2026 -- H 7627

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LC005095

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     STATE OF RHODE ISLAND

IN GENERAL ASSEMBLY

JANUARY SESSION, A.D. 2026

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A N   A C T

RELATING TO HEALTH AND SAFETY -- MATERNAL AND CHILD HEALTH SERVICES

FOR CHILDREN WITH SPECIAL HEALTH CARE NEEDS -- EARLY INTERVENTION

EXTENSION--BRIDGE TO PRESCHOOL

     Introduced By: Representatives Tanzi, Ajello, Speakman, Boylan, Donovan, Carson,
Cotter, Shanley, McGaw, and Bennett

     Date Introduced: February 11, 2026

     Referred To: House Health & Human Services

     It is enacted by the General Assembly as follows:

     SECTION 1. Legislative findings.

     The general assembly finds and declares the following:

     (1) Rhode Island has long been committed to delivering high-quality services to support

positive early childhood development and learning of children with developmental delays and

disabilities under Part C and Part B, Section 619 of the federal Individuals with Disabilities

Education Act ("IDEA") from infancy to kindergarten entry.

     (2) Early identification and delivery of high-quality early childhood IDEA services to

children with developmental challenges, developmental delays, and disabilities can improve

educational outcomes, reduce long-term costs of special education, and maximize the long-term

potential of children succeeding in school and life.

     (3) Effective early childhood IDEA services can help children make substantial

developmental progress. In Rhode Island, two (2) out of three (3) children with disabilities who

entered preschool below age expectations substantially increased their acquisition of knowledge

and skills to close or narrow the gap with same-age peers.

     (4) The Rhode Island early intervention program established pursuant to § 23-13-22,

managed by the Rhode Island Executive Office of Health and Human Services, is the state's

comprehensive, coordinated, multidisciplinary, interagency system that provides early intervention

services for infants and toddlers with developmental delays and disabilities and their families, as

described and partially funded through Part C of the federal Individuals with Disabilities Education

Act.

     (5) The Rhode Island Department of Education oversees the state's early childhood special

education services providing free, appropriate, public education to all eligible children ages three

(3) to five (5) with developmental delays and disabilities, partially funded through a preschool

formula grant under Part B, Section 619 of the IDEA.

     (6) Currently in Rhode Island, there is a strict cut off at a child’s third birthday of Part C

early intervention services. For children enrolled in early intervention who have spring or summer

birthdays, this cutoff can lead to a gap of services before they start the early childhood special

education services in September. Gaps are also created when a child’s transition from Part C to Part

B services is delayed for other reasons.

     (7) Federal law allows states to create an option for families to extend early intervention

services beyond a child’s third birthday. See 34 C.F.R. § 303.211.

     (8) Six (6) states (CO, CT, IL, MD, MO, TN) and the District of Columbia (DC) have

implemented federally-approved frameworks to allow families to extend early intervention beyond

the child’s third birthday. This helps ensure continuity of services, fewer gaps in services and more

students starting school in September with services in place.

     (9) Under 34 C.F.R. § 303.734, the federal government reserves fifteen percent (15%) of

any Part C appropriations in excess of four hundred sixty million dollars ($460,000,000) for states

with federally-approved early intervention extension options. In federal fiscal year 2023, the federal

government appropriated five hundred forty million dollars ($540,000,000) for Part C, meaning

that the funds reserved for early intervention extension states totaled twelve million dollars

($12,000,000).

     SECTION 2. Section 23-13-22 of the General Laws in Chapter 23-13 entitled "Maternal

and Child Health Services for Children with Special Health Care Needs" is hereby amended to read

as follows:

     23-13-22. Early intervention program for developmentally disabled infants.

     (a) The director secretary of the department of human services executive office of health

and human services (EOHHS) shall ensure that all developmentally disabled infants from birth to

three (3) years of age shall be enrolled in the early intervention program. Beginning July 1, 2026,

EOHHS and the department of education shall create a plan to allow children to remain in early

intervention until September 1 after their third birthday, as allowed by federal law 20 U.S.C. §

1435(c). Further, such plan shall include, but not be limited to, seeking any federal approvals

necessary or desirable to implement the aforesaid policy. By January 1, 2028, EOHHS shall allow

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children who turn three (3) years old between May 1 and August 31 to remain in early intervention

until September 1 after the child’s third birthday. Regulations governing the delivery of services

under this program, including eligibility criteria, shall be promulgated by the department of human

services EOHHS, with the advice of the interagency coordinating council; provided, however, that

all regulations promulgated by the department of health shall remain in full force and effect until

the time they are replaced by regulations promulgated by the department of human services

EOHHS. The regulations shall stipulate, at a minimum, the following provisions that are consistent

with the intent of this chapter:

