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This report covers the responses Appropriations SC on Article II received for their RFI for Interim Charge #5, relating to state investments in Early Childhood Intervention and evaluating opportunities to improve support. The RFI for this charge can be found here, and the full list of responses can be found here.

The HillCo report below is a summary of information intended to give you an overview and highlight of the various topics included in the responses. This report does not cover the entirety of each response, but aims to provide an overview of the testimony submitted.

Legislative Budget Board (pp. 2-16)

  • LBB provides presentation overviewing ECI program background, funding, performance measures, and General Appropriations Act (GAA) ECI riders
  • ECI provides services to children 0-3 years with developmental delay, certain medically diagnosed conditions, or auditory and visual impairment
  • HHSC contracts with local organizations to provide services
  • Funding within the GAA includes direct appropriations to the program and to Medicaid and CHIP used to provide therapies and other services, ECI training, evaluation, technical assistance and respite services and state office expenditures
  • Funding outside the GAA includes other insurance collections, family cost sharing, and other locally collected funds
  • Funding was $6.9M in 2018-19 biennium and $7.1M in 2020-21 biennium
  • Provides chart of ECI services funding within and outside the GAA for fiscal years 2016-2021
  • Outlines appropriations compared to expenditures; expenditures were underfunded 2016-2019
  • Outlines average monthly number of children served in comprehensive services 2016-2019; ranges from 27,000-31,000, increasing each year
  • Outlines average cost per child per month 2016-2019; approximately $400
  • 2020-21 GAA has several riders regarding ECI program:
  • Rider 81: Maintenance of Effort (MOE): ECI Services; requires quarterly report on state funds for MOE for federal IDEA funds
  • Rider 82: Education Funding; HHSC required to enter memorandum of understanding with TEA and submit copy to LBB and Governor
  • Rider 83: Limitation on Federal Funds Appropriations for ECI Services; prohibits spending of IDEA Part C funds in excess of appropriations without written approval
  • Rider 85: Reporting on ECI; requires reports and notification in event provider will terminate services
  • Rider 98: ECI Funding Maximization; requires a plan to maximize funding available to ECI providers and progress reports related to funding maximization
  • Strategies for Rider 98:
    • Evaluate Medicaid rate for Specialized Skills Training
    • Restructuring ECI provider contracts
    • Coordinate with TEA for drawing down more Federal Funds for HHSC ECI services
    • Work with CMS for accessing federal funds
  • Outlines ways in which HHSC is working to reach ECI funding maximization; slide 14

Texas Health and Human Services (pp. 17-25)

  • HHSC operates program through cost-reimbursement contracts with 41 agencies, services are individualized for patient and family needs
  • ECI is provided under IDEA part C; this funding is capped and has remained level for multiple years despite program growth
  • Federal regulations require services statewide, families must be served in their natural environment, and the program cannot start a waitlist
  • HHSC funds contractors based on an average number of children enrolled each month
  • IDEA Part C requires ECI contractors to treat all who need services regardless of funding and are out the difference if expenses exceed funding
  • Expenses exceeding funds occurred with more than 93% of contractors in last six fiscal years
  • If contractors withdraw and replacements cannot meet needs, state is in violation of IDEA Part C
    • Number of contractors has decreased from 58 to 42 in last 10 years
  • The supplemental $1.5M for FY 19 from the 86th Legislature was distributed to 11 contractors that were serving well over their contractual target
  • Overall additional funds made a positives impact on cost-saving measures, but many ECI providers had to leverage other agency funds to sustain their programs
  • All contractors received an increase as a result of FY 20 Exceptional Item funding
  • HHSC amendments to funding had to be made due to COVID to redistribute a total of $2,660,790
  • Outlines results of a March 2020 survey; five contractors anticipate having conversations about leaving the program
  • For FY 21, contractors requested $4.1M above the available contract dollars
  • Shift to telehealth for COVID was costly and time consuming
  • Over half of ECI’s providers budgets are collected from billing public and private insurance
  • HHSC expanded Medicaid reimbursement for ECI telehealth services in response to COVID-19
  • Outlines difficulties in providing for contractors with COVID; HHSC facilitated return of surplus funds and disbursement of those funds to other ECI contractors in need
  • HHSC currently had coverage for all Texas counties for FY 21
  • ECI saves money in reducing students in need of special education
  • ECI is currently working on a research project to measure cost savings and benefits of ECI to other state programs, preliminary findings anticipated in 2021

