interview and meet with them for the intake.
- A 2-day written notice will be provided to family as soon as the intake is scheduled.
- When the assessment is authorized, medical records will be requested.
- A developmental evaluation is completed to determine the child’s level of development. All six (6) levels of development including hearing, vision, and health status will be assessed. (The developmental evaluation may also occur at the time of intake with prior written consent).
- Once the developmental report is received, the interdisciplinary team meets to determine eligibility based on the evaluation results, observation, family input, medical records, and clinical judgment.
- If the child is determined ineligible; the service coordinator should:
- Document the results of the team meeting,
- Will inform the family by phone and before written notification is sent and give them the opportunity to discuss the evaluation, have an opportunity to ask questions of professional staff (I. E., physician, psychologist, service coordinator) and obtain recommendations for follow up services and resources.
- Inform the family of their right to appeal the decision and Submit for Case Closure to Support Staff.
- If the child is found to be eligible; the service coordinator will:
- Document the results of the team meeting in T19-notes in SANDIS,
- Complete the Statement of Eligibility (SOE),
- Contact the family by phone and send the family a letter of acceptance for regional center services, and
- Contact the family to schedule the initial Individual/Family Service Plan (IFSP) and send a 2-day notice for the IFSP.
Revision Date: July 2025