A child (under the age of 36 months) of any Connecticut resident who:

1.has a diagnosed medical condition such as Down syndrome, spina bifida, autism, blindness, deafness, or others that have a high probability of resulting in a developmental delay,
                                                OR
2. shows significant delays in development such as talking or walking.

Who can refer a child?

Anyone who has a concern about a child's development may make a referral. This includes parents, guardians, foster parents and family members; professionals such as pediatricians, other physicians, social workers, nurses, child care providers; or others who have contact with the child. If someone other than the child's parents makes the referral, the parents will be contacted for their permission before any action is taken.  Participation is voluntary.

How do I refer a child?

Call Child Development Infoline (CDI) at 1-800-505-7000. You will be asked for basic information, such as the name, address and telephone number of the family, along with the reason for referral.  You can also refer on-line.

Who will contact the family?

The CDI staff will contact the family to ask them to select a local early intervention program from the statewide network to evaluate their child's development. Program staff will then contact the family to schedule an in-home evaluation and, if the child is eligible, begin the process of planning for services and supports.

How are services delivered?

After the parents have selected a program, they and a team of people who match their child's needs will develop an Individualized Family Service Plan. This plan will describe the child's strengths and needs as well as the family's concerns and priorities for their child. It will also detail what services and supports need to be provided including their location and frequency.

Early intervention services may include any of the following:

1. Assistive technology devices and services
2. Audiological services
3. Speech and language services
4. Family training, counseling, and home visits
5. Health services necessary to benefit from other early intervention services
6. Medical services for Birth to Three diagnostic or evaluation purposes only
7. Nutrition services
8. Occupational therapy
9. Physical therapy
10. Psychological services
11. Service coordination
12. Special instruction
13. Social work services
14. Transportation or mileage reimbursement when necessary to receive other early intervention services
15. Vision and mobility services

In most cases, services are delivered in settings that are natural for that child, including the family home, child care settings, and other places where children usually spend time.

What is the cost to families?

Family Cost Participation

Public Act 03-03,effective August 16, 2003, changed section 17a-248g(e) of the Birth to Three statute to read:  The commissioner shall establish a schedule of fees based on a sliding scale for early intervention services.  The schedule of fees shall consider the cost of such services relative to the financial resources of the parents or legal guardians of eligible children.  Fees may be charged to any such parent or guardian, regardless of income, and shall be charged to any such parent or guardian with a gross annual family income of forty-five thousand dollars or more, except that no fee may be charged to the parent or guardian of a child who is eligible for Medicaid.  The Department of Developmental Services may assign its right to collect fees to a designee or provider participating in the early intervention program and providing services to a recipient in order to assist the provider in obtaining payment for such services.  The commissioner may implement procedures for the collection of the schedule of fees while in the process of adopting or amending such criteria in regulation provided the commissioner prints notice of intention to adopt or amend the regulations in the Connecticut Law Journal within twenty days of implementing the policy.  Such collection procedures and schedule of fees shall be valid until the time the final regulations are effective.

Questions and answers about family cost participation

Q       Where would I find the amount of my adjusted gross income?

A        On the Federal tax return (Form 1040) that is on line 35.  On the 1040EZ that is line 4.  On your state return (CT-1040) that figure is listed on line 1.
 

Q       How is the information about my income be collected? 

A        Service coordinators ask each family to complete a form indicating their level of income and family size.  The service coordinator also knows whether the family consented to have their health insurance billed or had declined consent.  Families who declined consent have to pay a higher rate and may wish to reconsider that decision.  Families are not asked to show proof of income in the form of income tax forms or pay stubs, however Birth to Three has the ability to verify incomes with the Department of Revenue Services.

Q       What if I did not file an income tax form last year?

A        Calculate your family’s gross income based on current wages or other sources of income.  You can then adjust, if you want, for 1) educational expenses, 2) IRA deductions, 3) student loan interest, 4) moving expenses, 5) ½ of self-employment tax, 6) self-employed health insurance, 7) self-employed SEP, SIMPLE, and qualified plans, 8) penalty on early withdrawal of savings, and 9) alimony payments.  You would follow the same rules in making these adjustments as you would if you were filing an income tax return.

Q       My child is covered by Medicaid.  Will I have to pay a monthly fee?

