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Early Support Services 0-3 Years

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Children’s Service Coordination (CSC)

Children’s Service Coordination (CSC) provides resources to families who have a child (ages 3 to 21) with a developmental disability or chronic health condition. The services provided are initiated by each family and are unique to their specific needs.

Determine eligibility and start the
intake process for your child:

Our Focus:

The focus of Children’s Service Coordination is to assist the family in accessing services. Our goal is to educate and empower families to identify, access and utilize available resources in ways that are most helpful to them. This is achieved by partnering with a Children’s Service Coordinator.

Children’s Service Coordination (CSC) provides:

  • information and referral to community services
  • Early Supports and Services 
  • assistance in planning for transitions
  • access to training
  • assistance with future planning
  • In Home Supports
  • information about acquiring benefits
  • parent-to-parent matches
  • referral to appropriate support programs
  • assistance to families with the special education process

The Family Council

The Family Council is an advisory group to the Area Agency, made up of parents and family members of children and adults with developmental disabilities. Learn more here.  

Environmental Modifications

Environmental Modifications (E-mods) are physical adaptations to a person’s home that are necessary to ensure the health, welfare and safety of the person. E-mods may also be made to a vehicle if it is the primary source of transportation to a person who receives services. Examples of E-mods include wheelchair ramps and lifts, hand rails, roll-in showers, lifts, automatic door openers and widened doorways and hallways. E-mods enable a person to live with greater independence. For individuals with unsafe wandering and running behaviors, outdoor fencing may be a needed e-mod. E-mods do not include the purchase of a vehicle or improvements to a home or vehicle that are not medically necessary or are not needed for a person’s independence in their home or community.

Early Supports and Services (ESS)

Family Centered Early Supports & Services (FCESS), also known as ESS, provide resources to children from birth to three years of age and their families, including a developmental evaluation, family coaching, guidance, instruction, referral to community resources and emotional support.

Early Supports & Services professionals partner with families in addressing their priorities and concerns. While building on families’ existing strengths, they aid in exploring resources that would help the child and their family.

The evaluation (and subsequent services if determined eligible) looks a lot like play and is usually very enjoyable for both child and family. The evaluation team may include professionals in the fields of physical therapy, occupational therapy, speech therapy, early childhood education, behavioral intervention, social work and other consultative services. ESS staff members work with families to support their children’s progression through developmental milestones, respecting families’ values, needs, cultures and priorities in the natural settings of homes and childcare facilities.

Some commonly asked questions:

To be eligible for Family-Centered Early Supports & Services in New Hampshire, children must meet one of the three specific eligibility categories:

  • Established condition;
  • Developmental delay of 33% or greater in any area of development (physical, cognitive, communication, social/emotional or adaptive development), or
  • At risk for developmental delay (in five or more documented conditions or circumstances).

A comprehensive developmental evaluation is provided to assist in determining a child’s eligibility for services. If your child is determined to be eligible, an Individualized Family Support Plan (IFSP) will be developed to address your child’s needs. Children eligible for ESS will also be eligible for Children’s Service Coordination at MDS. Once eligible, parents have the choice of two local providers, MDS Birth to Three and Rise for baby and family.

Who can make a referral:
Parents, or with parents’ permission, extended family, physicians, child care providers or anyone with a concern about a child’s development can make a referral. Call your MDS Intake Coordinator at 603-352-1304 to make a referral. Please be prepared to provide your child’s full name, date of birth, parents’ names and contact information, and insurance information. The Intake Coordinator will arrange an appointment with you to explain the program, gather relevant information for the evaluation team, and assist with signing the necessary releases and consents. The evaluation team will then contact you to schedule an evaluation to determine eligibility for the program.

Family Centered Early Supports & Services are funded by state and federal funds, private and third party insurances. No child will be declined for services because of the family’s lack of financial resources.

Each child who enters ESS receives service coordination. As a child moves through ESS, service coordination is provided to be sure that the child’s transition into the school system or other community settings will be seamless. Your Service Coordinator, as agreed upon by you and your team, will work with you through the transition process.

Once eligible, families have a choice of two local provider agencies for ESS Services:

MDS Birth to Three 
Early Supports & Services
121 Railroad Street, Keene, NH 03431
Phone: 603-352-1304
Fax: 603-352-1637

Rise for baby and family – Early Supports & Services 
147 Washington St, Keene NH 03431

In-Home Support (IHS) SDS

In-Home Support (IHS) services provides residential habilitation for children or young adults who have a developmental disability and significant medical or behavioral challenges.

