Sen. Valverde, Rep. Giraldo sponsor bill to address

workforce crisis in services to vulnerable infants,

toddlers

STATE HOUSE – Sen. Bridget Valverde and Rep. Joshua J. Giraldo are sponsoring legislation to address a staffing crisis in the programs that serve vulnerable infants and toddlers in Rhode Island who have - or are at high risk for - developmental delays or disabilities.

The legislation (2022-S 2546, 2022-H 7628), which is scheduled for a hearing before the Senate Finance Committee today, increases Medicaid rates for the Early Intervention and First Connections programs, allowing for payment of competitive wages for qualified professionals.

Neither program has had a rate increase in over 20 years, and low wages paid to employees of the nonprofit agencies that provide the services have led to staffing shortages so critical that, at one point last year, all nine Early Intervention providers in the state stopped accepting new referrals, leaving hundreds of toddlers without the developmental supports they needed. 

“It’s unacceptable that we’ve reached the point when children aren’t receiving the critical Early Intervention and First Connections services they need in a timely fashion because there aren’t enough staff, but it’s not at all surprising. Our state has been underfunding rates to these programs for years — so much, in fact, that the nonprofit providers operate at a deficit to run a program that our state is federally required to provide. Over the years, some providers have been forced to stop offering Early Intervention services. And the providers who are still around are struggling,” said Senator Valverde (D-Dist. 35, North Kingstown, East Greenwich, Narragansett, South Kingstown). “Our state’s failure to properly fund these programs is the reason children and families are having to wait for time-sensitive services, and the only way to fix this situation is to provide a permanent rate increase.”

The legislation would require the state to provide an estimated $4 million to increase Medicaid payment rates for Early Intervention services by 70% by Oct. 1, so wages paid to workers in the program are at or above the median wage for the profession. For First Connections, it would require the state to provide an additional $520,000 by Oct. 1 to increase rates by 123% to provide wages that are at or above the median wage.

The legislation further requires that the rates be adjusted annually to reflect increases in program operating costs, based on the Consumer Price Index.

Early Intervention provides supports to babies and young children with developmental delays and disabilities, and their families. First Connections is Rhode Island’s system to identify, locate, and evaluate all infants and toddlers with disabilities, required under the “child find” mandate in Part C of the federal Individuals with Disabilities Education Act.  

It is a short-term program for pregnant women and families with children younger than three that provides trained nurses and social workers to help with questions they may have about caring for their newborn or toddler. Because of the low rates for First Connections, several agencies that operate First Connections programs have notified the state that they will not be able to continue providing services in FY23 without a significant rate increase.

In September, a statewide coalition of 70 health and human services organizations issued an urgent call for the state to increase its rates for social services, saying years of underfunding, coupled with the high demands created by the pandemic, had plunged them into a workforce crisis that was crippling services. With low wages, skyrocketing caseloads, greater needs, low morale and widespread burnout, the agencies are struggling to keep employees or hire new ones.

“For many years, our state has been relying on the dedication of workers to the children they serve to keep these services running despite low rates. But dedication can’t pay rent. As caseloads have gotten heavier and the jobs have gotten more stressful, many overworked, underpaid workers have had to move on. Our state is at a moment of reckoning: We need to boost wages significantly, or our children are not going to get these critical services,” said Representative Giraldo (D-Dist. 56, Central Falls).