Robbing Peter to Pay Paul. Creative Approaches to Funding & Providing Early Intervention Services. Presentation By: Patti Rawding-Anderson MA, MSPT Director of Program Development for Early Childhood Services Easter Seals. Overview of Methods. Actual Revenues $$$$$$$
Creative Approaches to Funding & Providing Early Intervention Services
NH receives the least amount of Part C Dollars based on the national formula for state size. This combined with the BDS state dollars:
NH has a unique Early Intervention agreement with the state Medicaid system through a contract with EDS which began in September of 1993.
The Medicaid Bundle allows for all health related services mandated by then Part H and now Part C. This was a set rate of $137.07 per week per child regardless of the number of services provided. In 2002, the rate was increased to $200 per week per child / family.
Seven Services were included:
1. Assistive Technology Support (not equipment)
2. OT 3. PT 4. SLP 5. Social Work
6. Special Instruction 7. Family / Child training and counseling services (except by psychologists or psychiatrists)
The Medicaid Bundle also reimburses for assessments / evaluations / screenings at a rate of $200 per activity except those conducted by service providers outside the bundle – This category is primarily to determine eligibility
Targeted Medicaid Case Management
$8.41 per day per child / family for every day of the month in which that child / family is enrolled in the EI system as long as at least one case management contact has been made
This stream applies only to those children receiving NH Medicaid which in NH is called the Healthy Kids Gold Plan.
As long as Medicaid enrollment is up, this is a vital funding stream to support EI.
When Medicaid enrollment is down which is currently the case in NH , this funding stream is compromised.
In the mid 90’s the percentage of children with Medicaid receiving EI services was ~ 42%. Today, it hovers around 31% but varies considerably geographically. This is a huge loss of revenues to the system.
In the late 90’s, NH recognized a significant funding concern on the horizon. Thus a strong push for insurance revenue recovery was implemented.
Results of efforts varied across programs:
In the early 2000’s, revenue projections indicated that within 6 years, the EI system would be in extreme financial crisis.
Despite efforts, EI funding remains a concern in NH
In 2004, NH’s ICC decided to prioritize EI funding and implemented a strategic planning process
NH is currently reviewing all other states’ family cost share practices including:
Teaching Developmental Screening (ELOA / Baby Steps)
Access to Information
Delegation of Activities
Changing Standards of Practice
Innovative Funding Sources
Creative Activities from the Field?