California Early Start FAQ: Free Services for Kids Under 3

If you are worried about your baby or toddler's development, California Early Start may be one of the most helpful programs you never heard of. It is free. It works in your home. And you do not need a diagnosis to start.

Early Start is California's version of Part C of the federal Individuals with Disabilities Education Act (IDEA) — a law that promises early intervention to every eligible child from birth to age 3. This FAQ answers the questions parents ask most: who qualifies, how the referral works, what services look like, what it costs, and what happens when your child ages out at three.

What is California Early Start?

Early Start is a statewide system of early intervention services for infants and toddlers (birth to 3) who have a developmental delay, a disability, or a condition that puts them at high risk for delays. It is run jointly by the Department of Developmental Services (DDS), Regional Centers, Local Education Agencies (LEAs), and Family Resource Centers (FRCs).

Services are delivered in your home or other everyday places — park, daycare, grandma's house — because research shows young children learn best in the places they already spend their days. The whole point is to help your family support your child's growth during the period when brains are building fastest.

Who qualifies for Early Start?

A child under age 3 qualifies if one of these is true:

• 33% delay in one or more developmental areas. The five areas are cognitive, communication (speech and language), physical (gross motor, fine motor, vision, hearing), social-emotional, and adaptive (self-help skills). A 33% delay means the child functions at least one-third below their chronological age — for example, a 12-month-old functioning at 8 months or younger.
• Established risk condition. A diagnosed condition with a high probability of developmental delay, even if delay is not yet showing. Examples include Down syndrome, cerebral palsy, fetal alcohol syndrome, seizure disorders, and certain genetic conditions.
• Solely low incidence disability. Children with hearing impairment, visual impairment, or severe orthopedic impairment qualify even without a measured 33% delay. For these children, the LEA (school district) leads services instead of the Regional Center.

California used to also include a broader "at risk" category that covered things like prenatal substance exposure and very low birth weight. Budget cuts in 2009 narrowed the rules. Recent laws including SB 691 and related legislation have restored and clarified some eligibility pieces — ask your Regional Center what currently applies, since this area of law keeps evolving.

How do I make a referral?

Anyone can refer a child — a parent, doctor, daycare provider, grandparent, or the child's pediatrician. The fastest way is to call your local Regional Center directly. There are 21 Regional Centers across California, and one serves every zip code in the state.

You can also call the Early Start Baby Line at 1-800-515-BABY (2229), or contact your local Family Resource Center. No doctor referral, insurance card, or diagnosis is needed to start. A short phone call or online form is all it takes.

Once a referral is made, Early Start takes over the next steps — you do not have to figure out who does what.

What happens after the referral? (The 45-day timeline)

Federal law gives California 45 calendar days from the date of referral to complete three things:

• Intake and information gathering (what are your concerns, what is your child's story)
• Evaluation and assessment to determine eligibility and identify needs
• An initial IFSP meeting to write the plan and begin services

This clock is strict. If 45 days pass and you still do not have an IFSP, something has gone wrong — call the Regional Center or the state Early Start office. Evaluations are usually free and done in your home. You will meet professionals like a service coordinator, a developmental specialist, and sometimes a speech, OT, or PT therapist depending on your concerns.

What services can Early Start provide?

Services are based on what your child and family need, not a fixed list. Common Early Start services include:

• Speech and language therapy
• Occupational therapy (OT)
• Physical therapy (PT)
• Developmental services (sometimes called developmental specialist visits or infant development services)
• Vision services and orientation and mobility
• Services for children who are deaf or hard of hearing, including sign language instruction
• Assistive technology — communication devices, adapted equipment
• Nutrition services
• Nursing services
• Psychological and social work services
• Service coordination (a case manager who helps you navigate everything)
• Family training and support
• Transportation related to services, when needed
• Respite, in limited situations

Your service coordinator is your single point of contact. They do not provide therapy themselves, but they connect you with providers, write the IFSP, solve problems, and translate the system for you.

What are "natural environments" and why do therapists come to my home?

Federal and state law require Early Start services to happen in "natural environments" — the places your child would spend time if they did not have a delay. That usually means your home, but it could also be daycare, a playgroup, a park, or a relative's house. Clinic-based therapy should be the exception, not the default.

There is strong research behind this. Babies and toddlers learn through repetition in daily routines. A therapist teaching you how to build language into bath time, meals, and play gives your child many more learning minutes per week than a one-hour clinic visit. You are the expert on your child. Early Start therapists coach you and become part of your team, not outsiders who "fix" your child behind a closed door.

What is an IFSP and how is it different from an IEP?

An IFSP — Individualized Family Service Plan — is the written plan for your child's early intervention. It is different from an IEP in important ways:

• An IFSP is about the whole family. It names your concerns, your priorities, your resources, and what supports you need.
• IFSP outcomes are written in family-friendly language — "we want Mia to let us know what she wants without tantrums," not clinical goals.
• An IFSP is reviewed every 6 months and rewritten at least annually.
• An IFSP follows the child into natural environments; an IEP follows the child to school.
• IFSPs are driven by service coordinators at the Regional Center (or LEA for solely low incidence). IEPs are driven by school district teams.

