Rhode Island’s Early Intervention program provides special education services to infants and toddlers who have developmental delays or disabilities. These can include issues affecting a child’s speech, physical abilities, feeding and nutrition, or social skills. The program is mandated under the federal Individuals with Disabilities Education Act and is utilized by thousands of Rhode Island families every year.
Research has found that about one third of infants and toddlers who received high-quality Early Intervention services no longer had a developmental delay, disability, or special education need once they reached kindergarten.
For Early Intervention to have the most impact, the program needs to be fully staffed with qualified educators and therapists, and available as quickly as possible to Rhode Island’s youngest learners — from birth to age 3 — not only when they are showing signs they may have a developmental delay or disability, but also when they are considered to be at high risk for a developmental delay. They literally cannot wait to receive Early Intervention services like physical, speech, and occupational therapy.
Unfortunately, in recent years, Rhode Island’s Early Intervention program has come under enormous stress due to a combination of historically low reimbursement rates for providers and low pay for the professionals delivering essential therapy services. Early Intervention is struggling, not only to recruit but also retain highly qualified and specialized therapists. The tragic result of this crisis is that babies and toddlers who need these services are being placed on waiting lists. These infants and toddlers cannot afford to be waiting, as this negates and defeats the purpose of intervening early to see the most impact in a child’s life.
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As of February 2024, there were 623 infants and toddlers who had been waiting more than 45 days for services.
While Early Intervention providers are working hard to reduce these wait times, which have come down over recent months, the current situation is still unacceptable. We are failing too many babies, toddlers, and families who need these services now. As a state we must do better to support these families and young learners.
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Fortunately, Rhode Island’s elected leaders have invested in our Early Intervention system, providing a 45 percent rate increase for providers and allocating temporary ARPA funding to the program in 2022. While these investments have been a big help, the fact that we still have hundreds of infants and toddlers on waiting lists and that Early Intervention providers are still reporting staff and therapist shortages, demonstrates that much more support is needed.
What can the Rhode Island General Assembly do this legislative session to further stabilize Early Intervention and ensure that our youngest learners receive these federally mandated services as quickly as possible?
Governor Dan McKee’s FY 2025 proposed budget includes a 13 percent to 18 percent Medicaid rate increase for Early Intervention. We appreciate Governor McKee’s call for Early Intervention rate increases, but more needs to be done. We are urging the General Assembly to pass legislation sponsored by Representative Megan Cotter and Senator Bridget Valverde (H-7334, S-2359) that proposes a 25 percent Medicaid rate increase and annual cost-of-living adjustment for Early Intervention staff and therapists.
The General Assembly can also support our Early Intervention workforce by allowing them to tap into the successful Child Care for Child Care Educators program established last year. This program has helped child care providers retain staff with young children, and can work similarly for Early Intervention staff and therapists who may otherwise be forced to leave their jobs due to a lack of access to affordable child care. Legislation introduced by Representative Grace Diaz and Senator Alana DiMario (H-7123, S-2344) would do just that.
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Finally, Rhode Island needs to develop a comprehensive plan for both Early Intervention and Individuals with Disabilities Education Act special education services for young children. Due to funding and staffing challenges, school districts across the state are struggling to attract and retain qualified teachers and clinical staff to provide special education services to preschool aged children. Legislation introduced by Representative Lauren Carson and Senator Valverde (H-7438, S-2512) would establish an Early Childhood IDEA Task Force to develop a financing and staffing plan for a coherent system of educational and developmental services for babies and young children with developmental delays and disabilities, from birth up to kindergarten, across both Early Intervention and preschool special education.
These smart investments and policy improvements will go a long way to support our Early Intervention and special education systems, eliminating waiting lists, and providing absolutely critical services for our state’s youngest learners.
Silvia Velez, BS, is clinical supervisor/team leader in early intervention at Community Care Alliance, and Elizabeth Czerwein, DPT, is a physical therapist in early intervention at Children’s Friend.