An abrupt announcement by state officials that services for babies and toddlers with disabilities will be slashed starting next week drew condemnation Thursday from the state Capitol’s powerful joint budget committee. At the same time, they signaled a desire to find money to reverse some of the cuts.
Officials from the state’s Early Intervention Program, which provides physical, speech, behavioral and other services to young children, told providers Tuesday that a $4 million budget shortfall meant big changes. They would limit children to four hours of therapy a month, and children who are on Medicaid would no longer get certain therapies.
The news sparked an outcry Wednesday from providers who serve some of the most vulnerable, high-needs children in the state: premature babies who don’t know how to eat, children who can’t walk or talk, toddlers with severe emotional or behavioral challenges stemming from autism.
Two webinars hosted by the state with providers this week attracted more than 1,000 people. An official said the department has received hundreds of written questions. Families, as of Friday, had not been officially notified of the changes but began reaching out to state lawmakers after media coverage.
Joint budget committee members were swift in criticizing officials from the Department of Early Childhood for not notifying them earlier of the budget crisis.
“For some reason, the department didn't think we were worthy of knowing how serious this issue is, I find that incredibly insulting,” said Republican state Rep. Rick Taggart. “Not only to us but to give providers six days before changing services. How do you do something like that? And before telling them that, why didn't somebody come over here and say, ‘We got a perfect storm. We need your help.’ Nothing, crickets.”
Democratic Sen. Jeff Bridges said the committee wasn’t given the chance to make a choice about whether the cuts were needed, “to balance this against other priorities.”
Jeanni Stefanik, chief financial officer for the Department of Early Childhood said “the issue was not fully realized until just a few weeks ago.” She cited higher-than-anticipated referrals, caseloads, and costs as reasons for the announced cost-cutting measures.
By the end of the hearing, the committee had identified one option to help restore some Medicaid services. But the committee’s hands are tied as to how much money it can find because it must cut $1 billion this year to balance the budget.
A department letter said the cost-containment measures will continue into the next fiscal year, with additional strategies to be shared over the course of the next few months.
Families meanwhile, are gearing up for a prolonged advocacy campaign, starting with a petition asking lawmakers to bridge the funding gap has attracted more than 1,500 signatures. They’ve started sharing their stories.
These are some of the people cuts would impact:
Michelle Young’s son Zaia, 2, has a sensory processing disorder, suspected autism, and a condition where his knees and hips tilt inward making walking difficult. He can’t communicate verbally, and works with four different specialists who each come for one hour a week.
Young said these services are crucial to getting Zia developmentally where he needs to be to enter school. She took her son to his regular doctor’s appointment this week.
“The number one thing she said is how all of this therapy and help he has had since he was so young, has made such a difference in his progress, his speech, he's doing sign language,” she said.
Young’s services would be cut from four times a week to four times a month. Medicaid covers occupational therapy, speech language pathology and physical therapy. It doesn’t cover developmental intervention, social and emotional services including mental health and behavioral support, registered dieticians or a number of other therapies. Up until now, families have gotten those critical services through the state. The state’s letter to providers said families can no longer get the services.
“I’ve been in tears,” said Young. “It’s not fair how this will affect the kids.”
Young, who is a single parent, met with her son’s developmental therapist, who has been with him since he was 10 months old, for the last time Thursday.
“We have to say goodbye,” she said, crying. “We need them. This isn’t a want. It’s a medical need.”
Cassidy Norcross’s son August, 2, started getting services for autism in October. He has therapy three times a week with a speech therapist, an occupational therapist and a developmental therapist. August wouldn’t look at his parents, couldn’t communicate, and wasn’t responding socially as he should.
“He would have just terrible meltdowns because we could tell he was trying to communicate with us but he didn't have the ability to tell us what he wanted…and he was unable to understand what we were saying to him,” Norcross said.
But August has made tremendous progress in just the few months he’s had services.