For the full comparison, see IEP vs IFSP in California.

How much does Early Start cost?

Early Start evaluations, service coordination, the IFSP, and most services are free to families. California does not charge families for Early Start. There is no income test and no premium. Your insurance or Medi-Cal may be billed for some services, but that billing is between the provider and the insurance company — you do not get a bill, and your insurance benefits are protected by federal law from being capped because of Early Start use.

A small number of services (like respite) may have a family fee in rare situations, but core therapies and evaluations are always free. If anyone tells you to pay or give a credit card to start services, stop and call the Regional Center directly to verify.

Who administers Early Start — Regional Center, school district, or someone else?

It depends on your child's situation:

• Regional Centers serve most Early Start children — roughly 85%. If your child has a delay, established risk condition, or combined delays, you will probably be with a Regional Center.
• Local Education Agencies (school districts or SELPAs) serve children who are solely low incidence — meaning their only eligibility is hearing, vision, or severe orthopedic impairment. The LEA provides services through specialized teachers and therapists, often through programs for deaf and hard of hearing children.
• Family Resource Centers are a statewide network of parent-run centers that support every Early Start family, regardless of who provides services. They offer parent-to-parent support, lending libraries, workshops, and help understanding the system.

If you are not sure which applies to your family, make the referral and Early Start staff will route you to the right program.

What happens at age 3? (Transition)

Early Start ends the day your child turns 3. What comes next depends on your child's needs:

• Transition to a school district IEP. If your child may qualify for special education preschool services, the school district will do an IEP evaluation. This process starts around age 2 years 6 months — sometimes earlier. A transition IEP meeting happens before your child's third birthday so services can start seamlessly.
• Continuing Regional Center services as a client. If your child has a qualifying condition under the Lanterman Act (like autism, intellectual disability, cerebral palsy, epilepsy, or a related condition), they may remain a Regional Center client for life. Services shift from Early Start to regular Regional Center services at 3.
• Both. Many children have both an IEP at school and ongoing Regional Center services at home. The two systems run on parallel tracks and should coordinate through a team meeting before the third birthday.
• Exit. Some children catch up by age 3 and do not need ongoing services. That is a good outcome, and it is exactly what early intervention is designed for.

Ask for a transition meeting at least six months before your child's third birthday. Bring your service coordinator, school district staff, and any therapists who know your child.

What are SB 691 and AB 1004?

These are two California laws that shape Early Start in important ways:

• AB 1004 requires developmental screening to be part of well-child visits for children enrolled in Medi-Cal, using validated tools. It aims to catch delays earlier so referrals happen sooner.
• SB 691 and related legislation have restored and clarified Early Start eligibility rules, particularly around the "at risk" categories that were cut in 2009. The rules keep evolving, so when in doubt, ask your Regional Center what currently applies.

If your pediatrician has not offered a developmental screen, you can request one. Screens like ASQ, PEDS, or M-CHAT are quick questionnaires that help identify whether a full evaluation is worth pursuing.

Are services available in my language?

Yes. California is required to provide Early Start services and documents in your native language when feasible. That includes:

• Interpreters at IFSP meetings
• Translated IFSPs and written notices
• Therapists who speak your language when available, especially in Spanish
• American Sign Language and other sign language instruction for Deaf families

Tell your service coordinator your language preference at intake. If you need a specific dialect or a rarer language, ask — Regional Centers use phone interpretation lines when they do not have staff on site. You do not have to bring a family member to translate. In fact, the system prefers professional interpreters for accuracy.

What are my rights in Early Start?

You have the right to:

• Refer your child and have an evaluation at no cost
• Participate fully in all decisions about services
• See all records about your child and request corrections
• Consent (or not consent) to evaluations and each service separately
• Get written notice before anything changes
• Get a copy of procedural safeguards
• File a complaint or request mediation or due process if you disagree
• Get services in your natural environment unless you agree otherwise
• Decline any service without losing access to other services

Your Family Resource Center is the best free ally when something feels off — they know the system from the parent side and can help you advocate.

What if I already have a diagnosis from a doctor?

Great — bring the report to your intake appointment. A diagnosis can speed things up, especially if it is an established risk condition. But do not wait for a diagnosis to refer. Early Start evaluators can identify delays on their own, and research is clear that earlier intervention means better outcomes. Many parents start Early Start months before any formal diagnosis is made.

How is Early Start different from private therapy?

Private therapy is a paid service you arrange through insurance or out of pocket, usually at a clinic. Early Start is free, comes to your home, is coordinated by a service coordinator, and includes family coaching built in. You can do both at once. Many families use Early Start as the foundation and add private therapy for more intensive work. Your service coordinator can help you think through what combination makes sense.