The Early Steps Program served a decreased number of children in Fiscal Year 2004-05 and a smaller percentage of the birth to three population. Also, due to federal requirements, the program is shifting to providing services in the "natural environment." Some providers are choosing not to participate in the program because it can be costly to provide services in this way. These factors may affect the availability of services throughout the state. The program is also exploring tightening its eligibility requirements, which would affect both providers and the number of children served.
Although local program offices have reported funding shortfalls, the program has not used its full federal grant allocation. The program also has not fully analyzed the option of requiring families to pay some costs through a sliding co-payment scale or annual fee schedule, which some states use to increase available resources.
The program needs to revise its contracts with local offices to ensure that they provide adequate oversight of their providers. Also, while the program could be moved to another agency, such a transfer would not provide clear benefits.

Early Steps Has Revised Reimbursement Rates But Needs to Assess Impact of Expanded Outreach on Child Participation
Report 08-44 July 2008
Progress Report: Children's Medical Services Working to Expand Privatization and Reduce Administrative Inefficiencies
Report 04-35 May 2004
Children's Medical Services Privatization Is Feasible; Could Save Over $18 Million, But Barriers Must Be Overcome
Report 02-04 January 2002

Copies of this report in print or alternate accessible format may be obtained by email OPPAGA@oppaga.fl.gov, telephone (850) 488-0021, or mail 111 W. Madison St., Room 312 Tallahassee, FL 32399-1475.