A state program serving thousands of young children with developmental disabilities is making big changes to avoid running out of money.
The program, Babies Can’t Wait, provides help for children from birth to 3 years old who have developmental delays or have been diagnosed with physical or mental conditions likely to result in developmental delays. Georgia’s program, as of December 1, was helping 7,538 children. But, after going through $14.8 million of its $23.7 million annual budget in three months, officials there are planning major changes, including staff reductions.
The changes should make it “a more sustainable program,” said Brenda Fitzgerald, commissioner of the Georgia Department of Public Health, which has oversight of the program.
Babies Can’t Wait and similar programs in all the other states are partly funded by the Individuals with Disabilities Education Act. Research indicates children receive long-term benefits from early detection of developmental disabilities and intervention. The program, which has seen a 23 percent increase in children since 2007, “is definitely not going away,” Fitzgerald said.
That’s welcome news to Gwinnett County resident Keri Janton, who is receiving services for her son through Babies Can’t Wait.
“It’s just been priceless,” Janton said. “We have nothing but good things to say about it.”
The program has hit precarious financial times, in large part because of a policy change put in place in June 2011, officials said.
At that time, the program began paying upfront for services for the children, such as physical, speech and occupational therapy in 18 districts covering the state and then seeking reimbursements for qualifying costs from Medicaid and private insurers, following what’s known as a “pay and chase model.”
While the Gwinnett district was able to recoup about 60 percent of the costs for professional services, the recovery rate statewide was about 8 percent for the fiscal year that started July 1, 2011 and ended June 30, 2012, and about 4 percent in the first quarter of this fiscal year.
With those numbers in hand, Fitzgerald said, “I made the decision it was not a sustainable model and needed to change.”
A 100 percent recovery rate isn’t feasible since some children don’t qualify for Medicaid or have private insurance, said Kate Pfirman, chief financial officer for the Georgia Department of Public Health.
Effective Jan. 1, therapists and other professionals will be expected to bill private insurers and Medicaid and come to Babies Can’t Wait as the payer of last resort — a move that state officials say should help stretch the program’s limited dollars farther.
Therapists and other providers, who warned of pitfalls to the pay-and-chase model in 2011, are largely on board with Fitzgerald’s new plan, though they’ve also suggested other reforms to the program, said Kay Nelson, an occupational therapist and member of the Georgia Occupational Therapy Association.
“Just changing the billing isn’t going to make it successful,” Nelson said.
Pfirman said staff is actively scrutinizing the program’s budget, “making sure absolutely every expense is necessary.
“We don’t intend to run out of money,” she said. “We’re certainly trying to make everything be functional — not at the Cadillac version but at the Ford Focus version.”
Some staff reductions are expected, though the specifics have not been decided, said Ryan Deal, the department’s communications director.
Federal officials in the past have raised flags about aspects of the program, and it’s gotten mixed reviews from some parents.
DJ Jeyaram, a Atlanta health-care attorney, said he wasn’t impressed with Babies Can’t Wait when he and his family enrolled in the program to get help for his young son who was diagnosed with Williams Syndrome, a rare genetic disorder. Therapists would be scheduled to come to Jeyaram’s home, cancel the session with little notice and, instead of rescheduling, would just wait until the next month’s appointment, he said.
His child needed consistent intervention, and two months between sessions seemed to be defeating the purpose, Jeyaram said. He said the family decided to pay for private services.
Jeyaram said that, in his opinion, the scheduling difficulties and constant turnover with his Babies Can’t Wait service coordinator are due to the fact that many workers and providers got into the program to help others but became disillusioned by the bureaucracy and left.
Pat Nobbie, deputy director of the Georgia Council on Developmental Disability, said the program is a “critical first step” for families of children with developmental disabilities.
“A lot of families come home panic stricken,” Nobbie said. “The family is scared, isolated, so Babies Can’t Wait is the way to connect them with other families and professionals.”
Babies Can’t Wait is a program serving children from birth to 3 years old who have developmental delays or disabilities.
The number of children served by the program has increased by 23 percent since 2007.
Here’s how many were served —-
Fiscal year 2007 —————5,383
Fiscal year 2008 5,723
Fiscal 2009 5,632
Fiscal 2010 6,015
Fiscal 2011 6,640 served
As of Dec. 1, 2012 7,538
Source: Georgia Department of Public Health