Services that support healthy development in the years before starting school can reduce the incidence of disorders that have high costs and long-term consequences for children’s health, education, and well-being. State policy choices can affect the extent to which Medicaid- and CHIP-eligible children receive developmental screenings and follow-up treatment. Unfortunately, access to follow-up care, such as Early Intervention services, continues to be a challenge. This brief examines states’ Medicaid and CHIP policy choices that will be available under health reform and other federal legislation to develop a well-coordinated system of care for children receiving early intervention and other ongoing services.