     (1) The director secretary shall develop and maintain a procedure for the earliest possible

identification and efficient referral of all developmentally disabled infants;

     (2) The director secretary shall ensure that every infant identified and referred to this

program is enrolled as soon as possible after birth; and further, that for infants placed on a waiting

list for facility based group programming, an early intervention program shall be made available

within a thirty (30) day period from the time a need is identified in the individual program plan;

     (3) Unless parents refuse the service, the home visiting component of the program shall

commence as soon as the infant has been identified as having a possible developmental disability;

     (4) Any parent(s) who is/are dissatisfied with decisions or termination of service or with

practices and procedures of a particular agency or the department of human services EOHHS shall

notify the director secretary of the department of human services EOHHS in writing within thirty

(30) calendar days and the complaint shall be reviewed in accordance with department of health

EOHHS policy and procedures, as amended, and the Administrative Procedures Act, chapter 35 of

title 42.

     (5) An early intervention program for purposes of this section shall mean a comprehensive

array of educational, developmental, health, and social services provided on a calendar year basis

to eligible infants, children, and their families as specified in program regulations.

     (b) Within ninety (90) days after October 1, 2004, an evaluation plan describing outcome

measures that document the program’s successes and shortcomings from the previous fiscal year

shall be submitted to the speaker of the house of representatives, the president of the senate and the

house oversight committee and the governor and the interagency coordinating council.

Development of the plan shall be made in consultation with the entities with expertise in this area

and the interagency coordinating council. The plan shall include a memorandum of understanding

between the department of health, department of human services and the department of elementary

and secondary education that demonstrates coordination and continuity of early intervention

services among these departments.

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     (c) Within six (6) months after January 1, 2005 where prescribed outcomes documented in

the evaluation plan have not been accomplished the responsible agencies shall submit written

explanations for the shortfalls, together with their proposed remedies. The report shall also include

evaluation of the progress of the coordination efforts between the department of health and the

department of human services and the department of elementary and secondary education and the

interagency coordinating council and shall include any recommendations regarding modifications

of the reimbursement mechanisms of this chapter.

     (d) Within twelve (12) months after August 1, 2005 a final report shall include the progress

of the coordination efforts between the department of health and the department of human services

and department of elementary and secondary education, interagency coordinating council and shall

include any recommendations regarding modifications to the comprehensive array of educational,

developmental, health and social services provided on a calendar year basis to eligible infants,

children and their families as specified in an early intervention system.

     (e) All reports or documents required to be produced pursuant to 20 U.S.C. § 1471 et seq.,

shall be submitted to the speaker of the house, president of the senate and the chairpersons of the

appropriate house of representatives and senate oversight committees and the governor and the

interagency coordinating council. Adherence to such plans and reporting requirements, and budgets

and the timely achievement of goals contained therein shall be considered by the oversight

committees of the house of representatives and senate, among other relevant factors, in determining

appropriations or other systemic changes.

     (f) In developing and implementing the plan to extend early intervention services beyond

age three (3) as provided in subsection (a) of this section, the secretary shall:

     (1) Appoint and convene an implementation advisory committee to advise on the

implementation of the plan. The committee shall include:

     (i) The individual designated by the state to serve as the coordinator for Part C in EOHHS;

     (ii) The individual designated by the state to serve as the coordinator for Section 619 of the

Individuals with Disabilities Education Act (IDEA) in the department of education;

     (iii) Not fewer than three (3) representatives of early intervention provider agencies;

     (iv) Not fewer than two (2) representatives of local education agencies (“LEA”);

     (v) Not fewer than two (2) advocates or experts with demonstrated expertise in early

intervention or early childhood special education; and

     (vi) Not fewer than two (2) parents of children who have received early intervention

services and have transitioned to early childhood special education within the preceding three (3)

years.

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     (2) The implementation advisory committee shall:

     (i) Meet for a period of at least one year following the official effective date of the extension

policy;

     (ii) Identify strategies to reduce administrative burdens on families, early intervention

providers, LEA, and the state including, but not limited to, the use of federal funds earmarked for

early intervention extension to the extent allowable;

     (iii) Earmark appropriate federal early intervention funding and develop shared resources

to support training and development for early intervention providers and LEA regarding the

extension option; and

     (iv) Develop strategies to maximize providers’ ability to support the new over-three (3)

population during spring and summer months, including through the appropriate use of group-based

therapies while maintaining services necessary to meet individualized developmental needs.

     (3) All meetings of the implementation advisory committee shall be open to the public and

conducted in accordance with chapter 46 of title 42.

