Only half of NYC toddlers received timely services for developmental delays: report


February 23, 2023

By Madina Touré

NEW YORK — Just half of New York City children under age three received timely early intervention services for developmental delays, according to a new analysis.

Details: On average, 52 percent of eligible children citywide receive all of the services for which they are eligible —including speech and physical therapy — as part of the state’s Early Intervention Program within the mandated 30 days, according to a new fact sheet by Citizens’ Committee for Children of New York, an education advocacy group. When a child is evaluated for their service plan, they may be found to be in need of multiple services.

The program supports children under the age of three who have developmental delays or disabilities. The group said 30,000 New York City children are referred to the program but not all of those children will ultimately receive assessments.

The state requires children to get early intervention services within about a month of their Individualized Family Services Plan meeting, a written plan outlining the services. Under federal law, the initial IFSP meeting has to take place within 45 days of the date the child is referred to the Early Intervention program.

In fiscal year 2022, the average wait time for services was 21.6 days, an increase from 15.9 days the previous year. The group attributed the delays to provider shortages and an under-funded Early Intervention system.

“What we wanna do is make sure that we are providing services as early as possible so that those children aren’t needing even more intensive services later in life that might also be challenging to access,” Alice Bufkin, CCC’s associate executive director for policy and advocacy, said. “We really wanna make sure that we are getting them on the right pathway and ultimately that also can help reduce their need for preschool special education services or special education services.”

The services include speech therapy to help children who have delays in speech and communication as well as occupational therapy and physical therapy to address motor skills and daily living activities.

Bufkin said that while telehealth was crucial during the Covid-19 pandemic, it is now time to return to in-person services, noting a demand for that kind of help from families.

A spokesperson for the city’s Department of Health and Mental Hygiene said that 97 percent of children start receiving one or more services within the 30-day period and 52 percent of children received all services for which they are eligible within that period.

“There are clinical reasons that not every service starts within 30 days, including that children receiving services from multiple therapists are authorized for team meetings that cannot begin until the child has received several service sessions from each therapist,” the spokesperson said in the statement.

Impact: The group pointed to similar trends of delayed assistance statewide, notably in cities like Buffalo, Rochester and Syracuse.

To qualify for the services, children must have a disability or developmental delay in several areas — cognitive, physical, social-emotional, adaptive — inability to engage in life skills like getting dressed — or communicative.

A professional performs the evaluation and parents have to consent before a child is referred. Any individual, including the parent, can make a referral. A pediatrician, for example, can seek parental permission to make a referral and then contact an Early Intervention provider.

The outcomes are especially dire for Black and Latinx children. Only 42 percent of eligible Black children received services within 30 days, and just 48 percent of Latinx children did, compared to 60 percent of white children.

“There can be stigma associated with getting early intervention services,” Bufkin said, arguing more funding is needed for outreach. “There’s a really important role for community health workers and for outreach among EI providers to actually go out into communities and work with them.”

There was also an uptick in the number of delayed initial ISFP meetings. Children of color were also disproportionately left behind, with those students not being evaluated after referrals and not getting services after being deemed eligible.

What’s Next: The group called on state leaders to boost early intervention reimbursement rates for providers by 11 percent and put in place higher rates for costs like transportation and administration.

Advocates also recommended using revenue from the Covered Lives legislation — which allows providers to get reimbursed directly from the state through a fund paid for by health insurance companies — to increase reimbursement rates.

Assemblymember Amy Paulin (D-Westchester), chair of the Health Committee — who sponsored the bill — vowed to push for rate increases in the state budget.

“We know that there are so many fewer providers because of billing issues and also because of the low pay,” Paulin said in an interview. “So the rates do have to increase in order to shore up this group of providers for our kids, absolutely.”

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