Child development

How Early Intervention Works in New Hampshire

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New Hampshire's Part C program, Family Centered Early Supports and Services, sits inside the Department of Health and Human Services and reaches families through ten regional Area Agencies. No doctor's referral is required, and the state charges no family fee at all. Here is how eligibility, including New Hampshire's at-risk category, and the age-three transition actually work.

Last updated: July 2026

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How Family Centered Early Supports and Services Works

New Hampshire calls its Part C program Family Centered Early Supports and Services, or FCESS, and places it inside the Department of Health and Human Services' Bureau of Developmental Services rather than the Department of Education, which is where some other states house their Part C system 1. A family does not need a doctor's referral to start; a parent, relative, or provider can refer a child directly.

FCESS serves children from birth until their third birthday, and like every state's Part C program, it exists because Congress requires one under IDEA, with each state choosing its own program name and lead agency 1.

Housing FCESS under the Bureau of Developmental Services also connects it administratively to New Hampshire's broader disability-services system, which can matter later if a child continues to need publicly funded support beyond age three, since the same department oversees several of those adjacent programs.

Three Paths to Eligibility in New Hampshire

New Hampshire recognizes three separate paths to FCESS eligibility: a diagnosed developmental delay, an established medical condition likely to cause one, or being at substantial risk for a developmental delay even without a delay showing up on testing yet. That third category, risk alone, is optional under federal Part C law, and not every state chooses to include it the way New Hampshire does.

New Hampshire is one of the states that extends eligibility to children considered at substantial risk, not only those with a measured delay or diagnosis. This can matter for a family whose child has a known risk factor, such as a significant prematurity history or a documented biological risk, but no delay detectable yet on a standardized test 2.

A family does not need to argue their own case for which of the three categories applies; the multidisciplinary evaluation team makes that determination, and a child can move from the at-risk category into the delay or established-condition category later if that becomes the more accurate description of their needs.

Starting the Process Without a Doctor's Referral

Any parent, relative, child care provider, or physician can refer a child to FCESS, and New Hampshire does not require a doctor's note, a completed diagnostic workup, or an autism diagnosis before accepting that referral 34. A family waiting on a scheduled autism evaluation does not have to wait on that appointment before reaching out to FCESS separately.

The two processes run on different tracks: an autism diagnostic evaluation determines a specific diagnosis, while an FCESS eligibility evaluation determines whether a delay or risk factor is present, regardless of its cause.

What the First 45 Days Look Like

Federal law gives New Hampshire, like every state, 45 days from referral to complete the evaluation and, for an eligible child, hold the first meeting that produces the Individualized Family Service Plan, or IFSP 2. The IFSP documents the child's current abilities, the family's priorities, and the services meant to support them, and it is revisited at least twice a year.

Because FCESS is delivered through regional Area Agencies rather than a single statewide office, the specific team conducting the evaluation and building the IFSP depends on which of New Hampshire's ten regions covers the family's home.

Ten Regions, Ten Area Agencies

New Hampshire delivers FCESS through ten Area Agencies, each covering a defined geographic region of the state rather than one office serving everyone. A family's home address determines which Area Agency handles their referral, evaluation, and ongoing services, even though the eligibility rules and the 45-day timeline are identical everywhere in the state.

This regional model is common among states that want services delivered close to where families actually live rather than centralized in one city, and it means the practical experience of using FCESS, who shows up for a home visit and how quickly, can vary somewhat by region even though the program itself is a single statewide system.

A family relocating within New Hampshire, from one Area Agency's region to another, keeps their FCESS eligibility, but their day-to-day team and specific point of contact changes to whichever Area Agency now covers their new address.

What It Costs Families

FCESS is provided at no cost to New Hampshire families. The initial evaluation and the ongoing services that follow are funded through a combination of state and federal dollars, and while a family's private insurance may be billed, New Hampshire does not charge parents a fee or a sliding-scale co-payment for early intervention services.

In New Hampshire, cost is not a reason to delay a referral. This puts New Hampshire alongside states like Montana, Nebraska, and New Mexico, which also charge no family fee, in contrast with states such as New Jersey that use an income-based sliding scale for at least some services.