A        No.  Whether a child is covered by regular Medicaid (HUSKY A) or has been included on a Medicaid waiver, the family will not be billed.  Families with adjusted gross incomes below $45,000 will also not be billed.

          Q       My child is covered by HUSKY B.  Will I have to pay a monthly
               fee?
                 A        Yes, HUSKY B is an insurance plan. 

Q       I did not receive any services because we were away for the entire month, will I be billed?

A        No, families will only receive bills for months in which they receive services.  However, visits that are cancelled by the family with less than 24-hours notice will still count as “services”.  Your monthly bill will include the dates of services and visits that you cancelled with less than 24-hours advance notice.

Q       What if my child begins receiving services in the middle of the month or leaves the Birth to Three System in the middle of a month?

A        Families are only charged after the second full month of enrollment.  Therefore, if a child begins receiving services in the middle of February, the family’s first bill will be received in June for May services.  If a child leaves in the middle of February, the family’s last bill will be for January services.

Q       When will I be billed?

A        Bills will be sent out in the middle of the month for services received during the previous month.
 

Q       I have twins who are both receiving services.  Will I get billed twice?

A        No, each family will only be billed for one child per month, regardless of how many children are enrolled at the same time.

Q       If my Birth to Three program is charging my insurance plan and I’m also paying monthly, won’t the amount paid on behalf of my child be more than the cost of services?

A        The Birth to Three System pays each program, on average, $600 per month or $7,200 per year per child.  Programs get paid more for children who receive intensive services (more than 15 hours per month.)  Insurance plans are only required to reimburse programs for up to $3,200 per year and many do not pay at all (those that are self-funded and not required to follow state insurance laws.)  Therefore, it is unlikely that the combined reimbursement from insurance and parent payments will exceed the amount that the Birth to Three System pays the program for each child.  However, in the event that should happen, the family will be reimbursed for any excess payments at the time their child exits the Birth to Three System.

Q       What if I don’t fill out the form that indicates my income level?

A        You will be billed at the highest amount on the appropriate fee schedule.

Q       What if I don’t pay or what if my payments are late?

A        When payments are more than 90 days in arrears, the family and program will be notified that services will be suspended.  Service coordination, evaluation, assessment, and IFSP development and evaluation will continue to be provided at no cost.
 

Q       If I pay in full after services have been suspended, am I entitled to receive the services I missed?

A        No.  Once payments are current, services will resume.  You will not be billed for any month in which no services were received which includes any full month during which services were suspended.

Q       I have to pay a lot for my child’s medical bills and I really can’t afford one more bill.  Can I ask to have my payment reduced?

A        A family that has extraordinary expenses can request that their adjusted gross income be reduced by the amount of those expenses.  That will then reduce the amount of the monthly payment.  The categories allowed are:

§         Medical expenses that are greater than 6% of adjusted gross income

§         Payments made to support family members outside of the home

§         Home repair expenses to maintain your home in a livable condition

§         Tuition, books, room and board for college, technical school, or non-public

schools (maximum of $10,000)

§         Purchases of job-related necessities not furnished or reimbursed by your employer

§         Mandatory payments on large accumulated debts

§         Child care expenses (if both primary caregivers are employed)

If any of these categories apply, ask your service coordinator for an Application for Income Adjustment form.  The form is sent to the Birth to Three Fiscal Office for approval.  Adjustments are not retroactive.

Q       What happens if I apply for an income adjustment and it isn’t approved?

A        If you disagree with the decision, you may request an administrative review by writing to the DDS Commissioner (460 Capitol Ave.  Hartford, CT  06106) within 30 days of receiving the decision. 

Q       What if my income has changed a lot from last year?

A        If this change happens after you have already filled out the Family Cost Participation Form, ask your service coordinator for a new form.  If you already know that your income has changed significantly before you fill out the form, then fill in what you expect your adjusted gross income to be.

Q       I have given my Birth to Three program permission to bill my insurance but my insurance plan has denied payment.  Will I be charged more?

A        No.  As long as you have given us permission to bill your insurance plan, your monthly payment will remain the same.

Q       Who will actually be sending out the bills?

A        The state contracts with Benefits Processing Services, a private billing agency, for this purpose. 

Q       Are these payments deductible on my income tax return next year?

A        We don’t know whether these payments would be deductible as medical or educational expenses.  You will have to ask a tax preparation professional.

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