Duke Family Connects International (pp. 26-29)

  • Family Connects operates in five Texas counties and provides short-term nurse home visiting beginning in the first month after birth
  • Funded through a mix of federal and state funds along with philanthropic and MCO investments
  • Outlines operation of Family Connects in other states and services provided
  • 94% of families seen had one or more needs for specific education, recommendations, or community service referrals
  • Suggests offering universal newborn nurse home visiting and providing assistance in postpartum assessment/treatment; aim to remove stigma around these services
  • Outlines results of controlled trials to assess outcomes of the program

Susan Landry, The University of Texas Health Science Center at Houston (pp. 30-34)

  • Children’s Learning Institute applies research in child development and education to improve learning
  • One of their most successful programs is Texas School Ready, helping at-risk preschool age children be better prepared for kindergarten
  • TSR is a three-year professional development program for educators in early childhood education
  • CLI also developed nationally renowned parent program Play and Learning Services (PALS)
  • TSR classrooms narrow the gaps between skills of at-risk students in private childcare, Head Start, or public prekindergarten by the end of pre-school years
  • Over 80% of Texas school district use CLI Engage progress monitoring tools, CLI is able to track the early learning skills of approx. 280,000 children in Texas
  • CLI Engage resulted in significant cost-savings for public supported programs
  • CLI Engage serves 1,100 communities, 8,597 schools, and 31,708 teachers across Texas
  • Outlines where TSR draws state funds from; variety of bills and appropriations
  • Recommends advancing a whole-child focus by complementing TSR’s classroom-based services with the evidence-based parenting program, PALS
    • Additional appropriations would allow CLI to scale PALS parent coaching statewide
  • Recommends expanding specialist expertise in best practices for professional development of early care and education workforce; focus on family support and engagement
    • Additional appropriations would allow CLI to develop a micro-credentialing service and free professional development program for specialist who are interested in home-based interventions and family engagement

Cynthia Osborne, Prenatal-to-3 Policy Impact Center: LBJ School of Public Affairs (pp. 35-39)

  • Recommends state leaders use Prenatal-to-3 State Policy Roadmap for most effective policy suggestions for the state’s prenatal-to-3 system of care
  • Highlights policy goals, including the need to expand eligibility, reduce administrative burden, better identify needs/connection to services, and ensure families are healthy and supported
  • Need expanded income eligibility for health insurance and adopt/fully implement Medicaid expansion under Affordable Care Act
    • Texas has the highest percentage of uninsured, low-income women in the country
    • Will result in a decrease in uncompensated care for hospitals since passage of ACA
  • Should reduce administrative burden for SNAP; aim for median recertification interval of 12 months or longer among households with SNAP-eligible children under age 18
    • 2019 report by the USDA found that states that implemented streamlined admin policies decreased their per case cost
    • SNAP benefits stimulate the economy; allow low-income families to spend income
  • Recommend adoption and implementation of a paid family leave program of a minimum of 6 weeks following the birth, adoption, or placement of a child in foster care
    • Most employers report “no noticeable effect” or “a positive effect” of paid family leave on employee productivity, profitability, turnover, and morale
  • Should adopt and fully implement a minimum wage of $10 or greater
    • Estimated effects of a federal minimum wage increase to $9.80 equated in increase in GDP by $25B and net increase in jobs of 100,000 over 2 years
  • Should adopt and fully implement a refundable EITC of at least 10% of the federal EITC for all eligible families with children under 3 years old
    • Credit largely pays for itself by increasing taxes paid ($92 per household) and reducing public assistance received ($243 per household)
  • Should use moderate to broad criteria to determine eligibility and serve children who are at risk for later delays
    • Three-year cost avoidance estimates projected substantial cost savings
  • Comprehensive screening and referral programs
  • Should set base reimbursement rate for infants and toddlers in center-based care and family child care at the federally recommended 75th percentile using a recent market rate survey
  • Group prenatal care
  • Evidence-based home visiting programs; supplement federal funding for home visiting programs and serve eligible children by evidence-based home visiting programs
    • Return on investment: Outlines study that shows there are long-term benefits for programs like HFA, NFP, and PAT in which benefits well outweighed costs
  • Early Head Start: supplement federal funding got Early Head Start (EHS), and serve income-eligible children by EHS
  • Early Intervention Services: use a moderate or broad criteria to determine eligibility and serve children who are at risk for later delays or disabilities
    • Return on investment: Investing in services in the first three years helps decrease the number of children that will need special education services later, which are more costly

