Officials Join Call for State to Fix Early Intervention Program

Assemblymen Thomas Abinanti (D-Westchester) and Ken Zebrowski (D-New City) joined State Senator David Carlucci (D-Rockland/Westchester) and service providers in calling for the state to fix its Early Intervention program at the ARC of Rockland offices in Congers Thursday.

The system previously administered on the county level switched over to being run through the New York State Department of Health April 1, 2013 with the goal of providing mandate relief, but service providers claim the transition has left with overwhelming paperwork and lengthy delays in payment. 
"As I provider, I can tell you, I know I can stay in business one more month," said Sue Bailter of Blauvelt, the Associate Director of Speech and Communication Professionals. "Providers have to be paid and they have to be paid now so they can keep their doors open while our colleagues in Albany work out their problems."

"The early intervention has become a crisis," Zebrowski said. "These are such vital services. I don't know anybody who can run an agency or a business or even a household not knowing when payments are going to come. Weeks. Months. Entire quarters of payments delayed. We are going to run into a crisis that we won't have people providing these services, and as the senator said, we will have children fall through the cracks."

Abinanti called on the NYS Department of Health and Gov. Andrew Cuomo to fix the system, but even that isn't enough in his eyes. 

"The state broke a working system and it is up to the state to fix it," Abinanti said. "The money has to flow, the red tape has to be cut and frankly, I think heads have to roll. The Health Department blew it and blew it big time. This is a plan that was not well thought out. To make it worse, when it was rolled out by the Health Department, it was unbelievably poorly done.. We now have a situation where we have mainly small businesses about to go out of business and we have kids not receiving services."

State regulations ensure that providers of early intervention services for aproximately 69,000 children in New York with special needs are paid. Bailter said that early intervention has proven to be a key in helping children overcome developmental disorders and those that do not receive it become even more of a challenge once they reach school age. 

Before April 1, the counties administered those reimbursements. They paid the service providers directly, then collected payments from private insurance and Medicaid. They were also reimbursed by the state for 49 percent of the costs. The financial responsibilities of those entities has not changed, but the county no longer administers the program. Early intervention services include physical, occupational and speech therapies and special education. 

"Study after study shows how critical early intervention is," Carlucci said. "A dollar spent on early intervention can save hundreds of dollars down the road."

The switch to the state level was initially set for Jan. 1 of this year, but it was pushed back because the program was not ready. When the transition took place April 1, Baitler said the billing procedures were not in place.

"The State of New York knew for 10 months prior that these changes would be enacted and nothing was in place," Bailter said. "We couldn't even process bills. For four to five weeks, they sat in piles on every agency's desk because there were no procedures set up. That put each provider behind the eight ball. Then they started a new system. No training in the field at all. No procedures out. No contact information for us to call anybody. Everyone had to go through the system, on their own, learning it and falling down every inch of the way."

Much of the paperwork previously handled at the county level is now falling to the service providers.

"Even if they are getting paid, they are now being buried in an avalanche of paperwork," Abinanti said. "They are being told that they have to do three or four times as much paperwork as what our counties complained they had to do."

The result is at least three early intervention service providers in Westchester County alone planning to close by the end of September. 

"I don't know what will happen tot he calls I get from the parents of a newborn with Downs' Syndrome, or the parents of a six-month old just discharged from the NICU (intensive care for infants) or the two-year-old with cerebral palsy because there are not going to be services," Baitler said. 


"If someone wanted to divine a plan to cause the collapse of the early intervention system without any fingerprints on it and with the blame going somewhere else, this is the plan," Abinanti said. 

The State Health Department announced it would be taking action to pay early intervention providers in this release Tuesday. The release points to $133 million paid by the department through its fiscal agent for services and points to delays in payments from insurance companies, with 75,000 of 400,000 claims submitted since April 1 processed. 

The DOH gave counties the option of making "Preliminary Escrow Payments" to providers,drawing from county Early Intervention money. According to the release, few counties have done so. The DOH committed to paying providers 75 percent of their unpaid claims from insurance companies from April 1 to July 29 of this year. 

The officials and service providers present Thursday all said that the solution is temporary at best. Abinanti said those options may help with the Department of Health's image, but they are not enough to address the problem. He added that the issue of getting insurance companies to pay on early intervention services is not new. Even before the changes, at best, they only paid for four percent of the costs.

"The state threw us a bone," Baitler said. "The bone is 75 percent of a tiny portion. It's a band-aid with no adhesive. It's not going to stick and it's not going to fix anything.

"We need the system fixed. We need our elected officials, who represent us and all the families of this state, to pull together and say to the Department of Health and the governor, you have to fix it and  you have to fix it now. I appreciate very much that the Assembly and Senate are not in session. Can we wait until January to start working on this? No."

All three legislators agreed that a long-term solution must be found quickly.

"Unfortunately, the state has dropped the ball and it has not been up and running," Zebrowski said "Unfortunately, these agencies are hurting. We need this done yesterday. The payments need to come in from the insurance agencies. These agencies need to get payments for the services they provided already."

"This has to be a top priority for every level of government, from the legislature to the governor's office," Carlucci said. "We are here to say enough is enough. This time it has to change for good.

"We need to make sure we are working to ensure that every child in New York State who needs services is secured those essential programs."