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The Cost of Serving Infants and Toddlers Under Part C

Johnson, Jean L. DrPH; Brown, Susan MEd; Chang, Chuan PhD; Nelson, Dawna MSW; Mrazek, Susan MA

doi: 10.1097/IYC.0b013e3182014c97

To identify the per-child cost of providing Part C services, the authors analyzed extensive statewide expenditure data in Hawai‘i to determine the monthly and annual costs of providing early intervention services to infants and toddlers and their families. Identified were the costs of serving children with various numbers and percentages of delay, the cost of providing care-coordination services, and the administrative costs for local- and state-level providers of Part C services. Furthermore, the data provided an opportunity to identify the cost of transportation in providing Part C services. The authors also analyzed the cost of serving 2 special populations of children: (1) children receiving Medicaid and (2) children with an autism-spectrum diagnosis. In addition to findings on costs, other significant findings emerged from the study. Two-thirds of the enrolled children had 3 or more significant delays. The cost of transportation consumed more than one-fourth of service expenditures. Children received on the average fewer than 3 hours of service per month. Overall administrative costs amounted to 41.4% of total program expenditures. Most surprising was that the state was spending less per child than it was a decade ago. The study provides previously unavailable information on the cost of early intervention services.

University of Hawai‘i (Drs Johnson and Chang, and Mss Nelson and Mrazek), Hawai‘i Department of Health (Ms Brown), Honolulu, Hawai.

Correspondence: Jean L. Johnson, DrPH, Center on Disability Studies, University of Hawai‘i, 1776 University Avenue, Honolulu, HI 96822 (

This article is based on a study entitled, “The Cost of Serving Infants and Toddlers in Hawai‘i under Part C,” conducted by the Center on Disability Studies, University of Hawai‘i, Honolulu, 2009.

The authors express appreciation to Robert C. Johnson for his editing of the article. The authors also express appreciation to Linda Goetze, Utah State University, for her critical review of an early draft of the article.

©2011Lippincott Williams & Wilkins, Inc.