TexProtects, (pp. 40-44)

  • Investing earlier in lives saves money that will later be spent in education, criminal justice, and healthcare systems
  • Adverse Childhood Experiences (ACEs) are associated with negative outcomes throughout lifespan
    • Annual healthcare costs attributable to ACEs across North America are approximately $748B
    • Each case of child abuse or neglect equates $830K across the victim’s lifetime
  • Outlines the numbers for Texas children at risk for ACEs
  • These numbers have all likely increased due to COVID-19 and family stressors
  • Most cost-efficient and effective strategies offer support before a crisis occurs and during the first years of life when stability is key to healthy development
  • Recommends fully funding the Prevention and Early Intervention Exceptional Item Request to strengthen community-based, primary child abuse prevention programs for children prenatal to age 5 through Project HOPES and Texas NFP
  • Prevention funding has been cut during recessions, but this is a costly mistake for the long-term
  • Expand Universal Prevention Strategies in Public Health Settings
    • Highlights Family Connects, nurse visits post-partum, $3.02 return on every dollar invested in ER savings alone and 39% reduction in child abuse investigations
    • Suggests expansion of this program and ones like it
  • Leverage the opportunities in the Federal First Prevention Services Act to offer families at imminent risk of removal access to evidence-based mental health, substance use, and parenting supports
  • Support additional Prenatal to Three Collaborative Agenda Items: strengthening ECI, enhancing maternal health by extending Medicaid to 12 months postpartum and connecting infants and toddlers to health care through continuous, 12-month coverage in Children’s Medicaid

Protect TX Fragile Kids, (pp. 45-47)

  • Covers Charges 1 & 2 and their recommendations, as well
  • ECI are relatively small considering the reductions they cause in later costs for treatment
  • The longer intervention is delayed the more expensive and extensive it will be later on
  • Recommends examining state investments in the health and brain development of babies and toddlers, including ECI and other early childhood programs for children in first three years
  • Evaluate opportunities to boost child outcomes and achieve longer-term savings

Texans Care for Children, (pp. 48-52)

  • Early childhood experiences are shaped by state policies and programs and when they fall short, they fail children of all backgrounds but especially Black children
    • Black babies have an infant mortality rate twice that of White and Hispanic babies
  • COVID-19 has disrupted many support systems
  • In Texas, the children’s uninsured rate for all backgrounds are all higher than the national uninsured rate
  • Recommends connecting infants and toddlers to health care by establishing continuous 12-month coverage
  • Protect state budget for Medicaid and CHIP health insurance and maintain eligibility, benefits, and provider rates
  • Restore state outreach and enrollment efforts to help children enroll in and access Medicaid and CHIP
  • Accept federal Medicaid expansion funding to provide an insurance option
  • Women’s lack of access to health care, before pregnancy, during the first trimester, and after pregnancy contribute to the maternal and infant health challenges above
  • Recommends extending Medicaid coverage for new mothers from 60 days to one year postpartum
  • Maintain funding levels for Healthy Texas Women and Family Planning Program
  • Maintain funding levels for DSHS maternal and child health division, including funding for TexasAIM initiative and Texas’ Maternal Mortality Review Committee
  • Legislature should continue funding needed in future years so new mothers can receive postpartum care via HTW+
  • Promote group prenatal and well-childcare innovations like CenteringPregnancy and CenteringParenting
  • Support health coverage for low-wage Texas adults
  • Funding per child enrolled in ECI has still not been restored to prior levels; programs are still unable to serve all the children who need ECI services due to staffing and funding shortages
  • Recommends restoring ECI funding to 2013 level: $484 per child each month, accounting for projected caseload growth amid the state’s growing child population
  • Increase funding for Child Find to support community awareness and outreach efforts to ensure all eligible children are identified, screened, evaluated, and enrolled in ECI
  • Ensure state-regulated private health insurance plans cover and reimburse for critical ECI therapies and services insurance plans cover and reimburse for critical ECI therapies an services
  • Evaluate and address the disproportionate under-enrollment for ECI programs with Black families
  • Add Specialized Skills Training (SST) and Targeted Case Management (TCM) as covered services in CHIP
  • Recommend increasing funding for prevention programs through PEI to prevent child abuse and neglect, strengthen and support families, increase connections to community resources
  • 45% of children who enter foster care and 36% of children receiving family preservation services through CPS are three years or younger
  • Recommends identifying early childhood programs for the state’s proposal to the federal government for drawing down child welfare funding un the FFPSA
  • Leverage federal funding and other available resources to ensure quality childcare providers can continue to serve the children of low-wage Texans