     (4) Not later than September 30, 2031, the secretary shall prepare and submit to the speaker

of the house of representatives and the president of the senate a report evaluating the

implementation of the extension plan provided for in subsection (a) of this section. The report shall

include, but not be limited to: data regarding the number of families who elected to extend early

intervention services and the number of families who declined to extend early intervention services;

and an assessment of the impact of the extension provided for in subsection (a) of this section on

children, families, early intervention providers, LEA, and the state.

     SECTION 3. Section 27-18-64 of the General Laws in Chapter 27-18 entitled "Accident

and Sickness Insurance Policies" is hereby amended to read as follows:

     27-18-64. Coverage for early intervention services.

     (a) Every individual or group hospital or medical expense insurance policy or contract

providing coverage for dependent children, delivered or renewed in this state on or after July 1,

2004, shall include coverage of early intervention services which coverage shall take effect no later

than January 1, 2005. Such coverage shall not be subject to deductibles and coinsurance factors.

Any amount paid by an insurer under this section for a dependent child shall not be applied to any

annual or lifetime maximum benefit contained in the policy or contract. For the purpose of this

section, “early intervention services” means, but is not limited to, speech and language therapy,

occupational therapy, physical therapy, evaluation, case management, nutrition, service plan

development and review, nursing services, and assistive technology services and devices for:

     (1) dependents Dependents from birth to age three (3) who are certified by the executive

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office of health and human services ("EOHHS") as eligible for services under part Part C of the

Individuals with Disabilities Education Act (20 U.S.C. § 1471 et seq.); or

     (2) Dependents who are older than age three (3) and are eligible for services pursuant to §

23-13-22 and are certified by the EOHHS as eligible for services under Part C of the Individuals

with Disabilities Education Act (20 U.S.C. § 1431 et seq.).

     (b) Insurers shall reimburse certified, early intervention providers, who are designated as

such by the executive office of health and human services (EOHHS), for early intervention services

as defined in this section at rates of reimbursement equal to, or greater than, the prevailing

integrated state Medicaid rate for early intervention services as established by the executive office

of health and human services (EOHHS).

     (c) This section shall not apply to insurance coverage providing benefits for: (1) Hospital

confinement indemnity; (2) Disability income; (3) Accident only; (4) Long-term care; (5) Medicare

supplement; (6) Limited benefit health; (7) Specified disease indemnity; (8) Sickness or bodily

injury or death by accident or both; and (9) Other limited benefit policies.

     SECTION 4. Section 27-19-55 of the General Laws in Chapter 27-19 entitled "Nonprofit

Hospital Service Corporations" is hereby amended to read as follows:

     27-19-55. Coverage for early intervention services.

     (a) Every individual or group hospital or medical expense insurance policy or contract

providing coverage for dependent children, delivered or renewed in this state on or after July 1,

2004, shall include coverage of early intervention services which coverage shall take effect no later

than January 1, 2005. The coverage shall be limited to a benefit of five thousand dollars ($5,000)

per dependent child per policy or calendar year and shall not be subject to deductibles and

coinsurance factors. Any amount paid by an insurer under this section for a dependent child shall

not be applied to any annual or lifetime maximum benefit contained in the policy or contract. For

the purpose of this section, “early intervention services” means, but is not limited to: speech and

language therapy, occupational therapy, physical therapy, evaluation, case management, nutrition,

service plan development and review, nursing services, and assistive technology services and

devices for:

     (1) dependents Dependents from birth to age three (3) who are certified by the department

of executive office of health and human services (“EOHHS”) as eligible for services under part

Part C of the Individuals with Disabilities Education Act (20 U.S.C. § 1431 et seq.); or

     (2) Dependents who are older than age three (3) and are eligible for services pursuant to §

23-13-22 and are certified by the EOHHS as eligible for services under Part C of the Individuals

with Disabilities Education Act (20 U.S.C. § 1431 et seq.).

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     (b) Subject to the annual limits provided in this section, insurers shall reimburse certified

early intervention providers, who are designated as such by the department of human services

EOHHS, for early intervention services as defined in this section at rates of reimbursement equal

to or greater than the prevailing integrated state/Medicaid rate for early intervention services as

established by the department of human services EOHHS.

     (c) This section shall not apply to insurance coverage providing benefits for: (1) Hospital

confinement indemnity; (2) Disability income; (3) Accident only; (4) Long-term care; (5) Medicare

supplement; (6) Limited benefit health; (7) Specified disease indemnity; (8) Sickness or bodily

injury or death by accident, or both; and (9) Other limited benefit policies.

     SECTION 5. Section 27-20-50 of the General Laws in Chapter 27-20 entitled "Nonprofit

Medical Service Corporations" is hereby amended to read as follows:

     27-20-50. Coverage for early intervention services.