These supports, provided with the help of an In-Home Support service coordinator, include personal care and other related services to promote greater independence and skill development for children or young adults to allow them to remain living at home with their family and actively engage with their community.

To qualify, a child must have Medicaid, live at home with their family, and be 0-through age 20 and still in school.

In Home Supports services are intended to help the child and the family develop the skills that child needs to become an independent adult including such activities as:

  • Working on making meals and snacks.
  • Learning self-help skills such as showering, brushing teeth, dressing, and such.
  • Practicing using money and making purchases at stores.
  • Participating in social and recreational activities.
  • Learning how to be safe at home and in the community.
  • Getting exercise while having fun.
  • Learning to make choices.

Respite Services

The respite program at MDS allows family caregivers a much needed break, while giving the individual receiving respite care a chance to spend time in the community and enjoy personal interests with a trusted provider. The majority of individuals who receive respite funding have it covered through Medicaid. For those who do not qualify for Medicaid, MDS has additional limited funds available through a variety of grants such as Cheshire County grant and private donations.

How to use the respite allocation

Those receiving a respite allocation have a number of options, including:

Family Reimbursed Respite

The family pays out of pocket to cover respite hours, then submits a reimbursement form to receive their payment. They can choose whom they would like for a provider.

Respite Provider Hired Through MDS

The provider applies for the position through MDS. They would have an initial meeting with the family to see if it is a good fit. The family will not need to pay out of pocket; staff complete a timesheet, have the family sign off on it, and submit to MDS.

For more information on Respite Services:


Talk to your Service Coordinator.


MDS Birth-Three

MDS Birth to Three is part of the national Early Intervention program for infants and toddlers with disabilities and their families. The program is administered by the New Hampshire Bureau of Developmental Services’ Family Supported Early Supports & Services (FCESS).

MDS Birth to Three is founded on the belief that much of who we become is the result of our experiences within the first three years of life. All families, with the necessary supports and resources, can enhance their children’s learning and development. The primary role of a provider agency in early intervention is to work with and support family members and caregivers in children’s lives.

Early Intervention builds upon and provides supports and resources to assist family members and caregivers to enhance children’s learning and development through everyday learning opportunities.

Some commonly asked questions:

Parents, caregivers (with parental permission) and members of the medical community can make a referral to Early Supports & Services through the intake coordinator at Monadnock Developmental Services, 603-352-1304. After the area agency intake process, a team from MDS Birth to Three will conduct a developmental assessment to determine eligibility.

To be eligible for services, children must be under three years of age and have a developmental delay or be at risk for a developmental delay in one or more of the following areas of development: physical, cognitive, communication, social-emotional, and/or adaptive. If you are unsure if your child is eligible for services, then please consider having a developmental evaluation. It is completed at no cost to you and will probably provide valuable information about your child’s development.

MDS Birth to Three provides services under contract with, and is a program of Monadnock Developmental Services. Services are funded by private insurance, Medicaid, and State and Federal programs.

Key Principles in MDS Birth to Three Services

  • Infants and toddlers learn best through everyday experiences and interactions with familiar people in familiar contexts.
  • All families, with the necessary supports and resources, can enhance their children’s learning and development.
  • The primary role of a provider agency in early intervention is to work with and support family members and caregivers in children’s lives.
  • The early intervention process is individualized to reflect the child’s and family members’ preferences, learning styles and cultural beliefs.
  • Families’ goals must be functional and based on children’s and families’ needs and family-identified priorities.
  • The family’s priorities, needs and interests are addressed most appropriately by a primary provider who represents and receives team and community support.

Services for Families

  • Developmental evaluations
  • Guidance on how to incorporate therapeutic activities into the family’s routines
  • Special Instruction
  • Speech Pathology
  • Occupational Therapy
  • Physical Therapy
  • Service Coordination linking families with:
    * Information about community resources
    * Assistance with transitioning from Early Intervention
    * Advocacy Groups
    * Feeding/nutrition programs
    * Special Medical Services
    * Child Development Clinic
    * Neuromotor Clinic

Rise for baby and family

This Keene-based non-profit organization, commonly known as Rise, has been providing infants, toddler, and their families in the Monadnock Region with early supports and services since 1981.

Their mission is “To support families with infants and toddlers who have or are at risk for developmental delays or disabilities through comprehensive therapeutic services that build upon the family’s strengths and to be a resource and advocate for inclusion throughout the Monadnock Region.”

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