The National Association of Social Workers – Texas Chapter, (pp.53-54)

  • Recommends statewide Medicaid expansion to connect more babies, toddlers, and their families with comprehensive health coverage
  • The pandemic has disrupted normal childcare, health screenings and appointments, and families are losing health insurance coverage as they lose their jobs
  • Medicaid expansion would provide an insurance option to 1.5 million uninsured low-wage Texas adults
  • Recommends 12-month continuous eligibility for children with Medicaid
  • Recommends protecting the state budget for Medicaid and CHIP health insurance and maintain eligibility, benefits, and provider rates
  • Recommends funding for outreach and enrollment and full ECI services
  • Provide funding for Prevention and Early Intervention services
  • Extend Medicaid coverage for new mothers from 60 days to one year postpartum and promote group prenatal and well-childcare innovation

Children’s Defense Fund Texas (pp.55-57)

  • Texas leads the nation in the number and rate of uninsured children
  • Recommends ending state cutsto programs that enroll Texans in Medicaid for Pregnant Women, Children’s Medicaid, CHIP, and other programs
  • Expand outreach on children’s health insurance options
  • Allow children on Medicaid to maintain coverage for 12 months instead of checking eligibility mid-year
  • Extend Medicaid coverage for moms to 12 months instead of 2 months after childbirth to reduce maternal mortality and morbidity
  • Expand Medicaid, parents who are insured are healthier caregivers and more likely to have children be enrolled in coverage and access needed care

Children at Risk (pp. 58-61)

  • Early Childhood Education can buffer the negative effects associated with poverty and later academic achievement
  • About 1 in 10 Texas Children ages 0-5 live in a child care desert
  • There is a lack of participation in the TWC subsidy system
  • Recommends mandating participation of subsidy providers in TRS with a clear timeline for phase-in of the requirements and supports needed
    • Creates accountability for government funds and prioritizes quality of care
  • Lower reimbursement rates discourage providers and parents from participating in programs and limit the number of subsidized children they can enroll
  • Recommends increasing reimbursement rates above provider published rates

ECI Coalition (pp.62-66)

  • Increased appropriation to ECI during 2019 was helpful, but did not restore ECI funding per enrolled child; this has caused contractors to drop the program in the last few years
  • ECI contracts with community organizations to provide services to children under 3 with Autism, speech delays, Down syndrome, and other disabilities and developmental delays
    • ECI programs make children less likely to need special education by the time they reach kindergarten
  • ECI providers are under financial strain and too few Texas kids are benefitting from their programs
  • Current funding per child is that same as FY 16 and FY 17, when six ECI programs ended their ECI contracts with the state due largely to funding challenges
  • Texas serves a significantly lower percentage of young kids through ECI compared to other states
  • The racial breakdown of children enrolled does not reflect population
  • Recommends restoring ECI funding to the 2013 funding level of $484 per child each month to give contractors the capacity to enroll and serve all eligible children in their communities
  • Recommends increasing funding for Child Find to support community awareness and outreach efforts
  • Recommends increasing funding for health coverage outreach and enrollment to help children enroll in and access Medicaid and CHIP
  • Recommends ensuring state-regulated private health insurance plans cover and reimburse for critical ECI therapies and services
  • Evaluate and address the disproportionate under enrollment of Black children in ECI with discissions with families, researchers, health leaders, early educators, and community organizations
  • Connect infants and toddlers to health care by establishing continuous 12-month coverage
  • Through a CHIP state plan amendment, add Specialized Skills Training (SST) and Targeted Case Management (TCM)

Coalition of Texans with Disabilities (pp. 67-68)