     (a) Every individual or group hospital or medical expense insurance policy or contract

providing coverage for dependent children, delivered or renewed in this state on or after July 1,

2004, shall include coverage of early intervention services which coverage shall take effect no later

than January 1, 2005. The coverage shall be limited to a benefit of five thousand dollars ($5,000)

per dependent child per policy or calendar year and shall not be subject to deductibles and

coinsurance factors. Any amount paid by an insurer under this section for a dependent child shall

not be applied to any annual or lifetime maximum benefit contained in the policy or contract. For

the purpose of this section, “early intervention services” means, but is not limited to: speech and

language therapy; occupational therapy; physical therapy; evaluation; case management; nutrition;

service plan development and review; nursing services; and assistive technology services and

devices for:

     (1) dependents Dependents from birth to age three (3) who are certified by the department

of executive office of health and human services (“EOHHS”) as eligible for services under part

Part C of the Individuals with Disabilities Education Act (20 U.S.C. § 1431 et seq.); or

     (2) Dependents who are older than age three (3) and are eligible for services pursuant to §

23-13-22 and are certified by the EOHHS as eligible for services under Part C of the Individuals

with Disabilities Education Act (20 U.S.C. § 1431 et seq.).

     (b) Subject to the annual limits provided in this section, insurers shall reimburse certified

early intervention providers, who are designated as such by the department of human services

EOHHS, for early intervention services as defined in this section at rates of reimbursement equal

to or greater than the prevailing integrated state/Medicaid rate for early intervention services as

established by the department of human services EOHHS.

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     (c) This section shall not apply to insurance coverage providing benefits for: (1) Hospital

confinement indemnity; (2) Disability income; (3) Accident only; (4) Long-term care; (5) Medicare

supplement; (6) Limited benefit health; (7) Specified disease indemnity; (8) Sickness or bodily

injury or death by accident or both; and (9) Other limited benefit policies.

     SECTION 6. Section 27-41-68 of the General Laws in Chapter 27-41 entitled "Health

Maintenance Organizations" is hereby amended to read as follows:

     27-41-68. Coverage for early intervention services.

     (a) Every individual or group hospital or medical expense insurance policy or contract

providing coverage for dependent children, delivered or renewed in this state on or after July 1,

2004, shall include coverage of early intervention services which coverage shall take effect no later

than January 1, 2005. The coverage shall be limited to a benefit of five thousand dollars ($5,000)

per dependent child per policy or calendar year and shall not be subject to deductibles and

coinsurance factors. Any amount paid by an insurer under this section for a dependent child shall

not be applied to any annual or lifetime maximum benefit contained in the policy or contract. For

the purpose of this section, “early intervention services” means, but is not limited to: speech and

language therapy, occupational therapy, physical therapy, evaluation, case management, nutrition,

service plan development and review, nursing services, and assistive technology services and

devices for:

     (1) dependents Dependents from birth to age three (3) who are certified by the department

of executive office of health and human services (“EOHHS”) as eligible for services under part

Part C of the Individuals with Disabilities Education Act (20 U.S.C. § 1431 et seq.); or

     (2) Dependents who are older than age three (3) and are eligible for services pursuant to §

23-13-22 and are certified by the EOHHS as eligible for services under Part C of the Individuals

with Disabilities Education Act (20 U.S.C. § 1431 et seq.).

     (b) Subject to the annual limits provided in this section, insurers shall reimburse certified

early intervention providers, who are designated as such by the department of human services

EOHHS, for early intervention services as defined in this section at rates of reimbursement equal

to or greater than the prevailing integrated state/Medicaid rate for early intervention services as

established by the department of human services EOHHS.

     (c) This section shall not apply to insurance coverage providing benefits for: (1) Hospital

confinement indemnity; (2) Disability income; (3) Accident only; (4) Long-term care; (5) Medicare

supplement; (6) Limited benefit health; (7) Specified disease indemnity; (8) Sickness or bodily

injury or death by accident or both; and (9) Other limited benefit policies.

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     SECTION 7. This act shall take effect upon passage.

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EXPLANATION

BY THE LEGISLATIVE COUNCIL

OF

A N   A C T

RELATING TO HEALTH AND SAFETY -- MATERNAL AND CHILD HEALTH SERVICES

FOR CHILDREN WITH SPECIAL HEALTH CARE NEEDS -- EARLY INTERVENTION

EXTENSION--BRIDGE TO PRESCHOOL

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     This act would permit children with diagnosed developmental disabilities whose third

birthday is between May 1 and August 31 to continue to receive early intervention services through

September 1 after the child’s third birthday. Further, this act would direct the EOHHS to develop

and implement a plan to ensure continuity of services and minimize gaps in support as children

with services transition to early childhood special education. Additionally, this act would require

private health insurers to cover this extended early intervention option.

     This act would take effect upon passage.

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