Our View: “No Need to Wait: Investing Early for Lifelong Success”

By Nora OBrien-Suric, Ph.D.

Most of us like to fix problems as soon as they’re discovered—before they become bigger, more difficult, and more expensive to deal with. It’s common sense. But when it comes to serving children with developmental delays and disabilities, too often we, or really our children, wait.

In 2016 alone, nearly 1,000 infants and toddlers in Western and Central New York waited more than a month for needed screening and early intervention services. Research shows that early detection and treatment of developmental delays and disabilities can improve cognition, social skills, school readiness, and child and family well-being. Waiting does not.

Collaborating, advocating for change

As part of a larger state-wide advocacy effort, the HFWCNY is proud to provide leadership on this issue. We are the first foundation to join New York State’s Kids Can’t Wait initiative, led by The Children’s Agenda. This effort is building a coalition of parents, providers, medical groups and faith communities to secure reforms that ensure timely access to early intervention therapeutic services for children 0-3. It is an important complement to the Foundation’s programs aimed at increasing child development screening rates, including Help Me Grow and our new partnership with Liftoff.

“We believe all children in New York should have the best chance possible to grow and thrive,” says Lary Marx, CEO of The Children’s Agenda. “And vulnerable children should get the screening and other services they need, when they need it. That starts with reducing unnecessary waits for a whole range of important services.”

These Early Intervention services include hearing and speech, occupational, vision, and physical therapies. They can often prevent or lessen the risk of a child falling behind developmentally, which can lead to additional, sometimes lifelong problems. Addressing these issues early can also be significantly less costly than providing years of school-aged special education.

What will it take to do better?

The Children’s Agenda has identified several structural issues that prevent children from receiving early intervention services. These center primarily around reimbursement rates and how they are established. Specifically, Kids Can’t Wait will work on four policy changes, namely to:

  1. Establish reimbursement rate equity between early intervention and Committee on Preschool Special Education (CPSE) Related Services. Currently, a speech therapist providing services to a four-year-old and reimbursed through the CPSE is paid 20-50% more than the same services provided through Early Intervention to a two-year-old.


  1. Significantly increase Early Intervention and CPSE reimbursement. Early Intervention reimbursement rates have not increased since the 1990s. In fact, they have been cut in recent years. This has created a serious wage disparity between therapists who work with children under three and those who work with older children or adults. The result: too few providers of these much-needed Early Intervention services.


  1. Shift to a state-driven system to mitigate the effects of varying local budgets and limitations on generating new revenue, as well as to reduce the complexity of the local systems. This would allow the state Education Department and the Department of Health to work more closely and establish a single system for addressing early childhood development issues.


  1. Establish a statewide rate-setting methodology to determine appropriate reimbursement rates for all types of Early Intervention and CPSE services. This should take into account actual provider costs and prevailing wages.


The Health Foundation is proud to have committed more than $150,000 over three years to support this critically important effort. We wanted to get this work moving sooner, rather than later. We couldn’t wait to see progress for some of New York’s most vulnerable children.