  • Economists and researchers have reported for years that the earlier the investment in children, the greater the return in education, economic, health, and social outcomes
  • Approximately 46% of children that have access to ECI go on to not need more costly special education services in public schools
  • Recommend prioritizing funding to increase the per child allotment, fund for anticipated caseload growth, and increase funding for Child Find
  • Recommends ensuring that private health insurance plans cover and reimburse ECI therapies, SST, and TCM
  • There is a need for improvement and expansion of Inclusive Child Care
  • Recommends revising anti-discrimination language in the Human Resources Code to also prohibit discrimination by child-care facilities and registered family homes based on disability
  • Recommends adopting Child Care Licensing (CCL) Minimum Standards pre-service and annual professional development requirements that include training for children with developmental delays
  • Recommends strengthening relationships between ECI and child care providers to improve referrals

Texas Pediatric Society, Texas Medical Association, and Texas Academy of Family Physicians (pp.69-73)

  • Primary, preventive, and mental health services have decreased among children in Medicaid, they have not returned to pre-COVID levels
  • Texas should collaborate with providers and stakeholders to emphasize the importance of and safety of in-person health, behavioral, and dental services
  • Additional issue contributing to lack preventative care is the periodic Medicaid eligibility review system
    • Average of 4,100 children are disenrolled from Medicaid each month, but 9/10 are still eligible
  • Recommends increasing funding for health coverage outreach and enrollment to help access to CHIP and Medicaid
  • Recommends instituting the nationwide best practice of 12 months’ continuous coverage
  • Extend Medicaid coverage for new mothers to one year postpartum and find a coverage solution to ensure all low-income working Texans can gain access to affordable health care
  • ECI is very important in establishing positive social-emotional skills, acquiring knowledge and skills, and behaviors related to delf-care and health and safety
  • Recommends continuing investment in ECI services to ensure all children can access needed services
  • Recommends providing specific funding for ECI Child Find services to alleviate racial disparities in enrollment
  • Recommends Require Texas Department of Insurance-regulated health plans to pay for skills training and targeted case management to save funding in Article II appropriations
  • COVID-19 create an opportunity to invest in Early Childhood Prevention and Early Intervention Services
  • Recommends increasing funding Texas Department of Family and Protective Services prevention and early intervention programs and pulling down federal funding through Family First Prevention Services Act

Susan Murphree, Disability Rights Texas (p. 74)

  • Provide ECI services and appropriate Autism services, including ABA
  • Increase referrals for ECI programs
  • Increase population served by ECI program, Texas has some of the lowest rates in the country
  • Recommends ensuring that children with disabilities and their families are given resources to keep children at home rather than in group homes or institutions
  • Recommends providing timely community-based services, including Medicaid and Medicaid waivers to eligible individuals with disabilities 0-20 years
  • Recommends applying the Family Opportunity Act’s family income limit or 300% Federal Poverty Level after income disregards to the Texas Medicaid Buy-In for Children program

Lauren Gerken, Texas Council for Developmental Disabilities (pp. 75-77)

  • Between 2010 and 2019, the available funds per enrolled child dropped $91.40
  • The increase in the budget from the 86th Legislature was helpful, but the number of children being served also increased and resulted in a lower per child funding allotment
  • COVID-19 caused a 30% decrease in delivered services compared with last year, this means these children will need extra support and services post-pandemic
  • Recommend maintaining funding by last legislative session to prevent service losses and support service recovery post-pandemic
  • Recommends conducting a Texas-specific study of ECI’s long-term impact, examining special ed services when students transition to public school
  • Recommends requiring ECI programs to provide a comprehensive overview of Texas Medicaid Waivers

Autism Society of Texas (pp. 78-80)

  • Preventive services should be invested in and utilized to create greater returns in the long run
  • ECI is very important for children with Autism; it is not commonly diagnosed in 0-3 y/o, but providers can identify delays and make referrals
  • According to Texas Department of Rehabilitative Services, each dollar spent on ECI programs average a return between $2.50 to $17.07
  • ECI reduces need for more costly programs like special education
  • Texas consistently underfunds ECI services in per child spending and anticipated caseload growth
  • Underfunding causes programs to close, programs closing leave families without adequate resources
  • Recommends adopting standards to promote inclusive childcare for children with disabilities
  • Revise anti-discrimination language in the Human Resources Code to prohibit discrimination in childcare facilities and registered family homes
  • Adopt CCL Minimum Standards pre-service and yearly professional development, training for children with developmental delays and disabilities, support early childhood mental health
  • Strengthen relationship between ECI and childcare providers to improve referrals for ECI in babies and toddlers with developmental delays and disabilities

