EI to school system transition

thishappyhouse · September 2013

My daughter is a former micropreemie who has been in EI since NICU discharge with varying amounts of services. Right now she gets weekly PT and monthly speech. We are coming up on a review in a few weeks and depending on what services and quantity they recommend I may consider just transitioning to private services. Im pretty sure they are going to recommend continuing PT but maybe on a reduced schedule, but Im really not sure what they are going to say about speech or an educator. That said, if we are only looking at PT once a week or once every 2 weeks Id like to go to private therapies which are covered under our insurance and avoid the $250 monthly family fee that our state charges for EI.

I am concerned about what that might mean for school system transition though. Is this a shortsighted decision if it is only going to cause problems in a year when she is eligible through the school system? Would I need to re-enroll in EI to get an IEP at age 3?

mommyof4boys · September 2013

It shouldn't do much for the preschool transition. You still need to write a letter to the district asking for an evaluation around age three.

mommytoconnor · September 2013

When you are thru EI and at approx 2 yrs 9 months they will start transition for you. Your EI case mgr will start the process for you and do the application. Then there is typically several meetings that happen to determine eligibility for your LO. for example I had 5 mtgs. They gather all info, do some testing and then come to conclusion. I would cont with services thru EI until she turns 3. If you decide to opt out of EI for the cost fee then you would be responsible for the application for preschool transition and honestly it may be more work in the end, because you would have to get EI info sent to preschool. It's not as simple as just writing a letter asking for eval. They need records and such. I just went thru this and I was glad that EI did the legwork for me. Hope this helps.

mommyof4boys · September 2013

mommytoconnor said:

When you are thru EI and at approx 2 yrs 9 months they will start transition for you. Your EI case mgr will start the process for you and do the application. Then there is typically several meetings that happen to determine eligibility for your LO. for example I had 5 mtgs. They gather all info, do some testing and then come to conclusion. I would cont with services thru EI until she turns 3. If you decide to opt out of EI for the cost fee then you would be responsible for the application for preschool transition and honestly it may be more work in the end, because you would have to get EI info sent to preschool. It's not as simple as just writing a letter asking for eval. They need records and such. I just went thru this and I was glad that EI did the legwork for me. Hope this helps.

I've had the process both ways. We had 2 kids NOT in EI (that should have been but I wasn't as educated about it) and one that was. The only thing EI did for us was facilitate a timeline. We had to do everything. They didn't use any of his records at all. We wrote a letter around the 2.5 year mark asking for a comprehensive eval and the district ran with the rest. They, in fact, didn't care that he had specific services and tried to NOT evaluate OT and PT. Our one kiddo had PT once a week and OT once a week at that point. In addition, WE had to fill out information. Our case manager didn't have to fill out any applications at all.

My boys who weren't in EI, at 3, I sent a letter for evaluations in for one boy. The ped suggested it. It really wasn't much different than my other guy expect for one thing. The district came out and observed my kiddo in his home environment for my EI kid. My other boy, I sent in a letter after my one guy was approved for an IEP. They wouldn't evaluate him saying his skills were higher and to re-send his name in kindergarten for a speech eval. When we put him in preschool inclusion as a "typical" kid, the teacher asked for the eval within the first 6 weeks.

There are plenty of parents who don't utilize EI and do the private therapy route. It's not going to hurt her chances of needing an IEP. IFSPs and IEPs are fundamentally different. IFSP's provide therapy for specific diagnosis and will provide difference services for the families of children with special needs. They also provide services for delays period. In a school based setting, an IEP is based on the impact to the educational day. If the delay doesn't impact the educational day, they won't get that service. For example, my one boy, we are looking at a possible CP diagnosis. They don't provide PT for him saying it's not impacting him functioning within the classroom setting.

kcisthebombdotcom · September 2013

Eek, that's a tough one. EI in my state is free regardless of income so we went with them. With my son, by the end of ei he had no delays on paper ( and was actually ahead of the curve in some areas) but had difficulties with articulation. My ei team did absolutely everything for me for the transition--I just showed up for meetings. My SLP wrote a two page document on how even though he looked so great on paper he had some remaining issues that needed help and presented it ant the eligibility meeting. He qualified for speech twice a week-one private, one group. I would have likely gotten nothing doing it on my own but instead he gets more help than many severely delayed kids I know in my district.

