Early Intervention Services
March 2013
- Ensure that Early Intervention providers are paid no less than the state-established rate.
- Require the fiscal intermediary to manage the appeals process and to pay providers the full state rate while appeals are pending.
- Remove the health insurance representative from the decision-making process.
Early Intervention (EI) services actually pay for themselves in the long run. EI provides vital developmental and therapeutic services to children, ages birth to 3, the optimal time for affecting permanent brain development. By enabling children to increase their skills, EI decreases future costly disability-related expenses.
The Executive Budget would require EI providers to join health insurance networks and to negotiate their rates with insurers. Providers would have to accept the negotiated rate—even if it were lower than the appallingly insufficient rate paid by NYS. With only one tiny increase in the past 17 years, offset by a 5% cut two years ago, many providers have already closed! An additional decrease will push many more over the fiscal cliff into insolvency, leaving children nowhere to go for essential EI services.
The budget proposals would also burden EI providers with the task of handling the insurance appeals process—and foregoing payment until the appeals were resolved. EI providers lack the requisite experience in managing appeals, and they also lack the financial resources to continue providing services without reimbursement.
In a cruel blow to families, another proposal would add an insurance company representative to the team that develops the child’s Individualized Family Service Plan, thus interfering in treatment decisions, compromising confidentiality, and intimating parents. The proper role of the insurance company must be limited to paying for covered services.
Special Education Schools and Preschools
Preschools
- Reject a competitive bidding process for New York City preschool special education programs.
Children ages 3-5 with significant disabilities benefit immensely from preschool special education services.
In order to reduce rising preschool costs, the Governor is proposing to institute a competitive bidding process for New York City preschool special education providers. Currently, the State Education Department sets the preschool tuition rates, authorizing different rates to meet the needs of children with intensive, and costly, needs as well as those with fewer service needs.
Given the extreme diversity of the population, bidding makes no sense at all. Stuck with the lowest-bid, preschools won’t be able to provide needed services, especially high-cost services, and the children who need these services will be denied.
Experience proves that bargain-basement programs are likely to provide substandard services. In fact, families are still smarting from the disastrous results of the recent bidding for preschool related services and preschool transportation contracts.
A partial solution would be to initiate Medicaid billing for related services, which would offset a substantial portion of the costs.
Special Education Non-Public Schools and Preschools
- Provide a tuition rate increase for non-public schools and preschools.
- Do not permit school districts to waive state-imposed special education requirements.
The Governor proposes a 3%-4% increase in funding for local school districts but excludes the non-public schools and preschools! The Committees on Special Education assign tens of thousands of students with severe disabilities to non-public schools and preschools because the local school districts cannot provide appropriate services. These non-public schools are part of the public school special education continuum. Excluding the non-public schools is discriminatory and indefensible.
New York State is inviting crisis. Despite rising costs, non-public schools have had no increases for four years. A fifth year without the ability to cover increasing costs will result in school closures. New York State must provide an increase now—or answer for the fate of the non-public school students it is abandoning.
Throwing critical student protections to the wind, the Executive Budget would allow school districts to apply for a waiver of any state-imposed special education requirements that are not in conflict with federal standards. For example, districts could waive regulations governing class size, class grouping by age and learning needs, and time frames for implementation of the IEP. These regulations were adopted in order to foster successful learning environments. Waiving them will jeopardize successful student outcomes.