Dallas Early Education Alliance (pp. 81-83)

  • Early childhood is an opportunity to lessen the inequities that children already have experienced when entering kindergarten
  • Highest rate of return comes from investing as early as possible
  • Recommends expansion of full-day pre-k
  • Recommends Texas use federal funds from CCDBG, CARES Act, GEER fund to sustain high quality early childcare and pay early childhood educators more
  • Recommends investing general revenue to fund Child Care Regulation and free up federal CCDBG funds to support high quality childcare
  • Create stronger incentives and requirements for partnerships between community-based childcare and schools districts
  • Give childcare programs opportunities to apply for TEA pre-k funding
  • Collect data on Texas’ early childhood workforce and develop strategies to address income inequality, health benefits, business supports, and professional development
  • Ensure reimbursement rates set by TWC align with ratio requirements set by Child Care Regulation

Children’s Hospital Association of Texas (pp. 84-85)

  • The changes that began under DSRIP program should continue and be expanded upon
  • Quality improvement must occur in a coordinated system of care, there should be multidisciplinary pediatric expert and stakeholder input on decisions
  • Recommends establishing a data management strategy and infrastructure to provide information about the progress of programs and health improvements
  • Telehealth and telemedicine have expanded and improved because of COVID-19 and this should continue for better access around the state
  • Request state make flexibilities for telemedicine permanent
  • Recommends requiring reimbursement for telehealth and telemedicine services at the same rate as in-person services
  • Explore solutions for licensure reciprocity issues

Texas Council of Community Centers (pp. 86-88)

  • Last legislature’s increase in funding was vital, but insufficient due to the years of cuts the ECI programs have experienced before that
  • ECI decreases demand for special education, decreasing systemic costs, and increasing educational attainment and participation in the workforce
  • Investing in ECI coaching models helps families gain self-reliance and decreases abuse and neglect
  • Telehealth has provided better access to families across the state, expansion should continue as well as investment in broadband and other technology
  • Per-child funding rates are lower than a decade ago
  • As Texas population continues to grow, funding for ECI must increase to keep up

Cam Scott, Nurse-Family Partnership (pp. 89-92)

  • Outlines positive statistical outcomes of the Nurse-Family partnership program that helps mothers and babies transition to family life
  • Nurses have continued to provide these services via telemedicine during disasters and the pandemic; reached its highest enrollment ever on March 31st through telehealth
  • Every $1 invested in NFP yields $5.70 in savings on government spending
  • Individuals needing services will only grow due to economic impact of COVID-19
  • Recommends increasing funding for programs like NFP and ECIs to prevent harming Texas families when they need support
  • Outlines funding options for programs like NFP through DFPS recommendations, CARES Act, leveraging federal Medicaid funds and coordinating referral processes from state agencies and MCOs
  • Request and recommend an increase of $4.4 million over the biennium for NFP to serve at least 400 additional families in underserved counties
  • Request one FTE public health nurse position within the Department of Family and Protective Services to provide clinical oversight for NFP nurses

Judith Joseph, Texas Occupational Therapy Association (pp. 93-94)

  • Because of COVID-19 and lack of resources for young students, when schools return, Texas could be facing a special education crisis
  • Recommend that committee monitor eligibility requirements for services, to ensure Texas babies and toddlers with measurable developmental delays continue to have access to support
  • Review of 19 early childhood programs with benefit cost analysis showed $2-$4 return for every dollar spent
  • Recommends maintaining, and if possible, increasing funds for ECI programs

Rachel Gonzalez, Therapeutic Rhythms (pp. 95-98)

  • Outcomes for children in ECI that incorporate music theory are better than those who go without
  • In studies, music therapy proved to be one of the most cost-effective additions to children’s programming
  • Music improves brain processing that effect motor skills, communication, sensory stimulation, cognitive skills, and socialization
  • State support is needed to increase access for families across the state, should be invested in by the state within ECI programs

The Harrison Center for Music Therapy Team (pp.99-102)

  • Benefits of music therapy include multi-modal sensory stimulation, motivating learning experiences, relaxation/calming, communication, socialization, motor skill development
  • Brains that engage in music are changed and can be generalized to other settings
  • This therapy is proven to be helpful in ECI settings
  • State support is needed to increase access across the state
  • Were able to continue services via telehealth
  • Recommends including music therapy in Medicaid and ECI programs