Critics say rate plan could hinder services to children

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STATE HOUSE, BOSTON, SEPT. 16, 2014….Speech and physical therapists and other specialists who help young children with developmental delays are upset about what they say is a “paltry” rate increase set by the Patrick administration on Friday.

It has been eight years since early intervention care workers saw an adjustment to the rates they are paid for therapies they provide to infants and toddlers who need help with physical, speech or developmental problems, according to Robert Gagnon, president of the Early Intervention Consortium. The trade association represents 56 programs, with about 3,000 specialists, which contract with the state to provide services.

Babies from birth to age 3 who receive early intervention have a wide range of needs from therapies for autism to overcoming difficulty learning to walk or talk.

For the past two years, service providers have fought to get the state to pay more for the different services they provide. They said they were “shocked and frustrated” when Secretary of Health and Human Services John Polanowicz set the rates last week with a 6.09 percent increase.

Over the eight years, the increase works out to less than 1 percent per year, according to Gagnon. They were looking for a 21 percent increase, or 2.6 percent each year since the last adjustment.

“We never imagined that over two years later when they set the rate it would be that paltry,” Gagnon told the News Service Tuesday.

A therapist making a typical home visit will be paid $81.80 an hour with the 6.09 percent increase, according to Gagnon.

A speech pathologist who works for an EI program earns an average annual salary of $49,031, according to Gagnon. He compared that salary to speech pathologists in other industries, who earn an average of $71,700, according to figures gathered by the Massachusetts Department of Labor.

The rate increase means early intervention providers will be paid an additional $4 million from the state in fiscal year 2015, according to Alec Loftus, a Patrick administration spokesman.

“The Early Intervention program is extremely important to the families and children who utilize these services. We believe this is a fair, equitable rate that will allow providers to help children develop the skills they need to grow and thrive,” Loftus said in an emailed statement.

The rates were developed based on a review by the Center for Health Information Analysis (CHIA) after a public hearing last year. CHIA initially proposed a 2 percent rate increase, according to Loftus.

Although the Patrick administration officially set the rate Friday, the 6.09 percent increase has been in effect since January 2014, after administration officials set an emergency rate.

Early intervention providers argue they are strained by a surge in the number of babies and toddlers who need services, partly driven by an alarming increase of newborns exposed to narcotics or prescription drugs.

In the last year, the caseload of early invention programs in the consortium hit 36,126 children, an increase of 12.6 percent, according to Gagnon.

Children who need services are the ones who get hurt by the low payment rates, Gagnon said.

Early intervention programs have trouble hiring staff because the salaries they offer are lower than other organizations that work with children, like hospitals and schools, according to Gagnon. If programs do not have the staff they need, then children do not receive the therapies and services as regularly as they might require, he said.

“Children who could benefit by having a speech pathologist on a weekly basis, it might mean the program in that area doesn’t have the staff to provide those services,” Gagnon said.

In October 2013, specialists who work with young children took their pleas for a rate increase directly to Gov. Deval Patrick, staging a protest outside of his office. Around 50 demonstrators, some with young children in tow, held signs and clogged the hallway outside Patrick’s office, demanding to speak with him. The governor walked off the elevator in the middle of the protest and listened to the crowd. He later came back and told a handful of parents he hoped to work with them on the issue, and encouraged them to engage lawmakers.

The rates will be reviewed again in two years, as required by state law, according to Loftus.

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