Does Family-Centered Care Coordination Improve Outcomes for Children Enrolled in Early Intervention Services? An Analysis of Colorado's GO4IT Initiative.

Abstract

Objective: To measure the effect of the adoption of a family-centered care coordination approach in Colorado's early intervention program on family engagement and goal attainment outcomes.

Study setting and design: We estimated difference-in-difference models to estimate the effect of Colorado's approach to family-centered care coordination, using Massachusetts as a control group. Massachusetts was chosen because there were no major changes to family-centered care coordination during our sample period. The primary outcome measures one of four exit reasons: disengagement (measured as lost to follow-up or withdrawal), achievement of care plan goals before Age 3, no longer eligible due to Age 3, or moved. Multinomial probit models estimated the effect of Colorado's program on the probability of each exit reason. Additional analyses were stratified by child race and ethnicity groups.

Data sources and analytic sample: We obtained administrative early intervention data from Massachusetts and Colorado for children who were referred to early intervention in fiscal years 2013-2019 and had a documented exit reason. The full sample includes 103,635 children (n = 20,045 in Colorado; n = 83,590 in Massachusetts).

Principal findings: Participation in Colorado's program was associated with a 4.6 percentage point reduction in family disengagement (p < 0.01) and a 3.5-4.6 percentage point higher likelihood of meeting early intervention care plan goals before Age 3 (p < 0.01). Estimates by race and ethnicity revealed improved engagement of White, Black, and Hispanic families, though only White and Hispanic children were more likely to achieve care plan goals before Age 3.

Conclusions: Colorado's family-centered care coordination intervention improved family engagement with early intervention services, with fewer families lost to follow-up or withdrawn following early intervention care plan development. These findings can inform evidence-based recommendations to other states considering family-centered care coordination solutions to optimize early intervention service delivery and equity.