The Transition to Part B Before a Third Birthday

FCESS coverage ends at age three, and the transition to what comes next is meant to begin well before that birthday, not at the deadline itself. For a child who continues to need support, the typical next step is a move to the public school system's Part B special-education services under an Individualized Education Program instead of the IFSP 56.

Knowing how an IFSP becomes an IEP ahead of time helps a family walk into that transition planning with realistic expectations about what changes. Part B guarantees a free appropriate public education from age three through twenty-one, and autism remains one of the disability categories that can establish school-based eligibility 6. The same federal structure applies to early intervention in New Jersey, early intervention in New York, and early intervention in New Mexico, though each runs under its own program name and lead agency.

Common questions

No. FCESS evaluates for developmental delay, an established condition, or substantial risk, not for a specific diagnosis. Many families begin services while a separate autism diagnostic evaluation is still pending, or without ever pursuing one, because eligibility only asks whether a delay or risk factor is present.

New Hampshire is one of the states that includes at-risk children in its Part C eligibility, alongside those with a measured delay or an established condition. A documented biological or environmental risk factor, even without a delay showing on testing yet, can be enough to qualify.

No. A parent, relative, child care provider, or physician can refer a child to FCESS directly, and anyone who knows the child well enough to have a concern can make that call. A completed diagnosis, a specialist's note, or a pediatrician's sign-off is not required before the state schedules an evaluation.

Nothing. New Hampshire does not charge a family fee or sliding-scale co-payment for FCESS evaluations or ongoing services. The program is funded through a combination of state and federal dollars, and while a family's private insurance may be billed for some services, families themselves are never charged directly.

FCESS coverage ends at age three, and transition planning begins well before that birthday rather than at the last minute. Children who continue to need support typically move to the public school system's Part B special-education services, delivered through an Individualized Education Program instead of the IFSP that guided FCESS.

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Signs Worth an Evaluation Sooner Rather Than Later

  • —Losing words, gestures, or motor skills a child previously had, at any age
  • —No babbling, pointing, or other gestures by 12 months
  • —No single words by 16 months, or no two-word phrases by 24 months
  • —Not responding to their name or making eye contact by their first birthday

This article explains how a public program works and describes general developmental milestones. It is not a diagnosis and does not replace an evaluation by a qualified professional. Every child develops at a different pace; a formal evaluation is the only way to know whether a child qualifies for services.

References

  1. 1.Early Childhood Technical Assistance Center (federally funded) (2024). Part C of IDEA. ECTA Center. link ✓That Part C is a federally required early-intervention system that every state administers itself under its own program name and lead agency.
  2. 2.U.S. Department of Education, Office of Special Education Programs (2024). Part 303 (Part C) — Early Intervention Program For Infants And Toddlers With Disabilities. IDEA — sites.ed.gov/idea. link ✓The federal 34 CFR Part 303 requirements for evaluation timelines, the IFSP, and the optional at-risk eligibility category some states, including New Hampshire, choose to include.
  3. 3.Centers for Disease Control and Prevention (2024). Accessing Services for Autism Spectrum Disorder. CDC — Autism Spectrum Disorder (ASD). linkThat families can access Part C early intervention without waiting for a completed diagnosis, including an autism diagnosis.
  4. 4.Center for Parent Information and Resources (OSEP-funded) (2023). Part C of IDEA: Early Intervention for Babies and Toddlers. Center for Parent Information and Resources. link ✓The parent-facing referral and access steps for Part C early intervention described in this article.
  5. 5.U.S. Department of Education, Office of Special Education Programs (2024). IDEA Part C: Early Learning and Early Childhood. IDEA — sites.ed.gov/idea. link ✓The transition concept from Part C (birth-3) to Part B services at age three.
  6. 6.U.S. Department of Education, Office of Special Education Programs (2024). About IDEA. IDEA — sites.ed.gov/idea. link ✓What IDEA Part B guarantees at age three, including the IEP and the free appropriate public education guarantee.

6 sources, numbered by first appearance. General health information, not medical advice. AI-assisted editorial content — citations link their sources. Editorial policy

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