National Early Childhood Technical Assistance Center (NECTAC) was asked to identify essential elements for supporting high performance and provision of high quality early intervention Part C services as determined by the Annual Performance Review (APR) required under Individuals with Disabilities Education Act (IDEA). To respond, NECTAC interviewed one state and conducted a focus group with four other states that have consistently met requirements on the APR indicators and are maintaining effective, efficient practices. Additionally, the NECTAC review of states' APR early childhood indicators and technical assistance experience also helped inform the identification of commonalities across states that could be considered essential elements of a high performing Part C system. Four essential elements emerged from the discussion with the selected states: (1) Reliable and Current Data for Decision Making; (2) Monitoring and Accountability; (3) Adequate Numbers of Qualified Personnel; and (4) Strong Leadership, Administrative Support, and Partnerships between State and Local Levels. Each element is listed in this report and illustrated with specific activities and procedures noted by states. Quotes from participating states are included to provide examples of comments related to the various elements and to further describe how states are implementing these essential elements.