I would probably talk to your team about the transition process and what role they will play in it. If they're as much of a support as my ei experience was, it would most definitely be worth keeping. If they don't do a whole lot, I would look into getting an advocate to help you through the process and do private therapy instead.

finsup · September 2013

So you are getting 5 therapy sessions for a payment of 250.00 a month? I don't blame you for looking privately, it could potentially save you a lot and you could get more. That always bugged me about EI - it was the same in my state, and it bugged me that I could get 3 sessions a month based on my child's need, but another family got 10 sessions a month for their needs but we paid the same amount of money. Also, why only one session of speech a month? What good is that doing?

But, I agree with pp before making the switch be absolutely sure of the covered services of your policy, they can get tricky and often insurance companies don't even know what their own damn coverages are. Our OT gets a denial letter every month, and every month they have to call and explain over again, and every month it gets approved. But the process is the same month after month after month.

The other thing to consider is not only making sure you find a therapist who will fit your needs therapeutically, but who also takes your insurance and who also has openings. In my, fairly major metro area that was a harder task than I thought it should have been.

IME, EI didn't bring a ton to the table with regards to the transition to the school system. She provided me the paperwork to fill out and attended the first meeting to give the team background information and her final report. Which was a nice to have but totally not necessary. The school does all of their own evaluations anyway, and often the criteria for services is going to be different than what you were offered in EI.

thishappyhouse · September 2013

Thank you all for your thoughtful insight. You have brought up a lot of things that I had not yet thought of.

@finsup Monthly speech is pretty useless other than having the SLP keep tabs on where she is so that we can amend our IFSP to ramp up ST as needed. @-auntie- not sure what her educational needs might be in the next year and beyond. She is a busy kid and has a short temper so we are still trying to work through what is difficult for her and what is typical toddler stuff.

Also I did not realize how acute the difference between EI services and School System services are. Its eye opening and leaves me wondering what she will qualify for with an IEP. I am very aware that the next few years are critical for her though and she is high risk for developing a slew of things that may not be evident right now.

We are in CT - NY metro area, so while I dont know for sure that there are private therapists that meet our needs and are covered by our insurance, we will likely have some good options. In fact our EI provider has a private side to their practice. I do know for sure that PT and OT are covered with no cap by our insurance as long as the child is making "progress." What I dont know is how subjective that is.

I will certainly wait to see how our IFSP gets ammended before making any decisions. In doing some research I did realize that we can stay enrolled for free with our service coordinator, meaning we would have quarterly service coordination meetings and bi annual evaluations. This makes me feel better about a potential switch.

I hate making these types of decisions based on financial considerations but at the same time I think about how that $250 per month may be able to be used otherwise. Swim classes, music classes, other types of enrichment, etc.

kar5162 · September 2013

As others have said, it just depends. For DS, keeping EI (we also did private PT/OT in addition) was the difference between him qualifying for SN preschool (or an itinerant teacher) and not. I am certain that if he had been in just private PT he wouldn't have qualified, but (where we are), his EI team was able to do his transition evaluations and they were more cautious than (I believe) most would have been.

We had discussed it with them - he would clearly qualify for gross motor, but was iffy on adaptive. The issue was that *technically* at 2 yrs 9 mo at his evaluation, he wouldn't qualify at 1.5 dev behind, by a little. But they (and we) knew that he was highly unlikely to make the same amount of progress a typical kid would in the next 6-9 months so he *would* qualify by 3.5/4 since the expectations are higher. Instead of changing his placement in 6 months and having to fight for reevaluation, being very strict on the evaluation ensured he got the services he really needed from the beginning.

Hopefully by the time V hits 3 you no longer need services, but I would definitely at least understand the process for transitioning to school services and plan to get her reassessed in time for her to do 2 years of developmental preschool if needed. I know too many preemies who have a honeymoon period between 1.5-4ish when they "catch-up" for the most part, but then struggle when they get to K so I think it is a good idea to at least know the process and make sure you keep a close eye on her development.

zoeyandsummersmom · September 2013

Another Nutmegger,

CT EI services are very expensive. My DD gets about 12 visits a month and for that it makes sense to stick with the B23 program rather than go private. I also wanted the extra help in navigating the school system once we age out and I know they help a lot with transition. I also know there are advocates you can hire to help you out as well.

Sending you a PM (check your inbox) on a few other tips I have received that could help you depending on where you live in the state.

thishappyhouse · September 2013

dcmetrobride said:

Another Nutmegger,
CT EI services are very expensive. My DD gets about 12 visits a month and for that it makes sense to stick with the B23 program rather than go private. I also wanted the extra help in navigating the school system once we age out and I know they help a lot with transition. I also know there are advocates you can hire to help you out as well.

Sending you a PM (check your inbox) on a few other tips I have received that could help you depending on where you live in the state.

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