Abstract
OBJECTIVE: To evaluate the extent to which age of early intervention (EI) enrollment was influenced by policy changes associated with the introduction of telehealth and hybrid service delivery models into a statewide EI system across COVID-19 periods (pre-COVID [in person only], COVID [telehealth only], post-COVID [hybrid]). STUDY DESIGN: We used administrative data from Kentucky's EI system, Technology-assisted Observation and Teaming Support system. The Technology-assisted Observation and Teaming Support system is a web-based, real-time, data management platform that tracks children in Kentucky's EI as they enter and progress through Part C services. We analyzed data from 34 683 children from 2015 to 2023. We used a general linear model to investigate whether age of enrollment into EI was influenced by child factors and safety net program use across COVID-19 periods. RESULTS: Regardless of the COVID-19 period and associated service delivery models, factors that supported early entry into EI included the use of Women, Infants, and Children, having an established condition, and female sex. White children entered the system significantly earlier than Black, Hispanic, and Asian, children across all COVID-19 periods (all P < .001). During the pre-COVID-19 period, those using Medicaid entered EI at younger ages than those using private insurance (P < .01); however, differences in age of entry by insurance dissipated during and post-COVID-19. CONCLUSION: Service delivery model policies across COVID-19 pandemic periods did not significantly influence age of entry overall. Differences by race, ethnicity, sex, and safety net program utilization persisted throughout COVID-19 periods, likely exacerbated by telehealth access.