DSS Referral Form for Early Intervention Services (CDSA - info dhhs state nc 2026

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  1. Click ‘Get Form’ to open the DSS Referral Form in the editor.
  2. Begin by entering the 'Date of DSS Referral' and the 'Date of DSS Finding of Substantiation or In Need of Services'. This information is crucial for timely processing.
  3. Fill in the child's details, including 'Child’s Name', 'Date of Birth', and select their gender. Ensure accuracy as this information is vital for identification.
  4. Provide demographic details such as 'Race/Ethnicity' and 'Language', if other than English, to help tailor services appropriately.
  5. Complete the contact information fields, including address and telephone number, for both the child and parent/caretaker. If applicable, include legal guardian details.
  6. Answer questions regarding any known health problems or involvement with other agencies. This helps assess the child's needs comprehensively.
  7. Indicate whether the child has Medicaid/HealthChoice or other insurance options. This information is essential for service eligibility.
  8. Finally, provide any additional information that may assist the Child Developmental Service Agency (CDSA) in understanding your family's situation.

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Covered by your health insurance, Medicaid, or Indian Health Services. Some insurers will cover early intervention services, and some will not. In most cases, you must give your written consent before anyone involved with early intervention can access your private or public health insurance for payment.
The Childrens Developmental Services Agency is the local agency for Early Intervention in our community and is part of the statewide NC Infant-Toddler Program. The CDSA supports families who have children from birth to age three who have developmental delays or who are at risk for problems with their development.
A masters degree is often required to secure employment as an early interventionist, with other important steps including attaining experience working with children with a disability and gaining a license and certification.
Early intervention is a field with many professionals; the roles vary according to the needs of the child and family. One professional known as the primary service provider or PSP, may provide direct services to the child and family with other professionals provide consultation to the PSP.
According to federal regulations implementing IDEA (2004), EI service coordination is defined as services to assist and enable an infant or toddler with a disability and the childs family to receive the services and rights, including procedural safeguards (34 C.F.R. 303.34).

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The North Carolina Early Intervention Section (NCEI) is a part of NCDHHS Division of Child and Family Well-Being. It is the lead agency for the North Carolina Infant-Toddler Program (NC ITP). The NC ITP provides support and services for families and their children, birth to three who have special needs.

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