Increasing Access to Early Intervention and Behavioral Health Supports in Early Childhood Education Programs

The Need

This research project builds on the work we have undertaken over the past two years to collaborate with NYC ECE providers, parents and caregivers to identify policy solutions that address the issues families of young children face in finding and accessing comprehensive, affordable, and high quality early care and education services as documented in the May 2023 report, The Youngest New Yorkers: Building a Universal Early Care and Education System in New York City.

Our research has demonstrated that center-based and family childcare service providers are the backbone of New York City’s early care and education system and trusted by families across NYC communities. Unfortunately, our research also underscores that providers are very under-resourced and face multiple operational and workforce challenges in providing essential services to children and their families. At the same time, families have elevated concerns about rising behavioral health needs for caregivers and children and the multiple barriers they face in accessing a wide range of developmental and behavioral resources in their communities. Through this work, we identified a growing need for local policies and investments that would improve connections to Early Intervention and behavioral health services within ECE settings to address children’s developmental and social-emotional needs.

CCC maintains a robust database on the state of children in New York City, combining thousands of data points from local, state, and federal sources. You can view the database here and explore various indicators of well-being, including data on Early Intervention, Early Childhood Education, and Behavioral Health. For more detailed reports on connected topics, click on the three additional tabs for more links!

Findings from our analysis of enrollment and capacity data, as well as conversations with ECE providers, and a citywide survey of parents and young children are summarized in a report, The Youngest New Yorkers: Building a Universal Early Care and Education System in New York City. Our more recent data analysis, (Un)Affordability of Child Care and Out-of-School Care in NYC, further reinforces the need to strengthen the publicly funded ECE system to allow providers to offer high quality care for children in NYC.

Children throughout the city have been unable to receive timely and comprehensive developmental services due to provider shortages and a chronically underfunded Early Intervention system. To understand the impact of delayed EI services, CCC put together an Early Intervention fact sheet in 2023 with data on delays, referrals, and evaluations. Click here to read the factsheet. You can also read an overview of the factsheet details in the context of budget advocacy in this Insight from last year, Less Than Half of Children Receive All EI Services On Time.

CCC is also part of the Campaign for Healthy Minds, Healthy Kids (HMHK) as a leader and co-convener. The HMHK website has ample information about New York’s behavioral health crisis and advocacy around increase investments in the continuum. Click here to learn more and download an infographic.

Engaging Providers

CCC is hosting a series of workshops in early 2024 to elevate providers’ experience and views to inform findings and recommendations that will identify needed support for children and families and the workforce.

In light of the Department of Education requiring all contracted ECE providers to conduct developmental screenings and provide needed developmental or behavioral health services either in their settings or through referrals, for children in their care, we are engaging with contracted centers, including Head Start and Early Head Start providers, and Family Child Care Networks to learn about their experiences with these screenings. While developmental and behavioral health services are important for all children birth to five years of age, our focus is on providers serving infants, toddlers and three-year-old children for whom access to Early Intervention (EI) services, the transition between EI and Preschool Special Education (CPSE); as well as access to young child behavioral health supports are of critical importance due to their age.

Our goal is to learn and elevate providers’ experiences with leveraging screening instruments to guide curriculum development, facilitating access to services on site and referrals to offsite services, as well as providing inclusive services within their settings. In addition to elevating the most common challenges that providers experience, these workshops will also help identify successful practice among providers and opportunities for system-level change to improve access to developmental and behavioral health services within ECE settings.

What we know about access to Early Intervention and Behavioral Health for Young Children in NYC

The Early Intervention system has faced decades of underinvestment, which has resulted in widespread provider shortages, delayed services, and inequities in access. Low reimbursement rates are driving providers out of the program, leaving infants and toddlers waiting for and at times denied developmental services because no provider is available. Children continue to wait weeks, sometimes months, for the in-person services they need. As a result, they are falling behind their peers in developmental growth. Even when a child is identified in an ECE setting as having a developmental need, the shortage of EI providers contributes to the challenges families face in finding and receiving timely Early Intervention services.

In New York, our health system doesn’t have the capacity to treat the skyrocketing number of kids desperately in need of mental health support. Right now, children often have to get really sick to get help, and that help is too often delivered in emergency rooms and hospitals, rather than through the ongoing, high-quality services they need to stay healthy. Unfortunately, New York has not invested enough resources in the children’s behavioral health system to pay for the true cost of serving children or to provide high quality care to every child. As a result, providers across the state are facing severe workforce shortages, and families are left struggling to find urgently needed care. Within ECE settings, there are additional barriers to connecting young children with behavioral health settings. These include but are not limited to: A shortage of providers trained in how to offer supports to young children; too few bilingual and BIPOC providers of young child mental health; lack of payment models and local, state, and federal funding to support integrating early child mental health providers in ECE settings; a lack of integrated services across settings and agencies; and difficulty providing parents/caregivers with their own mental health services in these child-serving settings.