DENVER — Colorado is cutting critical services for thousands of the youngest and most vulnerable residents in the state.
The Early Intervention (EI) program supports children from birth through age 3 who have disabilities or developmental delays. Citing a budget shortfall, the state will no longer fund supplemental programs for children on Medicaid, and only Medicaid-covered services will continue.
Children will also be limited to four hours of care a month in their Individualized Family Service Plan (IFSP).
According to the Centers for Disease Control and Prevention (CDC), early intervention services can "change a child’s developmental path and improve outcomes for children, families, and communities," allowing families to better meet the needs of their children.
Parents and providers were stunned by the news, saying this will force families to choose what care their child will no longer receive. Many want an explanation as to why they did not receive more notice about the changes.
In a memo sent to providers on Tuesday, the Colorado Department of Early Childhood (CDEC) announced it is implementing "temporary cost containment measures for the Early Intervention (EI) program." The cuts are effective in less than a week, on March 3, and will last through Fiscal Year 2025-26.
- Denver7 obtained a copy of the memo through providers that received it. Read it below
The memo explains that in 2023, the definition of the EI program was expanded to serve more children. The increased caseload sparked concerns about the ability of the EI workforce to serve all eligible children.
According to the memo, $3.5 million of workforce investment funding will expire at the end of June.
"Referrals to the program continue to increase and stimulus funding that was previously available has fallen off, which impacted the amount of federal funding the EI program had available for FY 24-25," the document reads.
It continues to state that the number of children enrolled in Medicaid has decreased to around 36%.
Those factors — paired with strategies used to retain and recruit people into the EI workforce — have "put the EI program at risk" of spending more than the budget allows for the current fiscal year. That's why "cost-containment strategies are necessary" to balance the budget for Fiscal Year 2024-25, the memo claims.
As a result, a number of changes will occur, including:
- A suspension of reimbursement for subcontracted providers if a family does not show up or cancels less than 24 hours before a visit
- Non-Medicaid-funded services will no longer be covered by the state general funds
- All children in the EI program will only receive four hours of care a month.
Medicaid-covered services include occupational therapy, physical therapy, and speech-language pathology will continue, according to the state.
Erin Jurgemeyer is a speech-language pathologist who has clients who do not bill Medicaid for her services.
"I can try to bill insurance, but insurance does not cover speech therapy. So 10 times out of 10, that means that the state would have to pay me to see those children," Jurgemeyer explained. "The reason why they want to drop developmental interventionists and other therapists who cannot bill Medicaid is because I can bill Medicaid, so Medicaid can pay me and [other therapists] cannot, so that means the state would have to pay them."
Jurgemeyer said Medicaid does not cover a number of specialties, such as a feeding specialist, social-emotional therapist, or sleep specialist.
"There's already a shortage. There's already a waitlist of kids who are not receiving services," Jurgemeyer said. "We would like an explanation. This happened one day ago with no explanation why. They are $4 million short on their budget starting immediately. How did that happen? Why didn't we have months or a year to plan and figure this out?"
Lindy Gunn is an early childhood special educator who is a sleep consultant and infant massage instructor. Tessa Hansen is also an early childhood special educator.
"As early childhood special educators, we are licensed through a teaching license, right? So we can't bill Medicaid, but we could still take those clients and bill through state and federal funding, right? So I think both of us have half or more of our caseload for Medicaid. And now they're saying you can't," said Hansen.
"A lot of the kids that we see are on Medicaid, so it's about two-thirds of my income gone in a week with no warning," said Gunn. "The Medicaid thing, too, I think something to point out is that disproportionately impacts families who are living in poverty, people in rural communities, people of color."
Jurgemeyer, Gunn, and Hansen contract with Rocky Mountain Human Services, which provides early intervention services at no cost to families.
Katelyn Knox is an occupational therapist who runs her own business in Larimer County called Above and Beyond Therapy. She's done this kind of work since 2014 and said what keeps her doing the work is seeing the difference she makes in the community.
