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Senate Moves To Fix Early-Intervention Program

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A Senate panel is looking to help Early Steps, which serves infants and toddlers with developmental disabilities and delays -- and which has been struggling to keep up with the growing demand for its services in Florida.

A new report, presented this week to the Senate Children, Families and Elder Affairs Committee, shows that job cuts at Early Steps have kept the program from meeting federal standards for timely and quality services.

Those benchmarks are crucial because the younger that children are diagnosed and treated for disabilities and delays, the greater the chance they'll reach school age ready to learn.

"Experts consider that there's a very small window of opportunity, from birth to age three, when these services can have a significant impact on a child's long-term success," said Mary Alice Nye, chief legislative analyst for the Legislature's Office of Program Policy Analysis and Government Accountability, known as OPPAGA.

The benchmarks are also crucial because the state must meet them in order to receive federal funding.

What's more, the report found that Early Steps could be serving more children by using different eligibility and performance standards, among other changes.

"Early intervention researchers and experts suggest that Florida's criteria may not capture all children who could benefit from early intervention services," the report says.

Now the Senate committee is proposing a bill for the 2016 session that would expand eligibility, upgrade performance standards, work better with providers and save costs for Early Steps.

The federal government allocates funding for Early Steps to states based on a formula, and Florida's share of federal funding in the current fiscal year will be about $25 million. Additionally, the Legislature budgeted $45.3 million for Early Steps, including $13 million in new funding.

But demand for the program continues to climb. According to the Florida Developmental Disabilities Council, Early Steps providers reported a 5 percent increase in enrollment and a 6.5 percent increase in referrals last year. 

According to the state Department of Health, the total number of referrals to Early Steps jumped from about 43,000 three years ago to nearly 48,000 in the past budget year.

However, the report also found that the Early Steps program has fallen still further behind since the Department of Health cut most of the jobs at the program's central office last spring.

In response to a $6.9 million deficit in the last fiscal year, the department slashed 13 administrative jobs at the Early Steps central program office, leaving five people to support the 15 local offices.

At the time, in early March, Senate Health and Human Services Appropriations Chairman Rene Garcia, R-Hialeah, said the department assured him no services would suffer. "My question was, 'Is this going to affect services at the local level?'" Garcia said then. "And they said 'Absolutely not.' "

But Ellie Schrot, the Early Steps coordinator for Broward County, told senators this week that a backlog has caused delays of four to five months to get new providers credentialed to work with the program's children. Such delays can, in turn, cause local offices to miss their time requirements for connecting the child with a therapist.

"We are losing providers because of the lengthy time it takes to process claims," Schrot said.

"I would agree that several months is not acceptable," responded DOH Deputy Secretary Celeste Philip. "We acknowledge that."

The bill proposed by the Senate committee aims to address the delays, in part, by spelling out how Early Steps works with providers and insurers.

The measure would also standardize the Early Steps eligibility criteria. The OPPAGA report found that children's eligibility for the program varied from region to region, "from less than 50 percent of children referred for services in some areas of the state to as high as 80 to 90 percent in other areas."

Differences were also due to a lack of training for those using the program's screening tool to determine eligibility.

"(Early Steps) officials said that the eligibility criteria for established conditions and the state's developmental criteria are clear," the report noted. "However, research suggests that considerable variation exists in the percentage of children determined eligible."

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