Provider Manual

Early Intervention Program (EIP)

The Early Intervention Program (EIP) providesevaluation and developmental services when a child has or is suspected of having a developmental delay. The EIP has two components:

• The Infant-Child Health Assessment Program (I-CHAP) serves as the "child find" component. Only children with a risk factor for developmental delay should be referred to this component. Referred children are tracked to ensure that their pediatricians/PCPs conduct periodic developmental assessments and if such assessments indicate developmental delays, the program facilitates referrals to the EIP component.
• Services for a referred child are provided by the Local Early Intervention Agency’s (LEIA) network of approved EIP providers. The LEIA is under no obligation to use providers in the child's health plan network. When the services rendered are covered by a third party, the LEIA is authorized to bill the third party on behalf of the servicing provider.

New York State law requires all primary referral sources (e.g., primary care physicians (PCPs), specialists, hospitals, etc.) to refer a child under 3 years of age to the Local Early Intervention Agency (LEIA) corresponding to their county of residence within two working days of identifying the child with either a risk factor for developmental delay or an actual developmental delay or disability. In most cases, the LEIA is the County Department of Health. Parental consent is required for referral.

For information, please call the New York State Growing Up Healthy Hotline at 800-522-5006 (TTY/TDD: 800-655-1789). You may also call the LEIAs at:

• New York City: 1-800-577-BABY (1-800-577-2229) or 1-212-219-5213
• Nassau County: 1-516-227-8661
• Suffolk County: 1-631-853-3100
• Westchester County: 1-914-813-5094
• Orange County: 1-845-291-2333
• Rockland County: 1-845-364-2625

Preschool Supportive Health Services Program (PSHSP)

When a child from age 3 years up to their 21st birthday is identified as at risk for or having a developmental disability, pediatricians/PCPs shall, with parental consent, refer the child to the Committee on Special Education serving the school district in which the child resides. This program ensures such children are evaluated and receive needed special education and that disability-related health services are only provided by SSHSP providers approved by the Committee on Special Education. The program is under no obligation to use providers in the child's health plan network. The school district bills the state for services rendered to Medicaid managed care members. When the services rendered to non-Medicaid members are covered by a third party, the school district is authorized to bill the third party on behalf of the servicing provider. For more information, visit NYS Medicaid in Education.

Physically Handicapped Children's Program (PHCP)

PHCP provides financial assistance for medical care and support services to children that have severe, long-term health problems and chronic disabilities. Eligible conditions include birth defects, physical handicaps, and other conditions that can be improved with treatment and early intervention.

PHCP has two components: the Diagnosis and Evaluation Program and the Treatment Program.

• Diagnostic services are available to all children who are believed to have physically disabling conditions or serious chronic illnesses. To receive diagnostic services, families do not have to satisfy local financial eligibility criteria, but Preauthorization from the local PHCP must be obtained. Diagnostic services are provided through approved specialty centers or medical specialists. If the child is covered by health insurance or Medicaid, these funding sources must be billed first. If the child has neither insurance nor Medicaid, then the authorized services are paid for directly by the PHCP.
• The treatment component reimburses health care providers for services rendered to eligible children. Inpatient hospital care, physician office visits, durable medical equipment, and pharmaceuticals are examples of items covered by the program. PHCP will cover the cost of medically needed care and supplies not covered by some health insurance plans, such as over-the-counter drugs/supplies and transportation.

Application for the Treatment Program must be made to the county in which the child resides. There are some variations between counties for conditions covered and financial eligibility. Financial criteria are designed to assist families with low incomes or inadequate private health insurance. All services provided under PHCP must have Preauthorization from the county health department.

For more information, please call the New York State Growing Up Healthy Hotline at 800-522-5006 (TTY/TDD: 800-655-1789) or:

• New York City: 1-212-676-2950
• Nassau County: 1-516-571-0801
• Suffolk County: 1-631-853-2286
• Westchester County: 1-914-813-5328
• Orange County: 1-845-568-5280
• Rockland County: 1-845-364-2081

Project TEACH - Connecting Primary Care with Child Psychiatry

Primary care physicians (PCPs) such as pediatricians and family practice doctors are often the first-place families go to seek help or information about emotional or behavioral concerns with their children. Project TEACH provides all pediatric primary care providers in New York State with access to rapid consultation, education and training, and referral/linkage services to help them care for children and adolescents with mental health disorders. Additionally, other prescribers who are providing ongoing treatment to children, such as Child and Adolescent Psychiatrists, General Psychiatrists, and Psychiatric Nurse Practitioners, may request a second opinion through consultation. For more information about Project TEACH, visit projectTEACHny.com.