"They could need support with feeding. Maybe they have difficulties getting dressed and undressed at an age-appropriate level. Maybe they have sensory processing differences and get terrified during baths, or have a hard time with loud noises," Knox said as examples of the ways she helps the families she serves. "The big thing for me in early intervention is that we form such deep relationships with families. We connect every week or as often as we're in their home. We get to know the names of their dog, their cat, their siblings, their grandparents. We celebrate with them. We go to their birthday parties if we get invited."
Knox called the budget cuts unexpected and said the four-hour limit for care is devastating.
"If they want additional support, I am not allowed to bill Medicaid families privately for anything. And if the Early Intervention plan says that they can have four hours, I can't bill more than four hours," said Knox. "This is not an equitable cut across the board. It's not going to impact the child who just needs one service provider, where it's going to drastically change the life of a child who needs the four to six providers monthly."
- Hear more from parents and providers in the video player below
Parents like Jillian Banghart are concerned this four-hour monthly limit of support means they will have to choose what care their child gets and does not get.
Banghart's son, Leo, has spina bifida, and the family started their EI services with physical therapy.
"He was not expected to walk. He was expected to be a wheelchair user, and he's now independently walking. And that is definitely in large part thanks to our physical therapist through EI," Banghart said. "I would hope that the state will do whatever has to be done, figure out whatever has to be figured out, and do it quickly so that our kids do not lose out on the services that they need to continue to grow and thrive and have the exact same opportunities and experiences to continue to grow and have a great life."
Torie Kennedy's son, John, was born with intrauterine growth restriction (IUGR) as a premature baby. He left the NICU weighing only three pounds, 13 ounces.
"He was tiny," said Kennedy. "Feeding was an issue."
With the changes, Kennedy said she would have to reduce the types of services her son receives.
"I have to choose between one of the three services that he needs, and we have to go with the one that he needs the most, which for right now is speech," Kennedy explained. "But that means he loses his occupational therapy, he loses his behavioral therapy to regulate his emotions, and I lose my talk therapy to just continue through the postpartum woes."
Kennedy is angry about the budget cuts.
"Why don't the kids matter? Why is the first thing you cut the only thing that benefits the kids?" she asked.
The EI program serves an average of 11,178 children every month, according to CDEC.
An informational session about the budget cuts is scheduled for Thursday. More guidance is expected to be issued on Friday.
A spokesperson with CDEC provided Denver7 with a statement in response to questions about the budget cuts.
"The Colorado Department of Early Childhood (CDEC) is working with local communities to ensure continuity of services, including expanding telehealth options and connecting families with Medicaid-enrolled providers. CDEC is working closely with the early intervention agencies to continue to explore all options to minimize the impact of these measures. We remain committed to exploring innovative solutions and strengthening partnerships to support children’s development.
The Early Interventions (EI) initiative is experiencing higher-than-anticipated referrals, caseloads, and costs. CDEC remains committed to protecting current eligibility criteria, maintaining provider rates in compliance with state and federal law, and minimizing the impact of these changes on children and families. Our priority is to continue delivering high-quality services while managing the budget to sustain the program long-term.
To remain within the initiative’s available funding and continue to prioritize direct services to all eligible families, the Department of Early Childhood has evaluated areas where the program is more generous than required in state or federal law. The Department is implementing temporary cost containment measures for the EI program, effective March 3, 2025, through FY 2025-26. These measures relate to short-term funding the Department provided for EI provider workforce support, rather than direct service provision.
The Department was appropriated $87.4 million for the EI program, with approximately 70% of funding from the State. While eligibility changes have increased the state’s share of service costs, the Medicaid share has remained flat. Part C funds are required to be used as the payer of last resort after all other funding is exhausted. This continues to present challenges in the availability of State funds to maintain the level of funding required for match to comply with federal funding requirements."
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