“Just a few weeks ago, for the first time he came up to me and said he wanted ‘eggies’… eggs. I cried because it was like, ‘Oh my goodness,’ it was such a breakthrough for him to tell me what he wanted.”
The therapists introduced the family to many techniques, such as using printed pictures as a way to communicate, modeling calm behavior during emotional outbursts, and modeling language they want to hear from August.
“Before we started, I was just so scared and overwhelmed, and I just felt so helpless. His providers have gifted us the knowledge and the techniques so that we can help him thrive … there's just so many things that we've been taught by them.”
– Cassidy Norcross
Early Intervention services have been a lifesaver because the family makes a little too much to qualify for Medicaid but has no health insurance. The prospect of cuts leaves Norcross terrified. “Which one (therapy) do I pick?”
“It’s so discouraging. So overwhelming. I'm not thinking (just) about August, it's all the kiddos present and future. Birth through 3 is the time to intervene.”
Kimber Tichota is a registered dietitian and nutritionist who works in Denver, Jefferson and Adams counties. She works a lot with babies fresh out of neonatal intensive care units who may still be on a G-tube, a gastronomy tube inserted into the stomach or babies who have a hard time tolerating formula or swallowing. Some are still on oxygen as well.
Tichota said one of the scariest things for a family coming home from the hospital is not knowing if their baby is getting enough nutrition.
“And so, coming in and being able to give them exactly like a plan they can follow and then be a kind of a cheerleader, someone who’s coaching them through all this, giving them some both empathy and also just some confidence in being a parent because it's already scary to come home from the hospital and be like, ‘What do I do?’”
She prepares customized plans for families to help babies learn how to eat, how to roll over and sit up. If babies and toddlers don’t get therapy consistently, developmental delays will last longer. With early intervention, many times children catch up by the time they’re ready for preschool, she said.
Some children are diagnosed with a rare genetic condition or have a severe brain injury from birth, which are incredibly anxiety-producing for families. Tichota said Medicaid families will be losing social and emotional services along with nutrition support.
“All of that will be going away … And so that's kind of what's feeling very drastic about all of these cuts.”
Under the proposed changes, Tichota would lose most of the families she works with, which would impact her own family’s income.
“It’s devastating … but I'm really a lot more upset about the way it's being handled. It feels like they're not seeing the humans on both sides of this situation. The families are having services immediately taken away and we're no longer going to be able to support them.”
Cass Walker’s 3-year-old son was just 29 weeks old when he was born. He received Early Intervention services until his third birthday but still sees some of those providers through Medicaid. Her son was put onto a G-tube at 20 months and it was an Early Intervention provider who sounded alarm bells to her pediatrician that the boy was failing to thrive.
“Early Intervention providers see you on a weekly basis, so they have a much deeper understanding of your trials than any doctors that you're seeing.”
As a resident of Durango, she said Early Intervention services are one of the only ways families can access specialized care in rural areas. She was able to have tele-health sessions from Denver. Feeding, speech, physical, sleep and occupational therapy have all helped Walker’s son immensely.
“It's a long journey … But compared to what our journey could have been, he's doing really well. And honestly, I credit that to early intervention. We would be in a completely different situation if we had not had the support and resources from Early Intervention that we have.”
Walker felt compelled to speak out because she said the pending cuts are not just an early childhood and health issues.
“This is an education issue at every age,” she said. “This is a workforce issue. This is an economic issue. If you don't support our most vulnerable populations at the time that they need support, that will cost the state and it will cost the education systems and it will prevent kids going to college and becoming educated parts of our workforce.”
Early intervention is not a luxury, parents say. Research shows it prevents longer term health, social, emotional issues. It is less costly and more effective earlier in life and can reduce the need for special education later, enhance social-emotional skills, promote school readiness, and strengthen family relationships.
“It's not just about the impact on the families, which is obviously devastating, but it will have much bigger implications for the next generation,” said Walker.
